Inspection on 20/06/06 for Auburn Mere

This inspection was carried out on 20th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Auburn Mere 13/10/08

Auburn Mere 04/06/08

Auburn Mere 06/06/07

Auburn Mere 08/11/05

Auburn Mere 05/05/05

Auburn Mere 22/11/04

Auburn Mere 01/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Auburn Mere Woodlands Oxhey Lane Watford Hertfordshire WD19 5RE Lead Inspector Jeffrey Orange Key Unannounced Inspection 20th June 2006 07:25 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Auburn Mere Address Woodlands Oxhey Lane Watford Hertfordshire WD19 5RE 01923 247310 01923 247311 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Trafalgar Health Care Sandra Pauline Ewart Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: There are none. Date of last inspection 8th November 2005 Brief Description of the Service: Auburn Mere is a residential care home providing accommodation and personal care for up to 34 older people. It is owned and operated by Trafalgar Healthcare Limited, which is a wholly owned subsidiary of J. Sai Country Homes Limited who recently acquired Auburn Mere. Auburn Mere is located in Watford Heath, on the outskirts of Watford and within easy reach of the towns amenities. It is situated in extensive grounds with accessible seating areas that benefit from outstanding rural views. Accommodation is offered on three floors in single occupancy rooms, with three bedrooms large enough for sharing on a positive choice basis. The majority of rooms have en-suite facilities and there are bathrooms and toilets on each floor. The communal areas are well situated throughout the home and are of varying sizes. All floors are served by a passenger lift. Weekly charges range from £324 to £717, additional charges apply for newspapers, hairdressing and chiropody. (These details are correct at 20/6/06) The home has a service user’s guide and statement of purpose that are provided to prospective service users. Copies of the latest report on the home from the Commission for Social Care Inspection (CSCI) are available in the home. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been compiled following a site visit to the service lasting approximately 6.5 hours, starting at 7.25 am whilst the night care team were still on duty. The visit provided an opportunity to speak to service users and staff, to observe the care practices in the home and to look at key records. The proprietor was present for most of the visit and it was helpful to be able to discuss future development plans for the home. This report is also informed by any information received by the CSCI about Auburn Mere or any significant events that have taken place since the previous inspection visit in November 2005. What the service does well: What has improved since the last inspection? It has been an achievement to maintain the standard of care in the home during a period of considerable change. A greenhouse has been provided, which can used by any service users who enjoy active gardening. A programme of refurbishment is under way and several areas of carpet have been replaced. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 5 (Standard 6 does not apply to Auburn Mere) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Auburn Mere has a statement of purpose and service user guide which, together with the opportunity to visit the home, should enable prospective service users to make an informed decision about whether Auburn Mere can meet their needs and is a home they would feel comfortable in. On occasions, admissions are made solely on the basis of information provided by placement bodies before the home’s assessment process has been undertaken. This could lead to an inappropriate admission having to be rectified, which would be disruptive and unsettling for the service user concerned. EVIDENCE: The service user guide and statement of purpose have previously been seen. They should now be reviewed and revised as necessary to reflect the recent changes in ownership and prospective changes in manager. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 9 It has previously been established that prospective service users and/or those responsible for them are encouraged to visit the home prior to admission to enable them to look at the facilities and to meet other service users and staff. One service user had been admitted for respite care solely on the basis of an assessment provided by the local adult placement team. This had the potential to provide problems both for the service user and the home if it had then transpired that they could not after all appropriately meet that persons needs. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. If completed comprehensively and consistently, the care plan format would be adequate, however this is not the case. The storage and administration of medication is generally satisfactory and steps are being taken to improve the specific medication training for staff, which will benefit both them and the service users. A good standard of personal care is achieved and is given in a way that demonstrates proper respect for service users. Service users are assisted to access community healthcare services in line with their changing needs. EVIDENCE: The standard of care observed was good; “The staff are very good to me” was one typical comment made by a service user. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 11 A series of care plans were seen, few of which were comprehensively or consistently completed. It is understood from discussions with the Proprietor that the care plan format is to be revised as a matter of priority once the new manager is in post. Care plans seen and service users spoken with, provided evidence that appropriate access to community healthcare services is achieved. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are able to maintain contact with family and friends as they wish. The activities programme is still under development and there is a new chef in place who is reviewing and revising menus, so this is very much a period of transition, which provides an opportunity to improve this outcome area for service users to give them wider and more stimulating choices in the daily routines and activities of their lives. EVIDENCE: The activities programme was seen and the activities organiser discussed events that had already taken place or were planned for the near future. A craft session was observed, although most service users were in the lounge throughout this visit, with the television on if not visible or audible at all times. The chef described how menus are devised and choices given to service users, this is an informal approach, although service users confirmed that they can have alternatives to the main menu if they choose to do so. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy and procedure that provides opportunity for any complaint to be dealt with appropriately. Advocacy services are well publicised in the home which should enable service users to accessed them if they choose to do so. The staff and proprietor have a good understanding of abuse issues and have demonstrated an ability to deal appropriately to any allegation made. EVIDENCE: The complaints policy and procedure and details of advocacy services are prominently displayed in the home. Details of the complaints procedure is included in the service users guide. A recent allegation of abuse was reported promptly to Hertfordshire County Council Adult Care Services. The home co-operated fully with the investigation process and took robust action to deal with any areas of concern identified. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a comfortable environment for service users, however the practice of propping doors open detracts from the safety of service users. The home provides a wide range of communal areas, including extensive and attractive grounds that give service users a wide choice of different areas to sit and relax. EVIDENCE: Several doors were being held open by a range of wedges or objects, including the door to the kitchen. The outside side door to the home was open, which could compromise the security of service users. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 15 The home was clean and tidy on the day of this visit, the maintenance man was carrying out repairs and minor maintenance and details of refurbishment and renewal either underway or planned were discussed with the proprietor. Several service users said how much they enjoy sitting out when the weather permits, there had recently been a world cup barbeque held in the grounds. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Whilst staff numbers and training enable the needs of service users to be met, the recruitment practice of the home does not sufficiently protect them. The above judgement takes into account the fact that a requirement on references was made following the previous inspection but has not been met. EVIDENCE: Those members of staff spoken to were positive about training received, and several had already completed level 2 NVQ and were undertaking more advanced courses. The staff numbers are in line with those previously agreed and appear to be adequate to meet the needs of service users. The failure to obtain two references in every case, failure to check if employees are legally entitled to seek work in the UK and the practice of only obtaining standard level CRB clearance for non-care staff who nonetheless have unrestricted access to service users does not provide adequate checks on potential employees. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 37 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is currently without a registered manager and this together with the change in ownership has led to a period of particular challenge, which in turn has led to a deterioration in some of the record keeping practices of the home. Security of the home requires review to ensure service users are adequately protected from unauthorised access. Where the home holds money on behalf of service users, a reasonably robust system of accounting is in place to protect them. The home has a basic quality assurance system in place. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 18 EVIDENCE: The standard of record keeping seen was inconsistent, for example not all falls are recorded on the falls record in care plans and some are recorded in the home’s accident book whilst others, of equal seriousness are not The outside side door to the home was open and fire doors were propped open, both of which could compromise the safety and security of service users. Financial records of monies held on behalf of service users were spot checked and found to be in order. It is understood that an alternative system is under consideration, which will be an improvement and avoid the need to keep individual sums of money in the home for each service user. Details of service user meetings and surveys were discussed with the proprietor as was the provision of Reg.26 reports on the conduct of the home to the CSCI. Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X 2 2 Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 & 17 Requirement An audit of care plans must be carried out to ensure that all relevant parts are fully completed and maintained up to date, that they provide all the necessary information and are kept regularly reviewed. Where medication is prescribed in variable dosages, the exact dosage administered must be clearly recorded on each occasion. This requirement is carried forward again from the previous inspection as it has not been fully complied with. All fire doors not fitted with approved automatic closure devices must be kept closed at all times. The use of door wedges throughout the home must be reviewed, risk assessments carried out and recorded in each case and the advice of the fire officer sought and recorded. Any action recommended following this process must be taken. DS0000019276.V293862.R01.S.doc Timescale for action 31/07/06 2. OP9 13(2) 20/06/06 3. OP19 13(4)(c) 23(4)(c) 20/06/06 Auburn Mere Version 5.1 Page 21 4. OP29 19 Two written references must be obtained for each applicant, one of which should be wherever possible from their previous employer. Any gaps in employment history must be recorded and explained. The registered person must satisfy themselves that all applicants have the necessary permission to undertake paid work in the United Kingdom before they commence employment. This requirement is carried forward from the previous inspection as it has not been fully complied with. 20/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP3 Good Practice Recommendations The home’s statement of purpose and service user’s guide should be fully reviewed and revised as necessary to reflect the recent changes in ownership and management. Emergency admissions should be avoided wherever possible and routine admissions, whether for permanent residence or respite care, should only take place following a full assessment process by the home, to ensure that they can fully meet the prospective service user’s needs. The range and frequency of activities for all residents, throughout all times of the day and week should be reviewed in line with current best practice, making use of DS0000019276.V293862.R01.S.doc Version 5.1 Page 22 3. OP12 Auburn Mere the expertise and results of research, available to the care sector. 4. OP14 The manager and staff should, with the active involvement of service users, review all the routines and activities of the home, including dining and bathing, to see if they can be enhanced to better meet the preferences of service users. How service user choice is ascertained and recorded should be reviewed to ensure that service users can be shown to have control and choice over the way they live their lives. Where employees are effectively to have unrestricted access to service users, a CRB check at enhanced level should be made. Monthly proprietors’ reports on the conduct of the home should be provided to the CSCI until further notice. 5. 6. OP29 OP37 Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Auburn Mere DS0000019276.V293862.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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