Inspection on 05/05/05 for Auburn Mere

This inspection was carried out on 5th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Auburn Mere 13/10/08

Auburn Mere 04/06/08

Auburn Mere 06/06/07

Auburn Mere 20/06/06

Auburn Mere 08/11/05

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 Herts WD19 5RE Lead Inspector Jeffrey Orange Unannounced 05 May 2005 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 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Auburn Mere Address Woodlands Oxhey Lane Watford Herts WD19 5RE 01923 247310 01923 247311 Telephone number Fax number Email 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 Ewart Care Home 34 Category(ies) of OP 34 registration, with number of places Auburn Mere Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registratino. Date of last inspection 22 November 2004 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, PO Box 83,Hazel Grove,Stockport,SK7 4FD. 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 which 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. Auburn Mere Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Overall this was quite a positive inspection. Residents and relatives spoken to during the inspection were very positive about the standard of care provided in the home. Medication recording and practice was found to be good. However, although the general standard of record keeping was acceptable there are some areas where improvements could be made (for example, in the fullness and consistency of some care planning information). The environment of the home is attractive and clean. Those issues raised with the manager, for example the lack of lockable storage in resident’s rooms, are being dealt with. Some tightening up of recruitment practice is required and this was discussed with the manager. Some possible development work to take account of the range of abilities of residents was discussed, throughout the inspection the attitude of management and staff was positive and co-operative. What the service does well: What has improved since the last inspection? The range and frequency of activities in the home has continued to improve. Auburn Mere Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Auburn Mere Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Auburn Mere Version 1.10 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 standard(s) 1,2,3,4,5 (6 does not apply) The home’s documentation is sufficiently full to provide prospective residents and their relatives with the information they need to be able to make an informed judgement about Auburn Mere, what it can and cannot provide and what the terms and conditions of staying there are. Assessments are adequate and provide the basic information required. Care must be taken to make sure they are fully completed and legible. EVIDENCE: The home has a Service User’s Guide and Statement of Purpose, which are made available to all prospective residents. Individual contracts are held on resident’s files. Prospective residents and their relatives and carers are encouraged to visit the home prior to making any decision about whether it can meet their needs, in order to judge if they will be happy to live there. Auburn Mere Version 1.10 Page 9 Feedback from visiting health professionals, relatives and residents all indicated that resident’s needs are being well met. “We are well pleased” was the comment of one relative. Auburn Mere Version 1.10 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 standard(s) 7,8,9. The storage and administration of resident’s medication is well organised and provides safeguards to ensure that residents receive the correct medication as and when required. Care plans were generally adequate although they do need to be comprehensively completed to obtain the best out of the format used and this was not always the case. The standard of care observed was good and appeared to provide residents with the support they needed in an appropriate way. EVIDENCE: Care plans were examined, medication was checked, residents, relatives and community nurses were spoken to and other records were tracked and crossreferenced to see if what happens in practice in the home is reflected in the homes’ records. There are some indications that continued emphasis on good practice needs to be kept up, to ensure that an acceptable standard is maintained. However, “I am very comfortable here” was a typical comment made by one resident. Auburn Mere Version 1.10 Page 11 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 standard(s) 12,13,14 There has been a continued improvement in the range and frequency of the activities available to residents. Residents are consulted formally and informally, and their comments and suggestions are taken into account when the routines and care practices of the home are being determined. EVIDENCE: Individual residents are encouraged to pursue interests and hobbies. One resident has been provided with all the materials required to enable her to pursue her talent as an artist; ”They encourage me all the way” Minutes of resident’s meetings and floor meetings were seen and discussed with the manager to see how these had informed changes in procedures and routines in the home. Art and craft classes, which several residents mentioned, have been increased in frequency due to demand. Relatives spoken to confirmed that they are encouraged to visit the home, and several visitors were in the home throughout this inspection. Auburn Mere Version 1.10 Page 12 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 standard(s) 16,18 The home has an appropriate complaints policy. Staff training includes issues around abuse and were found to be aware of the action to take if it was suspected. There is a very open management style in Auburn Mere. EVIDENCE: Complaints policies were seen displayed on the main notice board, along with details of the Age Concern advocacy service and is included in the home’s literature for residents. It is hoped that residents would feel able to make use of the home’s complaints procedure, confident that any concerns would be addressed appropriately. Resident’s meetings are held and notes taken of them, with appropriate action to address any concerns raised. Auburn Mere Version 1.10 Page 13 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 standard(s) 19,20,21,22,23,24,26. The overall internal décor of the home gives an attractive, homely feel. It is furnished in an essentially domestic style, rather than institutional, which makes it more pleasant for its residents and their visitors. EVIDENCE: The home was seen to be clean and free from unpleasant odours during this inspection. The home has a maintenance man who was present during this inspection and it was also possible to talk to domestic staff, who it was confirmed had received appropriate training. The physical condition of the home was monitored and recorded throughout the inspection process. There were some issues about maintenance and provision for example lack of lockable storage in service user’s rooms and the use of door wedges. These were discussed with the manager and will be monitored at future inspections. Auburn Mere Version 1.10 Page 14 It is suggested that the home’s communal spaces should be reviewed to take account of the range of abilities and dependency levels of residents, which impact on the ability of all residents to have appropriate communal space. “The lounge is frightening” was the comment of one of the more able residents. One resident was sitting well out of reach of her call bell and another was found on the floor, attracting attention by banging her stick on the floor. The positioning and availability of call bells should be reviewed to ensure that at all times, residents are able to summon assistance appropriately. Auburn Mere Version 1.10 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The numbers of staff on duty appear adequate for the needs of the residents. Staff respond to “emergency” situations in an appropriate way and are able to provide a good level of personal care at other times. Some aspects of the home’s recruitment practice need slight adjustment. EVIDENCE: Staff rotas were seen and discussions were held with the manager. Staffing levels are at least at levels previously agreed and are being kept under review and adjusted as the needs of the residents dictate. It was positive to hear that the manager has responded to her own assessment of the dependency levels of residents now in the home to increase staffing at key times. This should enable staff to continue to provide the care required by residents in a manner that meets their needs appropriately, in an unhurried and respectful way. The files of recently recruited staff were seen – some concerns about the appropriate level of CRB check and the need to obtain specific references were discussed with the manager. Staff were observed giving appropriate care to residents throughout this inspection. Auburn Mere Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35,38 The manager has continued to make progress in the effective running of this home and both staff and residents are positive about the management and support given. EVIDENCE: Since the last inspection the manager has been registered by the CSCI and has almost completed the NVQ4 level award and will be undertaking the additional units to obtain the Registered Managers Award. Residents meetings are held regularly and minutes of these were seen. Residents were positive about he management and the support given. “The manager is absolutely great, you can do what you like” was how one resident put it. Staff confirmed that they are supervised regularly and senior staff have undertaken supervision training. Auburn Mere Version 1.10 Page 17 Records of a sample number of resident’s accounts, held by the home, were checked and found to be correct and supported by receipts. Auburn Mere Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 2 3 2 3 2 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 x x 2 Auburn Mere Version 1.10 Page 19 NO Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13(2) Requirement Where medication is prescribed in variable dosages, the exact dosage administered must be clearly recorded on each occasion. Lockable storage must be provided for all residents in their rooms. The positioning and functioning of call bells throughout the home must be reviewed. The results of the review must be recorded with associated risk assessments and any action required as a result taken to ensure that they are adequate and appropriate. Where unsupervised access to residents is likely, an enhanced level CRB check must be obtained in all cases. Two written references must be obtained for each applicant, these should be specific to the post applied for and not general to whom it may concern in nature. Timescale for action From 6.5.05 and thereafter. By 31.7.05 By 30.6.05 2. 3. OP24 OP22 23 (2) (m) 13 (4) & 23 (2) (e) 4. OP29 19 From 6.5.05 and thereafter. From 6.5.05 and thereafter. 5. OP29 19 Auburn Mere Version 1.10 Page 20 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 OP9 OP19 Good Practice Recommendations The home should obtain a suitable medication counting device to assist with the monitoring of medication. The use of door wedges throughout the home should 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 should be taken.(See reg.23(4)(c)(i)) The home should carry out a review of the use and disposition of its communal areas to ensure, as far as is possible, that it is possible for residents to have access to communal space which meets their physical and emotional needs appropriately. 3. OP20 Auburn Mere Version 1.10 Page 21 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts 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 Version 1.10 Page 22 - 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. 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