Inspection on 23/06/08 for Augusta Court

This inspection was carried out on 23rd June 2008.

CSCI found this care home to be providing an Adequate service.

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

Augusta Court 11/09/07

Augusta Court 20/03/07

Augusta Court 30/09/05

Augusta Court 11/05/05

Augusta Court 24/08/04

Augusta Court 19/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Augusta Court Winterbourne Road Chichester West Sussex PO19 4TT Lead Inspector Liz Palmer Unannounced Inspection 23rd June 2008 10:15 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 Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Augusta Court Address Winterbourne Road Chichester West Sussex PO19 4TT 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) 01243 532483/584495 01243 771173 ian.eyles@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust Mr Ian Michael Eyles Care Home 46 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - (PC) to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) Dementia (DE) The maximum number of service users to be accommodated is 46. 2. Date of last inspection 11th September 2007 Brief Description of the Service: Augusta Court is a care home in a residential area of Chichester providing personal care for up to 46 service users in the category of Older People. Augusta Court is a detached two-storey establishment providing 44 single and one double flat, each of which comprises of a bed, sitting room, kitchenette and shower room. Each floor has two distinctive wings with a lounge and on one wing, a hairdressing salon. A centrally placed lift gives access between the floors and the ground floor dining room, conservatory and offices. Anchor Trust voluntarily owns the service with their representative Mrs Jane Ashcroft appointed as responsible individual. There was not a manager registered for the service at the time of the inspection visit. Current fees are from £560 to £680 per week according to level of care needs. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection included a site visit to the home over a period of seven hours. During this time three staff were interviewed and the manager assisted with the inspection. Two service users were met and spoken to privately, others were observed and spoken to during the inspection. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the home’s Annual Quality Assurance Assessment (AQAA) that they completed and returned to us. We also looked at the last inspection report and other information received by us since the last inspection including notifications and information relating to safeguarding. What the service does well: What has improved since the last inspection? The new manager has made many improvements since taking over the home. There has been a programme of redecoration, which ensures residents live in a comfortable and homely environment. Framed pictures painted by one of the residents are hung in the corridor adding to the ‘homeliness’ and individuality of the home. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 6 Activities have improved including turning an unused lounge into a cinema, new chairs have been purchased and films are due to be shown shortly. There are now flexible dining times and no pre ordering of the menu items, these are chosen at each mealtime. The menu has been reviewed in consultation with the residents and adapted to their preferences. 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. The summary of this inspection report can be made available in other formats on request. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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 Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. Standard 6 does not apply. EVIDENCE: The AQAA states that a pre-admission assessment is undertaken before each admission by either the Home Manager or Deputy Home Manager, who have both had the relevant training. Considerable time is spent with prospective residents and their representatives to ensure all aspects of an admission are considered. They are involved in choosing a colour scheme for their room, reinforcing the individuality and choice for each individual. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 9 Three pre-admission assessments were sampled. They all included relevant information about the person including their medical history, mental health needs, care needs, religious preferences, next of kin and the general practitioners (GPs) name and address. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have their health and personal care needs met. Improvements to care planning and more consistency in the delivery of care would ensure their safety and respect their privacy. EVIDENCE: Three care plans were looked at. These are drawn up from the initial assessments undertaken prior to moving in. The care plans contain basic information and kept under regular review and changes are made as necessary. However, inconsistencies in the care plans and the delivery of care could invade people’s privacy and/or put them at risk. For example, each resident has a night check agreement that they have signed, two looked at showed that checks were not being carried out in accordance with the Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 11 agreement. Some staff are checking a resident every two hours when they have asked for beginning and end of shift only. Another inconsistency noted related to risk assessments. One resident had a falls risk assessment, another had a detailed mobility care assessment, which ensured staff mobilised this person safely. However, another resident had recorded incidents of being abusive to staff but no risk assessment or follow up plan of action was in place. Another example is that one file contained a completed ‘social history’ detailing the resident’s previous employment and key events in their life. For two others this had not been completed. Therefore, these people would not have the benefits of staff knowing their social history and acting accordingly by offering activities and initiating conversation. These issues were discussed with the manager who agreed that improvements were needed to the care plans. The AQAA states that improvements have been made in the delivery of care by the introduction of key workers. It was clear during the staff handover that key workers knew the residents very well and this system was providing some consistency of care. The AQAA also stated it’s intent to improve the care plans and the manager has arrangements in place to do this. Therefore, no requirement has been made. Improvements will be tracked at the next inspection. Residents in the home said they felt well cared for and staff were observed being sensitive and caring to a distressed resident during lunchtime. An individual and flexible approach was taken and the resident soon relaxed and returned to the dining room. Residents are all registered with a local General Practitioner (GP). Records showed evidence of medical needs being met in a timely and suitable way. Details of follow up and outcomes are recorded. Two residents spoken to during the inspection said they could ask staff to seek medical help when they needed it and said they felt safe and well cared for in the home. The administration, storage and recording of medication was sampled. The medication cabinet was seen to be suitably secure, clean and organised. No errors or omissions were seen on the records. The home uses a monthly blister pack system delivered by a local pharmacy. The storage and recording of controlled drugs was seen to be suitable. Policies on self-administration and controlled drugs are in place and accessible to staff. Arrangements are in place for those residents who wish to look after and administer their own medication. One resident commented that she liked to keep this bit of independence. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have a wide range of activities on offer in the home and they are happy with the choices. Everyone is satisfied with the food provided. EVIDENCE: A wide range of activities are available in the home. There is an activities coordinator who was spoken to during the inspection. She is very proud of weekly activity programme that includes music, crafts and fitness. She said there is also time to do one to one activities with residents, for example, feeding the birds and potting plants. Residents birthdays are celebrated by the home and people are encouraged to join in household tasks if they wish, for example, recycling the rubbish. Residents are consulted on the activities and individuality and flexibility is at the heart of decisions taken. Residents spoken to say there have enough to do and they always have the choice whether to join in or not. People are also encouraged to pursue their own hobbies and remain independent as far as possible. Those who are able go out to the local Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 13 shops. Others are accompanied on walks. Residents said their visitors are welcome and some residents have their own telephones to enable them to keep in touch with friends and family. Three monthly ‘community’ meetings are held where relatives and friends can attend and share their views on the home. The manager produces a bi-monthly newsletter, this keeps residents and relatives informed of upcoming events and any staff changes. Residents spoken to said they felt they had choice and control of their lives. One said they were looking forward to the new ‘cinema room’ being developed by the home. The manager has established links in the local community with religious groups and a local college who participate in activities in the home. There are no set routines and the AQAA states that independence and autonomy are paramount to all the decisions made. Lunchtime was observed to be relaxed. Choices were offered and those needing support were seen to receive this in a discreet and respectful manner. Special dietary needs were catered for, for example diabetes. Residents said they enjoyed the food and there was always two choices. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to complain and are protected by the home’s policies for safeguarding them. EVIDENCE: A complaints procedure is displayed in the home. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. Residents were observed making requests and expressing their views during the inspection. There was an open and relaxed atmosphere and staff dealt promptly with requests. The AQAA states that seven complaints have been made n the last twelve months all of which have been resolved within the given timescale. Three staff were asked about the homes procedure for safeguarding adults. All three have received training and were confident about their responsibilities if they suspected any abuse or were told of any. The home shown that it follows the safeguarding procedures and involves other professionals when necessary. There is one ongoing safeguarding issue, which the manager is following up with Adult Services. Residents said they felt safe in the home. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a clean and homely environment, which is well maintained. EVIDENCE: The inside and outside of the home are maintained to a high standard. Residents say their rooms are cleaned regularly and staff were seen to be wearing suitable gloves and aprons. Risk assessments are in place to promote the health and safety of residents and staff are trained in issues relating to health and safety. A resident commented on the high standard of hygiene promoted in the home. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 16 The AQAA states that laundry facilities are available and allow residents involvement if they wish and a home maintenance programme is in place to ensure continuous improvement. The AQAA also states that infection control procedures and policies are in place, hand washing is promoted at all times and guidance posters are in communal washroom areas. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements for recruiting staff protect the people who use the service. The training and support enables most staff to carry out their roles confidently and competently. EVIDENCE: During the inspection there were suitable numbers of staff on duty to attend to the needs of service users and spend time with them socially. Rotas looked at showed that extra staff are brought in to cover sickness and other shortages. Staff said they are still sometimes short due to the vacancies but that care is not compromised. The manager stated they have already held open days for recruitment and the AQAA states there is a recruitment plan in place. Residents spoken to said there were enough staff on duty during the day and night to meet their needs. They said call bells were answered promptly. Staff were observed interacting in a positive and respectful manner at all times. They responded to requests from service users and were caring and polite. The three staff spoken to during the inspection were confident and competent at their jobs. They spoke confidently about the needs and preferences of individual service users. They said there is on going training provided Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 18 including mandatory courses such as, first aid, food hygiene, infection control, health and safety, safeguarding adults and fire training which are provided to all staff. Staff are supported to undertake National Vocational Qualifications (NVQs). The home has over 50 of it’s staff having working towards NVQ level 2, or above. Their AQAA states their commitment to NVQ training and says they have two in-house assessors. The recruitment file of three staff members was looked at. These contained the records required to meet the standards. For example; two suitable references, a criminal record check and a protection of vulnerable adults check. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from the home being well managed. Improvements to the recording of care plans, risk assessments and fire evacuations would better protect the people who live in the home. EVIDENCE: The AQAA states that the manager is qualified to NVQ level 3 and is registered with us. He is working towards the Registered Manager’s award. Residents spoke highly of the management of the home and said they felt it is well run and they are in safe hands. They said there have been improvements since Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 20 the new manager took over. There is a clear line management structure and regular, Regulation 26 visits are carried out by the owner. Issues picked up during this inspection were also noted at Regulation 26 visits, for example, no photographs or social history on a care plan. A system to address any shortfalls highlighted at these visits would improve the management of the home. The AQAA does state where it would like to make improvements and the manager has plans on how to achieve them. Regulation 37 notices are sent to the Commission with regard to significant events in the home and the policy for reporting safeguarding is followed. People are supported to manage their own money where possible. The home holds cash for some residents who require assistance. The administrator is responsible for this and collates all the records. The money is stored in a safe and arrangements are in place to ensure that residents can have access to their money at any time. The balance was checked and matched the records held. The home has a policy on regular supervision for staff. Records sampled showed that this is not always followed through. However, annual appraisals are taking place and staff said they felt well supported and could talk to the manager whenever they needed to. The AQAA highlights a need for improvement in this area so we have not made a requirement at this inspection. Improvements will be tracked t the next inspection. On the checking of fire records for the home it was found that a fire evacuation plan was in place for each resident and the weekly testing of fire alarms was being carried out. However, the monthly checks were not recorded and sixmonthly fire drill had not been recorded since 2006. The manger stated that it had been done in 2007 but not recorded, in this case it was still overdue. The manager stated that staff evacuated the building on a weekly basis when the alarms were tested, however no record of this is kept. As this was discovered at 5.15pm, as the inspector was leaving the home staff were not asked about this. Since the inspection the manager has informed of his intention to rectify this. A requirement has been made regarding the carrying out of and recording of fire drills. Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 23 Requirement Regular checks of fire equipment and fire drills must take place in accordance with the fire procedures. Timescale for action 30/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Augusta Court DS0000014380.V365219.R01.S.doc Version 5.2 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. 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