Inspection on 23/05/07 for Austen House

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Austen House 18/06/09

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Austen House Kilnsea Drive Lower Earley Reading Berkshire RG6 3UJ Lead Inspector Yvonne Souden Unannounced Inspection 23 May 2007 10:00 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 DS0000069274.V330681.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. DS0000069274.V330681.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Austen House Address Kilnsea Drive Lower Earley Reading Berkshire RG6 3UJ 01189 266100 01189 662972 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) Barchester Healthcare Homes Ltd Ms Lynne Geeves Care Home 79 Category(ies) of Dementia (58), Dementia - over 65 years of age registration, with number (58), Old age, not falling within any other of places category (20), Physical disability (1) DS0000069274.V330681.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users from the age of 60 may be admitted in both Categories Old age not falling into any other category (OP) 20 and in the category Dementia (DE) 58 N/A Date of last inspection Brief Description of the Service: Austen House is owned by Barchester Healthcare Homes Limited and provides care and accommodation for 79 older people. The home is split over four units, Kennet, Thames, Bourne and Loddon. Each unit have their own lounge and dining room, and most bedrooms have an en-suite facility, those that don’t have a washbasin within the room. The home is situated in a residential area of Reading close to local amenities, and public transport is accessible from the home. Kennet Unit provides care for twenty frail older and physically disabled people, and Thames, Bourne and Loddon provide care for older people who have a varied degree of dementia related conditions. Austen House has a Statement of Purpose and Service Users Guide available on application to the home. Email Austen@barchester.com Information CSCI received 27/04/2007 confirm that weekly fees start from £920, with additional charges for Hairdressing, Daily Newspapers, Chiropody, Taxi Fares, Opticians and Physiotherapy. DS0000069274.V330681.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information gathered to support this report was gained over three days that included a ten-hour site visit to the home. The inspector spent the initial two days looking at documentation received from the home, inspection records from the date of the provider’s registration with CSCI and from returned CSCI surveys ‘Have Your Say About Austen House’. The site visit enabled the inspector to observe care practice within the home and hear the views of the service from residents, staff, management and visitors. The site visit also gave the inspector an opportunity to view further documentation and case track four residents’ files. What the service does well: This was a positive first visit to Austen House under the ownership of Barchester Healthcare Homes Limited. The home excels in providing the residents with a valued and fulfilled lifestyle, and makes sure residents are afforded choice in their life and are treated with dignity and respect in comfortable and homely surroundings. As quoted from a discussion with a visitor on the day of the site visit, “My friend is really taken good care of here, staff are very nice and approachable and Matron is very helpful, lots of staff around”. The home provides an activity plan and has activity staff to concentrate wholly on residential activities. An excellent menu ensures choice and encourages the residents’ appetite, and staff are available to unhurriedly assist those residents who require assistance with feeding. Snacks and drinks are served frequently throughout the day and fresh fruit is available on all units. Residents and their visitors said that management and staff are approachable should they have a concern or complaint, as quoted from a relative survey “if one supervisor is not available my wife just finds another, we have found that any nurse will listen and act if important”. Health and Social care professionals are fully informed and involved in meeting the residents health and social care needs surveys expressed their overall satisfaction of the care and attention the residents receive within the home. DS0000069274.V330681.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. DS0000069274.V330681.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 DS0000069274.V330681.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): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Austen House enables prospective service users and their representative to make an informed choice when considering the home as their new home. Service users nursing and care needs are assessed prior to a placement offer. The home does not provide intermediate care. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that inform the service users and their relatives/representatives of the service provided. Surveys and discussions with the deputy manager and a relative of a service user confirmed that an assessment of need is obtained by the home prior to a placement offer, and that service users and their representative have an opportunity to visit the home. Needs assessments viewed were thorough addressing the service user’s needs and associated risk. DS0000069274.V330681.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home works closely with Health and Social care services to ensure the service users’ health and social care needs are met with dignity and respect. EVIDENCE: Records identify that care plans are drawn from the service user’s initial needs assessment and that patient care file reviews take place monthly. The individual needs of the service user is identified within their care plan and have an action plan to meet those needs, with long term objectives set and associated risks identified. Daily progress records are maintained to a standard that enables the reader to build a picture of the individual well being and of the support received to meet their health and social care needs; an example of other records viewed to monitor the service users health and social care needs include wound assessment charts, nutritional profiles and psychological assessments on communication, memory, mood and emotion. DS0000069274.V330681.R01.S.doc Version 5.2 Page 10 It was evident from records viewed and surveys received that health and social care professionals are involved in meeting the care needs of the service users. Health and social care professionals said that they were satisfied with the overall care provided within the home and were able to see service users in private. As quoted from one of the survey comments’ “I am impressed with the very high standards that are maintained at Austen House and the genuine care and compassion shown to the residents”. It was evident throughout the day that staff were attentive to those service users who remained in bed, ensuring that their needs were met. Monthly pressure ulcer reports inform that management are closely monitoring those service users’ who have a pressure sore, the record identifies that three service users were admitted to the home with a pressure sore and one had developed a pressure sore within the home. Pressure care equipment was observed in use throughout the home. The inspector saw from observation that the home administers prescribed medication as dispensed by Boots the Chemist within a monitored dosage system. Observation saw that trained staff administer medication wearing a red tabard with yellow writing to highlight to others that they are not to be disturbed, and so reducing the risk of a medication error. Medication was securely locked within a medication cabinet/medication fridge and medication in stock matched records kept. The inspector spent a considerable amount of time on each unit and observed a relaxed atmosphere throughout, with positive interaction between service users and staff. Staff were observed to respect service user choice, keep a respectful distance from the service user to promote their independence and assist service users personal care needs in private to ensure their dignity was maintained. DS0000069274.V330681.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. The home is focused on making daily life interesting and enjoyable for the service users enabling them to live a fulfilled life that centres round choices they have made. Recreational and menu planning is of a high standard. EVIDENCE: Discussions with management and staff identified how proud they are in achieving themed areas of interest throughout the home referred to as ‘Memory Lane’. The themed areas encouraged service users to reminisce and re-enact on days gone by, and evidently contributed to feelings of being valued and respected in their lives. As quoted from one relative survey “the essential feature of Austen House is that the residents rights are addressed, this means they can say yes or no, they can stay within their rooms or not, they can choose”. DS0000069274.V330681.R01.S.doc Version 5.2 Page 12 An example of themed areas include a library, games area, shoe shine area, music area, war museum, nursery, sewing area, and an impressive wedding display of outfits with photographs of the service users, their relatives and staff members wedding day. One themed area was of a bank; staff informed the inspector that the bank fulfilled the need of one service user who wanted to make daily trips to the bank. Service users past and present hobbies/interests are listed within their file, and the three activity staff and activities organiser have developed a weekly activity schedule in word and picture format. Activities listed include a ladies and gents club, reading the newspaper, crafts, gardening club and many more. On the afternoon of the inspection entertainment was held for all service users who wanted to attend. The home has a bus that some relatives said is not used enough for day trips; discussion with the activity organiser confirmed plans to use the bus more frequently as they recently recruited a third activity assistant. The gardens are of interest with raised beds and sensory plants, and are designed to meet the needs of those service users who have dementia. Records show that a church service is held on the 3rd Thursday of each month and that the service users are predominantly of a Christian faith, with no other religion practised. There are three service users whose first language is not English. The home has overcome communication difficulties with those service users via some staff who speak the service users first language. A relative of a service user has provided staff with a Japanese phrase book to assist staff in communicating with a service user who frequently refers back to Japanese. The home has a varied and nutritionally balanced menu plan that offers choice to the service users, and show plates are used prior to lunch being served to ensure all service users are enabled to make a choice. Observations and discussions with the cook and staff confirmed breadsticks and squash are made available within the dining areas prior to lunch to encourage the service users appetite; fresh fruit and drinks were observed to be readily available and tea, coffee, cake and biscuits were served frequently throughout the day. Staff were sufficient in numbers on each unit to comfortably and unhurriedly assist those service user who required assistance with feeding. Mainly positive comments were received from service users and relatives about the food provided, however one service user said as quoted “the food was too fancy”, further investigation confirmed that a separate menu plan had been developed to meet the service users personal preference. DS0000069274.V330681.R01.S.doc Version 5.2 Page 13 Two comments received said that the food was too cold; discussion with management and kitchen staff identified that food is temperature probed prior to going into the oven, into the hot trolley and before going to the units. Management confirmed that they would investigate further to identify if food is served within the dining areas too soon before being served to the service user. There was no evidence to substantiate that food was served cold on the day of the site visit, the meals were attractively presented and service users and relatives were complimentary of the meals provided. DS0000069274.V330681.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 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 complaint procedure that is easily accessed by service users and their representatives. Some staff are not fully aware of adult protection procedures despite attending adult protection training. Staff have an awareness of what constitutes abuse and who to report to within the senior management team, should an allegation of abuse be made. EVIDENCE: Adult Protection Policies and Procedures are in place and training records identify that staff have attended ‘Safe Guarding Adults’ training. Discussions with staff confirmed that they would report allegations of abuse to management, and would do the same if they witnessed abuse. Some staff were unsure of whom to go to for example if an allegation of abuse was made against management or if a culture of abuse existed within the home. When asked some staff were unfamiliar with the homes whistle blowing policy. Management were fully aware of the Multi Agency Safe Guarding Adults Policy and Procedures. It was evident from returned surveys and discussions with service users and their relatives that they feel listened to, and are confident to take a complaint or concern to management. The home has a complaint procedure; records indicate that the home has responded to complaints within a twenty-eight day time scale. CSCI have received no complaints about the service provided within Austen House. DS0000069274.V330681.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): 19,20,24.25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable homely environment that is adapted to meet their needs but this was jeopardised by an unpleasant odour on one unit and temperature irregularities on another. EVIDENCE: The entrance to Austen House is welcoming with a receptionist desk, comfortable sofas, coffee machine and ‘Down Memory Lane’ videos that service users and visitors can enjoy. The units were observed to be comfortable and welcoming, with theme areas throughout. The gardens are maintained to a high standard and are designed to meet the needs of people who have dementia. One service user said “I sit in the garden most afternoons, weather permitting”. Visitors were complimentary about the gardens’ and the activity organiser informed the inspector of the home’s plan to enter a ‘ Garden in Bloom’ competition. DS0000069274.V330681.R01.S.doc Version 5.2 Page 16 The home was observed to be scrupulously clean and fresh and discussions with two domestic staff confirmed that a strict cleaning rota is adhered to, however the inspector observed that one area within Bourne had an unpleasant odour; this had also been reported to the inspector via surveys and discussions with visitors. The source of the unpleasant odour could not be detected to a specific spot, and when discussed, management agreed that this must be investigated further to identify the source of the unpleasant odour. Systems are in place to promote safe working practice and infection control. The most recent fire drill took place February 2007 and records show that fire training and weekly fire tests are ongoing. An Environmental Health Officer visited 27/03/07 and no requirements were made. Adaptations were visible throughout the home and records identified that maintenance checks of hoists/adaptations had taken place 20/02/07. An even and comfortable temperature was observed throughout the home; however, at lunchtime the temperature within Thames lounge decreased considerably whilst two service users were having lunch. The inspector discussed the temperature drop with a member of staff who confirmed that the air conditioning had been turned down to cool the room in time for scheduled entertainment that afternoon. The manager and deputy manager agreed that communual rooms must not be cooled to the degree of coldness felt whilst being used by service users. DS0000069274.V330681.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Austen House has a staff team that are competent, trained and sufficient in numbers to meet the health and social care needs of the service users. EVIDENCE: It was evident from the provision of care observed at the site visit that staff were able to meet the needs of the service users in an unhurried and attentive manner, and that the staff rota was compiled to maintain sufficient staffing levels to meet the needs of the service users. The home does not use agency staff. The homes policies and procedures on recruitment are followed as records show references and a CRB on prospective staff are obtained prior to the offer of employment, and identify that new staff are supernumerary until after their induction period; this was further evidenced from discussions with staff and records viewed. A full programme of external and internal staff training is in place, for example understanding dementia, palliative care, yesterday today and tomorrow and mandatory Health and Safety training; at the site visit the inspector observed staff training taking place ‘Managing Challenging Behaviour’. Over 50 of care staff have an NVQ. DS0000069274.V330681.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent and qualified manager whose leadership and management skills ensures service users needs are met in a relaxed and safe environment. EVIDENCE: The manager is a qualified nurse with over 12 years experience within the care home environment, and as with all staff in the home attends ongoing training to continually update her knowledge and skills particularly within dementia care. Surveys and discussions with staff, service users and visitors to the home confirm that the manager is approachable and has made changes to the home that benefits the service user. As quoted by a relative “this is a good home, DS0000069274.V330681.R01.S.doc Version 5.2 Page 19 the quality of staff has gone up recently with the current manager, it also seems fairly stable”. There is a positive and relaxed friendly atmosphere as you walk around the home, and records identify that regular, staff and resident/relative meetings take place. As quoted by a service user “staff very nice, very good, I’m never disturbed by other residents, Manager OK”. Discussions with management and records viewed identify that management maintain a regime of auditing to ensure standards are maintained, and that a senior member of staff within Barchester Healthcare undertakes a monthly inspection of the home. The provider and manager of the home do not act as appointee for handling financial affairs of the service users. It was evident throughout the home that the Health and Safety of service users, staff and visitors is paramount. The home has policies and procedures on safe working practice and staff receive regular training within Health & Safety, Fire Prevention, Moving and Handling, COSHH and Food Hygiene. The kitchen was observed to be clean, and safety audits maintained to ensure a safe working environment and ensure food hygiene standards are met. DS0000069274.V330681.R01.S.doc Version 5.2 Page 20 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 2 3 X X X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 DS0000069274.V330681.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 OP25 Regulation 23.2 (p) Requirement The home must ensure areas within the home used by the service users are within a comfortable temperature at all times. The home must ensure all areas of the home are clean and free of unpleasant odours. Timescale for action 23/06/07 OP26 23.2 (d) 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 Refer to Standard OP18 Good Practice Recommendations The home should re-enforce their whistle blowing policy/adult protection policies with staff. This could be achieved within staff training or within staff meetings/supervision to ensure all staff have an awareness of adult protection policies to safeguard the service users who live in the home. DS0000069274.V330681.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 DS0000069274.V330681.R01.S.doc Version 5.2 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!