Inspection on 30/11/06 for Autumn House

This inspection was carried out on 30th November 2006.

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

Other inspections for this house

Autumn House 23/09/08

Autumn House 11/10/07

Autumn House 27/04/06

Autumn House 19/10/05

Autumn House 29/04/05

Autumn House 18/11/04

Autumn House 12/05/04

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

CARE HOMES FOR OLDER PEOPLE Autumn House 25 - 27 Avenue Road Sandown Isle Of Wight PO36 8BN Lead Inspector Chris Johnson Unannounced Inspection 30th November 2006 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 Autumn House DS0000012463.V314835.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. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Autumn House Address 25 - 27 Avenue Road Sandown Isle Of Wight PO36 8BN 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) 01983 402125 Mrs Janet Holmes Mrs Debra Ann Young Care Home 34 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (34), Physical disability over 65 years of age (3) Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home accommodates one person under the age of 65 years. MD(E) applies to specifically named residents and will cease upon those residents no longer being accommodated at the home 27th April 2006 Date of last inspection Brief Description of the Service: Autumn House is a large period property situated in a busy part of Sandown. The property has been extended in recent years and provides accommodation on the ground and first floors for up to 34 older people and is registered to provide care for up to 20 older people with dementia. The first floor can be accessed via a passenger lift, though there are parts of the first floor that are only accessible for those residents who are fully mobile. There is limited parking in the street and staff park in the courtyard area of the building. There is a small area of garden to the rear of the property, with a terraced seating area for up to 20 people. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second key inspection of the home carried out for the year April 2006/07. The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards and compliance with regulations and previous requirements. Two inspectors undertook this visit, which included a tour of the premises completed that included looking at service user’s bedrooms and all communal areas of the home. Staff and care records were inspected; staff, residents and relatives were spoken with and staff were observed during their day-to-day interactions with residents. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. The manager and provider were present during the visit. The inspection looked at two complaints about the home that were being looked into by Social Services under their protection of vulnerable adults procedures. One complaint has been resolved and is discussed in the report under the Complaints and Protection section and the home have taken action to improve their practice and an apology was issued by the home to those concerned. The other complaint concerning residents’ finances is unresolved but as a consequence the policy and procedures and record keeping in the home have improved. What the service does well: Service users and relatives spoken with confirmed the care provided in the home is good. This was confirmed by a health are professionals, who commented that the home supports people who exhibit behaviour that challenges very well. The staff team were well motivated, and support service users with dignity and respect. Staffing levels are good. Food provided is good, and service users are offered a range of activities. The home was clean and warm throughout, and is well maintained. The home is managed by a competent manager, who is undertaking the registered manager’s award. Autumn House DS0000012463.V314835.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. Autumn House DS0000012463.V314835.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 Autumn House DS0000012463.V314835.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 - Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are appropriately assessed prior to admission to the home. EVIDENCE: Four service users were case tracked at this visit, one of whom had been admitted to the home as an emergency. There was evidence on the files that appropriate assessments had been undertaken by a member of staff to ensure the home would be able to meet the needs of the individuals. Care management assessments had been received prior to admission. Relatives spoken with confirmed they had looked around the home before the prospective resident was admitted. They had been provided with a welcome pack. Autumn House DS0000012463.V314835.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. Residents are well supported, and this is underpinned by their care plan, which reflects individual needs and wishes. Guidance for the administration of prn medication should be developed. EVIDENCE: Relatives spoken with were happy with the care provided. One relative said they were more than happy with Mum’s care, “there is a good feel – the home is very caring”. “A high standard is expected and we get it”. The husband of a resident confirmed “they look after her well”. The daughter of a resident commented that “Mum always looks nice – they put on her eye makeup and lipstick”. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 10 Records were available to demonstrate that residents’ healthcare needs are monitored and they are given sufficient support to access healthcare as necessary. Residents spoken with confirmed this was the case. A sample of care plans was seen. These were noted to be comprehensive. Likes, dislikes and wishes were recorded. For example one service user had signed her care plan to confirm that she did not wish to be checked at night, but preferred to use the call bell. Good life histories are recorded. Medication practice was reviewed. Administration records were seen and there were no gaps in the recording, but care must be taken to ensure that the codes are used appropriately to indicate the reason why a drug was not taken. As identified at the last inspection, guidance available for medication to be given as required (prn) should be developed to ensure staff are administering this consistently. Stock rotation of prn medication could be improved, as some were dated February 2006. One consultant was interviewed who commented that the home takes a number of residents who exhibit quite severe behaviour problems, and the home supports people well. Staff are tolerant and willing to listen and take on board advice or instructions. Communication is good and the manager will consult as necessary and pass on any concerns. Medication is managed well. Staff are comfortable with use of PRN and staff will make contact if there are any concerns. Autumn House DS0000012463.V314835.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 good. This judgement has been made using available evidence including a visit to this service. Residents are supported to exercise choice, and to maintain their independence. Residents are provided with nutritious meals. EVIDENCE: Relatives and friends are able to visit the home when they wish to do so, and all confirmed that visitors are welcomed. Residents choose how to spend their time, and their preferences are recorded in the care plans. Activities are provided, according to the wishes of the residents, and this is discussed at residents meetings, which are minuted. A record is kept of activities undertaken. Residents are encouraged and supported to maintain their independence. Residents spoken with said the food provided is very good. The menu is varied and nutritious, with choice provided. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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. 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. There is evidence that complaints are dealt with appropriately. Residents are protected by an improved recruitment procedure. EVIDENCE: Since the previous inspection all staff have completed adult protection training. The complaints log demonstrated that complaints are dealt with appropriately. At the time of the previous inspection a complaint had been received regarding aspects of the care of a service user in which social services had been involved. Aspects of the complaint were unsubstantiated, other matters were upheld. As a result an apology was made to the family of the service users, and the provider and manager have introduced systems to improve practice and to promote communication with families and other professionals. At this visit it was noted that staff sign to say when they have supported someone with personal care. Residents’ finances checked and maintained satisfactorily. Improvement was noted in recruitment practices. Required checks are carried out for staff. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is clean, comfortable and well maintained. EVIDENCE: During this visit a tour of the premises was carried out. This included several residents’ bedrooms and all communal areas. The home was very clean and tidy. There were no unpleasant odours. Good infection control procedures were observed to be in place. A maintenance person is employed and the maintenance book seen evidenced that issues are identified and dealt with appropriately. A previous recommendation made with regard to carrying out more frequent checks of residents’ rooms is now implemented, and evidence showed checks were completed three times a day, during each shift. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 14 The garden area now provided safe access for service users, so the previous requirement is now met. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a motivated and trained staff team. EVIDENCE: Staff rotas were examined during the visit to the home and these were found to be a true reflection of actual staffing levels. This demonstrated that staffing levels remain constant and are maintained at the same level as at previous inspections. The home employs domestic staff as well as care staff and this means that care staff can spend more time attending to residents’ needs. The home has a good level of staff retention and many of the staff team have worked there for a number of years. There is a clear delegation of duties and this ensures that staff are aware of their responsibilities on a given day or time. Residents and relatives spoke well of all the staff and commented that they were attentive, caring and friendly. The inspectors observed this to be the case and it was clear from speaking with staff that they enjoyed their job and working at the home. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 16 At the last inspection requirements were made regarding poor recruitment practices. From examination of recruitment records of staff appointed since the last inspection the inspectors were satisfied that the home was now following correct procedures and that all necessary checks had been completed prior to staff commencing work at the home. New staff receive a formal induction. The inspectors talked with the person responsible for staff training, who is an NVQ assessor, able to assess to level 2/3. Three staff, including the manager completed a four day moving and handling instructors course and are now cascading the training. Most staff have now been retrained. The training coordinator has been taken off the rota from Monday to Friday to concentrate on staff training and care plans. Training recently delivered and planned for the future includes: • health and safety • moving and handling • risk assessment for moving and handling • fire drills • food hygiene • dementia • abuse awareness • first aid. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 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 managed and residents are safeguarded by systems and procedures in the home. The quality assurance system should be formalised and developed further. EVIDENCE: The registered manager is due to complete the Registered Manager’s Award (RMA) by September 07. There are informal systems in place for assuring and monitoring quality, and it is recommended this is formalised and records kept. An audit of the Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 18 environment is carried out regularly. Catering meetings are held to look at menus. Residents meetings are held. Feedback sheets are kept by the front door. I Inspectors were shown the business plan for the current year. Business plan for 2006 seen, and this concentrates on areas the provider and manager wish to improve upon. Money is held on behalf of nineteen residents. A sample of five was checked. All balances were correct and stored appropriately. All monies received were receipted and a copy of receipt held on file. A receipt was given to the person depositing money. The hairdresser and chiropodist sign a book to confirm who has received a service. There was evidence that all staff have had appraisals, and supervision sessions are recorded by the manager. The manager was due to attend an appraisal course. It is the intention that the deputy manager will be attending supervision/appraisal training to enable some of this to be delegated. Some service contracts and maintenance records were seen and demonstrated that good systems are in place. The fire log book was seen. This demonstrates that regular testing of call points and fire safety systems is carried out. There is a need to check fire door closures more frequently. Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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 OP9 Regulation 13 (2) Requirement Written guidance must be produced in respect of any resident prescribed PRN medication. This is a repeated requirement. The registered manager must establish a formal quality assurance system at appropriate intervals for monitoring the services and care delivered in the home. This must be done in consultation with the service users and their relatives/ representatives to gain views and opinions. This is a repeated requirement. Timescale for action 01/05/07 2. OP33 24 (1)(2)(3) 01/07/07 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 Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Autumn House DS0000012463.V314835.R01.S.doc Version 5.2 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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