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Inspection on 13/04/05 for Autumn House Nursing Home

Also see our care home review for Autumn House Nursing Home for more information

This inspection was carried out on 13th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users said they were happy and stated, "The best thing about living here is the friendly and caring staff". A relative said "The staff were brilliant, nothing was too much trouble". All service users spoken with said the staff were very helpful and polite. Service users wanted to say how good the food was. They felt the cook went out of her way to please everyone. Relatives said if they had any concerns they would feel comfortable talking to the manager or nurse in charge. All service users felt well cared for and safe. The staff team were well trained and able to meet service users needs. It was felt that the home`s real strength was the relationships that the staff team had built with service users and their visitors.

What has improved since the last inspection?

The service user guide has been reviewed and is now more user friendly for service users. Care plans were now more detailed with service user involvement. A wheelchair store had been provided and the ramp adapted to the main entrance. The programme of redecoration is ongoing and several bedrooms had been redecorated since the last inspection. Over fifty percent of the care staff are trained to NVQ two or above. Staff said they had received much more training, which had helped them to understand the service users needs.

What the care home could do better:

Consent for medication must be recorded in the plan of care. The homes treatment room requires further lockable storage to store stocks of medication, which was being stored on open shelving. Several bins in the WC and bathing areas were without lids or broken and required replacing.

CARE HOMES FOR OLDER PEOPLE Autumn House Nursing Home 2 Station Road Worsbrough Dale Barnsley S70 4SY Lead Inspector Susan Smith Unannounced 13 April 2005 9:00 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. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Autumn House Address 2 Station Road Worsbrough Dale Barnsley S70 4SY 01226 243057 01226 243057 None Mrs Nurjahan Hossain Mrs Vijay Kumari Singh Mrs Patricia Davison Care Home with Nursing 35 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) Category(ies) of OP Old Age 35 registration, with number of places Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons accommodated shall be aged 60 years and above. 2. Of the 35 beds registered, all can be used for personal care. Twenty of these can alternatively be used for nursing care. Date of last inspection 08 September 2004 Brief Description of the Service: Autumn House is a care home providing personal care and nursing for 35 older people. The home is in a residential area of Worsborough Dale close to all local amenities and main bus routes. Accommodation is on two floors served by a passenger lift and stairs. It is well decorated with 23 single and six double bedrooms. Three of the double rooms have en suite facilities. There are two lounges, one dining room and a visitors room. The home is in an elevated position in its own grounds, and is reached by a steep tree lined driveway. Car parking is available at the front and side of the home. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over nine hours from 09:00 to 18:00. Opportunity was taken to tour the premises, examine records and talk with service users and staff. Most of the service users were seen during the inspection and seven were spoken to. The inspector was able to speak to five visitors during the day who gave their views of the service provided. There was a positive atmosphere. Staff and service users were friendly and welcoming and there was a positive rapport between staff and service users. What the service does well: What has improved since the last inspection? What they could do better: Consent for medication must be recorded in the plan of care. The homes treatment room requires further lockable storage to store stocks of medication, which was being stored on open shelving. Several bins in the WC and bathing areas were without lids or broken and required replacing. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 6 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. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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 Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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. The homes statement of purpose and service user guide provided clear up to date information regarding the service provided. All service users had been provided with a written contract /statement of terms and conditions. EVIDENCE: The service user guide had been reviewed to make it more user friendly and provide clear information for potential service users to be able to make a choice about living at Autumn House. The contract / statement of terms and conditions contained the range of information required. The admission process was well managed and all service users had their needs assessed prior to their admission. Three service users files contained a copy of the full needs assessment. The service users and or their representatives had been included with the drawing up of these plans. Service users said that it was the way they were welcomed by staff and service users that made their minds up that this was the home for them. All felt well informed about the home both before and after their arrival. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11 The service users health, social and personal care needs were well documented. The service users or their representatives had been involved in the drawing up of their plans. A range of health care professionals visited the home. Service users spoken with said they were satisfied with the care they received and that staff respected their privacy. Service users were encouraged to be responsible for their own medication and medication was dispensed safely. EVIDENCE: Each service user had a care plan that included risk assessments. Three care plans set out in detail the service users needs and the action to be taken by the qualified and care staff, to ensure these could be met. There was evidence that service users or their representative were involved in the monthly reviews of their plan of care. Nutrional screening had been undertaken and weightmonitoring records were maintained on a monthly basis. Consent for medication was not recorded. Two relatives spoken to say the quality of care could not be faulted and the record keeping reflected this. They stated that the standard of care had always been good but felt this had improved in the last twelve months. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 10 Service users said this was a happy home and said staff had always time to listen. If they had a problem they would always have time to help them with it. Administration of medication was observed and was considered safe. Threeservice users medication and records (MAR) were checked and were found to be correct and up to date. There was found to be a shortage of lockable storage space in the treatment room. Observation during the inspection showed that staff had a good awareness of how to protect service users privacy and dignity. They were seen to knock on doors and wait for a response before entering. All spoke to service users in a respectful way. Service users were well dressed in clean clothes and looked well cared for. One service user said, “It’s lovely to get in my clean comfortable bed”. Another said the laundress did a really good job and looked after her clothes. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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 and 15 Service users had a varied choice of lifestyle within the home. Visitors were encouraged and service users were able to maintain contact with family, friends and the local community. Meals served at the home were of a good quality and offered choice. EVIDENCE: An activity co-ordinator was employed to undertake activities with service users both individually and as a group. Activities were occurring during the inspection. One service user was going out for coffee and visiting a friends garden. A group of service users had a game of bingo. Service users said their families and friends were made welcome and were always offered refreshments. One service user said this is “Five star luxury and felt care could not be better, I can come and go as I please”. The best thing he thought was having people to talk to he said “I am never lonely now”. Everyone commented on the choice of food and how good it was. The menus were balanced and flexible to accommodate individual preferences. All could choose where they ate and several stated they preferred to eat in their own rooms. The lunch meal was observed and it was good to see service users being given assistance appropriately and discreetly. One service user said “I am very faddy with my food but this cook can not be faulted, we love her food”. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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 There was a clear and accessible complaints procedure. Complaints made by service users and their relatives were listened to and action was taken to deal with them promptly. Staff had an understanding of the procedure to be followed should they suspect any abuse at the home. EVIDENCE: The complaints procedure was displayed at the home. The service users and their relatives spoken with said that if they had any concerns they would feel comfortable talking to the manager or the nurse in charge. Discussions with service users confirmed that they felt they had nothing to complain about and were happy and well cared for. All staff had received formal training on adult abuse. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 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, 22, & 26 The home was clean and well maintained providing a comfortable safe environment for service users. EVIDENCE: The home was clean, bright and welcoming. Service users spoken to said the home was comfortable and well furnished. All were able to personalise their rooms and said they were happy and settled. The home had a full range of appropriate aids and adaptations to aid service users independence. These included grab rails, adapted baths and mobile hoists. All previous requirements in relation to the environment had been completed. The domestic staff maintained a good standard of housekeeping and the home was clean and free from odours. The majority of staff within the home had undertaken infection control training. A sample of toilets and bathroom areas were checked and several waste bins were without lids. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 14 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 and 30 Staff were employed in sufficient numbers to meet the needs of service users in accordance with agreed staffing levels. A training and development programme was in place, which met the changing needs of services users. EVIDENCE: The staff rota identified that the numbers and skill mix of staff was meeting service users needs. Staff spoken with felt that the staff numbers were adequate to meet the needs of service users. Over fifty percent of care staff had achieved their level two NVQ qualification and several were working towards NVQ level three. The deputy manager was working towards the manager’s award. All staff said that the training opportunities available to them were excellent. This they felt was because of their new manager who was very supportive and positive towards training. Four staff files were seen and all contained the relevant documentation. All staff had undertaken induction and foundation National Training Organisation (NTO) workforce training. The manager stated that she was very committed to staff training. In the last year she had worked hard to improve the training programme. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 15 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) 31,33,34,36,37 & 38 The home manager is competent and experienced and discharges her responsibilities fully. Service users benefited from her management approach by ensuring staff were trained to meet their needs. Safe working practices were in place to promote health, safety and welfare of service users. EVIDENCE: The manager is a Registered General Nurse with many years experience in the caring profession. She has kept up to date with current practice and undertaken the Managers Award. Service users, their visitors and staff make positive comments about the new management at the home. All felt their opinions really mattered and were taken into account when choices were being made. Service users families were invited to their meetings and outings. This was reinforced on the day when speaking to relatives. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 16 Staff were supervised on a daily basis and formal personal supervision was provided and records kept. The fire equipment was checked weekly and fire drill was held regularly. Mandatory health and safety training was ongoing. The manager stated that approved contractors had checked all the major systems. Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 17 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 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 Standard No 16 17 18 Score 3 x 3 3 x 3 3 x 3 3 3 Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 18 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. 2. 3. Standard 9 9 26 Regulation 17 13 16 Requirement Consent for medication must be recorded in the plan of care. Adequate lockable cupboards for storage of medication must be provided. Replace the defective bins in WC and bathroom areas. Timescale for action 6th July 2005 6th July 2005 8th June 2005. 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 NONE Good Practice Recommendations Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 19 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Autumn House Nursing Home J51 6470 Autumn House V218835 13.04.05 UI.doc Version 1.20 Page 20 - 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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