Inspection on 28/06/05 for Avalon Park Nursing Home

This inspection was carried out on 28th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Avalon Park Nursing Home 22/01/07

Avalon Park Nursing Home 11/01/06

Avalon Park Nursing Home 25/01/05

Avalon Park Nursing Home 12/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Avalon Park Nursing Home Dove Street Oldham Lancashire OL4 5HB Lead Inspector Fiona Bryan Announced 28 June 2005 09:00 th 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. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Avalon Park Nursing Home Address Dove Street, Oldham, Lancs OL4 5HB 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) 0161 633 5500 Southern Cross Healthcare Services Limited Mrs Denise L Simcock Care Home with Nursing 60 Category(ies) of DE Dementia - 30 registration, with number OP Old age - 11 of places DE(E) Dementia - over 65 - 30 PD(E) Physical disability - over 65 - 29 SI(E) Sensory Impairment over 65 - 1 PD Physical Disability - 28 SI Sensory Impairment - 1 Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 No service users under the age of 55 years to be admitted into the home. Service users to include 11 requiring personal care only. 2 Three registered nurses to be on duty between 8am-9pm. 3 Two registered nurses to be on duty between 9pm-8am. 4 First level RMN to be in charge of EMI unit. First level RGN to be in charge of elderly physically infirm unit. 5 Home manager to be a first level nurse and supernumerary to above stated levels. Date of last inspection 20th January 2005 Brief Description of the Service: Avalon Park is a care home providing 24 hour nursing care for 30 older people and specialist dementia care for a further 30 people. The home can also provide for up to 11 people requiring personal care only, within these numbers. Avalon Park is owned and managed by Southern Cross Healthcare, which is a private limited company. It is managed on a day-to-day basis by a manager who is also a qualified nurse. The home is a purpose built, two-storey building and operates as two distinct units. Service users requiring general nursing care or personal care are accommodated on the ground floor. Service users requiring dementia care are accommodated on the first floor of the home. The first floor accommodation is secure with access controlled by a keypad system. There are two lounges and two dining rooms on each floor. All bedrooms are single rooms with en-suite facilities. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to the lounges and dining rooms. The home is located in the Salem district of Oldham, on a main bus route, within a residential area and close to local shops. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this announced inspection, and spent time talking to residents, relatives and staff. The needs of seven residents were assessed at in detail, looking at their experience of the home from their admission to the present day. Records of care, staff duty rotas and staff personnel records were examined and a partial tour of the home was carried out. Prior to the inspection comments cards were sent to GP’s who visit residents at the home, however there had been no responses at the time of writing this report. Comments cards were left at the home for residents and visitors and nine relatives responded with mainly favourable comments. What the service does well: What has improved since the last inspection? The way that staff helped residents to move around the home had improved since the last inspection and staff were seen to be using the equipment provided properly. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 6 The general appearance of residents had improved with the majority looking neat and tidy, although a small number of residents on the first floor looked a little unkempt. Recruitment procedures were stricter which makes it less likely that unsuitable people will be employed to work at the home. 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. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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 Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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) 3 Residents are assessed before they come into the home. EVIDENCE: The care files for seven residents were looked at in detail. Community care assessments had been obtained and pre-admission assessments had been completed by staff at the home for all the residents. Social profiles had been completed in the majority of cases by the residents’ families. Several residents were quite aggressive towards each other – staff handled these situations reasonably well, trying to move residents away from each other, but there were no real means of distracting them or diverting their attention. The manager said that some of the staff have undertaken training in dementia care but many staff are still awaiting this training. Some efforts had been made towards a person centred approach to care, such as using meaningful pictures and signs on doors to help orientate residents but this needs to be developed. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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 and 10 Care plans identify residents’ physical needs but more detail is needed in planning to meet social needs and staff need to evaluate the outcomes of care provided more thoroughly. Residents’ health care needs are met but staff need to pay greater attention to detail regarding their personal hygiene and presentation. Staff treat residents with respect and maintain their dignity. EVIDENCE: Care plans were generally quite detailed and related to needs identified during the residents’ assessments. Residents or their families had been involved in discussions about their care and this was documented. Care plans were reviewed monthly but evaluations were limited and needed more specific information. Records showed that residents had been seen by GP’s, dentists, opticians, chiropodists, dieticians, TV nurses, continence nurse assessors, speech and language therapists and social workers. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 10 Risk assessments had been undertaken for falls, moving and handling, pressure areas and nutrition. Residents are weighed every two weeks. Care plans were in place for wound care but the evaluation of treatment needs to be more detailed and wounds should be photographed, mapped and measured. Social care plans were not as specific as those for physical care needs. The main intervention suggested in these care plans was to refer the resident to the activities organiser but there was little detail about the types of leisure pursuits each resident enjoyed. Some residents on the first floor had long fingernails, which were dirty and a very small number looked slightly unkempt although most residents were dressed neatly and were wearing socks or tights and slippers. One resident said staff were polite and respectful and other residents and relatives said their privacy and dignity were maintained and they were pleased with the care. One resident said “I like it here”. One visitor said his relative’s overall condition had improved since living at the home. Residents were well presented on the ground floor with well-manicured nails and a neat and tidy appearance. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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 and 15 Residents on the ground floor were satisfied with their lifestyle and the choices available to them. Further training is needed to ensure that staff are able to maximise the opportunities for social stimulation for residents with dementia. Friends and relatives maintain contact with the residents. Meals provided are varied and suit most residents’ tastes. EVIDENCE: Residents on the ground floor were satisfied with the activities provided by the home. An activities organiser arranges a programme of events and said that residents are always asked what they would like to do. Examples of some recreational pursuits that are provided include card games, dominoes, arts and crafts and sing-a-longs. The needs of some residents with specific religious and cultural beliefs are met with monthly visits from a Polish priest and a monthly ecumenical service is held for other residents. On the day of the inspection some residents went out to Alexandra Park and some residents spent time in the garden. Although residents from the first floor can join in with activities, opportunities seemed more limited for them. One resident who spent a lot of time in his Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 12 room due to treatment needed for a medical condition said he watched television, but seemed lonely and at the end of the conversation said it was nice to chat because he didn’t get to talk with many people. Activities were organised for the beginning of each week, but the activities organiser said that at the end of the week she spent time helping residents to get to and from the hairdressers so other events or excursions were minimal on these days. The activities organiser would benefit from some training in providing activities, especially for residents with dementia and the key worker system should be further developed to encourage staff to spend time with residents on a one-to-one basis. Visitors said they were able to visit when they wanted and were made welcome. Staff knew the residents well and could describe their usual routine and preferences. However one staff member stated she did not usually read the resident care files and was not sure about the detail about the aims of some of the care that had been planned. For example she knew that a resident needed to be encouraged to drink but was not sure what amount of fluid could be considered enough or how this would be monitored. Staff said when a new resident comes to live at the home they would read the paperwork and discuss their care needs with the nurse in charge. Residents were offered at choice of meal at lunchtime – fishcakes, chips, peas or potato hash. A menu was displayed on boards in each dining room. Dining tables were well presented and residents were assisted to eat where necessary in a discreet and pleasant manner by staff. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 13 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 and 18 Residents and relatives are confident that complaints will be dealt with properly. Staff need further training to ensure that residents are protected from abuse. EVIDENCE: The manager said there had been no major complaints since the last inspection. Residents said that if they had a complaint they would see the manager or would speak to one of the nurses and were happy that their concerns would be dealt with properly. The manager was observed a number of times during the inspection, being approached by relatives who were obviously comfortable to speak with her informally and well known to the manager. Staff were aware of the complaints procedure. Staff said they had been issued with policies and procedures for the protection of vulnerable adults and whistle blowing, and some staff said they had watched a video about abuse. All staff said that they would report any untoward incidents without delay. A number of residents on the first floor displayed aggression and challenging behaviour throughout the day of the inspection. Although staff said that they discussed strategies to cope with individual residents, none spoken to had received formal training regarding dealing with challenging behaviour. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24 and 26 The home’s décor, furnishings and fittings need updating. Residents live in a safe environment but old carpets and floor coverings make it less pleasant and hygienic to live in. More rigour is needed to ensure that minor maintenance jobs are carried out. Garden areas need to be regularly maintained. EVIDENCE: A partial tour of the building showed that the ground floor of the home was generally clean and tidy. However, as identified at the last inspection the first floor was malodorous. The carpets identified during this inspection must be replaced. Throughout the home residents’ bedrooms were homely and well-presented. Some bed linen and curtains had been purchased but a lot of the furniture was old and many carpets showed signs of wear and tear. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 15 The water taps in one resident’s room were not working and must be repaired. Bathrooms appeared cold and clinical and were also dated and showing signs of wear and tear. Bathroom floors identified during the inspection need replacing. A pleasant garden is provided for residents to sit in but the manager has maintained it personally. The front of the building looks overgrown and untidy in parts and must be maintained properly. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 16 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, 29 and 30. There are sufficient staff to meet the needs of the residents. Recruitment policies and procedures are adhered to, ensuring the protection of residents. Further staff training is needed to ensure that all staff have the skills and knowledge to deliver the care they are expected to provide. EVIDENCE: Examination of off duty records indicated that staff numbers were maintained at satisfactory levels. Staff said that there were usually enough staff on duty to meet the needs of the residents. Seven of the nine relatives who returned comments cards stated that they were satisfied with the staffing levels. Personnel files for two new staff members were checked and contained all the necessary documents and information to ensure they were suitable to work at the home. Training files were available which showed that staff had received fire training, food hygiene. Further update training is planned in these topics and in first aid and epilepsy. Staff need training in dementia care, challenging behaviour and other topics specific to the care they are expected to deliver to residents. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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 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) 33 and 38 Opportunities exist by which residents and relatives can give feedback about how the home is run. Some health and safety training is needed to ensure that residents are fully protected. EVIDENCE: Although no minutes were seen, staff said they had fairly regular meetings and were able to share suggestions about the organisation of the home and the working routine. Minutes were available of a residents/relatives meeting, which was held on 6/7/05. The manager is very approachable and a good staff atmosphere was noted during the inspection, with staff very pleasant and friendly and working well as Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 18 a team. Staff were motivated and happy, and said they enjoyed working in the home. Certificates for equipment maintenance and health and safety checks of the building were available. Following moving and handling training since the last inspection staff were observed using the hoist appropriately. A new staff member had not received fire training or fire drills and other staff were vague about the procedure to be followed in the event of fire. Kitchen staff were observed to be washing up by hand and said the dishwasher had been broken for some time and they were having to boil water to wash up. Some of the crockery was not very clean. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x x x x 2 Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 18, 30 Regulation 18 Requirement The registered person must ensure that staff receive training in dementia care, challenging behaviour and other training specific to the care needs of residents. The registered person must ensure that detailed information in residents care plans is explained to all care staff so they fully understand the care they must deliver. The registered person must ensure that care plans are evaluated thoroughly and updated to reflect the changing needs of the residents. The registered person must ensure that social care needs are identified and planned for. The registered person must ensure that residents personal hygiene and grooming is maintained. The registered person must ensure that training is provided to the activities organiser to ensure that residents with dementia have their social needs identified and met. The registered person must F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Timescale for action 31/12/05 2. 7 15 31/8/05 3. 7 15 31/8/05 4. 5. 7 8 15 12 31/8/05 31/8/05 6. 12 18 30/11/05 7. 19,26 23 30/11/05 Page 21 Avalon Park Nursing Home Version 1.30 8. 19 23 9. 21, 26 23 10. 24 23 11. 38 23 12. 38 16 ensure that carpets identified in the inspection are replaced. The registered person must ensure that the external grounds at the front of the building are regularly maintained. The registered person must ensure that the bathroom floors identified during the inspection are replaced. The registered person must ensure that the taps for the handwash basin in the residents room identified during the inspection are repaired. The registered person must ensure that all staff receive fire training and participate in fire drills. The registered person must ensure that the dishwasher is repaired. 30/9/05 30/11/05 15/8/05 31/8/05 31/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 12 Good Practice Recommendations The registered person should ensure that wounds are photographed, mapped and measured to ensure that treatment can be evaluated effectively. The registered person should ensure that the key worker system is developed to include provision of time for oneto-one interaction with residents. Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 0QD 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 Avalon Park Nursing Home F54-F04 S25426 Avalon Park v224563 280605 Stage 4.doc Version 1.30 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. 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