Inspection on 25/05/07 for Avon Manor Care Home

This inspection was carried out on 25th May 2007.

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.

Other inspections for this house

Avon Manor Care Home 01/12/06

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

CARE HOMES FOR OLDER PEOPLE Avon Manor Care Home 50 Manor Road Worthing West Sussex BN11 4SH Lead Inspector Ms J Hartley Unannounced Inspection 25th May 2007 09:40 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 Avon Manor Care Home DS0000067679.V336169.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. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avon Manor Care Home Address 50 Manor Road Worthing West Sussex BN11 4SH 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) 01903 230049 Cobham Care Ltd Mrs Lisa Moulding Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th March 2007 Brief Description of the Service: Avon Manor is a Care Home, which provides care and support to elderly people who have dementia and other related mental disorders. It is currently registered to accommodate up to twenty-four residents. The home is a detached property situated in a residential area of Worthing with local shops and other amenities within walking distance. The seafront and beach are nearby. Communal facilities include a lounge, dining area and a smaller dining area, which leads out onto a conservatory. There are twenty-four single bedrooms, which meet or exceed the national minimum standards for individual accommodation in care homes for older people. Six bedrooms are located on a mezzanine floor accessed by steps. There are limited outdoor facilities, which at the moment include a safe decking area, but there are plans to extend the outside area at the front of the house for use by residents. The current scale of fees being charged at the home is from £389 to £585 per week. The current fees range from £389 to £585 per week. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit for this key unannounced inspection took place over four hours. The registered manager Lisa Moulding was present throughout the inspection and provided the information required. The inspector examined information held on the CSCI service file since the last inspection in December 2006, and read previous inspection reports, the Service User Guide and the Statement of Purpose. Evidence was also gathered from the Annual Quality Assurance Assessment completed by the Registered Manager and the Registered Provider and the results of a survey, completed prior to the inspection by six residents and four relatives. During the visit the inspector spoke to the residents, and four members of staff. The inspector undertook a tour of the premises and looked at four care plans and three staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? Since the last inspection the management and staff of Avon Manor have made a lot of improvements to ensure that the home now meets the required standards. These include making the Service User Guide available to prospective residents; introducing new care plans that are thorough and regularly reviewed; ensuring all staff have the required checks and references prior to starting work and ensuring that the all the required records are available. Four requirements were made and these have all now been met. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 6 It was also clear at the site visit that the management have plans in place to continue to improve. 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. Avon Manor Care Home DS0000067679.V336169.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 Avon Manor Care Home DS0000067679.V336169.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. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service User Guide and Statement of Purpose are available to prospective residents to enable them to make an informed choice about where to live. Residents are only admitted on the basis of a full assessment of needs. The home does not provide Intermediate Care therefore Standard Six does not apply. EVIDENCE: The home’s Service User Guide and Statement Of Purpose were both seen prior to the fieldwork visit. Both documents were up to date and contained information for residents and prospective residents regarding the service. At the last inspection it was recommended that the Service User Guide be made available to all prospective service users. The manager said that this is now being done. All six of residents who returned survey forms said that they received enough information prior to moving into the home. All four relatives Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 9 who returned surveys said that they, (or their friend or relative), received enough information about the home to help them make decisions. Four residents’ files were examined during the fieldwork visit. They all contained a full, detailed assessment of the needs of the resident. One assessment of need observed identified that English was a second language and that this person would need access to an interpreter. Care records seen recorded visits by an interpreter. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ health and personal care needs are met. They are treated with dignity and respect. EVIDENCE: The care plans sampled during the visit were comprehensive. They set out in detail the action that needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of residents are met. The manager said that residents are involved with drawing up their care plans. All the care plans seen were signed by the resident concerned. Care plans are reviewed monthly by the residents’ keyworker who involves both relatives and residents in the review. At the last inspection it was noted that some residents had no care plan to assist staff to meet their assessed needs. A requirement was made that all residents must have an up to date plan of care, which includes the details of Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 11 how their assessed needs are to be met. The home has put new care plans in place for all of the residents so this requirement has now been met. Information provided by the manager prior to this visit to the home demonstrated that the home seeks professional advice when there are difficulties in meeting the particular needs of individual residents. Records seen during the visit showed that residents have access to Doctors, District Nurses, Chiropodist and any specialist services that they require such as Community Psychiatric Nurses. Records of monthly weight monitoring, diet and fluid intakes were seen on individual files. All the residents who responded to the survey said they always receive the medical support they need. Medication policies and procedures were seen prior to the site visit and found to be clear and thorough. Medicines were stored in a locked cupboard chained to wall. Medicines needing cool storage, including insulin, were stored in a section of a fridge. Appropriately trained staff administer medication, and training is updated on an ongoing basis. Records seen of the receipt, administration and disposal of medicines were clearly recorded. At the last inspection it was noted that medication keys were not kept securely. A requirement was made regarding this and has now been met. In the Annual Quality Assurance Assessment that the home completed prior to the inspection it is stated that, “All staff are trained in how to treat residents with respect paying particular regard to maintaining their privacy and dignity. Residents wishes are placed to the forefront.” Observation of the staff teams’ interaction with residents throughout the visit confirmed this. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily life and social activities at the home meet the needs of residents and allows them autonomy and choice in their lives. Residents enjoy the food provided. EVIDENCE: Information provided to the inspector prior to this visit reports that the home offers various activities including video afternoons, trips out, visits to the garden centre, Music 4 Health, quizzes, bingo and singing. On the day of the site visit a minibus trip took place. The home also has pet therapy available and the manager said that they have found that this is a good form of stimulation for people with dementia. The home has two cats and a canary. Activities and future events are advertised on posters in the hallway. The Statement of Purpose says that visitors are made welcome at all times and this was borne out by the number of visitors that had signed the visitors book at all times of the day and evening. Visitors are encouraged at any time and offered refreshments. There are a number of quiet areas in the home where Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 13 meetings can be held in private. Care plans seen recorded social contacts and interests. The home does not look after the financial affairs of residents. All the residents who replied to the survey said that they always like the meals provided at the home. Comments from residents include; “Food is nicely cooked and presented” and “It’s all good and I never leave much.” During the visit a resident asked for a jacket potato for lunch instead of the alternatives on the menu. It was noted that this was provided. The home provides specialist diets for those needing or requiring them. The menu includes a balance of healthy, nutritious choices. Staff were seen sitting and helping residents who need assistance to eat. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that their complaints will be listed to and acted upon. Residents are protected as far as possible from abuse by the homes’ policies, procedures and staff training. EVIDENCE: There is a clear complaints procedure on display in the entrance hall and in the Service User Guide assuring residents, relatives and visitors that all complaints will be taken seriously and acted upon. It has also been published in a format specifically designed for use by people with dementia, which incorporates images rather than words. All the residents and relatives who responded to the question in the survey said that they know how to make a complaint. All the surveys returned by relatives said that the home had responded appropriately if they or the person using the service has raised concerns about their care. The complaints book was seen and no complaints have been recorded since the last inspection. At the last inspection it was found that the recruitment records within the home did not demonstrate that sufficient Criminal Record Bureau checks and Protection of Vulnerable Adult checks had been undertaken for newly employed staff. A requirement was made that robust recruitment policies and procedures must be carried out. Since then the manager has ensured that all Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 15 staff have up to date CRB checks, the staff files seen included all the required checks and documentation. This Standard has now been met. The home’s adult protection procedures were seen prior to visit and found to be clear and robust. Staff spoken with during the visit demonstrated that they had knowledge of whistle blowing and adult protection procedures. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location and layout of the home is suitable for its stated purpose. The home provides a safe, well maintained environment for residents. The home is clean, pleasant and hygienic. EVIDENCE: Avon Manor is situated in a residential area of Worthing, West Sussex. The home is comfortably furnished with good quality furniture and fittings. Bedrooms and communal rooms are well maintained. Bedrooms have locks on the doors that can be opened by staff in an emergency. Windows have restrictors fitted and radiators are covered for the safety of residents. The lift has recently been renewed. The Annual Quality Assurance Assessment says that the home has an action plan for improvements to all the physical aspects of the home, which is reviewed weekly. Two cleaners are employed daily. Risk assessments were seen for both the communal areas and the residents rooms. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 17 These are reviewd monthly. The laundry area has recently been refurbished to meet health and safety standards. It is sited appropriately, away from food preparation and storage areas. Evidence was seen of regular safety checks on the equipment and services in the home. An air conditioning unit has recently been installed in the conservatory and special non-reflective material placed on the glass to minimise glare. On the day of the inspection the home was found to be clean, hygienic and free from offensive odours. The residents who responded to the survey said that the home is always fresh and clean. Policies and procedures were seen to be in place regarding the control of infection, and the safe disposal of clinical waste. Training is provided for staff in infection control. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is sufficient staff to meet the assessed needs of residents. Staff are well trained and collectively have the skills to meet the needs of residents. Recruitment practices protect residents. EVIDENCE: The staff duty rota was seen during the visit. The home has sufficient care staff on duty to meet the needs of the residents in the home. Domestic staff and a cook are also employed. There are two waking night staff on duty at night. All the residents who responded to the survey said that staff are available when they need them. All the relatives who responded said the staff always have the right skills and experience to look after people properly. Comments received from relatives concerning what the home does well include; “Employs staff who are cheerful and very caring”, “Tailors the care provided to the needs of the client on a flexible basis…”, “Staff and management and ethos of the home excellent”, Training records seen show that staff have a comprehensive training programme that provides them with the combined skills to address the needs of residents. Staff spoken with during the visit praised the level of training provided by the home. Health and Safety training, Induction training and Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 19 training relevant to the needs of the residents, e.g. dementia, are compulsory for staff to attend. Sixty percent of staff have a NVQ level 2 in care or above. At the last inspection it was identified that some staff had been employed at the home without current CRB and POVA checks, a requirement was made that all persons employed by the home have CRB and POVA First clearance checks carried out by the organisation. The recruitment records of four members of staff were examined at this inspection. They all contained the required checks and references so this requirement has now been met. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 20 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, 37 and 38. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. Residents and families are encouraged to have a say in how the home is run. The home is safe and well maintained. EVIDENCE: The manager has worked at the home since 1995 and has been in the management role for over two years. She has just completed her NVQ level 4 in care and is currently undertaking the Registered Managers Award. Certificates seen during the visit show that the manager keeps her training updated. She is currently studying for her ASET Level 2 Certificate in Dementia Care. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 21 Staff at the home had positive comments to make about the home and the providers. The home has a quality assurance system, which includes surveying residents and their representative about their views of the service. Samples of returned questionnaires were viewed at this visit and all showed satisfactory feedback. The home does not manage the finances of residents. At the last inspection a requirement was made that the home must make available all records detailed in Schedule Four of the Care Homes Regulations. This was found to be met at this site visit. The home has comprehensive Health and Safety policies, procedures and risk assessments in place, these also include a regular audit to ensure that the home provides a safe environment for residents. The maintenance and servicing of equipment in the home is up to date. Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 22 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 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 3 X 3 X 3 3 Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 24 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 Avon Manor Care Home DS0000067679.V336169.R01.S.doc Version 5.2 Page 25 - 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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