Inspection on 20/05/09 for Avon View Residential & Nursing Home

This inspection was carried out on 20th May 2009.

CQC found this care home to be providing an Good service.

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 View Residential & Nursing... 25/11/08

Avon View Residential & Nursing... 15/11/07

Avon View Residential & Nursing... 31/01/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Avon View Residential & Nursing Home Loring Road Christchurch Dorset BH23 2GZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Amanda Bell     Date: 2 1 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 21 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: Avon View Residential & Nursing Home Loring Road Christchurch Dorset BH23 2GZ 01202485170 01202482280 Telephone number: Fax number: Email address: Provider web address: www.dorsetforyou.com Name of registered provider(s): Type of registration: Number of places registered: Dorset County Council care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. The home may accommodate a maximum of 25 service users who require nursing care. The home may from time to time, admit persons between the ages of 60 and 65. Date of last inspection Brief description of the care home The home is located in Christchurch and there are public transport links to the town centres of Bournemouth and Christchurch. The home was opened in October 2006 having transferred residents and staff from the old premises. The building offers Care Homes for Older People Page 4 of 21 Over 65 20 50 0 0 0 10 0 1 1 2 2 0 0 8 Brief description of the care home accommodation to a maximum of 80 people, in the main building there are three floors; the ground floor offers a service to people needing specialist dementia care, the first floor is for older people and the second floor is a 25 bedded nursing unit. To the side of the building is another unit specialising in intermediate care helping people to return to independent living.The accommodation includes single rooms only and each has en-suite facilities including walk-in shower. There is a communal bath on each of the floors.To the rear of the premises there is a secure garden. Limited on site parking is available. All residents are referred through the local authority care management process. Care Homes for Older People Page 5 of 21 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place on the 20th May 2009 and took approximately four hours. The purpose of the inspection was to assess all of the key standards and improvements made since the last key inspection in November 2008 and a random inspection in February 2009. The inspection was carried out by two inspectors however the term we is used throughout the report to reflect the findings of the Care Quality Commission, CQC. The Registered Manager, Mrs Amanda Elliott, was on hand throughout to aid the inspection process. We gathered information in a variety of ways, which included reports made to CQC by the home; the annual quality assurance assessment, AQAA, completed by the Registered Manager; a random inspection in February 2009; a tour of the premises and discussion with those people living at, visiting and working at the Care Homes for Older People Page 6 of 21 home. We also reviewed a number of care records, recruitment and training records and maintenance documentation. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 21 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using 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. New residents move into the home having had their needs assessed and been assured that these needs will be met fully. Evidence: At the random inspection in February 2009 we reviewed the admission process for people who had moved into the home recently. The pre-admission assessments were detailed and gave enough information to the Registered Manager for her to be able to determine whether the home could meet the persons needs. People who used the service told us that they were able to visit the home prior to making any decisions about admission. No further admissions have taken place since the random inspection in February 2009. Care Homes for Older People Page 10 of 21 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using 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. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. Evidence: Since the last key inspection the standard of care documentation had improved greatly. We reviewed care files for six people living at the home. Each file contained detailed assessments, from which staff had used the information to formulate a detailed plan of care. Each file contained a life story of the resident if they were happy to share this information. This helped to inform staff about the personal preferences of each individual in their care and as a consequence we found that care plans were more person centred. There was evidence on file to indicate that the resident and or their representative had agreed to the plan of care that was drawn up and these were reviewed regularly. During the inspection we observed that care was given in accordance to the written plans. In general all the documentation we saw was clear and comprehensive but for some residents there was unreliable direction regarding their wishes in the event of Care Homes for Older People Page 11 of 21 Evidence: resuscitation being considered. It is recommended that the home develop and implement a policy for end of life care and associated considerations and thereby ensure that the care records provide staff with accurate and properly determined information. Two further recommendations of good practice have been made and are firstly, that the evaluations of care plans are more detailed and reflect whether the goals of care are being met appropriately. Secondly that the daily statements reflect whether the resident is in a state of ill or well being and whether they are responding to the care given. Where the need for specialist equipment was identified it was provided. This included pressure relieving mattresses and cushions and a variety of moving and handling equipment. It was clear from discussions with staff and residents that they had access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services, social workers and chiropodists. The medications policies and procedures were reviewed and we observed medications being administered to some people living at Avon View. The home had a medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Examination of records and observation of medication administration showed us that medicines were properly administered in accordance with the prescribers instructions and residents could be assured that they were getting the medication that their doctor said they needed. Residents we spoke with said they were happy with the care they received and confirmed that staff treated them with respect and were supportive and kind. Care Homes for Older People Page 12 of 21 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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. People living at Avon View are encouraged to maintain as much independence as possible. Social and leisure activities are varied and suited to the preference and ability of each resident. Evidence: Avon View continue to provide a varied activities programme for those people living there. People told us that they were happy with the programme and they could join in if and when they wanted to. They also told us that they spent their time how and where they chose. Residents confirmed that they could entertain their visitors in private if they so wished. Menus showed that the people who live there have a choice of meals through the day. The menu was varied and meals appeared nutritious. Staff observed at lunchtime, supported people where appropriate, in a quiet and sensitive way. Care Homes for Older People Page 13 of 21 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. Evidence: The home has a policy in place to deal with complaints. There had been two complaints made since our last inspection, which had been processed in accordance with this policy. We spoke with people who use the service and they told us that they were happy to speak with staff if they had any concerns and were confident they would be listened to. Since our last key inspection alot of work had been done to ensure that staff were trained in safeguarding vulnerable adults. We spoke with staff who told us that they found this training very beneficial and they showed us that they had a clear understanding of what to do if an allegation of abuse was made. When any untoward incidents had occurred the Registered Manager had been very prompt in raising alerts to the appropriate agencies so that action could be taken to minimise any risk to residents. Care Homes for Older People Page 14 of 21 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Avon View Nursing and Residential Home continue to provide an extremely comfortable, safe and home place in which to live. Evidence: Avon View continues to provide a very comfortable and supportive environment in which to live. We toured the premises and reviewed the maintenance documentation, which showed the home was well maintained inside and out. There was evidence that equipment was serviced regularly. People living in the home had easy access to all communal areas. Residents rooms were of a good size and furnished appropriately. Bedrooms were personalised with a variety of mementos, pictures and small items of furniture. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. People told us that the home was always kept clean and comfortable. The AQAA told us the home has a variety of general specialist equipment, hoist, height adjusted beds and indiviual residents were supplied with the correct equipment to meet their needs on admission to the home and this was regularly reviewed by an occupational therapist. Staff were trained in infection control. The laundry continued to be well managed. Adequate supplies of clean linen were seen to be available. Care Homes for Older People Page 15 of 21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using 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. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home.Staff are given the training and support so that they can give a good standard of care to the residents living at the home. Evidence: At the time of inspection staff rosters demonstrated that there were sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. Residents spoken with confirmed that staff were available when they needed them and they were not kept waiting. The home has an ongoing training programme, which includes NVQ level 2 in care and at the time of inspection over 50 per cent of care staff held this award. We reviewed one new staff recruitment file. The file was well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained. Training files demonstrated that staff were receiving induction training and staff we spoke with confirmed that they were encouraged them to take up training opportunities provided. Recent training included the protection of vulnerable adults; dementia care and first aid. Care Homes for Older People Page 16 of 21 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using 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 organised and the daily management and running of the home centres round the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. Evidence: Mrs Elliott is registered with the Care Quality Commission as manager of Avon View Nursing and Residential Home. She is supported by a hardworking and dedicated team of staff. Since the last key inspection the quality assurance systems in place were much more robust and had identified any shortfalls in the services and facilities provided in the home. Where any shortfalls were identified action was taken promptly to rectify the situation. People living at, visiting and working at the home we spoke with said that they felt confident in the management team and that they were well supported and listened to when they had comments to make. The Registered Manager confirmed that the home held a small amount of money for residents if they so wished. Records showed that all such monies were accounted for. Training records showed us that staff had received recent training in fire safety and Care Homes for Older People Page 17 of 21 Evidence: manual handling updates and staff we spoke with confirmed this had taken place. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were well recorded and further action was taken as necessary. Care Homes for Older People Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 21 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The monthly evaluation of care plans should be detailed enough to reflect whether the aims of care are being met effectively. Daily records should reflect the wellbeing of the resident. It is recommended that the home develop and implement a policy for end of life care and associated considerations and thereby ensure that the care records provide staff with accurate and properly determined information. 2 3 7 7 Care Homes for Older People Page 20 of 21 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 21 of 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!