Inspection on 25/04/05 for Avonbloom Rest Home

This inspection was carried out on 25th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Avonbloom Rest Home 17/06/08

Avonbloom Rest Home 07/06/06

Avonbloom Rest Home 06/02/06

Avonbloom Rest Home 08/12/04

Avonbloom Rest Home 29/07/04

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 Avonbloom Rest Home 351 Squires Gate Lane Blackpool Lancashire FY4 3RG Lead Inspector Gwen Miller Unannounced 25th April 2005 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. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Avonbloom Rest Home Address 351 Squires Gate Lane Blackpool Lancashire FY4 3RG 01253 401455 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) Mrs Mandy Jackson Care Home 15 Category(ies) of Old Age (OP) registration, with number of places Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate 15 older people (OP) Date of last inspection 8th December 2004 Brief Description of the Service: Avonbloom is registered under the Care Standards Act 2000, to accommodate fifteen older persons aged 65 years and over. The accommodation includes one double room, six single en suite rooms and seven single rooms without en suite. Bathing and shower facilities are available. There are two comfortable lounge areas one of which is the designated smoking room. There is also a pleasantly furnished dining room and a first floor quiet lounge area. The premises are situated on a busy main road in the south shore area of Blackpool. The home is close to local amenities and facilities and has good access to all transport services and routes. Some of the service users go out independently. Mrs Mandy Jackson is the registered provider, she runs the home in an informal manner and aims to provide a homely environment for her service users. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.15am. It took place over a day and a half. Mrs Jackson, the registered provider was not present the first day, the deputy, Ann Griffiths, acted in her absence. The inspector spoke to eight residents, two staff members and one volunteer. Case tracking (whereby the inspector focuses on a small number of residents and examines their care, from admission to the present time) of three residents, could not be carried out due to the lack of assessment of their needs and subsequent care plans. Part of the inspection was spent looking at daily notes and information about the home and residents. Time was spent observing the workings of the home and how staff members supported residents. A tour of the home was part of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Whilst some work has been done to improve the decoration of the home, more needs to be done to improve the physical standard in general. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 6 The home could be consistently cleaner by employing a dedicated cleaner in addition to existing staff members. Assessment and care planning must be improved to ensure that staff know what to do for each resident. Generally, record keeping must be improved. Staff must be recruited properly so that people living in the home are protected. Staff also need to be supported and given appropriate training and supervision. Suitable activities should be sought for residents to add variety into their lives. 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. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.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 Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.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) 1,3,6 The home does not provide residents with sufficient information they need, to make an informed choice about where to live. The assessment process is inadequate, new residents must have a comprehensive assessment prior to moving into the home, without it there is no assurance that care needs will be met. EVIDENCE: A Service User guide has yet to be completed, residents spoken with said their information about the home was gained through “word of mouth”. This lack of information was noted at the last inspection where a requirement was made to produce this document. There was no evidence that this action had been taken. The admission procedure is not adequate to guide staff on the actions to be taken to ensure that new residents needs are properly addressed and planned for. The newest resident spoken with, was aware of her own care needs but these had not been recorded nor did she have a contract outlining terms and conditions of her residency. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 9 The staff members spoken with did not know about care assessments of need, nor where such information would be stored. planning, Individual records are now kept for each resident but inspection found that none had full assessment information recorded for any resident. This situation was also seen at the last inspection visit when a requirement was made for action to be taken to ensure that proper assessments were carried out before prospective residents entered the home. There was no evidence that this action had been taken. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 There is no clear care planning system in place to adequately provide staff with the information required to meet the changing needs of the residents. The health care needs of residents need to be identified and met. These shortfalls have the potential to place residents at risk. EVIDENCE: Individual care plans for residents were very brief and only covered basic care needs, they did not contain any signatures of residents nor were they reviewed. Care plans do not contain risk assessments and therefore do not document the action staff should be taking to minimise any potential risk to a resident. Falls and accidents are not recorded and detailed in an accident record book. GP visits are recorded in the home’s daily diary. One resident had chosen to self medicate, her signature was seen on her file, to confirm this was her choice. She said this was “important to her dignity.” Staff spoken to were all able to describe the care needs of individual residents despite the lack of consistent care plans. Residents spoke highly of the staff saying “they cant do enough for you” and “she knows what I need”. This style Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 11 of working is dependent on good verbal communication but in danger of putting residents at risk should such informal systems breakdown. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Although there was a lack of activities, social contacts were encouraged and meals were varied, providing daily variation and interest for people living in the home. EVIDENCE: The manager said that no activities were offered in the home due to “lack of interest by the residents” although she was taking some able bodied residents to the Ice Show, later on in the week. Social activities mentioned in the home’s statement of purpose were incorrect. Visitors were seen in the home in both morning and afternoon, residents said their families and carers “are welcome to visit at any time”, this was confirmed by staff. A good relationship between staff and relatives was noted. A number of people living in the home were spoken to and everyone who commented on the food, said how good it was with good portions. The cook said that fresh produce was bought locally on a daily basis. The dining room was attractively set out with matching table linen. Some residents preferred to eat in their own rooms. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 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) 16,18 Complaints are not handled objectively and residents are not confident that their concerns will be listened to, taken seriously or acted upon. There has been no progress on providing accredited training, arrangements for protecting residents are not satisfactory, placing them at possible risk of harm or abuse. EVIDENCE: The home has a complaints procedure but the complaint record, individual resident’s records and anecdotal evidence indicated that this is not followed. Some residents spoken with were not clear who to complain to, one said “there’s no point in complaining as nothing gets done about it”. One particular issue had been mentioned to the manager on a number of occasions, without being resolved, the deputy confirmed this. Accredited training in the protection of vulnerable adults has still not been provided for staff at the home. This was the situation on the previous inspection where a requirement was made to provide such training by 1.1.05 There was no evidence that this action had been taken. Staff confirmed they had no training in understanding or dealing with physical and verbal aggression, nor were they aware of “No Secrets” documentation. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 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) 19,25,26 Limited improvements to the décor and furnishings have been made. The outstanding matters do not provide the people living in the home with safe, comfortable surroundings. EVIDENCE: Since the last inspection the home has continued with their refurnishing and recarpeting of the communal lounge areas. Residents were pleased with the results. A number of other areas require attention, in particular: Toilet doors still require locks and bedroom doors still require locks as rooms become vacant. This situation was also seen at the last inspection visit when a requirement was made for action to be taken to ensure the privacy and dignity of residents is respected. There was no evidence that this action had been taken. The carpets in bedrooms number 2 and 2A were malodorous despite assurances from yourself that the one in 2A would be replaced following the previous inspection on 8th December 2004. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 15 The carpet in bedroom number 3 was worn, stained and needed replacing. The carpet in bedroom number 4 needed cleaning. The downstairs hallway carpeting was very stained and the floor of the entrance to the kitchen was particularly dirty. The floor of the office needed replacing, floorboards were rotted creating a danger to the health and safety of residents using the lift which is situated in the office. An immediate requirement notice was therefore issued. The bedroom window of bedroom 8 would not close shut and was packed with paper towelling. An immediate requirement notice was issued for immediate repair. Other minor issues were noted and discussed with the manager at the time of inspection. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 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) 28,29,30 The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to people living in the home. EVIDENCE: Staff personnel records did not contain information required. Three out of seven files did not hold any date of birth. None of the files seen held documentary evidence of relevant qualifications. One file only held two written references one of which was undated, none held declarations of fitness for employment. Criminal Records Bureau clearances were still not available for any staff other than yourself and your husband. This was the situation on the previous inspection where a requirement was made to obtain staff clearances by 1.1.05. There was no evidence that this action had been taken. Induction and foundation training that meets National Training Organisation requirements and targets, is still not provided for new staff. The above issues were noted on the previous inspection where requirements were made for action to be taken to ensure that all persons employed at the home are fit to work at the home and that staff are trained and competent to do their jobs. Some residents at the home, suffer from confusional states, suitable training is needed. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 17 Other minor issues were discussed with the manager during the inspection. Staff on duty at the time of the inspection did not know where any records relating to the home, were kept. They also said they had previously paid for the Criminal Records Bureau checks, but never knew their outcomes. With the exception of one person, all residents spoken with praised the staff for their friendliness and attentions in meeting their needs. They added that their call bells were answered promptly during the night and “nothing is too much trouble”. The inspector observed staff working with residents and was satisfied that all tasks were carried out in a pleasant and courteous way. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 18 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 There is no leadership, guidance and direction to staff to ensure residents receive consistent quality care. This results in some practices that do not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The manager is currently undertaking NVQ (National Vocational Qualification) level 4. Policies and procedures relating to the Care Homes Regulations 2001, have now been set up, these need to be read and understood by the staff. Staff spoken with said that they felt unsupported in their roles and that they have no supervision sessions or appraisals systems. This lack of supervision was also noted at the last inspection where it was recommended that staff should be provided with formal supervision, a minimum of six times a year. There was no evidence that this action had been taken. It was also noted and recommended that quality surveys should be carried out with residents, their Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 19 relatives and other stakeholders to assess whether provision in meeting the aims of the service is to the satisfaction of those concerned. There was no evidence that this action had been taken, this still needs addressing. The inspector was provided with a letter from the home’s accountant to certify financial viability. Up to date certificates referring to electrical, gas and lift maintenance were not available, nor was the lift maintenance certification. Residents generally spoke well of the manager, this was an unannounced inspection therefore comment cards were not sent to assess the views of residents and relatives. Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 20 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 1 x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 1 x x x x x 2 1 STAFFING Standard No Score 27 x 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 2 2 2 3 x 1 x x Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 21 yes 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 OP1 Regulation 5 Requirement A Service User Guide must be produced. A copy to be issued to each service user and to the Commission for Social Care Inspection by the date indicated. (Previous timescale of 01/01/05 not met) A needs assessment, assessment of risk and plan of care must be completed for each service user. (Previous timescale of 01/01/05 not met) Accredited training in the protection of vulnerable adults must be provided for all staff. (Previous timescale of 01/01/05 not met) Personnel records must be extended to include information and documents, as per regulatory requirements. Criminal Records Bureau clearances for all staff must be available for examination at the next visit . (Previous timescale of 01/01/05 not met). Induction and foundation training must be provided for new staff members that meets National Training Organisation requirements and training F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Timescale for action 12/07/05 2. OP3 14 28/06/05 3. OP18 13 12/07/05 4. OP29 19 28/06/05 5. OP30 18 12/07/05 Avonbloom Rest Home Version 1.20 Page 22 targets. (Previous timescale of 01/01/05 not met 6. 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 OP19 Good Practice Recommendations Toilet doors should have locks with suitable override facilities. Bedroom doors should have locks where the service users wishes. Locks should be installed on all bedroom doors as rooms become vacant. 50 of care staff should achieve NVQ level 2 by 2005 A registered manager holding NVQ level 4 in management and care should be in post by 2005. Policies and procedures should be retained in a specific file. Staff members to sign and date when policies and procedures have been read and understood. Quality surveys should be carried out with service users, their relatives and other stakeholders to assess whether provision in meeting the aims of the service is to the satisfaction of those concerned. Formal supervision should be provided for care staff, in line with Standard 36 of the Care Home Regulations, a minimum of six times a year. 2. 3. 4. OP28 OP31 OP33 5. OP36 Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Area Office, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Avonbloom Rest Home F57 F09 S9785 Avonbloom Rest Home V222368 250405 Stage 4.doc Version 1.20 Page 24 - 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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