Inspection on 07/08/08 for Avondale Residential Home

This inspection was carried out on 7th August 2008.

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

Avondale Residential Home 12/03/09

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/10/2008.

CARE HOMES FOR OLDER PEOPLE Avondale Residential Home Whitehouse Road Bircotes Doncaster DN11 8EQ Lead Inspector Mary O`Loughlin Unannounced Inspection 7th August 2008 09:00 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 Avondale Residential Home DS0000070949.V369914.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. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avondale Residential Home Address Whitehouse Road Bircotes Doncaster DN11 8EQ 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) 01302 743673 01302 750556 a5wan99@yahoo.co.uk Aswan Care Ltd Mrs Ann Hopson Care Home 31 Category(ies) of Dementia (31), Old age, not falling within any registration, with number other category (31) of places Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old Age, not falling within any other category - Code OP. 2. Dementia - Code DE. The maximum number of service users who can be accommodated is 31. N/A New Service, first inspection. Date of last inspection Brief Description of the Service: Avondale is a detached property that is situated within a residential area. The home is owned by Aswan Care Ltd and offers accommodation for up to 31 Older people including people who suffer from Dementia. There are 27 single ensuite bedrooms and 4 single only. The dementia unit is separated via a locked door and is fully equipped with lounge, conservatory, enclosed garden, and an assisted bath. Some single rooms are not occupied whilst major upgrade is taking place. The Home is undergoing refurbishment and some areas are not in use at the present time. There is a separate smoking lounge. A passenger lift offers access to the first floor and a range of specialist lifting equipment is available for people with dependent needs. The current charges are £294.00 to £390.00 per week. There are separate charges for hairdressing and newspapers. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 5 The service user guide, and statement of purpose are available in the entrance hall and the current Certificate of Registration is also on display. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. A review of all the information we have received about the home was considered in planning this visit including the Annual Quality Assurance Assessment (AQAA), and this helped decide what areas were looked at. This was the first inspection of the home since its registration in November 2007. The main method of inspection used was called ‘case tracking’ which involved selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Members of staff, people who use the service and their relatives were spoken with as part of this visit. A partial tour was undertaken by the regulation inspector, which included looking at people’s bedrooms and communal areas of the home. The quality rating for this service is 1 star this means that people who use the service experience adequate quality outcomes. What the service does well: One person told us, “I would tell anyone who wants to come in the home to do so, it’s better than being at home alone, you feel safe here and there is always someone to speak to.” People in the home live in a well-maintained environment, which is clean and warm. Staff are supervised and trained to meet their needs. There is a registered manager in place who is liked and respected by everyone at the home. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 7 People feel listened to and taken seriously by the staff at the home and one person told us that ”Staff are always polite, always take me to the toilet when I ask and are friendly and chat to me” What has improved since the last inspection? 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 Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 9 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 Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 10 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): 1-3-6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager ensures that people are assessed before they are admitted to the home but people that require regular respite care have out of date care plans in place that do not reflect their current needs. Intermediate care is not provided. EVIDENCE: We looked at the information that is provided for all prospective people who wish to come into the home and we found that the information was in large print and gave them sufficient information to ensure they knew about the services provided. We asked 4 people if they felt they had sufficient information about the home and 3 said they had. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 11 The records of a recently admitted person showed that a trained member of staff had visited the person and assessed their needs before they came to the home, this ensured that staff could draw up a plan of care in consultation with the person which informed staff of how the person wished their care to be delivered. The process of frequent admissions for people that stay at the home for short periods was unsafe, staff received information and recorded this within daily records for any changes that had occurred in their condition, however they did not revise the previous care plans to reflect those changes and people are placed at risk as a result. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 12 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): 7-8-9-10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People in the home feel well cared for and supported by staff to maintain their health and wellbeing. The lack of up to date risk assessments and care plans does not ensure that all aspects of a person’s health are suitably monitored and managed safely. EVIDENCE: A relative said “Mum has been living at the home for a few years, things are much better since the new people took over, the manager is very good, we visit at lunchtime and staff always speak to us, and call us if there are any changes in her condition. Mum is at risk of falling but she is fiercely independent and staff do all they can to prevent accidents. Staff are lovely to mum, she never wants to move from here, its tiptop. We have no concerns, small things get put right straight away.” Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 13 The responses to our surveys from people living at the home show that people feel their health and personal care is managed well. We asked, Do you receive the care and support you need 4 of 4 responded - always. Do you receive medical support when you need it 4 of 4 responded – always The manager told us that she plans to implement a new care planning document and we saw evidence that this had been purchased but not yet in use. We examined the care plans of 3 people and found that there were some shortfalls in ensuring that people are regularly assessed for any risks to their health. We found that nutritional risks had been assessed at admission and staff had weighed people regularly, however they did not record within a plan of care what they were doing about the problems they had identified and had not reviewed the risk assessment monthly or as required. One person had a serious risk of falling but there was no revised risk assessment and no care plan addressing the way staff could control or eliminate the risk. Staff always complete risk assessments when a person is admitted but over time as people’s needs changed there were insufficient safeguards in place to ensure that any changes in need were planned for. One person had developed a pressure sore and staff had ensured that external professionals were involved and suitable pressure relieving equipment had been obtained. Staff told us that they were aware of changing the person’s position regularly and reporting changes to the District Nurse, however the care plans were out of date and did not inform anyone unfamiliar with the resident of the support they required to maintain their health. People told us that they received their medicines on time and we saw staff undertaking a medicine administration round, the manager always makes sure that 2 staff administer medicines to ensure people’s safety. The medicine records showed that the management of medicines is safe and in accordance with the law. People living at the home told us they were treated well, one person said, ”Staff are always polite, always take me to the toilet when I ask and are friendly and chat to me” Another person said, “I would tell anyone who wants to come in the home to do so, that its better than being at home alone, you feel safe here and there is always someone to speak to.” Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 14 Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 15 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): 12-13-14-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to enjoy opportunities for activities, visits from friends and relatives and are provided with a good diet. EVIDENCE: People had a social profile in their records and life history record and these are used to inform activities available in the home. The responses to our surveys, people told us that there were always activities in the home that they could take part in if they choose. People told me that the managers son comes in about 3 times each week to provide activities such as quiz or board games. The manager said he had done some training in providing activities for older people but were intending to obtain more information and training in this area, with particular regard for people who suffer from Dementia. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 16 The lounge areas are fitted with very large plasma screens and people could see them clearly and were watching programmes of their choice. The notice board listed external vocalists coming in August to entertain residents. People had newspapers to read and told me they enjoyed what was on offer and did not think they wanted anything more. They told me they had regular visits from their families and went out frequently with their families. Staff support people’s religious needs, one person told me they regularly see the priest and receive Holy Communion in their room. Written information provided to residents tells them the times of meals and drinks. People told me they could have what they want, one person said she has difficulty sleeping and staff always bring her a drink in the night or offer her a snack. The dining area was very clean and spacious with French doors leading off via level access to the garden. Windows were low height and allowed people to see out when seated. The responses to our surveys tell us that people always like the meals provided. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 17 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): 16-18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are listened to and taken seriously. The lack of up to date policies on safeguarding adults does not ensure that staff are fully aware of what they should do to protect people. EVIDENCE: We spoke to people living at the home and they told us they felt safe. One person said, “you feel safe here and there is always someone to speak to.” The manager told us in the AQAA that they had not received any complaints or safeguarding alerts since registration last November 2007. The commission has not received any complaints or safeguarding referrals about the home. One concern was passed to us about the non availability of call bell extension leads, during this inspection we did not find that people were concerned about their call bell facility, however the manager is aware that she must complete a risk assessment should people not be provided with a suitable alarm facility to meet their needs. The home has a clear complaint procedure and this is also displayed in the main hall, it is provided in large print for people to read easily. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 18 2 Relatives said they are always listened to and that small things are put right straight away. All 4 responses received from our surveys to people living at the home said that they knew who to speak to if they were unhappy or needed to complain. People said they knew who to speak to if they had any concerns or complaints but generally staff listened and acted on what they say. Staff have received some training from the manager on how to protect vulnerable people from abuse. The manager told us that further training is planned to ensure staff are fully aware of their role in protecting people. The policies and procedures available to staff on making safeguarding alerts are out of date and the manager was advised to obtain the up to date local procedures. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 19 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): 19-26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean pleasant and hygienic. EVIDENCE: Since the new owner registered with the commission in November 2007 major refurbishment has taken place and is ongoing. There are 27 single ensuite bedrooms and 4 single only. The dementia unit is separated via a locked door and is fully equipped with lounge, conservatory, and enclosed garden. Some single rooms are not occupied whilst major upgrade is taking place. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 20 The home is clean and pleasant with light airy lounges and level access to grounds. There is a passenger lift close to the dining room entrance and a disabled toilet facility just outside of the lounge and dining room. Four people responded to our surveys and said that their room was always fresh and clean, one said they like the alterations that have been done and that their room was warm and clean. There is a separate smoking lounge, but the manager has not ensured that this is compliant with the Regulations and was advised to ensure she contacted the local council about this. We saw a copy of the environmental report following the inspection of the premises on 08/04/08, which reported good standards and made no recommendations for improvement. The manager ensures that staff are trained in safe infection control procedures and staff files confirmed that they have received training in February 2008. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 21 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): 27-28-29-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are in safe hands and protected by the home’s recruitment practices. EVIDENCE: We examined 3 staff files which showed us there is a good recruitment procedure that is followed in practice and recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff receive induction training that meet the National Minimum Standards, ensuring that people are trained in their role. Staff records of training show that there are shortfalls in National training targets but the manager told us about this in the AQAA showing she is aware that there are some gaps in the training programme and plans to deal with this. The number of staff on duty in the afternoon does not allow sufficient cover in the Dementia unit. The manager said that she has appointed more care staff and they are due to commence work next week, which will improve the Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 22 numbers. Staff and residents spoken with felt there was sufficient numbers of people on duty. All 4 respondents to our surveys felt there was always or usually staff available to meet their needs. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 23 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): 31-33-35-38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is working hard developing the service but the management of fire safety does not ensure people are safe. EVIDENCE: The manager is registered with the commission and continues to update her skills. She is presently doing a distance-learning course in Dementia Care. 2 relatives, 3 staff and 5 residents all spoke well of the manager, found her approachable and organised and listened to what they say. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 24 The manager has developed a questionnaire that she intends to send out to people living at the home to obtain their views of the service provided which will inform any improvements to the way the home is run. More work is needed to ensure that the practices of the home are suitably monitored to ensure that any changes in legislation are suitably implemented to ensure that the outcomes for people are good. The AQAA contains clear, relevant information and lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. The homes statement of purpose tells people that there are regular meetings between residents, relatives and staff, however these are not currently being held. People manage their own money where possible; the manager said she is not the appointee for people at the home. Only small cash floats are held securely if desired and each person has suitable accounting procedures in place. Fire alarms and equipment checks are done weekly. A hoist blocked the ground floor fire exit on the corridor on the Dementia wing and staff told me they had been allowed to place the hoist there to prevent people exiting via this door. The manager moved the obstruction and ensured that the exit was accessible. Staff training in first aid required updating but the manager was planning this within the staff training matrix. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 25 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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 OP3 Regulation 14(2)(b) Requirement Make sure that people who are admitted for respite care have a suitable up to date care plan written up that reflects their current needs to ensure their health and wellbeing. Make sure that people are assessed for any risk of falling and that this is reviewed monthly, recorded within a plan of care that reflects any changing need and objectives for managing the risk. Make sure that people are assessed for any risk of them developing pressure sores, and any nutritional risk, review these assessments each month and use the information to inform a plan of care that sets out how the staff are to manage the risks. Make sure that staff are trained in the prevention of abuse and that policies and procedures reflect current local guidance on how to manage any suspicion or allegation of abuse. Make sure that there are DS0000070949.V369914.R01.S.doc Timescale for action 30/08/08 2. OP7 13(c) 30/08/08 3. OP8 15(1) 15 (2) (b) 30/08/08 4. OP18 13(6) 30/10/08 5. OP27 18(1)(a) 30/08/08 Page 27 Avondale Residential Home Version 5.2 6. OP38 23(4)(b) sufficient numbers of staff on duty to meet the needs of the people accommodated. Make sure that fire exits are not obstructed in order that they provide adequate means of escape. 07/08/08 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 3 4 Refer to Standard OP3 OP19 OP33 OP33 Good Practice Recommendations Make sure that records for people who are admitted for frequent respite stays have clear information on the dates of each new admission and discharge. Make sure that the smoking lounge is compliant with the Smoke-free (Premises and Enforcement) Regulations 2006. Develop ways of auditing the practices in the home for the number of falls and accidents to ensure that practices are suitable to manage any risk to the people accommodated. Commence meetings for people at the home enabling them to have a say in how the home is run. Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Avondale Residential Home DS0000070949.V369914.R01.S.doc Version 5.2 Page 29 - 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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