CARE HOMES FOR OLDER PEOPLE
Aycliffe Burnhope Way Newton Aycliffe Durham DL5 7ER Lead Inspector
Bridgit Stockton Key Unannounced Inspection 6th March 2008 10:00 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 Aycliffe DS0000071022.V359971.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. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Aycliffe Address Burnhope Way Newton Aycliffe Durham DL5 7ER 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) 01325 307262 01325 307255 Southern Cross BC OpCo Ltd Mrs Heather Hardy Care Home 55 Category(ies) of Dementia (55), Old age, not falling within any registration, with number other category (55) of places Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person 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 to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 55 2. Dementia - Code DE, maximum number of places 55 The maximum number of service users who can be accommodated is: 55 N/a Date of last inspection Brief Description of the Service: Aycliffe Residential Care Home provides residential care services For up to thirty four older people who have dementia and up to twenty one older people who require personal care. Aycliffe Residential Care Home is situated in a quiet part of Newton Aycliffe and is conveniently located for access to all local amenities. The home is a twostorey building that is serviced by a passenger lift. All bedrooms have en suite facility. There is ample car parking space located at the front of the home and the gardens are safe and well kept. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Aycliffe Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent five hours at the home. . I was also accompanied on this visit by someone called an expert by experience who talked to the people who live at the home about what it is like to live at Aycliffe Care Home. Some of her finding and observations will also be included in the report. The manager also completed the home’s pre-inspection questionnaire. These questionnaires provide valuable information to help me form a judgement about the quality of service offered at Aycliffe Care Home. What the service does well:
The people we spoke to said they are happy with the care and support they receive. One person said ‘I am very happy living here, the staff are friendly, I am really enjoying myself ’. Another said that the staff are ‘lovely and very hard working’. Relatives of the people who live at Aycliffe Care Home commented that the ‘Staff are very kind’. Visitors talked to me during the inspection and spoke very highly of the manager and her team. One person said ‘ it’s a really difficult decision to make when choosing a care home. When we visited here, and saw how staff were with people we knew it was the right place, the staff are brilliant’. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. One person said ‘my family sorted this place out for me, and the manager came to see me in hospital. I am feel very comfortable and looked after’. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff or the manager if I have a problem’. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate.
Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 6 People looked very well cared for, the atmosphere was relaxed and calm. There was a good relationship between staff and people living at Aycliffe Care Home. People said they really enjoyed the activities that take place. There was some art and craft session taking place on the dementia unit and people were really enjoying themselves. People said they enjoyed the food they were given and said that there was a good choice. One person said ‘the meals are great, home cooking nothing to fancy’ There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Aycliffe DS0000071022.V359971.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 Aycliffe DS0000071022.V359971.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): 3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff visits the person at home or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. Relatives confirmed that visits take place before admission and the manger visited and assessed their relative before offering them a place at the home. The home does not provide intermediate care. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10 People who use the service experience good quality outcomes in this area. Good systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: I looked at four care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers. Most of the care plans have been rewritten and staff have been updated and trained in how to complete them in accordance with the new providers documentation. I found the plans to be comprehensive and well written. Careful and thoughtful strategies to address particular needs or problems were well documented and sensitively written. Staff showed a very good understanding of how people’s needs were to be met in a planned and risk assessed way. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse.
Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 10 During my visit I looked at how peoples medication was looked after by the staff at the home. Administration of medication is carried out properly and audited by the manager on a regular basis. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. People said that the ‘girls are kind’. Another person said ‘the staff in this home are always caring, helpful and competent. My father receives an excellent standard of care’ Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, &15 Quality in this outcome area is good The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. One person said ‘we can come and go when we please, I often go home with my family for an afternoon’ Some people were enjoying chatting with each other; some were listing to music. The activities coordinator really knows what people at the home enjoy doing. On the morning of the inspection she was busy on the dementia unit doing craft work. On the afternoon people downstairs were playing bingo, they were really enjoying this. Everyone said the food was good, and a choice of meals was offered. The expert by experience was asked to join the residents for lunch. She said the food was lovely, there was a good selection of vegetables and the portion size was good. She said that most people had the roast turkey and they all said how nice it was. If anyone needed extra supplements during the day, milkshakes and fruit smoothies were some of the things offered. One person
Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 12 said ‘I eat very well, I have no complaints about the food’. People could either have their meals in the communal dining area or else in the privacy of their bedrooms. The majority of people chose the communal facilities. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The staff team were clear and confident in the protection of vulnerable adult procedures. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People live in a safe, comfortable, well-maintained and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. The bedroom doors all have locks, and there is a lockable storage space in the rooms. This means that people can keep their belongings private and secure. The home is fresh, clean, comfortable and well maintained. Everyone who commented agreed that the home is always well kept. Staff have had training in controlling infections and there was plenty of disposable gloves and aprons for their use. The laundry facilities were clean and well organised.
Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 15 There were no outstanding requirements from the fire and rescue service inspections or from environmental health inspections. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 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 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 good. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home. I looked at a selection of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. Staff said they enjoyed the training they had been given and said they were encouraged by the manager to attend training sessions. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 good The home is safe and well managed and people who live and work at the home can contribute to the decision-making processes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the qualifications and the skills to manage the home effectively. Residents and relatives meetings are held, although I was told they are not very well attended. The home sends out questionnaires to relatives, in order to gain information about how people view the service and what improvements they would like to see. Relatives said the home was very well managed, they said the manager was ‘excellent’ The operational manager visits the home and carries out audits, to make sure the home is operating to company policy.
Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 18 I looked at the records held at the home regarding people’s personal allowance. All transactions are recorded correctly and receipts are kept. One person’s money was counted and matched the total on the record. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 X 3 Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 20 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 Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Aycliffe DS0000071022.V359971.R01.S.doc Version 5.2 Page 22 - 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!