Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Deeside Alliston Way Southam Basingstoke Hampshire RG22 6SW 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: Peter McNeillie
Date: 2 6 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home
Name of care home: Address: Deeside Alliston Way Southam Basingstoke Hampshire RG22 6SW 01256323334 01256346042 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Anne Haydock Type of registration: Number of places registered: Hampshire County Council care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 33. The registered person may provide the following category of service only: Care home only (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 (OP) Dementia (DE) Date of last inspection Brief description of the care home Deeside is purpose built care home owned and managed by Hampshire County Council and is registered to provide care and accommodation for 33 persons who are at least 65 years of age some of whom may have dementia. The home is situated in a residential area of Basingstoke close to local shops and public transport with easy access to Basingstoke town centre and the M3 motorway. Accommodation is arranged Care Homes for Older People
Page 4 of 26 Over 65 0 33 33 0 Brief description of the care home on four wings, each with its own lounge and dining area. Disabled residents are able to access all areas of the home and garden through the use of ramps and lifts. Care Homes for Older People Page 5 of 26 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: This report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, previous reports, sampling residents records, staff training and recruitment records responses by residents, residents relatives,staff and health care professionals to a pre inspection CSCI satisfaction survey, responses to an in house satisfaction surveys and talking with residents, staff and visiting health care professionals. We also considered information provided by the manager in a pre inspection Annual Quality Assurance Assessment. (AQAA). During this inspection which took place on 17/09/08 between the hours of 9.00 am and 2.20 pm all of the key standards for older persons and any previous requirements were Care Homes for Older People
Page 6 of 26 inspected. The results and findings contained in this report will determine the frequency and type of future inspections. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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. The home has a system of assessing and identifying residents needs which ensures residents safety and that their assessed needs can be met. Intermediate care is not provided so this standard does not apply. Evidence: We were informed that that residents were only admitted in accordance with corporate pre admission policy that requires a detailed written assessment of need and risk being carried out by a member of the homes management team in consultation with the prospective resident. A Sample of four residents pre admission assessments chosen at random were viewed. These were produced in accordance with the policy and procedure previously mentioned and took into consideration residents care, nutritional and communication needs, wishes, choices,aspirations as well as any present or potential risks.
Care Homes for Older People Page 10 of 26 Evidence: As part of the admission process management also liaise with external health and social care professionals regarding any care needs, risks, equipment and aids, that need to be considered and included when developing a plan of care. Records also confirmed ongoing assessments of need and risk for all residents are carried out on a regular basis and care plans (Section 7-11 of this report refers) updated to reflect any changes. Respite care is not available in the home so this standard does not apply. Care Homes for Older People Page 11 of 26 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. The home has a well-developed system of planning and reviewing care, which reflects residents, wishes, and aspirations and ensures residents needs are met within a risk management policy involves residents and residents representatives or relatives in decisions that affect them. A previous requirement has been complied with Evidence: As part of our inspection plan, we viewed a random sample of four residents care plans chosen at random. All of the care plans which were reviewed at least monthly were based on pre admission assessments to identify what help and support individuals needed and any attendant risks. (The previous section of this report; standards 1-6 refers). Some residents verbally confirmed they were consulted about and participated in the production of the plan, others could not remember. Records seen confirmed this. Care Homes for Older People Page 12 of 26 Evidence: All of the residents spoken with residents responses to our pre inspection satisfaction survey confirmed they were very satisfied with the care and support they received. They advised us they were contented, liked the staff and management and were treated with respect. They felt wanted and would recommend the home to anyone. Individual residents and visiting relatives responses to our questions about how they were cared for, liked living in the home and the quality of the service included comments such as Its lovelyy here I am very happy, No complaints , Care is very good The staff are very kind and look after us all very well Hotel service A1 Resident also confirmed that their individual privacy was respected and that staff always knock on their bedroom door and wait before entering, a practice we observed during this visit. Residents right, and the opportunity to take risks is seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. This process identified individual risks and how they were to be managed. Staff who had a good understanding of the contents of the care plans and risk assessments and were able to explain how the care plan was put into day-to-day practice a view confirmed by a visiting health care professional who added they are allways kept well informed and contacted in good time when residents need them. Further confirmation of the above views was given by visiting professionals in their responses to our pre inspection satisfaction survey. Residents informed us were able to see the doctor of their choice (Currently approxiamatly forty plus doctors from six local practices visit) or any other health and social care professional when they needed to. The records viewed indicated that apart from doctors, district nurses, physiotherapists, occupational therapists, other specialists had been consulted when required. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice and treatment given. In response to our questions relation to equality and diversity, in there AQAA completerd by the manager we were told: We do the following to ensure that race, gender identity, disability, sexual orientation, age, religion and belief are promoted and incorporated into what we do: Corporate
Care Homes for Older People Page 13 of 26 Evidence: Equality Policyhttp:/www3.hants.gov.uk/adult-services/aboutas/departmentalprocedures-main/adults-procedures.htm - information available to the public also available in hard copy from Adult Services offices.http:/intranet.hants.gov.uk/adultservices/equalities-2.htm - information for HCC staff.Residential, Nursing and Day Care Practice Manual V.2/3http:/intranet.hants.gov.uk/adult-services/procedurespolices.htmWe apply these policies for both residents and staff in this home, including in our recruitment programme. The Corporate Equalities Officer, informed by legislation, research and stakeholder consultation, regularly updates this policy.We will undertake a Race & Equality Impact assessment where the need is identified, as a systematic way of finding out whether an existing or proposed policy or strategy of our service will affect different groups differently. In this way we are able to challenge and eradicate any residual institutional discrimination in this home, and ensure that policies, services and strategies do not, and will not, impact in a discriminatory way. (link http:/intranet.hants.gov.uk/equality/impact.htm) We ensure that specific cultural and religious needs are incorporated in our care planning.Residential, Nursing and Day Care Practice Manual V.2/3http:/intranet.hants.gov.uk/adultservices/procedures-polices.htmWe actively encourage the involvement of carers, family, friends and community groups in the daily life of the residents.We are able to provide specific issue training for our staff where necessary, and when possible we prefer to undertake this in liaison with the community. All medication which is dispensed by a pharmacist into a blister packsis securely stored and administered in accordance with a medication policy and procedure by staff all of whom have received training in the administration, recording and the security required when handling residents drugs and medication. All staff handling medication told us they were aware of and had read the procedure. The record of drugs and medicines administered to residents and unwanted drugs disposed of were complete and accurate. A procedure was in place to enable residents who whish to assume responsibility for their own medication. At the time of the inspection two residents were managing their own medication in accordance with a risk assessment. Care Homes for Older People Page 14 of 26 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. Family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: An in house activities organizer is available to ensure a good variety of suitable selection of in house and community based activities was available. Since the last inspection a large room has become available for activities due to a day center moving out. In house activities on offer include, quizzes, discussion groups, library, keep fit, arts and crafts, cake decorating, musical therapy, bingo, visiting enterntainers and reminiscence in which staff had bee trained. The residents also enjoy a number of community activities, theaters, shopping, visits to garden centres and general sight seeing trips. Residents expressed how important the activities were and how much they enjoyed them. All confirmed that participation was up to the individual; no one was forced to join in. Care Homes for Older People Page 15 of 26 Evidence: In discussion we highlighted the need to ensure that activities on offer were suitable for all residents especially those with dementia. A verbal undertaking was given to consult with the local Alzheimers society to seek their advice to ensure that the needs of residents with dementia were also being addressed. Residents spoken with informed us they were fully consulted and were able to exercise choice in all aspects of their lives for example; when to get up and go to bed, mealtimes and where meals are taken, visiting times, the right to receive and converse with visitors and to make and receive telephone calls in private in compliance with a previous requirement. The quality, quantity, presentation and choice of food served came in for particular praise from the residents. A written daily menu based on resident’s likes and dislikes was displayed.We highlighted the need to ensure that the menu was displayed in format that all residents would understand. This is of prime importance for persons with dementia who may find the addition of pictures would be beneficial to understanding the daily menu and when making choices. A verbal undertaking was given that the home would look into the way menus were displayed in future. We observed residents taking their mid day meal. This was conducted in a relaxed unhurried manner with staff available to give any resident assistance should they require it. Residents informed us meals could be taken in their own rooms if they wished. Tea and coffee were available to residents and visitors at all times as was water and fruit squash. We observed staff encouraging residents to drink flids to ensure they did not become de hydrated. Care Homes for Older People Page 16 of 26 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. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. The home has clear policies and procedures in place which ensures residents are protected from abuse. Evidence: A corporate Hampshire County Council Adult Protection policy/procedure designed to Safeguard vulnerable residents from abuse was available as were records to confirm all staff had received training. Records viewed, management and staff spoken with confirmed they had received training in recognising abuse and demonstrated they knew what to do should they witness or suspect the abuse of any resident. The homes complaints procedure was which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection was seen as was a record of complaints. Residents spoken to stated they felt comfortable in discussing any concerns they had with the homes management and confident any matters raised would be dealt with fairly and promptly. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: All areas of the home were clean and free from unpleasant odours and obvious hazards. Residents confirmed the home is always clean and smells fresh. Those responsible for the level of hygeine in such a large building used by so many people are to be congratulated. Whilst generally the home is maintained to a hight standard we did notice a few tiles missing off the wall in the kitchen resulting in a possible hazzard to health. We were informed this matter has been brought to the attention of those responsible for the maintenance of the home. As this matter is in hand, no requirement will be made on this occassion but we would expect the matter to be resolved as soon as possible and any potential hazard eliminated. Furniture was comfortable, homely and in a good state of repair, in keeping with the decor and met residents individual and collective needs. All communal areas were accessible by residents including the well-tended established
Care Homes for Older People Page 18 of 26 Evidence: and safe garden. A number of plans are in hand to improve the envirromnent apart from normal day to day maintenance,theres include,making external garden areas more secure,the provision of a sensory garden and refurbishing the current activities room. We were informed any new furnishings and decorations will take into consideration the particular environmental needs of persons with dementia. Care Homes for Older People Page 19 of 26 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. Residents needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The planned daily staffing levels for the home each day is: 7am - 2pm: Duty Manager, five carers plus a cook,kitchen assistant, 4 cleaners, 2 laundry assistants and an administrator. 2pm - 10 pm, Duty Manager plus four carers,10pm to 7 am three waking night carers plus on call emergency arrangements. The daily staff rota confirmed these staffing levels. At the time of our visit, in our view, the number of management, care and support staff available met residents needs, a view supported by the manager, staff and residents who informed us there were always enough staff on duty and they rarely had to wait for attention. We viewed three staff recruitment and training files selected at random. All files viewed included evidence that staff are employed in accordance with a robust corporate recruitment, equal opportunities and selection procedure, which is designed to protect residents. Care Homes for Older People Page 20 of 26 Evidence: This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Due to the absence of the manager we were not able to view staff pre employment references or evidence of CRB checks as these had been locked away separatley due to there confidential nature. Before the inspection was concluded the manger became available and we were able to confirm the existance of the missing information. We highlighted the need to ensure the information above was available at all times and confirmedin the case of CRB reports the number of the report would be sufficient for the purposes of checking. Following their appointment, records viewed confirmed that all staff are subject to an in house induction and compulsory training programme that include first aid, handling medication, food handling, moving and handling, POVA, infection control and dementia. All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided by the Registered Manager in the AQAA indicated that Currently 77.8 of staff has been trained to at least NVQ level two. Additional training is available to all staff and can be accessed via a corporate training programme. Care Homes for Older People Page 21 of 26 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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents, whose views about living in the home are formally sought. Evidence: The registered manager who has experience of managing resources for older persons for many years. Apart from her experience the manager holds a registered managers and NVQ level four qualifications in social care and a City and Guilds award in management. In talking with staff we were satisfied that the home has a clearly defined management structure, staff were aware all of their responsibilities and the limits of their authority.
Care Homes for Older People Page 22 of 26 Evidence: They described the management both internal and external as supportive, approachable and accessible and willing to listen to any ideas they may have for the improvement of the service. As part of the homes quality monitoring system, residents and residents relatives/representatives and staff are invited to participate in satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. Currently visiting health and social care professionals are not asked for their views. A verbal undertaking was given that this deficiency will be highlighted and discussed with external managers with a view to having the scope of the surveys enlarged to capture the views of this most important group. A sample of records and cash held by the manager on behalf of residents was checked. Receipts were available and the cash balances held reconciled with the records seen. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health/ safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents, procedures to follow in the event of fire (including evacuation). We were informed that all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered to prevent a resident or staff being burnt.. The issue of infection control was discussed at length especially the availability of disinfectant gel for staff. Whilst supplies were available at certain areas in the home these supplies were spread around and not always convenient for staff who should ideally carry personal supplies. A verbal undertaking was given to review the current procedures. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: 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 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 © (2008) 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 26 of 26 - 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!