Inspection on 10/10/08 for The Adelaide

This inspection was carried out on 10th October 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Adelaide 12/10/06

The Adelaide 30/11/05

The Adelaide 17/06/05

The Adelaide 20/01/05

The Adelaide 15/07/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Adelaide Adelaide Place Ryde Isle of Wight PO33 3DQ     The quality rating for this care home is:   three star excellent 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: Nick Morrison     Date: 1 0 1 0 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Adelaide Adelaide Place Ryde Isle of Wight PO33 3DQ 01983568621 01983568622 susan.gibbs@iow.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Gibbs Type of registration: Number of places registered: Isle of Wight Council care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 3 persons between and including the ages of 50 to 65 years may be admitted for intermediate care. Date of last inspection Brief description of the care home The Adelaide is a Local Authority owned, purpose built, two storey resource centre situated in a pleasant residential area of Ryde, close to local shops and buses. The complex includes sheltered housing, day care services and residential intermediate care, with facilities for respite and rehabilitation. The Commission regulates and inspects the intermediate care unit, which is registered to provide care and accommodation for up to 24 older people. The home may also accommodate up to 3 people over the age of 50 years. The home offers single room accommodation for residents on both levels, with a large passenger lift to the first floor. There are parking Care Homes for Older People Page 4 of 25 0 0 0 Over 65 5 24 2 Brief description of the care home spaces at the front of the building and level access into the home. Weekly fees range from £69.55 to £319.13. The manager states that a copy of the homes service users guide is provided to all prospective residents, or their representatives where applicable, copies of which can be found in all bedrooms. Care Homes for Older People Page 5 of 25 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: three star excellent 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 represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 10th October 2008 and lasted six hours. During this time we toured the premises, looked at five service users files and met with five people staying at the service. We also met with the Manager and spoke with four other members of staff. All records and relevant documentation referred to in the report were seen on the day of inspection visit. We have also referred to the Providers Annual Quality Assurance Assessment (AQAA). Care Homes for Older People Page 6 of 25 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 7 of 25 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 8 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs assessed prior to using the service and are given clear information about the service. Evidence: All referrals to the service are through Care Managers and a care management assessment is required for each person prior to them using the service. In addition to this the service undertakes its own detailed assessment in the first few days of the person using the service. Many people use the service on a regular basis, but referrals and assessments are completed on each occasion and there is no assumption that peoples needs have remained the same as they were previously. At the beginning of each admission a member of staff goes through a list of the facilities and options with the service user, this includes individual informaton such as how much, if any, checking the person requires during the night and whether or not they require a newspaper in the morning. In each room there is a bedroom brochure which gives the Care Homes for Older People Page 9 of 25 Evidence: service user information about the service and the facilities. It contains informaton on how to make external calls, use of the heating controls, use of the call system, activities, laundry and all other aspects of using the service. In addition to this informtion, a member of staff goes through a list of information about the service and facilities and personal preferences with each person on admission. The admission process emphasises the homes hotel model of service. The process of using the service is similar to checking into a hotel, with the addition of an assessment of personal care needs. Care Homes for Older People Page 10 of 25 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. Service users benefit from having clear care plans in place and from having their needs met. They are also protected by the services medication policies and practices. Evidence: During the first twenty-four hours of a persons stay care is provided on the basis of the referral information and the information gathered at the time the person enters the service. The service does not rely on previous assessments and care plans for the person because it is accepted that peoples needs and preferences may have changed since the last time they used the service. The information gathered in the first twentyfour hours is then used, along with the referral information, to develop a formal care plan which is agreed with the service user. Care plans identify needs and how they should be met and also contain information about the persons preferences such as whether they want a newspaper each morning and how they prefer to be addressed. Care plans are recorded against on each shift and each time care is provided. This information is used in staff handover meetings so that the staff coming onto a shift are aware of which people are staying at the home and what their needs are. Where risks Care Homes for Older People Page 11 of 25 Evidence: are identified there are formal risk assessments in place designed to minimise risk and these are kept in the folder with the care plans and referred to in the care plans. Staff spoken with during the inspection visit were aware of the care plan for each person staying at the service and service users spoken with were aware of their own care plans. Health needs are identified in care plans and the service liaises closely with District Nurses and the service users own GP to ensure that health needs are met. Medication is well-managed in the service. People staying there can retain and administer their own medication, subject to an assessment of the risk involved. All service users have locked drawers in their rooms where medication can be stored safely. For those people administering their own medication the service assesses whether or not they require any support, such as staff reminding them or checking that they have had their medication. For other people medication is kept and administered by staff at the service. All staff involved in administering medication have received appropriate training and the medication is stored safely in a locked cabinet in the Assistant Managers office. This room is usually kept locked and there is often a member of the Management Team in the office. Some medication needed to be kept in a fridge in this office and, although there had been no incidents of medication falling into the wrong hands, we discussed with the Manager the need to purchase a lockable fridge so that there was no possibility of people in the future taking medication they did not need. Medication records were clear, up-to-date and accurate. There were records of all medication administered as well as information about all medication coming into and going out of the service. There was a system in place for auditing medication and records of audits were kept. All service users spoken with during the inspection felt that they were treated with dignity and respect while staying at the service. Observation of staff interaction with service users showed that staff were very skilled in ensuring that people were treated with respect throughout their stay and all staff spoken with demonstrated a commitment to this. We observed staff shutting doors and windows while they needed to discuss particular individuals, to ensure that they were not overheard. Care Homes for Older People Page 12 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a very sociable and stimulating atmosphere and are supported to maintain contact with their friends and family. The food in the home is very good and the service ensures that mealtimes are a very enjoyable time for service users. Evidence: Staff had received training in communicating with people who have dementia and were skilled in communicating with people living at the home. Service users methods of communication were recorded and there was close liaison with families over the needs, choices and wishes of each service user. Families confirmed that all the staff in the home were very good at communicating effectively with their relatives and that they were respectful of the choices they made. Observation of staff on the day of the inspection visit showed that they gave time and consideration to all service users and attempted to respond to their wishes at all times. They spent time listening to people and engaging them in conversations. The Manager had spent time over the year introducing newer and different activities to try to get service users involved. Emphasis was placed on activities that helped service Care Homes for Older People Page 13 of 25 Evidence: users to maintain both mental and physical skills and abilities. Current activities in the home included a wide range of number and word games such as scrabble and dominoes, ball therapy, reminiscence and a regular entertainer. All staff were required to be in the lounge with service users in the afternoons to ensure there was enough stimulation and support available for people to be involved in activities. The television in the lounge was not turned on during the day as it was thought that this would hinder peoples ability to socialise with each other. Each service user had their own television in their room and there were other, smaller lounges where televisions were available for people who wanted to use them. The home has no restrictions on visiting times and service users may receive visitors whenever it is convenient to them. Incoming telephone calls are put straight through to the service users room and they are able to make calls from their own room, for which they are invoiced at the end of their stay. Feedback from service suers about the food in the home was extremely positive. One service user asked us to be sure to mention in this report that the food in the home could not be better and that the cook was excellent. There were two sittings for lunch, one at twelve Oclock and the other at one Oclock. Breakfast was between eight and nine in the morning and tea was served between four thirty and six Oclock. Supper was served at eight Oclock. There was an eight week menu in place so that regular service users did not become bored with the options available. There were two hot choices for each meal and alternatives were made available for people who did not like either of them. The choices were written each day on the notice board in the entrance to the building. Food was served by staff and service users were able to have their meal in their own room or in the dining area. The dining area was laid out so that people could sit with friends or on their own. We observed that people came to the dining area at different times during the lunch period. They were welcomed by a member of staff and asked where they would prefer to sit. The member of staff then took their order and served their meal to them at their table. One service user was asked if she wanted to have meal as soon as she arrived or if she would prefer to wait for her friends to arrive before eating. Service users were able to have visitors at mealtimes, who were able to eat with them. The food we observed on the day of the inspection was of very good quality. Everyone was served individually and also asked what condiments they required on their table. There was also water and napkins on each table. When people had started their meal, staff came around and asked if everything was satisfactory. There was sufficient staff support available for anyone who needed assistance with eating. Staff ensured that the mealtime was a very enjoyable experience for people staying at the home. The atmosphere was more similar to that of a quiet restaurant than that of a care home. Care Homes for Older People Page 14 of 25 Care Homes for Older People Page 15 of 25 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. Service users benefit from a clear complaints policy and are protected by the services safeguarding policies and procedures. Evidence: The home has a clear and effective complaints policy in place. The policy is made available to service users and their families on admission and a copy is also available in the front entrance of the building. Service users and their families told us they were aware of the complaints policy and how to use it, but said they had never had to make a complaint. The home has a very positive attitude to complaints and actively encourages people to complain. However, there had been no complaints since the previous inspection. Discussion with staff and examination of training records showed that all staff had received training in adult protection issues and were aware of their responsibilities within the adult protection procedures. The manager was clear about the reporting procedures and had used them in the past to highlight concerns. Care Homes for Older People Page 16 of 25 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. Service users benefit from a clean and safe environment and facilities that ensure their stay is an enjoyable experience. Evidence: All parts of the building were kept very clean, but the home retained a homely and comfortable appearance. The furniture in the home was comfortable and of good quality and was maintained and replaced as necessary. On the day of the inspection visit carpets were being replaced in some areas of the building. The Provider ensured that items in the building were replaced as and when necessary. There was also a programme of routine maintenance and records were kept to demonstrate that maintenance issues were responded to swiftly. The home employs adequate numbers of domestic and maintenance staff to ensure the home is kept clean. The garden area was kept in very good repair so that service users were able to make use of it. There were comprehensive cleaning rotas in place, including one for cleaning the kitchen. Infection control procedures were in place and were posted in places throughout the building to ensure that staff were able to refer to them throughout their work. Feedback from service users and their families confirmed that they thought the home Care Homes for Older People Page 17 of 25 Evidence: was always kept clean and tidy. Care Homes for Older People Page 18 of 25 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. Service users benefit from being supported by adequate numbers and well trained and well supported staff. Evidence: Rotas showed that there were sufficient numbers of staff on duty throughout the week. The rotas corresponded to the staffing arrangements seen on the day of the inspection visit. In addition to care staff there were sufficient domestic staff and a Maintenance/Gardener person who works twenty five hours a week. Members of staff told us that that staffing numbers were good; one member of staff said, Staffing levels are always high, service users never seem to be rushed. Service users also told us the staffing numbers were good; one said, the home is well staffed and we get good and prompt attention. Employment records showed that the home had a very low turnover of staff and a Care Manager told us that providing consistency of care and consistency of staff was something the service does well. Each member of staff had a Learning and Development Plan in place that was linked to their ongoing support and supervision sessions. Training records showed that staff Care Homes for Older People Page 19 of 25 Evidence: receive regular and appropriate training. One member of staff told us there are always new training courses available and management will always try to accommodate our training needs. One the day of the inspection visit it was clear that staff were skilled in communicating with the people who live in the home and spent time talking to people and ensuring their needs were met. One relative told us staff provide reassurance with patience and understanding. Another said that what the home does well is to provide a warm friendly atmosphere, helpful staff, nothing is too much trouble. Examination of staff records demonstrated that the recruitment policy was followed and that all necessary pre-employment checks were undertaken prior to people beginning work in the home. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a safe and well managed service. The service is focused on the needs and views of service users and managed so that they have a comfortable and enjoyable experience while they are away from home. Evidence: The Manager is registered and has the skills, knowledge and experience to manage the service. All the feedback from service users, relatives, staff and the Care Manager about the Manager of the home was very positive. One member of staff told us the Manager of the home has time for everyone and has high standards. A relative described the management of the home as a good balance between efficiency and a relaxed atmosphere. Service users had their own bank account and there was a system in place for accounting for money held on services users behalf in the home. The system was thorough with regular checks taking place. Good records were kept of all transactions. Care Homes for Older People Page 21 of 25 Evidence: Records in the home showed that all staff fire training was up-to-date. Staff at the home confirmed this. Health and safety was well managed in the home. Comprehensive workplace risk assessments were in place and these were monitored and reviewed on a regular basis. The Manager was clear about health and safety legislation and specific regulations were accounted for within the homes health and safety policies. Procedures for safe working practices were posted around the building and were covered in staff induction training. Staff were clear about the need for ensuring the health and safety of themselves, their colleagues and service users in all the work they undertook. Any incidents or accidents were recorded clearly and these records were regularly reviewed to ensure that practices were changed where necessary. All staff received regular training and updates in health and safety issues. Substances hazardous to health were well managed and stored safely. Staff had received information in controlling these substances. The laundry area was very well equipped and well managed. The home has a quality assurance system in place based on the views of people living in the home as well as their relatives and other stakeholders such as healthcare professionals and Care Managers. The quality assurance process was linked to monthly monitoring by the Provider and the records seen demonstrated that identified issues were responded to very quickly and very effectively. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!