Inspection on 20/04/06 for The Albany Nursing Home

This inspection was carried out on 20th April 2006.

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

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

Other inspections for this house

The Albany Nursing Home 24/02/09

The Albany Nursing Home 21/02/08

The Albany Nursing Home 15/02/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Albany Nursing Home 7 London Road Headington Oxford OX3 7SN Lead Inspector Philippa MacMahon Unannounced Inspection 20th April 2006 09:30 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 The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 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. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Albany Nursing Home Address 7 London Road Headington Oxford OX3 7SN 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) 01865 744444 01865 744485 albany@schealthcare.co.uk Trinity Care (Crown) Limited Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Terminally ill over 65 years of age (3) of places The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Condition 1 On admission persons should be aged 60 years and over Condition 2 The total number of persons that may be accommodated at any one times must not exceed 48. Condition 3 Eight beds are for the provision of intermediate care within a separate unit in the home. Condition 4 CSCI has agreed to the use of two rooms as double rooms within this unit due to the circumstances at the time of the commissioning of the unit by the local authority. Condition 5 Admission to the Intermediate Care Unit is for people aged 55 years and over. Condition 6 The Intermediate Care Unit is staffed separately from the rest of the home, with one registered nurse covering the hours of 8am to 6pm, and two care assistants from 7am to 8pm. Night cover is one care assistant, from 8pm to 7am, with support provided from the homes establishment. Condition 7 The home has two registered nurses on duty from 8am to 8pm each day. 15th February 2006 5. 6. 7. Date of last inspection Brief Description of the Service: The Albany Nursing Home is a purpose built home that is registered to care for 40 older people. It is situated in the Headington area of Oxford, close to shops and amenities. The Albany is part of Trinity Care (Crown) Limited (part of the Southern Cross Healthcare Group), which has a number of similar homes in Oxfordshire. Accommodation is on two floors, accessed by a lift or stairs, and all the bedrooms overlook the attractive gardens. There is a spacious conservatory that opens onto the gardens and a safe walkway through the garden for service users. The home provides a discrete six-bedded intermediate care unit with four single rooms and two large shared rooms, all with en-suite facilities. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 5 There is a sitting room with a kitchen area that is designed to enable the service users to build up confidence in being independent and safe before being discharged home. A further communal sitting room has been provided on the ground floor, which provides an opportunity for socialisation. The range of fees at this home are £518 per week to £913.08. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09:30 hours and was in the service for six hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The inspector, in carrying out this inspection, met with the registered manager and other staff on duty, both within the home and the intermediate care unit. The cook, handyman and activities co-ordinator were also spoken to. The inspector spent some time talking with residents and relatives, and joined a group of three residents for lunch in the dining room. A sample of care plans, staff files and other records required by regulation were examined. Two of the care plans examined by the inspector were followed through by meeting with the residents to see if the care needs identified were appropriate and being met. A tour of the building was made. What the service does well: The home is well managed and coping well with all the changes as the new company policies and procedures are being implemented. The Albany provides a comfortable home that is tastefully furnished and decorated throughout. Residents and relatives spoken to were very appreciative of the care provided and felt that the lifestyle within the home was appropriate for the people living there at the present time. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 7 The intermediate care unit is working very well and achieving the objective of maximising on regaining independence to enable the resident to return to his or her own home. 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 Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 8 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 The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are given most of the information they require and the service users’ guide is in draft form following an update since the company was taken over. It is good that all residents at the home have an assessment of their care needs prior to being admitted to the home. It is good that the intermediate care unit is achieving the aims of the unit and the people using the service are achieving independence and returning to their own homes in most cases. EVIDENCE: All new residents to the home are given a comprehensive brochure that outlines the service provided. The statement of purpose is a corporate document drawn up by Southern Cross and agreed with the Commission for Social Care Inspection, and then individualised by each home. The Albany is in the process of completing the process and a copy was shown to the inspector. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 10 Once this is completed all the residents and prospective residents will be provided with a copy. Southern Cross policies and procedures are in place in the home. The inspector examined a sample of care plans and found pre-admission assessments that reflected the residents care needs and these formed the basis of the care planning. The intermediate care unit was visited by the inspector who found that it is achieving its objectives of maximising individual’s independence and enabling them in returning home. One of the residents had just returned from a home visit as part of the plan to go home. The inspector spoke to the occupational therapist who is relatively new to the post and is enjoying the work very much. She said that she finds it difficult being part-time as this means that if a new person is admitted on a Friday, they will not have a programme of care until the following Tuesday. This issue is being addressed with the intermediate care team. The manager raised the issue of the home carrying out its own assessment of need for people on the intermediate care programme prior to them being admitted to the home. The intermediate care team has developed a single assessment protocol for people requiring intermediate care and feel that it is sufficient for the home to admit from that assessment. The manager feels that they should make their own assessment, using the intermediate care assessment, to ensure that they are able to meet the person’s needs as they staff the unit 24 hours a day and have a duty of care to those individuals, in ensuring that all their care needs are met. It is recommended that the manager should discuss this issue with her line manager and communicate the outcome to the intermediate care team. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Every resident has a care plan in which their assessed needs are identified and the action required to meet those needs. The care planning process is adequate but needs to be further developed. Residents are able to take responsibility for their own medication but a suitable risk assessment tool needs to be introduced to ensure the safety administration of the medicine. EVIDENCE: A sample of the care plans was examined and found to reflect the residents care needs and the action required to meet those needs. The care provided at the home is very much looking at the physical and mental needs of the residents and little reference is made to the individual’s special interests, hobbies and previous lifestyle. It is recommended that the individual resident’s care plans should reflect their lifestyle and special interests, and how these are going to be met. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 12 None of the care plans examined had had a recent review and, in one case, a resident had been weighed on 2nd November 2004 and not since, and in the daily record showed difficulty with eating. It is a requirement that all the care plans must be reviewed regularly and any changes communicated to the resident or their relative. The residents spoken to were well cared for and very appreciative of the care provided. They said that they were always treated with dignity and respect and were very comfortable living in the home. The medication systems both in the home and the intermediate care unit were examined and found to be in good order. The residents on the intermediate care unit are shown a few days prior to discharge what they will be required to do in relation to their medication on returning home. No risk assessments are made of the individual’s ability to be responsible for taking their medication. It is recommended that the registered manager should implement a risk assessment tool for residents who wish to take responsibility for their own medication in the home. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities is adequate but requires more commitment from all the staff. The residents are provided with an adequate diet. Staff have a good appreciation of the issues of privacy and dignity and treat the residents with respect. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. EVIDENCE: The activities co-ordinator was spoken to and she is now keeping individual records of the activities the residents have taken part in. She sometimes finds it hard work to develop activities, as the staff do not appear to support what she is doing. A tea party was in the process of being planned for the Queen’s 80th birthday celebrations and there had been little encouragement from the staff. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 14 Residents spoken to liked the planned programme of activities which they could choose to take part in or not. Without exception they said what a wonderful person the activities co-ordinator was. One of the residents who had lived in the home for some time said that the home was very comfortable and provided a lifestyle that was appropriate to the care group. The inspector joined a group of four residents for lunch, and found that the way that the dining room had been laid out allowed each group of people to enjoy each other’s company without being intrusive. The residents spoken to really enjoyed the meals and mealtime and were appreciative of the choice of meal offered. The residents meals looked appealing and were served in an appropriate manner by the staff. The meal the inspector chose was a salad, clearly not a choice often asked for, and the meal was rather basic. Staff were observed to assist the residents in a kindly and appropriate manner, and clearly understood issues of privacy and dignity, such as knocking on doors before entering a resident’s room. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good complaints system in place that is accessible to the residents and relatives. Every effort is made to protect the residents from any abuse. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. EVIDENCE: A copy of the complaints system is displayed in the entrance hall and is in the service users’ guide that is in the process of being completed. All staff are given training in the protection of vulnerable adults and staff spoken to showed that they had a clear understanding of this important aspect of care. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is cleaned and maintained to a high standard. The furnishings and décor are in good order throughout the home. EVIDENCE: The inspector toured the building and found all areas to be clean and orderly. Staff raised a concern that the ambient temperature of the home was so high that they felt ill whilst going about their work. The inspector recorded a temperature of 27ºC in the manager’s office, and noted a room thermometer recording 30ºC in one of the residents rooms. The manager was informed and she raised it with the estate’s manager. Immediately post-inspection the manager informed the inspector that the thermostat on the boiler had been adjusted and that the temperature levels are now correct. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient numbers and skill mix of staff to enable the care needs of the residents to be met. However, this provision is only adequate, as there is a need for a deputy manager to support the registered manager. The recruitment policies and procedures are good , and the provision of staff training adequate. EVIDENCE: Staff rosters were examined and showed that sufficient staff are on duty on each shift. The manager does not have any hours to carry out her management duties at the present time, as she does not have a deputy. It is hoped to appoint to this position in the near future. Staff records were examined and showed that correct recruitment procedures are in place. Evidence of training taken place was also found on the staff individual files. The company is committed to training and development and a training matrix has been developed to readily show what skills are available and where further development needs are to be made. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed with evidence of good teamwork and every effort is made to protect the residents health, safety and wellbeing, and any financial interest. EVIDENCE: The manager has recently successfully completed the Commission for Social Care Inspection fit person process and is now the registered manager for the home. There is clear evidence of good teamwork, and the registered manager has a clear understanding and working knowledge of the day-to-day operation of the home. The registered manager is undertaking the Registered Managers Award and is nearing completion of this. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 19 Southern Cross has quality assurance systems in place,and these are being implemented but are still in the early stages. Residents finances are dealt with centrally. Individual “pockets” are kept with the residents’ money, and all receipts are kept of any transactions made. The registered manager regularly audits these. Records required by regulation were examined and found to be up to date and complete. The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 X 2 X 3 X X 3 The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2)(b) Requirement It is a requirement that all care plans must be reviewed regularly and any changes communicated to the resident or their relative. Timescale for action 18/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP6 Good Practice Recommendations It is recommended that the manager should discuss the issue of the pre-admission assessment for people requiring intermediate care with her line manager and communicate the outcome to the intermediate care team. It is recommended that individual resident’s care plans should reflect their lifestyle and special interests, and how these are going to be met. 2. OP8 The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House Cascade Way Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Albany Nursing Home DS0000065923.V290291.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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