Care Home: Addison Court Nursing Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well People who use the service were treated with respect and personal care was carried in private. One person said, "Staff are brilliant, they will do anything for you." Another person said, "The staff are lovely and good to get on with. You can get up and go to bed when you want." One person stated in the survey that they were glad to be at Addison Court. A district nurse visiting the home and said, " The care is excellent, they draw my attention to any problems. The staff are friendly and have a good rapport with people living at the home." Training for all members of staff was actively encouraged. More than half of the care workers had National Vocational Qualifications in health and social care at level 2 or above. Five members of staff completed the survey and all of them stated that they were given training which kept them up to date and enabled them to meet the individual needs of people using the service. All the people asked said the daily routine was flexible. One person said, "You can get up and go to bed when you want and choose what to do." What has improved since the last inspection? Most of the requirements made at the last key inspection of 28 April 2008 had been addressed by the time of the random inspection of 6 October 2008. The following action has been taken to comply with the requirements made at the random inspection. The locks to the toilet door on the first floor Baxenden unit and the shower room have been replaced. Locks have also been fitted to all the ground floor bedroom doors. This promotes privacy and dignity for people using the service. What the care home could do better: The amount of medication left over from the previous month should be recorded on the new medication administration record. This will ensure medication is managed correctly and also enable accurate checks to be made. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. The unpleasant odour in the bedroom on the top floor must be addressed. This will ensure the person using this room lives in a homely and comfortable environment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Addison Court Nursing Home Addison Street Accrington Lancashire BB5 6AG     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: Susan Hargreaves     Date: 2 1 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things 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 © (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Addison Court Nursing Home Addison Street Accrington Lancashire BB5 6AG 01254233821 01254393628 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Speciality Care (Addison Court) Ltd care home 50 Number of places (if applicable): Under 65 Over 65 0 50 dementia old age, not falling within any other category Additional conditions: 50 0 The registered person may provide the following category of service only. Care home with nursing - Code N to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; Dementia - Code DE. The maximum number of service users who can be accommodated is: 50. Date of last inspection Brief description of the care home Addison Court is a purpose built home situated in a small cul-de-sac in a mainly residential area. It is close to a number of shops and a church. The centre of Accrington is approximately 10 minutes walk away. The home has a small garden, which is accessible to residents who wish to sit outside when the weather permits. There is adequate parking for staff and visitors. Addison Court offers 24 hour nursing and personal care for up to 50 older people or people suffering from dementia. Accommodation is provided in single en-suite rooms. A passenger lift facilitates access to all areas of the home. The current fees charged at Care Homes for Older People Page 4 of 26 0 6 1 0 2 0 0 8 Brief description of the care home Addison Court are £385 - £675 per week. Additional charges are payable for private chiropody, hairdressing, toiletries and newspapers. A copy of the service user guide was available to prospective residents and their relatives on request. 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: A key or main unannounced inspection, which included a visit to the home, was conducted at Addison Court Nursing Home on 21 April 2009. As part of the inspection process we looked at all the information we have received about Addison Court since the last key inspection which took place on 28 April 2008. This included a random inspection on 6 October 2008 to monitor compliance with the requirements made at the last key inspection. Information about these inspections can be obtained from Addison Court Nursing Home or www.cqc.org.uk The manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some Care Homes for Older People Page 6 of 26 numerical information about the service. Six completed surveys were returned from people who use the service and five from members of staff. At the time of this visit thirty seven people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty, people who use the service and their visitors. Discussions also took place with the matron and the manager regarding issues raised during the inspection. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.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. A through admission procedure ensured the health and social care needs of people using the service were identified and met. Evidence: A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. These supply information about the care and facilities provided at the home. The manager or deputy manager visited people who were considering using the service in hospital or their own home before admission. The purpose of this visit is to assess the persons health and personal care needs to ensure they can be met at the home. We looked at the care records of four people using the service. Pre-admission assessments were seen in all four files. These assessments provided important information for the development of their care plans. Care Homes for Older People Page 10 of 26 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. People who use the service were cared for in a manner which promoted their privacy and dignity. Medication was managed safely. Evidence: We looked at the care plans of four people who use the service. These plans identified the health and social care needs of each person and provided clear directions for staff to follow to ensure their individual needs were met the way they preferred. The care plan for one person suffering from dementia advised members of staff to approach them in a friendly and smiling manner. Another care plan explained what staff needed to do in order to prevent the person from becoming agitated. It was clear from the daily report that these directions had been followed when one member of staff recorded that she had prevented agitation by taking this person to their room and reading to them. Appropriate risk assessments including ones for falls, nutrition and the development of Care Homes for Older People Page 12 of 26 Evidence: pressure sores were in place. Guidance for staff to follow about how to manage identified risks was also included in the care plans. A written report about the care given to each person using the service was written during each shift. This ensured that all staff had up to date information about the condition of each person to ensure continuity of their care. Care plans and risk assessments were reviewed monthly and usually updated when the needs of the person changed. However, in the evaluation section of some care plans staff had recorded a change in the persons condition which had not then been transferred to the care plan. The manager was advised to ensure that such information was included in the persons care plan so that members of staff had easy access to up to date information. Where possible the person using the service or their relatives were involved in care planning and signed the care plan to indicate their agreement with the care provided. There were records of the involvement of GPs and other healthcare professionals including the chiropodist, optician, psychiatrist and social workers in the care of people who use the service. Medication was stored correctly and administered by qualified nurses and care workers who had received training in the administration of medication. We looked at the records for the management of medication. These included a record of medication received into the home and a record of unused medication collected for disposal by a licensed waste carrier. We checked a sample of medication records and stock but found it difficult to account for for some medication. This was because the amount of medication left over from the previous month was not recorded on the new medication administration records. Keeping detailed and accurate records helps to prevent the mishandling of medication. One person was prescribed a tranquiliser to be given when required. However, there were no instructions for staff to follow about the signs of agitation this person might display when they needed this medication. Having clear written instructions for the administration of when required medication ensures people are given their medication only when they need it. We checked how controlled drugs were handled, these are medicines that can be misused. A special register was used for record keeping and was seen to have been completed correctly. Care Homes for Older People Page 13 of 26 Evidence: We looked at the records of how medication was checked by the manager. These were done every two months and involved checking all aspects of the management of medication. Members of staff were also assessed to ensure they followed correct procedure and handled medication safely. Personal care given in the privacy of the persons own room or the bathroom. Members of staff were observed attending to people in a polite and friendly manner. One person said, The staff are lovely and good to get on with. Five of the six people using the service who completed the survey answered yes to the question Do staff listen and act on what you say? Two members of staff explained in detail how they promoted privacy and dignity for people using the service and considered this to be an important part of their care. 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. Peoples choices were respected and they were supported by members of staff to have a fulfilling lifestyle. Meals were wholesome and appetising and people enjoyed them. Evidence: Discussion with people using the service and members of staff confirmed that a variety of activities were organised in the home. These included baking, watching films and television, listening to music, craft activities, pamper sessions, armchair exercises to music, reminiscence, gardening and playing dominoes. Outside entertainers visited the home every month and special occasions such as St Patricks day are celebrated. During the morning of this visit people on Baxenden unit were obviously enjoying listening to music. A care worker was encouraging to one person to clap to the music and another person was playing a hand held percussion instrument. Another person was doing a puzzle. The manager explained that they were encouraging people using the service to become involved in developing a therapeutic garden and a few people had visited a community garden and made hanging baskets. One member of staff said the activities organiser had taken two people out for a walk the previous day and she sometimes took people to the local workingmans club. However, four of the six people who completed the survey indicated that there were sometimes activities that they Care Homes for Older People Page 15 of 26 Evidence: could take part in, one usually and one always. One person said, I like it here we all have a sing song. Another person said they had planted sunflower seeds. Local clergy regularly visited the home and offered communion to people who wished to practice their faith in that way. People using the service and members of staff said that visitors were welcomed into the home at any time and offered refreshments. The daily routine was flexible in order to meet the needs and preferences of people using the service. All the people asked said they could choose when to get up and ago to bed. One care worker said, People can get up and go to bed when they want we always ask them. The meal served at lunchtime looked wholesome and appetising a choice was offered for both the main course and dessert. Blended meals were served with each item of food blended separately so people could identify the food and experience the individual flavours. Members of staff were observed sitting in the lounge on Baxenden unit and assisting people with feeding in a patient manner. All the people asked said the meals were good. 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. Complaints would be taken seriously and investigated. Members of staff had the training necessary to ensure people who use the service were protected from abuse. Evidence: A copy of the complaints procedure was displayed in the home and included in the statement of purpose and service user guide. Eight people who use the service completed a survey and four indicated that they knew how to make a complaint. The manager said no complaints had been made since in the last inspection. No complaints have been made directly to the Commission. Policies and procedures about the safeguarding of vulnerable adults were in place. Discussion with four members of staff confirmed that they had received training in safeguarding vulnerable adults. They all said they would report any concerns to the manager immediately. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provided a comfortable and homely environment for people who use the service. Evidence: A tour of the premises confirmed that the home was clean, tidy and generally well maintained. This provided a safe and comfortable place for people using the service to live. The six people who completed surveys indicated the home was always or usually clean and fresh. However, there was a strong unpleasant odour in one bedroom on the top floor of the home. An unpleasant odour does not promote the wellbeing of the person who uses this room. The manager explained that two bathrooms currently not in use were due to be refitted with assisted baths within the next few months. The shower room on the Baxenden unit also not used and the shower room on the ground floor were also going to be refitted. This will improve bathing facilities and provide more choice for people living at the home. People who use the service were encouraged to bring personal items for their bedrooms to make them more homely. These included ornaments, photographs and pictures for the walls. The grounds and gardens were well kept and accessible to people using the service if Care Homes for Older People Page 18 of 26 Evidence: they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitably equipped laundry room ensures clothes are washed promptly and returned to people using the service. Gloves and plastic aprons were available throughout the home for members of staff to use in order to protect themselves and people using the service from infection. 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. Members of staff are encouraged to acquire the skills and knowledge necessary in order to meet the needs of people who use the service. Recruitment procedures are thorough. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. Six people who use the service completed the survey and in answer to the question are staff available when you need them three stated always, two usually and one sometimes. We looked at the file of one member of staff appointed since the last inspection. This file indicated that all the required information had been obtained before this member of staff had started working at the home. These included two written references and a Criminal Records Bureau check. These checks ensure people who use the service are protected from the employment of unsuitable staff. Discussion with the manager and members of staff confirmed that training was actively encouraged. This included induction training for new employees, moving and handling, fire safety, safeguarding vulnerable adults, health and safety, basic food hygiene, dementia, managing challenging behaviour, management of medication and Care Homes for Older People Page 20 of 26 Evidence: first aid. In addition to this more than half of the care workers had National Vocational Qualifications at level 2 or above in health and social care. 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 home has a competent manager and the views of people using the service are considered when decisions about the care and facilities provided at the home are made. Evidence: The registered manager is a qualified nurse with experience of caring for older people. She is currently training for the Leadership and Management for Care Services Award. The manager also said that she had almost completed a training course in caring for people with a dementing illness at the University of Central Lancashire. Members of staff said the manager was approachable and supportive. One care worker said, Shes the best manager weve had. Discussion with the manager confirmed that she was committed to running in the home in the best interests of the people living there. The people using the service and their relatives were asked to give their views about the home by completing Care Homes for Older People Page 22 of 26 Evidence: satisfaction questionnaires. The last one was done in August last year and a chart was displayed explaining peoples responses, which were mainly positive. The manager explained how she held a weekly surgery so that the friends and relatives of people using the service could talk to her about any issues relating to the home and the care provided. Meetings for people using the service were held every two months to enable them to discuss any aspect of their life at the home. The manager had also started producing a monthly newsletter to help keep people up to date with news and events. The Annual Quality Assurance Assessment stated that as a result of listening to the views of people using the service the menus have been changed to include more choice and ensure peoples likes and dislikes are catered for. Several people using the service had a small amount of money kept at the home to pay for hairdressing, chiropody and other personal needs. To ensure this was managed safely records of all transactions were kept. We checked some of these during the visit and found them to be up to date and accurate. Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place to for people to live and work. Fire alarms were tested weekly and emergency lighting monthly. An up to date fire risk assessment was in place and fire drills took place regularly. We looked at records of the routine servicing of equipment. These included up to date electrical installation and gas safety certificates and evidence that the testing of small electrical appliances was carried out annually. 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 1 26 16 The unpleasant odour in the bedroom on the top floor must be addressed. This will ensure the person using this room lives in a homely and comfortable environment. 29/05/2009 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 1 9 The amount of medication left over from the previous month should be recorded on the new medication administration record. This will ensure medication is managed correctly and also enable accurate checks to be made. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. 2 9 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 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!