Care Home: Ailwyn Hall Care Home

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What the care home does well The service provides residents living in the home with a homely and relaxed environment, and a good level of care and support. An enthusiastic staff team is available to help meet the needs of the residents living in the home, which are identified and detailed in pre admission assessments and individual care plans, and some of these were examined during our visit. A wide variety of activities are available to people living in the home including games, entertainment and trips out. A good choice and variety of food is available, and homemade cakes always available, and residents can choose whether they want some of their meals in their own rooms. A visiting family member told us that the care was excellent, nothing is ever to much trouble, and that she can leave her mother without having to worry. We were told by some of the residents that the food was fantastic, that it was absolutely wonderful and that they had nothing to worry about. What has improved since the last inspection? Since our last visits, some redecoration has taken place and a new kitchen installed, but no major changes have been made. Some of the homes documentation has been revised including resident contracts and life history books and the service now has the use of a minibus. What the care home could do better: The service needs some refurbishment both inside and out, although on the day of our visit work was underway in the garden to create a safe area for residents to spend time in, and new carpets are on order. The lounge areas are to be refurbished shortly, which will improve the comfort of the residents. The service needs to ensure that documentation in the home is up to date, that individual care plans show how the resident or family member have contributed to them, and staff records need to be better organised. This will ensure that people living in the home can be confident that suitable staff are employed and able to meet their identified needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ailwyn Hall Care Home Berry`s Lane Honingham Norwich Norfolk NR9 5AY     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: Alan Buttery     Date: 2 4 0 7 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 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Ailwyn Hall Care Home Berry`s Lane Honingham Norwich Norfolk NR9 5AY 01603880624 Telephone number: Fax number: Email address: Provider web address: info@ashleycaregroup.com Name of registered provider(s): Name of registered manager (if applicable) Gastank Ltd Type of registration: Number of places registered: care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category/ies of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Old age, not falling within any other category - Code OP Date of last inspection 39 0 Over 65 0 39 Care Homes for Older People Page 4 of 25 Brief description of the care home Ailwyn Hall is a care home providing personal care and accommodation for 39 older people, most of whom have dementia. The home comprises of two units Emily unit and Rosie unit. The home is owned by Gastank Ltd and the responsible individual is Ashley Oliver George. The home provides care and support to both privately and local authority funded residents The home is located in the village of Honingham. The home is close to the main A47 providing easy access to both Norwich and Dereham. The home has 30 single rooms, 19 of which are en suite and 4 double rooms, 2 of which are en suite. The home has a passenger lift. The home is set in a picturesque setting in its own grounds surrounded by mature trees and well maintained gardens. There is parking to the front and to the side of the property. The weekly fee at the time of writing the report is between £417 and £550 a week. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection, and during our visit, we looked at records held in the home including resident and staff records, and discussed the support the service provides with the acting manager of the home. We also spoke to two staff members working on the day of our visit and to three of the residents of the home, and we have included some of their views within the report. Prior to our visit, the service completed our Annual Quality Assurance assessment (AQAA) and information from this is also contained in this report, together with comments received from resident and staff surveys that were sent to the service. 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. Care Homes for Older People Page 7 of 25 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 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place that ensure prospective residents have a full assessment of need carried out before they move into the home, which ensures that the prospective resident can be confident their needs can be met by the home. Evidence: During our visit, we discussed the admissions process with the manager of the service. Enquiries are logged when they first come in, and often followed by a visit either from the prospective resident, but often from family members looking for suitable homes for their relatives. If the enquiry progresses then the manager of the service would visit the prospective resident either at their home or in hospital, or sometimes in a previous care home. A detailed assessment would then be carried out, and information gathered from a number of sources including previous staff, family members, professionals involved in the persons care and GPs. Care Homes for Older People Page 10 of 25 Evidence: This information is used to form the initial care plans in readiness for the admission, and to ensure that any aids or adaptations that may be required are available. The format of the initial plans has changed slightly since our last visit to reflect the involvement of the resident. We looked at the assessment records for four people that had recently moved into the home, and spoke with three of these residents. The information on the files confirmed that procedures were being followed, and the people we spoke with told us how the manager had visited them and talked about what they needed staff to help them with. The assessment process is used to ensure that the needs of the person can be met by the home, and at times they have to turn down a prospective admission when this is not possible, and this happened shortly before our visit. A detailed brochure is given to prospective residents and families detailing the support and facilities available within the home. The service does not offer intermediate care. Care Homes for Older People Page 11 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. Individual plans show how the assessed needs of residents are met, and in a way suited to the person. Evidence: As already indicated, individual plans are prepared following the pre admission assessment and in readiness for new residents to move into the home. The plans are closely monitored over the first few days, to ensure that they do show how the persons needs should be met, and are then reviewed on a regular basis, at least once a month. As indicated earlier in the report, we looked at the individual files for four of the residents living in the home, from which the above detail was taken, and in addition looked at medication records for these people. We also spoke with staff working with these residents on the day of the inspection, Care Homes for Older People Page 12 of 25 Evidence: and to two of the residents whose files we looked at. During our visit, we observed staff interactions with the residents of the home, and the appropriate way they spoke with the people, and helped them at meal times. Staff appeared to have time to spend with the residents, and were not having to rush around, and the staff we spoke with felt that had enough time to carry out their duties. The new resident would be registered with the GP surgery close to the home, and the GP visits the home for routine matters every fortnight, although is of course available at other times. The surgery also provides district nurse support, and support is also available through the surgery from other health professionals including dietitians and continence advisors. The surgery has its own pharmacy, and provides medication to the home in blister packs for ease of administration. Senior staff are responsible for administering medication, and receive Medication management training either through Boots or Age Concern. Although procedures are in place to support anyone who was able to manage their own medication, the home do not currently have any residents who have chosen to do this. The individual records that were examined during our visit all included the required care plans, and these included evidence of recent reviews. However, no evidence was seen how the individual or their families were involved in the preparation of the care plans. Care Homes for Older People Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good range of individual and group activities are available so that people living in the home can choose how to spend their day. Evidence: A range of activities are available to people living in the home, and we discussed these with the manager of the service and with some of the residents. Activities include games, arts and crafts, exercise and music and movements sessions, manicures, magical memory sessions, and outside entertainment. Trips and outings are also arranged from time to time, and a garden party is currently being planned for later in the summer, once work on the gardens is completed. A monthly communion service is provided by the nearby church. During our visit, we spent some time observing one of the activity workers, who was sat with three of the residents, talking about their memories of their earlier life, and looking at old postcards. This appeared to be very beneficial for the ladies involved and generated considerable discussion. Care Homes for Older People Page 14 of 25 Evidence: Following the recruitment of a new cook shortly before our last inspection, the quality and choice of food has continued to improve, and this was confirmed by the residents we spoke to during our visit, who told us that the cook was fantastic. Staff talk to every resident during the morning, offering them a choice for their main meal, and during our visit we were able to observe a member of staff discussing this with the residents, and explaining the choices available for lunch that day. Nutritional assessments are carried out for everyone living in the home, and their weights checked at least monthly. Where necessary dietary supplements or special diets are provided, and at the time of our visit 3 of the people living in the home needed a soft diet. 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. Procedures are in place to deal appropriately with any concerns, complaints or allegations, and people living in the home know who to speak with if they have concerns. Evidence: The service has a complaints procedure in place, although this does need to be updated to ensure that it contains current contact information for the Care Quality Commission. A copy of the procedure is included within the service user guide, and residents that we spoke to were aware of who to speak to should they have concerns. Information provided within the AQAA indicated that the service have received 3 complaints in the past year, and that these have been dealt with in accordance with the procedures. Safeguarding procedures are in place, in accordance with the local authority policies. All staff receive initial safeguarding training within their induction, and an annual update session, and evidence of this was seen within the 4 staff files we examined during our visit. There have been no safeguarding issues since since our last inspection. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although clean and homely, the planned improvements need to be made as soon as possible to ensure that residents have the best environment possible to live in. Evidence: During our visit, we discussed with the manager the plans that are in place for updating the facilities available in the home. This will improve the facilities available to people living in the home, and ensure that the home meets their needs. Current facilities include lounge and dining areas, and sufficient toilets and bathrooms to meet the needs of people living in the home Over the past year, improvement work had largely been on hold, but the providers have now started a programme of improvement, and on the day we visited the home, evidence of the works being done in the garden to provide a safe and accessible area was seen, which will ensure that people are able to spend time in the garden, and are safe. This is particularly relevant to people with dementia. A new kitchen has been installed recently, and the front entrance redecorated. Further improvements that are planned include the refurbishment of the lounge areas with new carpets and redecoration, changes to the laundry facilities which at present Care Homes for Older People Page 17 of 25 Evidence: are very cramped, a new shower facility in the upstairs part of the home and creation of a sensory garden. On the day of our visit, the home was clean, although as acknowledged by the manager, there were unpleasant odours in parts of the home. This is being addressed, and new carpets were being measured for, which will alleviate the problem. 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. Recruitment procedures and staff training ensure that people living in the home are supported safely by staff. Evidence: During our visit, we discussed the staffing of the home with the manager and also met with two of the staff on duty on the day, and looked at their recruitment files, as well as the files of two other staff. Policies are in place to ensure that all the information required within the regulations is obtained, and we discussed this with both staff members, who had joined the home in the past year. They confirmed that they had both completed application forms and attended an interview, and also told us of the training they had already received which included Moving and handling, safeguarding, health and safety, dementia awareness, first aid and food hygiene. Evidence of this training was seen on the files we examined. The staff records are currently being checked and put into better order, and although most of the information was available on the files we looked at, one of the four files had only one reference. The manager was advised to obtain a second reference if possible. This was the only issue we found on the files examined. Care Homes for Older People Page 19 of 25 Evidence: The service is currently fully staffed, and operates with 6 care staff in the mornings (5 in the afternoon) together with an activity worker, domestic and cleaning staff, and at night there are 3 staff on duty. The staffing includes a Senior carer at all times. The current manager of the home has been very impressed with the staff team since she moved there in June, in particular how enthusiastic they are about training, and operate very well as a team. As previously indicated, staff had time to spend with the residents, and this was observed during our visit. Staff did not appear to be rushed, and the staff we spoke to during our visit were happy with the tasks they had to do. The residents we spoke to all felt that the staff did a good job, and were able to help them with any issues they had. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is currently well managed, and the interests of the residents placed at the fore. Health and safety procedures are in place to ensure that people can live and work in safety in the home. Evidence: The registered manager of the home left in June this year, and at the time of our visit, the service was managed by the manager of another local home owned by the providers, who is obviously very aware of the policies and procedures in place within the group. She holds the Registered managers award, and has a number of years of management experience. The proprietor visits the home on a regular basis, and a meting was scheduled for the week following our visit to resolve the long term management arrangements. The residents and staff that we spoke to were very happy with the manager, and her Care Homes for Older People Page 21 of 25 Evidence: way of working, although also saying how good the previous manager was. We discussed with the manager some of the changes planned, including the recruitment files, a revised complaints policy and environmental changes. Residents that we spoke with were happy with the way their views are taken into account, although the manager did advise us of improvements she plans to introduce including regular residents meetings and a newsletter. We were told by residents that we spoke to that the home that the home is absolutely wonderful the new manager is just as good as the old manager was the staff are very good, both the males and females they like to go out into the garden they have nothing to worry about, and know how to complain It was acknowledged that staff supervisions need to be on a more structured basis, as the previous manager had not held formal supervision on a regular basis, and this is something that will be addressed to ensure that all staff do receive regular supervision. The AQAA confirmed that all policies and procedures are up to date, and maintenance of equipment in the home is recorded properly. There is a maintenance man available to ensure any works required are done quickly. 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 1 2 3 7 18 19 Individual plans should show more clearly how the person contributed to their own plan. The service should ensure that all details within the complaints procedures are kept up to date. The service should ensure that the home is free from unpleasant odours, and worn carpeting is replaced. Care Homes for Older People Page 24 of 25 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 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. 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