Care Home: Albert Residential Home

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What the care home does well This service offers the residents a home which is relaxed and supportive. The residents are able to engage with staff in a way the maximizes their potential. The residents are supported and encouraged to become part of the greater community. They are encouraged by staff to participate in a range of activities both within the home and the local community. The staff group are committed and understanding. The service has a good range of assessment documentation in place to ensure that they can effectively met the individual needs of each resident. The residents have care plans and risk assessments in place, and are supported by staff to engage in active and fulfilling lives. Physical and mental health care needs are effectively being met, in such a way as to promote residents independence. The arrangements for staffing are satisfactory. What has improved since the last inspection? A process of review has been undertaken on policies and procedure. Staff files have been reviewed and audited to ensure that they comply with current employment legislation. All recommendations and requirements from the previous inspection reports have been fully complied with. What the care home could do better: The service should ensure that all documentation, policies and procedures are introduced as and when they are reviewed or updated. The families and Representatives of the residents must be supplied with the a quality assurance questionnaire. The manager must review the safety and hygiene arrangements in the kitchen. Individual cabinets must be introduced for the safe storage of items in the toilet and bathroom. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Albert Residential Home 40 The Warren Worcester Park Surrey KT4 7DL     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: Kenneth Dunn     Date: 0 1 0 5 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 27 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 27 Information about the care home Name of care home: Address: Albert Residential Home 40 The Warren Worcester Park Surrey KT4 7DL 02083372265 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): corry328@hotmail.com Mr Kanwarjit Singh,Mrs N Singh The registered provider is responsible for running the service care home 3 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 3 The registered person may provide the following category of service only; Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Albert Residential Home is a small three bed home catering for the needs of older people. It is located in a residential area of Worcester Park and is close to local amenities. There is a purpose built ramp to the front of the property for good access and off street parking. Residents also have access to a garden to the rear of the property. The fees at the home start from #350 per week. 0 8 0 5 2 0 0 8 Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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: The inspection of this Care Home for Older People was an unannounced Key Inspection. Regulation Inspectors Mr Kenneth Dunn undertook the site visit. The registered manager was present during the site visit. The registered manager requested that the people living at the home prefer to be known as residents, therefore this term of reference is used throughout his report. The inspector looked at how well the service is doing in respect to the National Minimum Standards for Care Home for Older People. The site visit took into account detailed information provided by the registered provider/manager, and any information that th Commission for Quality Care has received about the service since the last inspection. In addition the service has submitted the Annual Quality Assurance Care Homes for Older People Page 6 of 27 Assessment prior to the inspection, some details of which have been added to the report. Documents sampled during the inspection included the home policies and procedures and certificates from professional organizations or contractors. The inspector would like to thank the registered provider and registered manager for their time, assistance and hospitality during this inspection. The quality rating for Albert Residential Home is two star. This means the people who use this service experience good quality outcomes. 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 Care Homes for Older People Page 8 of 27 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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. People who are thinking about moving into the home are given helpful information about what life is like there to help them decide if the home will be suitable for them. They can be confident their needs will be thoroughly assessed before a place is offered. Evidence: People who are considering moving into the home are given detailed information about what life is like there. The information is contained in the Statement of Purpose and Service User Guide both documents have been recently reviewed and updated, the most recent review was completed January 2009 . The documents are presented in a user friendly format with pictures to help people understand them. Copies of the service user guide are placed in each residents personal file. People who are thinking about moving into the home can be confident their needs will Care Homes for Older People Page 11 of 27 Evidence: be thoroughly assessed to ensure the home will be able to provide appropriate care and support for them. No new people have moved into the home since the last inspection. Admission procedures and other records show the home carries out a thorough assessment of need before anyone moves into the home to ensure their needs can be met. People are encouraged to visit the home wherever possible to meet staff and other residents so they can experience what life is like there before deciding to move in. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the service benefit from comprehensive care plans and detailed risk assessments in place, that ensure their needs are met. Evidence: As part of this site visit two care files were sampled for the purpose of case tracking. These provided evidence that care plans and risk assessments had been completed. The care plans are developed to ensure that the lifestyle and quality of life expectations of each individual is fully discussed and fully recorded. The care plans sampled included information in regard to physical health, personal care, social skills and leisure. The random sample of the care plans demonstrated that annual reviews had been undertaken by the service, with additional monthly reviews between residents and their key workers. The manager stated that some residents require support when making decisions, and risk assessments for certain activities are in place. Care Homes for Older People Page 13 of 27 Evidence: Risk assessments were evidenced in the care plans sampled, and had been reviewed on a regular basis. The arrangements in place to meet the health care needs of the residents are satisfactory. All the residents are registered with a local GP. The residents have access to a full remit of health care professionals to ensure that all the health needs are fully safeguarded. The home has medication policy in place and all staff who administer medication are familiar with this policy. The medication recording charts (MAR) were seen and are well maintained. The systems in place for the safe storage of medication was discussed with the manager during the site visit. During the site visit residents were treated with dignity and respect. Staff were observed to interact with residents in a caring and professional manner. Care Homes for Older People Page 14 of 27 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. The people who live in the service are encouraged by staff to participate in a range of appropriate activities both within the home and the local community. A healthy and balanced diet is provided for residents. Evidence: The manager stated that the residents are encouraged and supported by staff to be as independent as they are able. A random of sample of documentation demonstrated that clear records of the activities undertaken by residents are maintained. The manager stated that the residents are fully supported can choose whether or not to partake in activities if they do not want to. There was clear evidence contained within the residents files that staff support individuals to maintain contact with their families and friends, and that visitors are always welcomed at the home. During the site visit residents were observed to have access to all communal parts of the home, which includes the lounge and a garden. A member of staff stated that they promote residents privacy and dignity through treating them as individuals, calling them by their preferred names, promoting their Care Homes for Older People Page 15 of 27 Evidence: independence and knocking on bedroom doors. This was confirmed by observations during the site visit. The manager stated that food was appropriately stored in the kitchen area, and records of fridge/freezer and cooking temperatures were maintained by staff throughout the day. However a small quantity of food was stored in the freezer with no labels or covers, this was discussed with staff and actions were taken to rectify this. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints process is satisfactory, the policies and procedures are readily available to staff and the residents. The arrangements for the protection of the residents are well developed all staff have now completed training in safeguarding adults to ensure the welfare of service users. Evidence: The home has a complaints and compliments folder. There had been no records of any complaints being received at the home since the last inspection. The manager stated that in the event of a complaint being made he would respond to it on an individual basis. The resident have access to a user friendly complaints process updated and reviewed 31/03/2009. There have been no vulnerable adult issues since the last inspection in May 2008. The home uses the Surrey Multi Agency Procedures however there is reference to this procedure in the homes policies. All members of staff employed at Albert Residential Home have undertaken Safeguarding and Protection of Vulnerable Adults training offered by Surrey County Council. A sample of staff files indicated that the training was undertaken over a period of time from July 2008 to the most recent completion in March 2009. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises were generally satisfactory the residents live in a well maintained and comfortable environment. The residents have access to spacious and comfortable communal facilities. Heating and lighting is satisfactory. The arrangements for control of infection were good Evidence: On the day of the inspection the home was clean relatively well presented. The home is well maintained with a good standard of individual decoration. The manager stated that they have a maintenance schedule in place to ensure that home is at its best decorative oder. The home is however very cluttered with items of surplus furniture and ornaments. This was discussed with the manager during the site visit and a good practices recommendation was made to review the amount of items in the home. The grounds were private secure attractive and accessible to the residents. The Communal lounge was spacious airy and relatively well furnished. A tour of the home was completed as part of this site visit. The toilet and bathroom contained quantities of personal items belongings to both staff and residents. The manager stated that restrictions in storage has meant that residents and live-in staff Care Homes for Older People Page 19 of 27 Evidence: have started to leave items in these communal areas, the manager has agreed to provide individual storage cabinets in these areas in order to meet the needs of the residents. The kitchen requires to be reviewed in order to maintain the health and safety of the residents, the worktops were found to be worn and damaged and the flooring was split and requires to be replaced with an appropriate product that can be maintained at a hygienic level. The home had policies and procedures in place dealing with infection control. Observations confirmed staff practiced infection control measures and used gloves and washed their hands regularly Care Homes for Older People Page 20 of 27 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. The residents are supported by sufficient staffing levels to enable them to participates effectively within the home and in the community. Evidence: The staff rotas reflected that the residents are supported by the effective allocation of staff throughout the day and night. There is no ancillary support for the home, and the catering is managed completely by staff. The staff spoken to had a good understanding of the residents needs, and their care plans. They also had a good understanding of their roles and responsibilities. The home has reviewed and updated there recruitment procedure in order to safeguard the residents. The policy is designed to protects the residents living in the home. The recruitment policies sampled were fully compliant to current employment law. A selection of three staff files were sampled as part of the site visit. These are well maintained and included all the required documents required for employment Care Homes for Older People Page 21 of 27 Evidence: legislation, including two written references, an employment history, and a CRB (Criminal Records Bureau) disclosure number. The review of the staff training files demonstrated that there were no gaps within the mandatory training required to be undertaken by all staff employed in a care home. The was recorded evidence that all staff had received appropriate training in recognizing the rights, privacy and dignity of the residents. Care Homes for Older People Page 22 of 27 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 day-to-day management of the home is generally good. The policies and procedures at the home have been fully dated and reviewed. The arrangements for safe working practices have been reviewed and improved to promote the safety of residents and staff. Evidence: The registered manager who has many years experience in the provision of care as a manager and is fully supported in the service by a deputy manager and an operational manger. The home undertakes quality monitoring to ensure that the system and practices are in place meet the expectations and reflective of the experiences of the residents their families and friends . A part of this site visit the policies and procedures were randomly sampled. The Care Homes for Older People Page 23 of 27 Evidence: documents have been reviewed and updated by the service and have been fully implemented by the home policies. A good practice recommendation was made to ensure that the policies and procedures are fully representative of the service and the residents. The service has a health and safety policy and staff have all had training in health and safety, fire safety, first aid, food hygiene and infection control. Care Homes for Older People Page 24 of 27 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 25 of 27 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 19 30 The manager must ensure 12/06/2009 that the kitchen offers a safe environment to produce appropriate meals. To safeguard the residents from food contamination. 2 21 30 The manager must ensure that all items stored in the toilet and bathroom are stored appropriately. To safeguard the residents from cross contamination and infections. 12/06/2009 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 2 19 37 The manager should review the storage of surplus furniture and ornaments in the home. The manager should review all documentation to ensure that it accurately reflects the service and services offered by the home. Care Homes for Older People Page 26 of 27 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). 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