Care Home: Altham Court Nursing Home

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What the care home does well Altham Court provides homely and comfortable accommodation to its residents. It is situated in a quiet residential area and provides spacious ground floor accommodation. All areas of the home are well-decorated and maintained, clean and tidy. ` A relative commented, `The home is immaculately clean from top to bottom.` In the middle of the home is a large, secluded courtyard with lawns, cherry blossom trees, a fountain, and a variety of foliage and flowers. This a a feature of the home and a popular place for residents to spend time. One told us, `In the summer I like to help in the garden.` A relative said, `When it`s warm they take the residents to sit outside with sun hats and suncream on.` The home has a full-time activity organiser who provides a varied programme of activities for everyone who lives in the home. All residents have activity care plans which identify their hobbies and interests and what they would like to do. In the mornings the activity organiser works on a one to one basis with the more frail residents. On the day of the inspection she took sprigs of cherry blossoms to their rooms so they could see, touch, and smell them. During the afternoons group activities take place. We saw a card game (with large easy to read cards) in progress in one of the lounges. This proved to be a lively and well-attended activity with much laughter and banter. A meal was served during the inspection in the dining room. Tables sit between two and six, so residents can dine in friendship groups if they wish. There were flowers on each table, and both pictorial and written menus to make it easier for residents to choose what they would like. One resident told us, `The food`s lovely.` A relative said, `I`ve sat with my (relative) at mealtimes and the food always looks nice.` During the inspection staff were observed as being warm, caring, and professional, and to have excellent relationships with the residents. One told us, `I have a laugh with the nurses and carers. They are a brilliant bunch.` Another said, `The staff always have time to talk to me.` Relatives also praised the staff team. One commented, `I love the warmth of the staff.` What has improved since the last inspection? A new Manager has been appointed and registered. She is a qualified nurse with substantial experience in management and caring for older people. Staffing levels have increased, and staff training, support, and supervision improved. The monitoring of fluid intake has improved. This will help to ensure that residents do not become dehydrated. The recording of medication stock balances has improved following a recommendation being made at the last inspection. What the care home could do better: More staff should undertake Mental Capacity Act/Deprivation of Liberty Safeguards training. This will help to ensure that residents continue to be safeguarded. Key inspection report Care homes for older people Name: Address: Altham Court Nursing Home Altham Terrace Lincoln LN6 7SP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kim Cowley     Date: 2 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Altham Court Nursing Home Altham Terrace Lincoln LN6 7SP 01522511373 01522511471 burrowsl@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Carol Burrows Type of registration: Number of places registered: care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Altham Court is registered for forty-eight older people, including ten with physical disabilities, and provides both personal and nursing care. The home is situated in a quiet lane within walking distance of the Lincoln city centre. It was purpose built and all services are situated on ground floor level. There are forty-four single bedrooms, and two doubles, all with ensuites. The home has extensive gardens with seating areas. Car parking is available at the front of the building and there is a bus service close by. The fees are negotiable, depending on care needs, and additional charges are made for 0 1 1 0 2 0 0 9 0 10 Over 65 48 0 Care Homes for Older People Page 4 of 26 Brief description of the care home services such as chiropody, hairdressing, and newspapers. Further information about the home is available from the Manager. 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: This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of we indicates the Care Quality Commission) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five and a half hours, we checked the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to two other residents, two relatives, the Manager, Deputy Manager, administrator, maintenance man, one nurse, Care Homes for Older People Page 6 of 26 and three carers. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: More staff should undertake Mental Capacity Act/Deprivation of Liberty Safeguards Care Homes for Older People Page 8 of 26 training. This will help to ensure that residents continue to be safeguarded. 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 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 9 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 10 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. Residents needs are assessed prior to admission to ensure the home is suitable for them. Evidence: People who are interested in coming to Altham Court are invited to visit prior to making a decision. The Manager or her Deputy assesses all prospective residents in their own homes, in hospital, or during a visit to Altham Court. The assessment process helps to ensure the home is suitable for residents who are considering living there. Records relating to three recent admissions were examined. All were of a good standard and the views of relatives, and assessments carried out by health and social services staff, had been taken into account. The Manager told us she advises potential residents to look at a few homes before Care Homes for Older People Page 11 of 26 Evidence: deciding which is best for them. They are then able to make a more informed decision. If they want to come to Altham Court they are offered a trial stay to see if they like it. One relative told us, We looked at three homes but this was the best. Since the last inspection new terms and conditions for residents have been developed, and the homes brochure updated. Standard 6 was not inspected, as this home does not provide intermediate care. Care Homes for Older People Page 12 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. Residents health and personal care needs are met by well-trained and respectful staff. Evidence: All residents have care plans (know as Personal Plans), which set out how their health, personal and social needs are to be met. Residents and their relatives, where appropriate, are consulted when care plans are written. Those care plans inspected were person-centred, well-written, and gave clear instructions to staff about how best to meet residents needs. Case tracked residents talked to us about their preferences with regard to personal care, likes/dislikes, and interests, and it was positive to note that this information was in their care plans. Residents are registered with local GPs. District Nurses are consulted and visit the home if nursing care is required for non-nursing residents. Records showed that residents have access to a full range of health care treatment including input from chiropodists, dentists (NHS and private), and opticians. Care Homes for Older People Page 13 of 26 Evidence: Since the last inspection the monitoring of fluid intake has improved. Charts are put in place when needed, for example if a resident has had an infection. The homes hostess takes every resident a jug of water and cup in the mornings, and hot and cold drinks are offered throughout the day. This helps to ensure that residents do not become dehydrated. Medication is properly stored and only senior trained staff administer it. However all staff involved in caring for residents do a medication awareness course. The recording of medication stock balances has improved following a recommendation being made at the last inspection. Medication stocks and records are audited weekly and the Regional Manager carried out spot checks to ensure it is being kept and administered properly. The Owning Body employs a qualified pharmacist who provides advice to staff on request. It was observed during the inspection that staff treat residents with respect and help to maintain their dignity by providing care discreetly and sensitively. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents social and cultural needs are identified and met. Evidence: The home has a full-time activity organiser who provides a varied programme of activities for everyone who lives in the home. All residents have activity care plans which identify their hobbies and interests and what they would like to do. In the mornings the activity organiser works on a one to one basis with the more frail residents. On the day of the inspection she took sprigs of cherry blossoms to their rooms so they could see, touch, and smell them. During the afternoons group activities take place. We saw a card game (with large easy to read cards) in progress in one of the lounges. This proved to be a lively and well-attended activity with much laughter and banter. Other activities include producing a newsletter for the home, exercise classes, bingo, and sing-a-longs. A community event, sponsored by the Owning Body, is organised once a month. The next one on the calendar is the creation of a community crops garden and local schoolchildren will be involved in this. Care Homes for Older People Page 15 of 26 Evidence: A meal was served during the inspection in the dining room. Tables sit between two and six, so residents can dine in friendship groups if they wish. There were flowers on each table, and both pictorial and written menus to make it easier for residents to choose what they would like. One resident told us, The foods lovely. A relative said, Ive sat with my (relative) at mealtimes and the food always looks nice. If residents would like to dine with their families and friends a table can be set up in one of the lounges for a group meal. The home charges £3 per person for this, with the money going to the residents comfort fund. Tea and coffee making facilities are also available for visitors in one of the lounges where they can help themselves. 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. Residents and their representatives are encouraged to talk to staff about any concerns they might have. Staff know how to safeguard residents. Evidence: All the residents and relatives we talked to said they would speak up if they had a complaint. One resident told us, If I wasnt happy about something Id tell Linda (the Manager) and shed sort it out. The Manager is approachable, having an open door policy, and talking to residents and relatives on a daily basis. She told us that she reminds everyone of the homes complaints procedure at the monthly residents and relatives meeting. The homes complaints procedure is available in leaflet form, and all residents get a copy of this in their welcome packs when they come into the home. Records are kept of any complaints made, however minor, and the action taken to resolve them. The home has a safeguarding procedure in place which explains what staff should do if they have concerns about the way a resident is being treated. All staff have safeguarding training so they know what do to and who to contact if a resident is at risk. They work closely with the local social services department where necessary to help ensure residents are safeguarded. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an environment that is safe, comfortable, and well decorated and maintained. Evidence: Altham Court provides homely and comfortable accommodation to its residents. It is situated in a quiet lane close to Lincoln city centre. It was purpose built, and is ground floor only. There is good access throughout the home to people with limited mobility. The home has two lounges and a dining room so residents have a choice as to where they sit. There are forty-four single bedrooms, and two doubles, all with ensuites. We looked at five bedrooms and saw they had been personalised with pictures, ornaments, and pieces of furniture. In one bedroom the activities organiser has painted a themed mural on the wall at the request of the resident whose room it is. In the middle of the home is a large, secluded courtyard with lawns, cherry blossom trees, a fountain, and a variety of foliage and flowers. This a a feature of the home and a popular place for residents to spend time. One told us, In the summer I like to help in the garden. A relative said, When its warm they take the residents to sit outside with sun hats and suncream on. All areas of the home inspected were fresh, clean and tidy. A relative commented, Care Homes for Older People Page 18 of 26 Evidence: The home is immaculately clean from top to bottom. 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. A well-trained staff team meets residents needs. Relationships between staff and residents are warm and caring. Evidence: During the inspection staff were observed as being warm, caring, and professional, and to have excellent relationships with the residents. One told us, I have a laugh with the nurses and carers. They are a brilliant bunch. Another said, The staff always have time to talk to me. Relatives also praised the staff team. One commented, I love the warmth of the staff. Another told us, My relative prefers to stay in her room and the staff are always popping in to see her. And they are so helpful. I rang them to ask them to put a TV programme on for her and it was no trouble at all for them to do it. Since the last inspection staffing levels have increased, and staff training, support, and supervision improved. The staff we talked to were positive about the changes that had taken place. One told us, I love it here now. Ive had all my training including NVQ 2 and 3. Another commented, The atmosphere in the home has improved over the last few months and it is now a much friendlier place to work which will benefit the residents. Care Homes for Older People Page 20 of 26 Evidence: At the last inspection it was identified that staff needed more training in dementia, and other conditions that can affect older people. This has been provided. A member of staff told us, There is now much better training available to all staff ... there is also a better induction. However only one member of staff has had training on the Mental Capacity Act/Deprivation of Liberty Safeguards. More staff need to undertake this training. All staff are subject to CRB (Criminal Records Bureau), and references are obtained. Staff files were sampled and had the appropriate documentation in place. This helps to ensure suitable staff are employed to work at the home. 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. Residents live in a home that is safe and well managed. Evidence: Since the last inspection a new Manager has been appointed and registered. She is a qualified nurse with substantial experience in management and caring for older people. She is a hands on Manager who is knowledgeable about the needs of all the residents in the home. A member of staff told us, The Managers approachable, if theres any problem you can go to her. She always listens. Residents and relatives meetings are held once a month (at varying times of day to help ensure as big an attendance as possible). The Owning Body sends out annual questionnaires to residents and other stakeholders. The results of these are analysed, and the home produces an action plan based on the feedback received. In addition, the homes Regional Manager visits once a month to formally monitor the home and talk to residents about their experiences of living there. These initiatives help to ensure the home is run in the best interests of the residents. Care Homes for Older People Page 22 of 26 Evidence: Records showed that the Owning Body and Manager have taken the necessary steps to promote and protect the health, safety, and welfare of residents and staff. Since the last inspection the home has been awarded five stars (the top rating) by their Environmental Health Officer. The home is supported in maintaining the safety of the environment by a central team of experts employed by the Owning Body. 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 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 30 More staff should undertake Mental Capacity Act/Deprivation of Liberty Safeguards training. This will help to ensure that residents continue to be safeguarded. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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