Care Home: Amberleigh House

What the care home does well The home provides a detailed service user guide for prospective service users and their relatives. Medications are dealt with safely. A high level of activities is provided. Meals are varied and nutritious. The home is decorated and furnished to a good standard and is clean throughout. The home is fully staffed and training opportunities have been offered to all staff. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Amberleigh House Longmoor Lane Liverpool Merseyside L9 7AL Lead Inspector Jeanette Fielding Key Unannounced Inspection 10:00 26th June 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberleigh House Address Longmoor Lane Liverpool Merseyside L9 7AL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 525 8047 www.c-i-c.co.uk. Community Integrated Care Mrs Debra Patricia Higgins Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 38 Personal Care and 19 Nursing Care within the total number of 38. To accommodate one named service user under 65 years old Date of last inspection 17th April 2007 Brief Description of the Service: Amberleigh House is registered to provide nursing and personal care for up to thirty-eight elderly persons who have dementia. The home was formerly called Longmoor Lodge. It is located within the grounds of Fazakerly Hospital, on the corner of Longmoor Lane and Lower Lane. All service users are provided with a single bedroom with en-suite facilities. Recent work has been undertaken within the home to provide full access to all areas, redecoration and refurbishment. A number of communal areas are provided to enable service users to choose which area they spend their day. Service users are free to use their bedroom or any of the communal areas as they wish. All décor is good. Bedrooms are appropriately furnished and decorated and the staff strive to provide a homely environment. The fees charged by the home are in line with those paid by the Local Authority. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This inspection took place over a period of five hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans for five service user were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the manager, nurses, care staff and service users to obtain their views and opinions of the service. If this was not possible due to communication difficulties, then through observing people using the service. The manager had completed an Annual Quality Assurance Assessment which gave further insight into the home. What the service does well: What has improved since the last inspection? What they could do better: The home should continue to develop and improve the services provided for service users. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their families are provided with full information regarding the home and the services offered to enable them to make an informed decision regarding their care provider. EVIDENCE: The service user guide has recently been updated to reflect changes that have taken place within the home. These are issued to all prospective service users and their relatives to give them full information regarding the services and facilities offered by the home. Details on how to access services has been detailed on a laminated sheet which is placed in each service users bedroom. All prospective service users are assessed with regard to their care needs prior to admission. These assessments are undertaken by the manager or one of Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 9 the senior nurses. The care files of service users recently admitted to the home were inspected and were found to contain detailed information regarding their health, care and social needs. The new pre admission assessment documentation provides for the recording of more detailed information than previously recorded. The manager is currently arranging for key workers to be involved in the admission process to given them greater insight into the individual needs and preferences of service users. The pre admission assessments provide sufficient information to enable the initial plan of care to be prepared. The home does not offer intermediate care. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have improved to provide staff with full information regarding the specific care required by each individual service user to ensure that their needs are fully met. EVIDENCE: Individual care plans are prepared for each service user. Improvements continue to be made to the plans and are now more detailed in respect of the specific care required. The files inspected were reviewed regularly and were found to contain risk assessments together with risk management plans to remove or reduce any potential risks to the service users. The staff at the home are now developing individual life books for the service users to give greater insight into their life. These include photographs and information gathered from relatives and friends. Care plans are discussed with relatives to ensure that they are made aware of the care given. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 11 More information is being recorded with regard to the service users’ dementia and how this impacts on their care. Detailed records are held of visits to and by other healthcare professionals i.e. GP, dietician, speech and language therapist and primary care services. Records of visits are recorded in the daily record with full information regarding changes to their care recorded in the care plans. The daily records completed by the staff provide evidence of the actual care given on a daily basis. All care files are regularly audited to ensure that they are maintained accurately. None of the service users at the home are able to administer their own medications and so this is attended to by the staff. The home has a detailed policy and procedure for the administration of medications only the nurses and identified carers are permitted to deal with these. All medications were found to be stored safely and no unwanted medications were found. Records were clear, accurate and up to date. The medications room was clean and organised. Appropriate disposal arrangements are in place for medications which are refused or no longer required. Regular audits are undertaken on medications to ensure accuracy and compliance with the policy and procedure. All service users are accommodated in single bedrooms, each having en-suite facilities. Personal care is given in the service users own bedroom or in the bathroom as appropriate to ensure that their privacy and dignity are protected. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A choice of meals is offered to service users and a balanced diet is provided to promote good health. EVIDENCE: The home employs an activities co-ordinator on a full time basis. A high number and range of activities are provided for the service users to keep them stimulated and entertained. Activities are provided in groups and on a one to one basis. These include games, reminiscence, gardening, music and entertainers. Birthdays and notable days are celebrated and relatives are welcome to participate. Detailed records of activities are made to provide evidence of these. Survey forms responded to by relatives of service users commented particularly favourably about the activities co-ordinator and comments included ‘she is very caring and kind’. Relatives are welcome at the home at any time and one relative said in the survey ‘the staff are very helpful and make me welcome at any time of day’. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 13 Service users are free to meet with their visitors in the privacy of their own bedroom or in one of the communal areas as they wish. Staff promote choices in all aspects of daily living to promote independence. The care plans contain details of individual preferences to enable staff to provide the type of lifestyle that each service user would want. Much of this information is gathered from relatives as the majority of service users are unable to express their wishes due to their dementia. Meals are served in the dining room or in the service users own bedroom as they wish. Two dining rooms are provided, one for service users who are accommodated for personal care and one for those who require nursing care. Staff were observed to assist service users with their meals in a discreet and dignified manner. A choice of meals is provided and details of the meals available are displayed in the dining rooms. The menus provide evidence that a varied and balanced diet is offered and the meal served on the day of the site visit looked and smelled appetising. Special diets are provided where necessary and include diabetic, soft and liquidised meals. Tables are attractively laid and the dining rooms are bright and attractively decorated. The kitchen is clean and organised and a good supply of fresh fruit and vegetables are available. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All staff have been given training on the protection of vulnerable adults to ensure that service users are protected from abuse. EVIDENCE: The home has a robust complaints procedure which is detailed in the service user guide, in each bedroom, and is displayed on the notice board in the entrance to the home. No complaints have been received by the home since the last inspection. Training is given to staff on the different types of abuse and of the action they should take in the event of it being suspected. Evidence of this training is held on their individual files. Staff spoken to during the inspection were able to demonstrate that they were knowledgeable of adult protection issues and knew to procedure to be followed. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvement within the home have ensured that service users are provided with a bright and pleasant environment in which to live. EVIDENCE: Amberleigh House is a single storey, purpose built home, where service users are provided with a single bedroom and en-suite facilities. Improvements have been made to the décor and furnishings within the home since the last inspection. The layout of the main lounge has been changed to provide a larger seating area and a specific dining area. The conservatory area of this lounge has been provided with new wicker furniture to provide a bright and comfortable seating area. This area has proved popular with service users when meeting with their relatives. New carpet and flooring has been fitted and Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 16 attractive blinds fitted to windows. Comfortable armchairs are provided and specialist chairs for service users who require these. The décor in the main lounge is bright and clean and provides a pleasant and comfortable area for service users. Clocks with dates have been provided in communal areas to promote orientation for the service users. Plasma televisions have been provided in lounges together with new pictures, mirrors and lamps to improve the environment and make it more homely. The majority of bedrooms have been redecorated and many have been fitted with new carpets. Carpets for the remaining bedrooms have been ordered and their delivery is awaited. New blinds have been fitted to the windows in all bedrooms. Magnetic devices, connected to the fire alarm system, have been fitted to bedroom doors to allow service users to have their door open as they wish, whilst maintaining safety in the event of fire. Relatives and staff have ensured that bedrooms are provided with pictures, photographs and items of memorabilia to promote a warm and homely environment. A five year redecoration and improvement plan has been prepared for the home and some of this work has already commenced. Some of the corridors have been repainted and are clean and welcoming. The gardens have been landscaped and new fencing fitted to improve the environment and provide a safe area for service users. The inner courtyard is pleasant and provides seating, plants and flowers and service users are free to use this area at any time as they wish. All areas of the home are fresh and clean and are maintained to a high standard. Laundry is attended to carefully and clothing was seen to be neatly folded in drawers or hung in wardrobes. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the service users’ support needs which is evident from the positive relationships which have been formed between staff and service users. EVIDENCE: The home is now fully staffed and also employs it’s own bank of staff to cover annual leave and sickness and provide service users with familiar faces and a consistent level of care. All staff, including bank staff, have been given full induction training by CIC. The home employs qualified nurses, senior support workers and support workers to provide for the service users. The home also employs and activities co-ordinator, administrative, catering, laundry, domestic and maintenance staff to ensure the smooth running of the home. Training is given to all staff, appropriate to their role. The home has a robust recruitment procedure. This involves the completion of application of an application for prior to being selected for interview. Two references are taken together with checks on the Criminal Record Bureau and Protection of Vulnerable Adults registers. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 18 Staff records inspected were found to contain full information and evidence of on-going training. An induction training handbook is issued to all new staff and must be completed during their first few months at the home. Regular training is given to all staff and the home has full access to a training co-ordinator provided by the company. Regular supervision and appraisals provide staff with the opportunity to identify their own training needs and to give them time with their line manager on a one to one basis. The company offers ‘E Learning’ for the staff to further develop their knowledge, skills and understanding. A two team system for support workers has been put in place to make a more structured off duty and a good skill mix. Relatives commented favourably in the survey forms and said that staff were ‘caring, helpful and kind’. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear development plan and vision for the home, which she has effectively communicated to the service users, staff and relatives. EVIDENCE: The registered manager of the home is a qualified nurse who holds a management qualification and is an experienced manager of care services for elderly people. The manager is well supported by the company, a representative of which, visits the home each month and completes a report of the findings of that visit. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 20 It is evident from the records, and from observation, that the ethos of the home has improved to promote the well being of the service users, with the needs of the service user being given total priority at all times. Regular relatives meetings are held and the manager meets with service users and their relatives on a one to one basis whenever possible. Staff meetings are held regularly and provide a forum for open discussion and for the dissemination of information. Regular audits are undertaken in all aspects of care provision and documentation. Detailed records are made of all monies held on service users behalf. Receipts are held for all purchases made on service users behalf. None of the service users have the ability to attend to their own finances. The owners of the home act on behalf of a small number of service users and all others have their finances dealt with by relatives or advocates. Safety certificates were all found to be well maintained and up to date. Tests are made on fire detection equipment as appropriate and are duly recorded. Training on fire prevention is given to all staff on a regular basis. Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Amberleigh House DS0000025198.V363251.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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