Care Home: Amberley Lodge

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What the care home does well The service usually provides care in a way that people using the service feel is done well. It was seen as good practice that tea rooms with tea making equipment are available for people who use the service and relatives. This helps provide some independence and maintain dignity when receiving visitors. The building was particularly hygienic and clean at the time of this inspection. What has improved since the last inspection? A new manager has been registered with the commission. Much new decoration has occurred in, toilets and bathrooms, and most community areas. There is new carpet in the corridors The manager now does the initial assessments with staff. Procedures for making complaints have been put in all peoples rooms. Care plans are now reviewed monthly and recorded. Provisions have been made for people to hold their own money in a lockable space in their rooms. Policies and procedure are now made available to all staff, and they now sign to confirm they have read and understood these. What the care home could do better: The fact that the building is locked preventing people who use the service free access to leave the building, needs to be in the statement of purpose so that people know this before being placed. Care plans could be more person centred and better reflect the individuals life and preferences. Key inspection report Care homes for older people Name: Address: Amberley Lodge Amberley Lodge Nursing Home 86 -94 Downlands Road Purley Surrey CR8 4JF     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: Barry Khabbazi     Date: 2 1 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 21 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 21 Information about the care home Name of care home: Address: Amberley Lodge Amberley Lodge Nursing Home 86 -94 Downlands Road Purley Surrey CR8 4JF 02086680999 02086680378 manager.amberleylodge@careuk.com www.careuk.com Care UK Community Partnerships Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Emmanuel Bamidele Ajala Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 60 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD Date of last inspection 2 7 1 1 2 0 0 8 60 60 0 Over 65 0 0 60 Care Homes for Older People Page 4 of 21 Brief description of the care home Amberley Lodge is a large purpose built Care Home registered to provide care for up to 60 service users. On the ground and first floors it provides personal and nursing care for people over 60 years of age and who have dementia. The second top floor has changed registration and now provides personal and nursing care for up to 23 older people who have past or present mental disorder including PTSD Post-Traumatic Stress Disorder or who have dementia. The home has a single Manager with team leaders on each floor. Whilst the home is not registered to cater for service users with physical disabilities the home is adapted to meet the needs of service users who may have mobility problems; this includes assisted baths, ramps, grab rails and similar aids. Laundry and catering services are provided centrally with lounge and dining areas on each floor. The homes Statement of Purpose states that the single bedrooms are at least 12 square metres and have ensuite toilets. The home itself is located in Purley to the South of the main A22/A23 Purley junction and is therefore close to shops and transport. Fees range from 407 to 793 pounds per week depending upon the arrangements at time of admission plus extras for personal items and extra fees for extra care may also be negotiated with the fee payers if the need arises. Care Homes for Older People Page 5 of 21 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 overall quality rating of the service is 2 star. This means the people who use this service generally experience good outcomes. This inspection was unannounced. At this inspection the new registered manager was interviewed and recruitment records, policies, care plans, and the building were also examined. We spoke to people who use the service. Comments from them on this occasion included: its ok here, they make sure Im Ok , and the foods not bad. People were generally relaxed and happy during the inspection period. All the key Standards identified throughout this report were re-assessed at this inspection. This inspection also focussed on following up on previous requirements and recommendations, and any new issues arising. Due to the inspection being brought forward for operational reasons, service user surveys were not available at the time of this inspection to support this report. However, all the 7 people who completed the Care Homes for Older People Page 6 of 21 previous surveys said that the home did well in providing care, that they knew how to make a complaint, and 5 said that the food was always suitable, 1 said usually and 1 said sometimes. By the time of this inspection, all previous requirements had been implemented and improvements in the home had been identified. Please see the section what has improved since the last inspection for details. Information provided from all of the above sources along with our observations during visits to the service have been used to reach the judgements made in this report. Care Homes for Older People Page 7 of 21 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 21 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 21 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. 3&6 People who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Peoples needs are assessed before they start at the home to ensure that all needs are known by the staff. This home does not provide intermediate care with a view to return to the community and Standard 6 is therefore not applicable. Care Homes for Older People Page 10 of 21 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. Standards 7, 8, 9, and, 10. People who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Plans of care record health and social care needs to ensure these needs are all known and met. People are protected by the homes health monitoring procedures. People are protected by the homes medication procedures. People are treated with respect and their privacy is maintained. Care Homes for Older People Page 11 of 21 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. Standards: 12,13,14,and,15. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: People experience a lifestyle in the home that generally matches their expectations. People are provided with opportunities to remain part of the local community and are able to take part in appropriate activities. The daily routines and the homes policies promote choice and rights, to ensure equality and that all rights are enjoyed by all. Dietary needs are catered for and a balanced diet is provided, to ensure health and enjoyment of food. Care Homes for Older People Page 12 of 21 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. 16 & 18 People who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Complaints are managed well which should ensure that concerns are listened to and acted upon. However the complaints procedure needs to be made more accessible. The homes policies and procedures help protect people from abuse and help staff if they need to tell someone about any bad care practice they may see. Care Homes for Older People Page 13 of 21 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. Standards: 19, and 26: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: The home is in good condition externally and internally, and is decorated in a homely fashion. This creates a pleasant environment that promotes dignity and emotional well-being. The home is hygienic and clean, homely and comfortable; this environment therefore promotes a pleasant environment, health, and emotional well-being. Care Homes for Older People Page 14 of 21 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. Standards 27, 28, 29, and 30. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Staff numbers are of sufficient quantity to meet needs and provide consistency. People are supported by a staff group where 50 or more have the required qualifications. This raises the quality of staff, their knowledge and their practices. The current staff vetting procedure does protect from undesirable staff. Induction and foundation training to National Training Organisations specifications is in place. This ensures a well inducted staff group. Care Homes for Older People Page 15 of 21 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. Standards 31, 33, 35, and 38. People who use this service experience Good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: People who use the service now benefit from a well run home, with a qualified manager. The home has implemented a quality assurance system and an annual development plan, with both involving people. This should ensure that the home is run in a way that involves peoples and a way that is in their best interests. The financial interests of people are managed in a way that protects their rights. The home promotes the health and safety of the people who use the services, so that practices and the environment do not place their health and safety at risk Care Homes for Older People Page 16 of 21 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 3 14 Residents must not be 30/01/2009 admitted without their needs being assessed by suitably qualified person. So as to confirm that the home can meet their needs. 2 7 15 Care plans must be prepared 30/01/2009 and kept under review. Standard 7 and 8 apply. So as to provide details about how residents needs will be met. 3 16 22 Each resident or their representative must be provided with an up to date copy of the homes procedures for complaining including details of the local social services care management teams. So people know how to complain about poor services. 30/01/2009 4 17 13 All staff must receive training 30/01/2009 in the new mental capacity act. Standards 17 and 30 apply. So that they are familiar with decision making on behalf of residents so that residents rights are protected. Care Homes for Older People Page 17 of 21 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 5 18 13 The home is to provide the 30/01/2009 Commission with evidence that all staff have been given refresher training each year on the protection of vulnerable from abuse. So all staff are familiar with the procedures for recognising and reporting abuse. 6 27 18 The Commission must be provided with a sample four week duty roster. So as to demonstrate how staffing levels will be maintained in order to meet the needs of residents particularly those requiring close supervision or one to one care. 30/01/2009 7 31 8 A suitably qualified and 30/03/2009 experienced manager must be appointed and registered to be in day to day charge of the service. This so that staff and residents will be properly managed and supervised. 8 35 16 Proper provisions must be made for residents to hold their own money for it to be managed safely by the home. So residents have choice about personal funds and their money will be held safely. 30/01/2009 Care Homes for Older People Page 18 of 21 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 9 38 13 Policies and procedures and guidance must be made available to all staff. So as to show that the home is taking reasonable steps to prevent resident being harmed or abused. 30/03/2009 Care Homes for Older People Page 19 of 21 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 1 The fact that the building is locked preventing people who use the service free access to leave the building, needs to be in the statement of purpose so that people know this before being placed. The home should continue to look at ways to make the care plans more person centred and better reflect the individuals life and preferences. The plan in place should direct the care to be person centred and less task based. 2 7 Care Homes for Older People Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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