Care Home: Amberton Court

What the care home does well Assessments of people`s needs are undertaken and include details of risks, to ensure people`s needs can be met. People receive care in a way that respects their privacy and dignity. A relative said: "The home feels very comfortable and relaxed when you enter the building; it is the sort of place you could call home. Staff clearly know their residents very well and have a lovely rapport with them, nothing is too much trouble". Staff said: "We tend to people`s needs and preferences promoting independence where possible". "I really enjoy working here; it is very homely and comfortable. The food is nutritious and appetising and people said they enjoyed it.Training for staff is provided and one hundred percent of staff have or are undertaking the National Vocational Qualification in Care this helps to make sure that care is given by staff who have the relevant knowledge about how to give care safely. Staff said "I find the manager very supportive and she listens to my ideas". What has improved since the last inspection? People have information available to them about what the home has to offer them and people are given time to make sure that they can make an informed decision about if the home is the right place for them. Care plans and risk assessments have improved in most case`s however there is still some work to be carried out in this area. Risk assessments for the use of bed rails are being developed within the home to help protect people. Falls risk assessments are undertaken for all new admissions, and appropriate referrals are made to make sure people are protected who are prone to falling. People are addressed by their preferred name to maintain their dignity. Medications are signed for upon receipt into the home and balances of medications are recorded to help maintain adequate medication procedures. Activities are provided that meet people`s needs, interests and abilities. Complaints are recorded and dealt with. The home has developed a protocol for dealing with challenging or difficult behaviour which protects all parties. Hand sluicing in the laundry does not take place and this ensures infection control is maintained. People within the home do not wear other people`s clothes. The laundry services are improving with the recent stability of staff within this department. The environment has been improved and tubular commodes are no longer in use at the home. Staffing levels have been increased since the last key inspection; however these levels should continue to be reviewed to make sure people are looked after by adequate numbers of staff. There is an annual training plan in place to make sure staff receive training to help maintain their health and wellbeing. Quality assurance surveys are now sent to people living in the home and to other parties to gain their views, any issues identified are dealt with. The home has complied with the West Yorkshire Fire and Rescue Service Improvement Notice so that people`s health and safety is protected in relation to fire. What the care home could do better: Pre admission assessments should be signed and dated by to make sure that a record is kept of who carried out the assessment and on what date it was undertaken. Care plans must be created for new problems to make sure that staff are aware of people`s new needs. Care plans and risk assessments must be reviewed at least monthly or when a persons needs change. People living in the home or their chosen representative should be asked if they want to take part in care plan reviews, this will help keep people fully informed. Audits of care plans and risk assessments should be put in place to make sure that the quality of these documents is consistent. Medication must be gained from the GP surgery timely so that people`s health is not adversely affected. Medication trolleys must be secured within the treatment room and the temperature of the medication fridge should be taken and recorded daily to make sure that the fridge is operating within the correct temperature range to maintain the effectiveness of the medication stored with it. Records of kitchen cleaning should be recorded and kept for inspection to maintain food hygiene. Double glazed bedroom windows with condensation trapped in the glass should be replaced, so that people can see out if they wish. The management team should review staffing level as the number of people living in the home increases. Supervision for all care staff should be undertaken to make sure that staff can discuss their practice and highlight any further training needs they may have. The higher management should make sure that the managerial staff at the home have sufficient time to undertake their managerial duties. The manager should inform us of any incident which adversely affects a person health and wellbeing by sending in a Regulation 37 form to help keep us informed. CARE HOMES FOR OLDER PEOPLE Amberton Court Thorn Mount Gipton Leeds LS8 3LR Lead Inspector Denise Rouse Key Unannounced Inspection 22 April 2009 10:00 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 Amberton Court DS0000033262.V374725.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. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberton Court Address Thorn Mount Gipton Leeds LS8 3LR 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) 0113 2406475 0113 2486469 Leeds City Council Department of Social Services Ms Bridget Glynn Care Home 35 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (35) of places Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The place for LD(E) is only for the use of the service user named in the Variation application dated 6 July 2005 One specific service user named on variation dated 5th September 2006 may reside at the home. One specific service user requiring temporary accommodation, named on variation dated 5th September 2006, may reside at the home. 12th May 2008 Date of last inspection Brief Description of the Service: Amberton court is a local authority care home, without nursing, providing accommodation for up to 35 people of both sexes over the age of 65. It is a single storey building with bedrooms grouped around 5 lounges, each of which has its own dining and kitchen area. There are no en-suite bedrooms. There are accessible grounds at the back of the home with outdoor seating and car parking space at the front of the home. The home is on a bus route with services running to and from the city centre. The current fees range from £108.10 to £510.30 per week. Additional charges are made for hairdressing, private chiropody and newspapers. More up to date information can be obtained from the home. Copies of previous inspection reports are available in the entrance of the home. Amberton Court DS0000033262.V374725.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 1 star. This means the people who use this service experience adequate quality outcomes. The accumulated evidence used in this report has included: A review of the information held on the home’s file since its last key inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment. Surveys received from ten people living at the home, one health care professional and three staff. An unannounced visit to the home, which lasted five hours forty minutes undertaken by one inspector, which included a full tour of the premises. Evidence was gained by direct observation during the site visit; which involved talking with people living at the home, visitors, the management team and other members of staff. Inspection of records, including care profiles, medication administration records, staff files and some of the home’s policies and procedures. What the service does well: Assessments of people’s needs are undertaken and include details of risks, to ensure people’s needs can be met. People receive care in a way that respects their privacy and dignity. A relative said: “The home feels very comfortable and relaxed when you enter the building; it is the sort of place you could call home. Staff clearly know their residents very well and have a lovely rapport with them, nothing is too much trouble”. Staff said: “We tend to people’s needs and preferences promoting independence where possible”. “I really enjoy working here; it is very homely and comfortable. The food is nutritious and appetising and people said they enjoyed it. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 6 Training for staff is provided and one hundred percent of staff have or are undertaking the National Vocational Qualification in Care this helps to make sure that care is given by staff who have the relevant knowledge about how to give care safely. Staff said “I find the manager very supportive and she listens to my ideas”. What has improved since the last inspection? People have information available to them about what the home has to offer them and people are given time to make sure that they can make an informed decision about if the home is the right place for them. Care plans and risk assessments have improved in most case’s however there is still some work to be carried out in this area. Risk assessments for the use of bed rails are being developed within the home to help protect people. Falls risk assessments are undertaken for all new admissions, and appropriate referrals are made to make sure people are protected who are prone to falling. People are addressed by their preferred name to maintain their dignity. Medications are signed for upon receipt into the home and balances of medications are recorded to help maintain adequate medication procedures. Activities are provided that meet people’s needs, interests and abilities. Complaints are recorded and dealt with. The home has developed a protocol for dealing with challenging or difficult behaviour which protects all parties. Hand sluicing in the laundry does not take place and this ensures infection control is maintained. People within the home do not wear other people’s clothes. The laundry services are improving with the recent stability of staff within this department. The environment has been improved and tubular commodes are no longer in use at the home. Staffing levels have been increased since the last key inspection; however these levels should continue to be reviewed to make sure people are looked after by adequate numbers of staff. There is an annual training plan in place to make sure staff receive training to help maintain their health and wellbeing. Quality assurance surveys are now sent to people living in the home and to other parties to gain their views, any issues identified are dealt with. The home has complied with the West Yorkshire Fire and Rescue Service Improvement Notice so that people’s health and safety is protected in relation to fire. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 7 What they could do better: 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. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 8 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 Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 9 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): Standard 3 (6 Not applicable) People who use this service experience good quality outcomes in this area. People are assessed so that the home is aware of people’s needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People are assessed before they are offered a place in the home. The assessment can be undertaken in a persons own home or hospital or when people visit the home to have a look round. Three people were case tracked on the inspection. One person’s assessment was not signed or dated by the member of staff undertaking the assessment, this should be signed and dated to make sure that people know who undertook the assessment and on what date. Information about people’s preferred social needs and their state of mind is included in the assessment. Information is gained from the individual, their relatives and chosen representative, also from discharging hospitals and care Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 10 management to ensure that the home has a picture of people’s needs and to make sure these can be met. Prospective individuals are invited with their family to spend time at the home, to come for a meal or an overnight stay or trial period. People are provided with information in the service user guide, statement of purpose and last inspection report. A key worker is allocated at the first visit to liaise with people who are considering moving into the home, this helps people to feel supported and the key worker can help people understand what is available to them. Surveys undertaken indicated that people were happy with the information they received about the home. All ten people said they were asked if they wanted to move into the home. One person commented “I wanted to leave my old address and I now like living here”. Intermediate care is not undertaken. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 11 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): Standards 7 8 9 and 10. People who use this service experience adequate quality outcomes in this area. People may not have their needs met when their conditions change and care plans and risk assessments are not always reviewed monthly, which may place people at risk. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The care records for a number of people were inspected, some work has been achieved to improve care planning and risk assessment. However some work still needs to be done to make sure all care plans and risk assessment’s are reviewed monthly and are person centred. Some staff have grasped the person centred approach to writing care plans well, however some still need some further training. This is to be made a priority by the home manager to make sure all records are of a consistent standard. One person had fallen and sustained an injury. Upon checking there was no care plan in place in relation to their injury. This was put in place at the time Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 12 of the site visit. Care plans must to be created timely for new problems so that staff have up to date information about the care that people need. People living in the home or their chosen representative should be asked if they want to take part in care plan reviews. A system should be put in place to make sure people are invited to take part in this process to make sure their views are gained and acted upon. People’s nutritional needs are assessed and weight loss and gain is monitored so that people’s nutritional needs are met. One respite admission had bed rails in place; there was a risk assessments in place provided by the district nurses, the risk of entrapment was added to this risk assessment at the time of the site visit. This person had only just been admitted and the home was in the process of developing their own care plans and risk assessments. Health care professionals are asked for help and advice to enhance the care that people receive. People can go to the local surgery supported by staff or have the general practitioner visit them at the home. Staff were seen to respect people’s privacy and dignity and call people by their preferred names. A survey completed by a health care professional said to the question “Does the care service seek advice and act upon it to manage and improve individuals health care needs “They ask for advice and request visits for residents appropriately in most cases, they seek advice when unsure”. Specialist equipment is available to ensure that peoples individual and special health care needs are met. People follow their chosen routines. Staff help and support in a sensitive way, to promote their dignity. People chose what clothes they wanted to wear. There was no complaints from people spoken with that they had been given someone else’s clothes. Medication systems were inspected a monitored dosage system is in operation. Medications received are recorded and signed in by staff who are trained to give medications. One person had run out of medication that was required, the staff had contacted the surgery to gain more medication. It was important for the person to receive this medication for their health and wellbeing. However this had not been able to be given for two days. Medications that are vital for health and wellbeing must be gained timely so that people’s health is not adversely affected. The medication trolleys stored in the locked treatment room could not be attached to the wall for secure storage this must be undertaken. There was a fridge for the cold storage of medication, however the fridge temperature was not taken or recorded. This should be undertaken to make sure that medication requiring cold storage is kept within the correct temperature range. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 13 At present no one is able to self medicate however the manager stated that people would be assessed and helped to self medicate if they were capable and safe to do so. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 14 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): Standards 12 13 14 and 15. People who use this service experience good quality outcomes in this area. People’s social needs are met and they are provided with a nutritious diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People’s preferred social activities are recorded and provided. There is no formal activities programme. One activity are available, as well as some outings, there is local trips to the pub, to Roundhay Park and Temple Newsome. Entertainers also come to the home. People can choose to join in with the activities if they wish. These is an area in the home where reminiscence can occur with an old singer sowing machine and a china cabinet with antique items stored in it, and pictures to help people remember products and times from their past. Motivation and Company attend the home to give exercise and stimulating activities to people who wish to take part in these events. People were seen listening to music, watching television, sitting out in the garden, conversing and socialising with other people who live in the home. A hairdresser attends the every Monday, and a chiropodist also visits. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 15 Library books are available in large and regular print for people to enjoy. One member of staff said on their survey they would like to see more outings offered to people living in the home. Local clergy visit the home and Holy Communion is provided for people who wish to attend and lay preachers visit the home regularly. A Gospel group also visit the home. This ensures that people’s religious needs are met. People follow their preferred routines and can choose where they would like to spend their time in the many lounge and dining areas available throughout the home. People are able to sit in the grounds and go out with their relatives and friends if they wish. People receive visitors at any time and they are made welcome, and can have a meal at the home with their relative. Comments received included “I plan my day out after breakfast; I then come back into my room, put my wireless on and read my paper. I go for a walk with my Zimmer, talk to people and have a cup of tea and then its dinner time. My friend comes to see me on Sundays; she brings me papers and books. We have a good talk, then I go into the garden when the weather is warm I sit in the garden for as long as I like”. Another person said “I do make my own decisions I go to town 5 days a week”. Special events are celebrated, at Easter people made Easter bonnets and there was a special meal provided. Christmas is well celebrated and local school choirs come into the home to give Carol concerts. Resident and relatives meetings are undertaken, so that people can give their views of the home and the services provided. A choice of food is available; people can choose where they wish to eat. There is a cooked breakfast on offer each day and supper is available for people. The dining areas are well presented with table clothes. People choose what they would like to have to eat. The menu of the day is displayed in each dining room so that people know what is available to them. The food served on the day of the site visit looked appetising and nutritious; there were beautiful home made buns for desert, which people really enjoyed. A lot of people spoken with said the food was excellent. The food served at lunch looked appetising and nutritious. People needing help with their meal were assisted by patient staff to ensure that people were not being rushed. The chef knew people’s special dietary needs, and these were catered for. People have input into the menu at the resident and relative meetings. It was noted that the chef came out of the kitchen at lunchtime to see how the food was being enjoyed and also sat and patiently helped a person to eat their meal this is good practice. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 16 The kitchen has been inspected by environmental health recently and a four star rating has been awarded, some shortfalls found on this inspection have been rectified. However it was noted that the cleaning schedule for the kitchen had not been filled in April, this should be recorded to make sure that all necessary cleaning is undertaken to help maintain food hygiene standards. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18. People who use this service experience good quality outcomes in this area. People can raise complaints these are looked into and addressed. People are protected from abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The complaints procedure is available to people. Complaints are investigated and the person informed of the outcome. The manager operates an open door policy; anyone one can see her to make their views known at any time. People surveyed said they knew how to make a complaint and issues raised would be dealt with. They knew who to speak to if they were not happy. One person commented “The manager is always happy to listen and would act on any issues raised”. Nine people said in their surveys that they knew how to make a complaint. Comments received included “So far I have been very happy here, I have nothing to complain about, I am so very pleased I came into this home”. Another person said “I would speak to the manager”. A safeguarding policy is in place, issues raised are dealt with appropriately. Staff spoken with knew what to do if an allegation of abuse occurred. Three staff surveyed said they knew what to do if a person had concerns about the home. Ongoing training and information relating to the whistle blowing procedure has been given to all staff and issues would be brought to the manager’s attention for appropriate action to be taken. This helps to make sure that people are be protected from abuse. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 18 Checks are undertaken to ensure new staff are suitable to work in the care industry. All three staff surveyed said their employer had carried out checks, such as Criminal Record Beuro checks and had gained references before they were allowed to start work at the home. This helps to protect people. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 19 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): Standards 19 and 26. People who use this service experience good quality outcomes in this area. People live in a home that is maintained and hygienic for people to live in. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is maintained and decorated to make sure it is homely and inviting for people to live in. There have been new carpets fitted to some bedrooms and some areas of the home, there are more about to be fitted. A totally new fire alarm system has been fitted and is now in operation. The manager informed the inspector that the Improvement Notice issued by West Yorkshire Fire and Rescue Services has now been lifted. This helps to make sure that the home has adequate fire protection systems in place to protect people. There is a secure gated entry system to the grounds and a secure door entry system to the building this helps to make sure that unauthorised entry cannot be gained. There is secure garden’s all this helps to make sure people cannot Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 20 wander of this helps to protect people. Level access is providing to the garden and patio areas which help people gain access to all areas of the home. The grounds are suitable for disabled access, and garden furniture is available for people to sit on. The lounges and dining areas are pleasant and there are plans to redecorate some of these areas. One person commented “The home always smells fresh and looks clean”. People surveyed said they were happy with the facilities the home had to offer. Eight people said in their surveys that the home was always fresh and clean. One person said “The toilets, bedrooms, lounges and kitchen are always clean, I have no complaints”. Bedrooms are personalised and have vanity units with hand basins for people to use. Tubular commodes that were in use within the home at the last inspection have been replaced. Some double glazed bedroom windows require replacing due to these units having failed and condensation is trapped in the glass which means that people cannot see out of their window. Net curtains have been placed over these windows. These windows should be replaced. The laundry facilities inspected are adequate for the home. Soiled linen is sent to the laundry in red bags which are not opened by the staff these are placed in washer on a sluice cycle this helps to protects staffs health and safety. Hand wash facilities are available throughout the home to help maintain infection control. There has been issue’s with staffing the laundry which has caused some problems for people getting their clothes returned correctly. Staffing has now improving. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 21 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): Standards 27 28 29 and 30. People who use this service experience good quality outcomes in this area. People are looked after by well trained staff. However further training is required in relation to care plans and risk assessments to make sure these documents are consistent and reviewed regularly. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff spoken with were friendly approachable and positive about the role they played in the home. Staffing level were adequate on the day of the site visit to ensure people got the care they require. The home had a number of empty beds. People spoken with had no concerns about the staffing levels provided at this moment in time. There has been an increase of staffing numbers supplied at the home on a night, from two staff to three. This arrangement may be due to change shortly and the management team should review staffing level, especially those provided at night time to make sure that people’s needs can be met, and that there are adequate arrangements in place to make sure that staff can receive the statutory breaks they are entitled to. All ten people surveyed said that the staff “Always” treated them well; seven said the care staff listened and acted on what they said. Comments received included: “Staff listen and they are very helpful” and “Staff are very kind”. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 22 Staff receive regular training to make sure they have the skills to look after people safely. However further training is required in relation to care plans and risk assessments to make sure these documents are consistent and reviewed regularly by the staff, the manager said this training would be undertaken as a priority. Three staff surveyed all said they “Always” received training relevant to their role. Staff are recruited using thorough methods and there is an equal opportunities policy in place so that recruitment is fair for all applicants. New staff have a period of induction, which is undertaken so that they can develop the skills they need to be able to give good care. The home has 100 of their care staff who have achieved or are undertaking the National Vocational Qualification in Care at level two or three. This helps staff to develop their skills. However supervision for all care staff is not up to date and this should be undertaken to make sure that staff can discuss their practice and highlight any further training needs they may have. Staff meetings are held to gain the views of people working in the home. Any issues raised are looked at by management acted upon. Staff spoken with said they felt valued and supported by the manager of the home and felt they all worked well as a team. All three said in their surveys that they “always” received up to date information about the people they support and care for. One health care professional said in their survey to the question “What do you feel the service does well?” they replied “caring attitude of staff”. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 23 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): Standards 31 33 35 and 38. People who use this service experience good quality outcomes in this area. People benefit from having an experienced home manager who listens to people’s views and acts upon their comments. People are protected from financial abuse. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager has been at the home for six years, she is experienced and approachable. There are two care officers to help support her and a team of care and ancillary staff. The Principal Unit Manager visits the home regularly to make sure that the home is operating effectively. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 24 Some quality assurance procedures are in place. Audits are carried out in regards to falls and medications. However audits of care plans and risk assessments are not undertaken and this should be put in place to make sure that the quality of these documentation are consistent for all people living in the home. The manager only receives six hours for administration work, this places pressure on her and restrains the amount of auditing that can be successfully accomplished, this should be reviewed to make sure that she has enough time to undertake the administration required thoroughly. One member of staff said in their survey” I think the department needs to consider the roles of the senior team in light of the amount of administration duties being de- centralised with no increase to our administration hours. This then takes us away from supervising staff and “ Injecting” knowledge and skills into the staff who work with the residents”. The higher management should make sure that staff have sufficient time to undertake their managerial duties. People living in the home, their relatives and health care professionals are surveyed each year to find out people’s views about the services the home provides. The manager and staff also ask people informally about the service they are receiving. Policies and procedures are in place. Staff and resident and relative meetings are held regularly. The management team look at how they can address any issues that are raised. Personal allowance accounts are provided for people living in the home, some balances were checked and were found to be correct. Receipts are kept for all transactions. This helps to protect people from financial abuse. Health and safety checks and regular maintenance is undertaken to make sure that the home is a safe for people to live in. Double glazed windows in people’s bedrooms which have condensation trapped within them should be replaced. (See Environment). The home has complied with the West Yorkshire Fire and Rescue Service Improvement Notice so that people’s health and safety is now protected in relation to fire. One regulation 37 form had not been sent to the Care Quality Commission to notify us that a person had fallen and an injury had been sustained. The manager must inform us of any incident which adversely affects a person health and wellbeing. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 25 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 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP7 Regulation 15 Requirement Care plans must be created for new problems when they occur to make sure that staff are aware of the care people need to meet their new needs. Care plans and risk assessments must be reviewed at least monthly or when a persons needs change, to make sure that people are receiving the care they need. Medication that is vital for a person’s health and wellbeing must be gained timely so that the person’s health is not adversely affected. Medication trolleys must be able to be secured to the wall for safe secure storage. Timescale for action 22/06/09 2 OP9 13(2) 22/06/09 Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations Pre admission assessments should be signed and dated by to make sure that a record is kept of who carried out the assessment and on what date it was undertaken. People living in the home or their chosen representative should be asked if they want to take part in care plan reviews. This will help people keep fully informed so that they feel included and can make their views known. The temperature of the medication fridge should be taken and recorded daily to make sure that the fridge is operating within the correct temperature range to maintain the effectiveness of the medication stored with it. Records of kitchen cleaning undertaken should be recorded and kept for inspection to make sure that cleaning being undertaken is recorded, to maintain food hygiene. Double glazed bedroom windows with condensation trapped in the glass should be replaced, so that people can see out if they wish. The management team should review staffing level, especially those provided at night time to make sure that people’s needs can be met, and that there are adequate arrangements in place to make sure that staff can receive the statutory breaks they are entitled to. Further training is required for all care staff in relation to care plans and risk assessments to make sure these documents are consistent and reviewed regularly, so that people’s changing needs are known and can be met. Supervision for all care staff should be undertaken to make sure that staff can discuss their practice and highlight any further training needs they may have. 8 OP33 The higher management should make sure that managerial staff in the home have sufficient time to undertake their managerial duties. Audits of care plans and risk assessments are not undertaken and this should be put in place to make sure Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 28 3 OP9 4 5 OP15 OP19 6 OP27 7 OP30 that the quality of this documentation is consistent and up to date for new problems that occur. These documents should be reviewed monthly or as a person’s needs change, to make sure people’s new needs are known and are being met. The manager should inform us of any incident which adversely affects a person health and wellbeing by sending in a Regulation 37 form. Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Amberton Court DS0000033262.V374725.R01.S.doc Version 5.2 Page 30 - 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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