Care Home: Anastasia Lodge

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What the care home does well The home provides consistently excellent outcomes for people. We found that the needs of the people case tracked were within a range of those specified inthe statement of purpose. The home provides a statement purpose that is specific to the home and the resident group that they care for. The statement of purpose confirmed that the cultural and religious needs of people would be respected. People are supported to maintain their cultural and religious identity. A person who lives at the home said, "The manager visited me in hospital, and asked me what help I needed." Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. A person spoken to told us "staff are kind. They do understand how to help me." Care plans make sure that people`s needs are addressed in a person cantered way. Detailed nutritional, tissue viability, falls and manual handling assessments have been put in place. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for people living at home. People spoken to told us that activities are provided regularly. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. There were policies on handling complaints, abuse and protection. People feel safe and well supported by the home, which has their protection and safety as a priority. The home has the necessary adaptations to support people to move around safely. The home provides an accessible and safe environment for people to live in. Bedrooms were personalised with items of furniture and pictures belonging to the people who live at the home. People are encouraged and supported to personalise their bedrooms. The rota showed that a consistent staffing level was being maintained in the home. There is consistently enough staff available to meet the needs of people living at the home. People spoken to felt that staff had the necessary skills to meet their needs. One person said, " Staff are excellent." Staff are supported through training to meet the individual needs of people. The acting manager has extensive experience of managing a service for older people. The registered manager has a clear understanding of how to deliver good outcomes for people living at home.Anastasia LodgeDS0000071446.V366222.R01.S.docVersion 5.2Page 7We discussed health and safety issues with staff and they demonstrated their understanding. Health and safety checks, procedures and training make sure that people living in the home are safe. What has improved since the last inspection? There were three areas for improvement identified at the last inspection. Since the last inspection the home has improved it`s recording of activities taking place in the home. We found that these records showed what activities are provided each day and which people living in the home had taken part in them. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. Further training had been provided for staff based on the host local authorities (Haringey) safeguarding procedures. Staff are trained to recognise and respond to suspected abuse in ways that make sure that peoples safety and well-being is maintained. The acting manager explained that she has reviewed the equal opportunities policy for the home. We found that the policy now reflects all the key areas of equality and diversity in line with current legislation and best practice. The policy is a positive statement that promotes peoples right to have their equality and diversity acknowledged in all areas of their life within the home. What the care home could do better: No areas for improvement have been identified at this inspection. CARE HOMES FOR OLDER PEOPLE Anastasia Lodge 10-12 Arundel Gardens London N21 3AE Lead Inspector Tony Brennan Unannounced Inspection 24th June 2008 11:30 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 Anastasia Lodge DS0000071446.V366222.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. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anastasia Lodge Address 10-12 Arundel Gardens London N21 3AE 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) 020 8886 1034 020 8886 1034 info@anastasialodge.com Ourris Residential Homes Limited Care Home 29 Category(ies) of Dementia (29), Old age, not falling within any registration, with number other category (29) of places Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC 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 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 29 Date of last inspection Brief Description of the Service: Anastasia Lodge is a registered care home, which provides accommodation for 29 older people. The home is located in a residential area in Winchmore Hill, North London, and is accessible to community resources and facilities such as a supermarket, local shops, places of worship and public transport. A major extension was completed in Spring 2005. There are now 25 single and 2 double bedrooms on three floors, all with en-suite facilities. The home has 2 large lounges and a separate dining area. There are attractive and well maintained gardens at the front and back of the home. About half of the residents at the home speak Greek as their first language. Fees range from £470-£570/week. This report is available Commission’s web site. Anastasia Lodge DS0000071446.V366222.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 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the three areas for improvement identified at the last inspection had been addressed. Prior to the inspection the home had completed its Annual Quality Assurance Assessment. The Annual Quality Assurance Assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. We also looked at any other information we had received about the home since the last inspection. This included any information regarding incidents that the home had told us about. The inspection took place over two days. We were assisted by the acting manager, Christine Argyrou, with the inspection. We spoke with six people who live at the home, and four members of staff. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the acting manager, and areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the service does well: The home provides consistently excellent outcomes for people. We found that the needs of the people case tracked were within a range of those specified in Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 6 the statement of purpose. The home provides a statement purpose that is specific to the home and the resident group that they care for. The statement of purpose confirmed that the cultural and religious needs of people would be respected. People are supported to maintain their cultural and religious identity. A person who lives at the home said, “The manager visited me in hospital, and asked me what help I needed.” Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. A person spoken to told us “staff are kind. They do understand how to help me.” Care plans make sure that people’s needs are addressed in a person cantered way. Detailed nutritional, tissue viability, falls and manual handling assessments have been put in place. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for people living at home. People spoken to told us that activities are provided regularly. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. There were policies on handling complaints, abuse and protection. People feel safe and well supported by the home, which has their protection and safety as a priority. The home has the necessary adaptations to support people to move around safely. The home provides an accessible and safe environment for people to live in. Bedrooms were personalised with items of furniture and pictures belonging to the people who live at the home. People are encouraged and supported to personalise their bedrooms. The rota showed that a consistent staffing level was being maintained in the home. There is consistently enough staff available to meet the needs of people living at the home. People spoken to felt that staff had the necessary skills to meet their needs. One person said, “ Staff are excellent.” Staff are supported through training to meet the individual needs of people. The acting manager has extensive experience of managing a service for older people. The registered manager has a clear understanding of how to deliver good outcomes for people living at home. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 7 We discussed health and safety issues with staff and they demonstrated their understanding. Health and safety checks, procedures and training make sure that people living in the home are safe. What has improved since the last inspection? What they could do better: No areas for improvement have been identified at this inspection. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 8 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. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 9 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 Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 10 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 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and relatives are helped to decide if Anastasia Lodge is the right home for them by the quality of the information (including at visit to the home) they are given about the home People’s needs are assessed prior to admission to the home to make sure they receive the care and support they need. National Minimum Standard number 6 is not applicable to this service, as the home does not provide intermediate care. EVIDENCE: Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 11 We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose identified the skills and staffing resources available to meet the needs of people. Since the last inspection the home has successfully applied to the Commission to care for people who have dementia. Both the statement of purpose and the service user guide stated that the home would meet the needs of people who have dementia. We observed how staff supported people with dementia; they demonstrated an awareness of good dementia care practice. Staff spoken to were able to explain in detail how they met the needs of people who have dementia. Training records showed that staff had completed training on meeting the needs of people with dementia. The home provides a statement of purpose that is specific to the home and the resident group that they care for. The statement of purpose confirmed that the cultural and religious needs of people would be respected. We found that as the home caters for the needs of people from the Greek Cypriots community the statement of purpose and service user guide had been translated into Greek. People who live at the home told us that they were given information about the home to help them decide if they wished to come and live at Anastasia Lodge. One person said, “ I got information about the home it was very useful. It helped me to decide whether I want to come and live here.” Records showed that people were supported by the home to maintain contact with their church or other community groups. People are supported to maintain their cultural and religious identity. People living at the home have varying degrees of disability and dementia. The environment has been adapted so that it is accessible. We observed that people were able to move about the home safely. The homes environment is adapted to meet peoples diverse needs. A person who lives at the home said, “ Before I came to live here the manager talked to me about how I would like to be looked after.” The people case tracked had both assessments from placing authorities, and ones carried out by the home. These identified the individuals’ needs for support and care. The acting manager explained that as the home had recently been registered with the Commission to care for people with dementia. She had reviewed the initial assessment format to make sure that dementia care needs are identified as part of the initial assessment. We found that it now included a section to record the dementia care needs of people. We found that the people case tracked had initial assessment that included information on their dementia care needs. This included any behavioural issues that the individual might have. As part of the assessment process information on the needs of people had been obtained from health professionals. This had been used to inform the home’s own assessment. We spoke with the acting manager who told us that cultural and religious needs would be addressed and identified through initial Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 12 assessments and care planning. The initial assessment of the people case tracked all referred to their religious and cultural needs. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. Initial assessments recorded the involvement of people and their representatives in identified the areas where they needed support. Both relatives and people living at home told us that they had been actively involved in the initial assessment process. Detailed initial assessments are carried out with the involvement of people and their representatives to make sure their needs are identified. A person told us, “Staff are very helpful and understanding.” Care staff spoken to were able to explain the individual needs and preferences of the three people case tracked. We observed the interaction between staff and people who have dementia. We found this supported their continued well-being. Admissions to the home only take place when staff have the necessary skills to meet the assessed needs of perspective residents. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 13 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 10 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. Peoples right to privacy is supported. EVIDENCE: The annual quality assurance assessment stated that care plans were, “ based on individuals needs and Person centred.” One person said, “ staff have helped me to do things for myself, and I feel better.” We found that the care plans of all the people case tracked were highly personalised and clearly identified how the needs of people would be met. Care plans included a life history of the individual. This gave information about individual’s past life, their interests and past occupations. Care plans were based on initial assessments of the people case tracked. As the home now admits people who have dementia care Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 14 plans had been updated to include information on peoples dementia care needs. Care plans for the people case tracked included details of the individuals dementia care needs. This included how any behaviour that might challenge the service should be addressed to support people’s will being. We observed staff with people who live in the home and they demonstrated their understanding of their needs. A relative commented about the staff caring attitude and said, “ They treat each resident as an individual. I often see them spending time with the residents.” There were clearly defined actions highlighted in the care plans to meet the needs of people. Care plans for the people case tracked were found to reflect their choices and preferences. Care plans included peoples wishes about how they wish to express their religious and cultural needs. For example, one of the people case tracked is Roman Catholic and his care plan identified that he wished to see the priest at least once a week. When we spoke to this person they confirmed that staff were supporting him to do this. People commented that they had been asked about how they wish to be supported by staff. A relative said, “The staff take a lot of interest in everyone who lives here at Anastasia Lodge.” Staff were observed to interact respectfully and sensitively with people living at the home. People said that staff respected their privacy and treated them with respect. People we spoke to told us that they felt staff understood their needs. We saw examples where staff members related well with people living at the home. For example, speaking to people in a way that was appropriate given their age. A key worker system is in place. Care plans were personalised, and referred to the cultural needs of people. People are involved in the planning of their care that affects their lifestyle and quality of life. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. The people case tracked all had nutritional assessments. People were being weighed regularly and action taken if their weight changed. The continence needs of people had been assessed and recorded as part of their care plans. Each care plan includes a manual handling risk assessment. Equipment had been provided to assist people to mobilise safely and independently. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for people living at the home. Diary notes showed that appropriate medical attention and advice is sought. Diary notes also confirmed that the people case tracked had access to their General Practitioner when necessary. A person told us, “The doctor always comes when you ask for a visit.” We observed that people were alert and able to interact with staff. When we checked the medication records we found that the people case tracked were not on large amounts of sedative medication. The registered manager explained that she always tries to use other means Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 15 than medication to support people with dementia care needs. The use of medication is only considered after all other ways to manage behaviour have been tried. Where the General Practitioner had recommended specific medical interventions these were followed up. People’s health is promoted to ensure their continued well-being. The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that people were getting their medication as prescribed by their general practitioners. We found where the General Practitioner had made changes to peoples medication this was signed to confirm the change had been made. We found that the medication for each of the people case tracked was accurately recorded. All people living at the home are supported by staff to take their medicines. The people we case tracked had their consent to staff administering their medication recorded in their care plans. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure peoples safety. Medicines were stored safely. All medicines are stored at the appropriate temperature. A system to record controlled drugs was in place if people had to have these drugs. There are no people living in the home currently take controlled drugs. The management team monitor staff to make sure that the correct procedures are followed when administering medication. Regular management checks are carried out to make sure that medication is administered safely to people. Training has been provided on the safe administration of medicines. Training records confirmed that this training had taken place. We were able to observe staff administering medication, and confirmed that this was done safely. Staff understands how to administer medication safely to people living at the home. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 16 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 15 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. The menu reflects the preferences of people living at the home and offers a balanced diet. EVIDENCE: We spoke with people who live at the home who told us that they are provided with regular activities. One person told us, “ theres always activities to keep you busy.” The annual quality assurance assessment highlighted that there is an, “ on going regularly programmed internal and external activities for people.” We found that the home has a varied programme of activities and outings. Since the last inspection an activities organiser has been appointed. People told us that since the activities organiser had been working at the home Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 17 there had been an increase in the range of activities provided. A relative commented, “I always see activities going on whenever I visit.” We observed that activities were taking place at various times throughout the day. Since the last inspection the home has improved it’s recording of activities taking place in the home. We found that these records showed what activities are provided each day and which of the people living in the home had taken part in them. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. As there are a number of Greek Cypriot people living at the home a selection of Greek television channels has been provided. This gives the Greek residents more choice about what they can watch. Greek people living at the home go to their church to attend services. The priest from the Orthodox Church regularly visits the Greek people who live at the home. Greek speaking people said that they found this really valuable. They appreciated this aspect of life at Anastasia Lodge and as one person commented made the home, “ a very nice place to live.” We spoke with two other people who were both Irish and Roman Catholics. They explained that the home supported them to maintain contact with the Roman Catholic church and that the representative from the church visits them regularly to take Mass. One of the people told us that he has been supported by the home to maintain his regular contact with the local Irish Centre. Peoples cultural and religious needs are supported by the home to ensure their well-being. We observed that staff spend time talking with people who live at the home and listening to what they had to say. For example, we observed that peoples birthdays were celebrated. One person said, “ Staff are good. Im happy with the way they treated me.” Staff spoken to understood the importance of oneto-one contact for people. Relatives commented that there were no restrictions on visiting the home. A relative said, “ you can come in at any time in the day. You always get a friendly welcome from the manager and staff.” People told us that they could see visitors in private if they wished. Diary notes showed that people had regular contacts with family, friends and the wider community. The menu showed that options are offered at each meal. This included meal options reflecting the cultural and religious backgrounds of people living in the home. The menu is varied offering a number of choices of meals. We spoke with people who were generally pleased with the quality of the food provided. A person who lives at the home said, “ the food is very good.” We observed that people are asked whether they preferred the first or second choice on the menu. Another person commented about the choice of food offered and that staff, “ do bring an alternative to whats on the menu.” People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 18 Meals were balanced and nutritious. People’s dietary needs recorded as part of their care plans (for example if they were diabetic or needed a puree meal). We observed that meals were well presented in a warm and friendly way. We saw that people were supported to eat. We observed that this was done at the pace of the people being assisted. People able to enjoy their meals in the dining room or in their own bedrooms if they wished. Tables were laid with napkins and condiments the use of people. People are able to enjoy the food they prefer and like. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 19 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 18 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that their complaints will be listened to, taken seriously and acted upon. The home’s procedures protect people from abuse. EVIDENCE: The annual quality assurance assessment confirmed that a clearly defined complaints policy with agreed timescales for managing complaints was in place for people to use. We found that the detailed policy was in place. We saw that the complaints policy was available for people to consult. To support people whose preferred language is Greek the complaints policy had been translated into Greek so they knew how to make a complaint. People living at the home told us they had received a copy of the complaints policy. Both people living at the home and relatives said that if they had a complaint they would talk to the manager. They felt that once an issue had been discussed with the manager it would be taken seriously and sorted out. No complaints had been referred by the Commission to the home since the last key inspection. A complaints book is available to record all concerns, allegations and complaints. We found that the complaints book recorded the actions that had Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 20 been taken to address issues. The complaints record showed actions taken to resolve complaints. People with whom we spoke confirmed that they knew how to make a complaint. A person told us, “I can tell the manager or my relative if I had a complaint.” The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. The home is continued to develop its practice in making sure that people are safeguarded from potential abuse. Further training had been provided for staff based on the host local authorities (Haringey) safeguarding procedures. There were policies on handling abuse and protection. These policies reflected the host local authorities guidance on reporting and handling allegations of abuse. People living at the home felt confident that any concerns they raised would be handled sensitively and appropriately. A person told us, “ I can tell staff if I am worried about things.” All the people living at the home with whom we spoke said they felt safe. There had been no adult protection issue since the last key inspection. We found that staff had received training on adult protection. Staff spoken to could recognise the signs of potential abuse, and explained how they would respond to it. Staff also understood the importance of sharing concerns about suspected safeguarding issues either with the management of the home or other relevant agencies (for example, the host local authority or the Commission). People feel safe and well supported by the home, which has their protection and safety as a priority. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 21 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 26 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that provides a safe and homely environment. The home is clean and hygienic. EVIDENCE: We saw that the home provides a safe and homely environment for people to live in. People living in the home and relatives felt that the home provided a pleasant place to live. One relative commented that the home was, “ paradise on earth” for their elderly relative who lived there. A passenger lift provided access for people to all floors. We observed that people were able to access all areas in the home safely. The home has the necessary adaptations to support Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 22 people to move around safely. There are adapted bathrooms and toilets on each floor. These are accessible to people who have mobility difficulties. Hoists were available. Records showed that these had been maintained. There are large dining and sitting areas for the use of people. The home provides an accessible environment for people to live in. Bedrooms were personalised with items of furniture and pictures belonging to people. We observed that bedrooms had been decorated in line with the individual wishes and preferences of people living at the home. The registered manager explained that as part of providing a supportive environment for people with dementia neutral colours had been used in the communal areas of the home. Bedroom doors had a picture of the person on them, to help with recognition of their bedroom. All bedrooms are single occupancy and have en suite facilities. One person said, “ My bedroom is very nice. I have my own things.” People are encouraged and supported to personalise their bedrooms. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. Effective infection control measures are in place to ensure the safety of people living at the home. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 23 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 30 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are always available to meet the needs of people who live at the home. Staff do have all the skills to meet all the assessed needs of people who live at the home. People who live at the home are protected by the home’s recruitment practices. EVIDENCE: The rota showed that a consistent staffing level was being maintained in the home. Staff said that the current staffing level allowed them to meet the needs of people. We observed the staff were always available to meet the needs of people living at the home. A person who lives in the home told us, “ the staff here are very good and helpful.” People living at the home told us that staff are available to meet their needs. We observed that staff were available at key times of the day (e.g. mealtimes) to assist people. Staff were also observed to spend time with people both individually and in small groups. This allowed more attention to the individual Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 24 needs of people. There is consistently enough staff available to meet the needs of people living at the home. The registered manager was able to show 100 of staff has achieved the National Vocational Qualification in care. Training records we examined confirmed this. As part of completing their National vocational qualification staff had received training in promoting equality than diversity. A relative told us, “ the staff treat residents very well, and there’s a very caring attitude here.” Language training in how to speak Greek had been provided for those staff that did not speak Greek as their first language. People are supported by staff who can meet their cultural needs. Staff training records showed that staff had done training the essential areas, such as food hygiene, health and safety, administration of medication and infection control and first aid. Staff told us that they had received training in dementia care. They understood what it meant to deliver Person centred care to people who have dementia. We discussed this with the manager who explained that all staff had been on some dementia training. Training records we saw confirmed this. A relative said, “ The manager makes sure that staff have access to a lot of training.” We observed that staff demonstrated that they knew how to support and care for people. The home ensures that all staff receives relevant training that is focused on delivering improved outcomes for people. We looked at two staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with people who live at the home. Their employment record had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The staff group reflect the cultural backgrounds of people living at the home. People living in the home said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of people. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 25 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 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people receive the care they need. People who live at the home are consulted about the quality of the service, and encouraged to make suggestions for improvement. People who live at the home have their financial interests protected by the home’s procedures. People who live at the home and staff are protected by the home’s health and safety procedures. EVIDENCE: Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 26 Since the last inspection the registered manager has resigned. A new acting manager has been appointed. The acting manager explained that she is currently making application to be registered with the Commission as the registered manager for Anastasia Lodge. We emphasised that the registration process should be pursued so that a home has a registered manager. The acting manager explained that she has reviewed the equal opportunities policy for the home. We found that the policy now reflects all the key areas of equality and diversity issues in line with current legislation and best practice. The policy is a positive statement that promotes peoples right to have their equality and diversity acknowledged in all areas of their life within the home. The acting manager has extensive experience of managing a service for older people. The acting manager has maintained and updated her skills since starting work at Anastasia Lodge. The acting manager has completed a certificate course in dementia care. She has a clear understanding of the key principles and focus of the service to make sure that people receive the care they need. A person who lives at their home said, “ I can talk to the manager, she always listens to what you have to say.” We observed that the acting manager spent time talking to people who live at the home. The acting manager has a clear understanding of how to deliver good outcomes for people living at the home. The home has successfully been registered to care for people who have dementia. We found that the home provides a safe and supportive environment for people with dementia. The manager has made sure that staff have the necessary skills and understanding to meet the needs of people with dementia. We observed that staff knew how to respond to peoples needs in a sensitive and Person centred way. The home provides care to people with dementia that acknowledges and supports their personhood and well-being. Staff spoke very highly of the acting manager. They said they felt well supported and received clear directions and leadership. The acting manager and staff work to make sure that the home is running in the best interests of people who live there. We observe this throughout the inspection. A relative said about the acting manager, “ shes very good at her job.” Relatives and other professionals provided positive feedback about how the home was managed and has been improving how it makes sure that the needs of people are met. The registered manager works to continuously improve the home and provide an increased quality of life for residents. She has completed a detailed annual quality assurance assessment and this provides a clear picture of how the service will be developed for the benefit of people living at the home. The home has a system for obtaining the views of the quality of the service it provides. The home makes sure that any areas for improvement are Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 27 addressed. A survey of the views of people who live at the home, relatives and professionals had recently been carried out. The findings of this survey had been action to improve the home. Minutes of meetings with relatives and people who live in the home were seen and these confirmed their involvement in the running of the home. People who live at the home have meetings on a regular basis to discuss how they wish the home to be run. Staff meetings take place to make sure that staff are aware of how they should support and care for people. People’s views are sought and provide the bases for improving the quality of the service. The home does not hold money for people who live at the home. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. People who use the service can have confidence in the home’s procedures for handle their money safely. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Fire drills were taking place and the fire alarm was tested regularly. We found that the fire risk assessment includes an assessment of all the potential fire risks in the home. We questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. We discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of people who live and work at the home. The temperatures of the fridges and freezers were recorded and within safe limits. Health and safety checks, procedures and training make sure that people living in the home are safe. Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 28 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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X x 4 Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 29 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 Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Anastasia Lodge DS0000071446.V366222.R01.S.doc Version 5.2 Page 31 - 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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