Care Home: Andora House

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What the care home does well Information received from Mrs Smith prior to the inspection visit reported : "I provide a warm and comfortable home for my two residents and aim to give them choices in everything they do. I follow the guidelines in the national minimum standards and health a safety guidelines to ensure the home remains financially viable and is a safe environment for residents, staff and visitors. I keep policies and procedures up to date and review them at least annually. My main aim is to ensure the residents lead fulfilled and happy lives. We use care plans which we update with our residents every six months at least unless there are any changes which need recording earlier We carry out risk assessments that are updated at the same time as the care plan and discussed with the residents. We make adaptations to the home to suit residents` changing needs. We involve our residents in decision making about their lives and about the running of the home" The findings of the inspection concur with the comments. What has improved since the last inspection? Mrs Smith has decorated the lounge and a bathroom and replaced three toilets and provided a downstairs shower room. Alterations have been made to the home as detailed above with adjustments to a shower to make it more accessible for one resident. A shower seat was supplied to enable one resident to enjoy a shower rather than a bath after she complained that she could not stand up in the shower. New furniture was bought after one residents asked for a new chair. What the care home could do better: There are a number of areas that would benefit from completion of repairs and upgrading CARE HOME ADULTS 18-65 Andora House Andora House 6 Albert Road Margate Kent CT9 5AN Lead Inspector Geoff Senior Unannounced Inspection 26th March 3:00pm Andora House DS0000023157.V359131.R01.S.doc Version 5.2 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 Andora House DS0000023157.V359131.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 Adults 18-65. 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. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Andora House Address Andora House 6 Albert Road Margate Kent CT9 5AN 01843 230857 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) Mrs Anne Dorothy Smith Mrs Anne Dorothy Smith Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2007 Brief Description of the Service: Andora House is registered to provide residential care for up to three people who support due to their learning disabilities. The home is a terraced property close to the sea front in a residential area of Margate. The home is within short walking distance of amenities such as rail and bus services, health centre, shops, churches and library. Staffing comprises of a Registered Owner/Manager and other family members, the residents live as part of a family. Fees are £323.01p Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Andora House included an unannounced visit to the home that was undertaken on 26/03/08. Time was spent talking with the Provider, Mrs Smith who is also the manager. The opportunity was taken to discuss with the service users, their experiences and opinions of the home. Observations indicated that they were settled in the home, were comfortable in the company of staff and had plenty to do. Throughout the visit, Mrs Smith’s attention to the service users’ needs her patient, friendly manner and her treatment of each service user as an individual was observed and noted. The premises were viewed and a range of records was inspected. Not all NMS were inspected at this visit. Unless noted, only the core standards were inspected in each outcome group. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes What the service does well: What has improved since the last inspection? Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 6 Mrs Smith has decorated the lounge and a bathroom and replaced three toilets and provided a downstairs shower room. Alterations have been made to the home as detailed above with adjustments to a shower to make it more accessible for one resident. A shower seat was supplied to enable one resident to enjoy a shower rather than a bath after she complained that she could not stand up in the shower. New furniture was bought after one residents asked for a new chair. 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. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. Mrs Smith continually monitors, and discusses the service with the two residents, to ensure their needs and aspirations continue to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two Service Users have lived in the home for approximately 11 years and initial care plan documentation identified their needs and choices. Mrs Smith reported that much attention is paid to their continuing needs and aspirations and action taken as appropriate. Examples were cited of environmental changes made, and how efforts at re-establishing family contact have improved individual circumstances. Further inspection of this standard was not undertaken as the Registered Provider stated that she would not be taking any more Service Users. A previous inspection stated that suitable information is available about the home for prospective Service Users and their families. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 9 Detail from the home’s annual self-assessment stated: “When our current residents came to live here 11 years ago we followed the procedures now set out in the minimum standards, inviting them to view the home, have a meal with us, etc. We have a Statement of Purpose and a Residents’ Guide to the home that are updated as necessary and any changes would be sent to CSCI.” Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. People who use the service experience adequate quality outcomes in this area. Care plans reflect Service Users needs and choices. Service Users are enabled to make decisions about their own lives. Service Users are enabled to take risks as part of an independent lifestyle This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Provider lives on the premises and her daughter lives next door. The Service Users live as part of the family. It was previously reported that Care plan contents were basic but included picture diagrams for the individual Service User to be able to better understand different aspects of their care The picture format in the care plans is simple to Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 11 understand and assists Service Users to describe if they enjoy any particular activity. Mrs Smith reported that little has changed but, as the staff team comprises her and her daughter, any change of circumstance would be noted and addressed. Formal reviews are undertaken at the Day Centre that both service users attend on five days each week. Risk assessments are undertaken. One Service User confirmed that they had been enabled to travel to the local shop by Mrs Smith encouraging and promoting confidence in travelling alone. This is good practice. Previous report noted: The Registered Provider stated that obtaining care management support has been very difficult and at best she has a telephone number for the duty officer if required and that no care management review had been undertaken. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. People who use the service experience good quality outcomes in this area. Service Users are encouraged to take part in age appropriate activities. Service Users take part in community activities. Family contact is encouraged and welcomed. Service Users rights are respected. Meals are varied and are chosen daily by Service Users. This judgement has been made using available evidence including a visit to this service. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 13 EVIDENCE: It was reported that both the service users choose to go to the local Day Centre five days per week. They enjoy the activities and pastimes available during the day but now decline the evening clubs. Service users spoke about the holidays and days out enjoyed with Mrs Smith and the efforts made to celebrate significant events and birthdays. Service users have their own rooms, decorated, furnished and with ornament and personal items of their choosing. Personal privacy is respected and service users may sit in the communal lounge or retire to their own rooms without restriction. Efforts are made to maintain links with family members and arrange visits where possible. Formal menu plans are not in place simply because the service users choose what they fancy on a daily basis. Records are kept of meals taken. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. Service users receive personal care support in accordance with their needs and preferences. Health care needs are monitored and addressed and medication is appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both service users require some assistance with matters relating to personal care, Mrs Smith ensures it is offered only where needed and in a sensitive and dignified manner. A pictorial format to the care plans helps the service users express their personal care preferences. Mrs Smith described how facilities have been improved in order to meet service user’s changing needs. There are adequate bathing facilities and each service user has their own room to maintain privacy. Mrs Smith reported that: “As we are such a small home we know our residents Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 15 extremely well and can recognise when they are not feeling well or if something else may be affecting them. We support them in the way they prefer and enable them to visit doctors, hospital, etc with support as necessary. We recognise new needs as they are getting older and explain these changes to them in a sensitive manner. We have also had sensitive discussions about dying and death.” Medication storage and management is adequate for the needs of the home. Records seen were up to date and complete. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Staff training and systems are in place to protect the service users from the risk of harm This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Smith and her daughter have undertaken adult protection training as well as having adult abuse polices provided by the local authority. A complaint procedure is available. Service users said that they would talk to Mrs Smith if they were unhappy or worried about anything. They would also talk to day centre staff if they needed other people that they could confide in. No concerns or complaints had been received since the last inspection. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Service users have a generally clean and comfortable environment in which to live. . This judgement has been made using available evidence including a visit to this service. EVIDENCE: Andora is Mrs Smith’s home and the service users live very much as part of the family. The house is reasonably decorated and comfortably furnished. One service user pointed out that new easy chairs had been bought at her request. There were signs of ongoing maintenance and repair still in need of completion and other areas where facilities had been improved since the last inspection visit. As noted earlier, the service users have their own room. Each is adequately furnished and decorated to individual preference. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 18 The Registered Provider has a large and friendly pet dog that is very much part of the family home. The laundry area has suitable machines for reaching recommended temperatures. The small paved garden at the rear offers an area for Service Users to sit in. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. Competent and qualified staff supports Service Users. The staff has all been CRB checked. All staff are NVQ4 qualified This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both Mrs Smith and her daughter have attained the Registered Managers Award. There are no external members of staff. Only the Registered Provider/manager was available to speak to and she confirmed that the family worked together to ensure Service Users were fully supported. The Registered Provider lives in the home and the remaining family live next door. A copy of the GSCC code of conduct was seen in the home. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home is run in the interests of the service users who have opportunity to express their opinions. Health and welfare of all in the home is promoted and protected This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Smith presented as an experienced, well informed individual committed to the care of the two service users. She does not intend to admit any more service users. Mrs Smith reported that: “As we have only myself as registered manager and my daughter for emergency cover, we work together well in running the home. We are both qualified and experienced with this client group. Quality assurance is carried out during normal daily living routines as I live with the residents and ask their opinions about what we are doing or what they would Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 21 like at all times. I keep our policies and procedures up to date and aim to keep up to date on any new legislation. I ensure health and safety guidelines are followed.” An open, family atmosphere has been established and it would appear that the health, safety and welfare of the service users is paramount to the provider. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 23 no Are there any outstanding requirements from the last inspection? 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. 1 Refer to Standard YA24 Good Practice Recommendations The home’s premises are suitable for its stated purpose; accessible, safe and well maintained; meet service users’ individual and collective needs in a comfortable and homely way; and have been designed with reference to relevant guidance. Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Andora House DS0000023157.V359131.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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