Care Home: Anglesey Court

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What the care home does well The home has demonstrated and evidenced compliance with all the requirements made at the previous key inspection in September 2009. The home provides a homely environment for people living there. People are supported to remain as independent as possible with their personal and health care. Details of how to support people with regard to this are included in the care planning processes. What the care home could do better: No additional requirements have been made as a result of this inspection. The home needs to ensure changes made are embedded into care practices and they continue to look towards changes such as the new care planning process to ensure people living at Anglesey Court have the best possible outcomes from the care and support they receive. Random inspection report Care homes for older people Name: Address: Anglesey Court 26 Crescent Road Alverstoke Gosport Hampshire PO12 2DJ one star adequate service 09/09/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Gina Pickering Date: 2 4 0 3 2 0 1 0 Information about the care home Name of care home: Address: Anglesey Court 26 Crescent Road Alverstoke Gosport Hampshire PO12 2DJ 02392582322 Telephone number: Fax number: Email address: Provider web address: angleseycourt@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Anne Margaret O`Gorman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Anglesey Court Limited care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 20 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admisison ot the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Anglesey Court is a large detached house, situated in the village of Alverstoke, Gosport. The home has a garden at the front of the property and a car park to the rear. There is a public park opposite the house and the beach is a short distance away. Care Homes for Older People Page 2 of 10 0 9 0 9 2 0 0 9 Brief description of the care home Angelsey Court is registered to provide care and accommodation for up to twenty older persons. There are five double and ten single bedrooms. Residents also have access to the communal lounge and dining room. Care Homes for Older People Page 3 of 10 What we found: This random inspection was completed to assess the services compliance with requirements made following the last key inspection on 9 September 2009. Information for this inspection was obtained by a variety of methods. We used information from the improvement plan that we received from the service on 24 December 2009 detailing the actions they had taken and were going to take to ensure compliance with the requirements. A visit to the service was made on 24 March 2010 where we looked at documentation and the environment, and spoke with the matron, staff members and four people living at the home. We sent surveys to people living at the home, their relatives and staff working at the home. We received five surveys from people living at the home and two surveys from staff members and information in these has been used in the inspection process. At the last inspection a requirement was made that there must be detailed reviews of care plans to ensure that they provide guidance for all aspects of care that people need or want in the home including moving and handling, dietary needs, medication, emotional and social needs to minimise risks. The improvement plan told us us the service had reviewed all care plans with people living at the home and people had agreed fully detailed descriptions of their daily routines and bathing preferences. We looked at care plans for four people living at the home. A detailed description of each persons daily routines had been included. This included details about preferred rising and retiring times, where and when people like to take their meals and assistance needed at meal time, their mobility and any aids or support they need to mobilise and their leisure and social interests. A separate description details their bathing and washing preferences. Examples included when the person likes to have a bath and which bathroom they like to use, assistance required getting in and out of the bath, how hot they like the water, what they can do for themselves, what they need assistance with and what bathing products they like to use for example bubble bath or soap and water. Detail is also included of the support the person needs to get dressed and the style of clothes they generally chose to wear. The care plans provided further details of personal care needs that included going to the toilet, whether the person manages themselves or what assistance they need and for those that require aids what aids they use, how often they are changed and whether they manage the aids themselves. For people with specific medical problems there was detail about how to monitor that person medical condition that included the person being supported to administered their own medications and dietary requirements and when medical assistance needs to be sought. Details about peoples mobility included whether they use a walking aid to mobilise, whether they need the assistance of a staff member and how areas of the environment of the home affect their mobility. For example one person with a certain mobility problem has difficulties some times going through door ways. Detail is included about how to support this person so he/she can pass through doorways. There is an assessment of the persons risk of falling and the action taken to reduce any risks of falling. Further risk assessments include assessing the risks to the person of accessing various areas of the home including the garden areas and the use of the passenger lift, risks as result of peoples poor eyesight, continence problems, use of mobility aids, the use of hot water in wash sinks and moving and handling assessments. Action to be taken to reduce Care Homes for Older People Page 4 of 10 any of the identified risks is detailed. People living at the home told us that staff provided the care and support they need in the manner they prefer. People living at the home also confirmed to us that staff enable them to manage their own personal and health care needs if they are able to do so. For example one person manages his/ her own continence aids and another person is supported to manage her/his own medical condition by administering his/her own medication for it. Returned surveys from people living at the told us they received the care and support they need to meet their personal and health care needs. Staff told us in surveys they have up to date information to ensure the care they provide for people living at the home is the care and support they need and wish for. In addition to these improvements the manager has identified that the current care planning documents used at the home do not lend themselves to providing in depth detail about peoples needs and their personal preferences. As a result of this an improvement officer from Social Services has been supporting the home to implement a new format of care planning which will allow for greater detail and a clearer process for recording peoples needs and the actions to be taken to meet their needs. It was noted during our visit to the home that all care plans and risk assessments have been reviewed monthly and that all plans and daily routines were signed by the individual person living at the home indicating their involvement in this process. This information means the home has evidenced compliance with the requirement made about care planning. Two requirements were made following the last inspection about the management of medications. There was no up to date evidence that staff administering medications had received relevant training. The home told us in their improvement plan that all staff who administer medication had completed training and assessments provided by the pharmacist about the management and administration of medications. We saw documentary evidence that this training had been completed in December 2009 for the senior care staff who are the only staff members who administer medications. At the last inspection there were medications detailed on Medication Administration Record (MAR) charts that had not been signed for. No reason had been documented as to why these had not been administered. We looked at the MAR charts for peoples whose care plans we had looked at. All medications were signed for. Changes to the medications on the MAR charts corresponded to information in the relevant care plans about changes of medications by medical practitioners. The manager confirmed to us the process for ordering medications which includes the viewing of prescriptions to ensure what is being received from the pharmacy is what has been prescribed for the person living at the home. This means people are receiving the medication prescribed to them by their medical practitioner. This information means the home has demonstrated compliance with the requirement made about medications. A requirement had been made about the use of the bathroom on the second floor being used for cleaning purposes. We noted that this bathroom was accessible for the use of people, with cleaning equipment being stored in cupboard areas. We were told that this bathroom is rarely used by people living at the home for bathing. There was an accessible toilet for the use of people on the second floor. Plans have been made to create a further storage area in this bathroom so it is left clear for bathing purposes. This means the Care Homes for Older People Page 5 of 10 home has complied with this requirement. A requirement was made about the quality assurance processes at the home that they must ensure shortfalls in the service are identified and action taken to address the shortfalls. We spoke to the matron about the quality assurance processes at the home. Management processes are quality assured by a professional company to ensure they are robust and serving the home and people who live there. The views of people are obtained in a variety of ways. We were told that one to one conversations often result in peoples wishes being expressed that the home can act on. Meetings for people living at the home are held four times a year, during which they can raise any concerns and wishes. Records are kept of these meetings, evidencing peoples involvement in the the planning of meals and activities. The records also detailed that people living at the home are informed about changes in the running of the home which can include any staff changes and the role of the Care Quality Commission. During the course of our our visit we had conversations with several people living at the home who knew what our role as CQC inspectors was without having to explain it to them. The manager told us she was going to re introduce periodic surveys to gain the views of people about the running of the home. A system is in place for the identifying, recording and responding to maintenance issues at the home. By looking at the relevant documents it was evidenced that maintenance issues are identified and addressed within acceptable time scales to protect the wellbeing of people living at the home. This means the home has complied with this requirement. A requirement was made following the last inspection about health and safety aspect of the home. Concerns were raise in the report about substances hazardous to health not be locked away. Information in the improvement plan told us that the cupboards for these substances now all have locks on them. This was found to be so during our visit to the home and no substances hazardous to health were identified as being left unattended. This means people living at the home are being protected from the risks associated with these substances. It was identified at the last inspection that toilet rolls were dangling on the floor, and there were bars of soap in bathrooms, all of which posed a cross infection risk. We were informed by the service in the improvement plan that this had been addressed. At the inspection we observed that all toilet rolls were in a covered toilet roll dispenser, paper towels were in towel dispensers and there was dispensing liquid soap in all bathrooms with no bars of soap in the bathrooms. We were told that if a person has a bath or wash in one of the bathrooms who wishes to use their own bars of soap the practice is to return the bar of soap back to the persons bedroom immediately after the bath or wash has been completed. We looked at the risk assessments for the home. These included risk assessments for equipment and possessions for example risks for people associated with the use of footstools, walking frames and handbags: risks associated with the external environment of the home for example use of the washing line, the condition of paths; risks associated with the internal environment including the kitchen, furniture and fittings, radiators and hot water; staff practices including lifting and handling and the use of electrical equipment. there were details of the action being taken to reduce the risks associated with any of these areas. It is concluded the home has complied with requirements made about health and safety at the home. What the care home does well: Care Homes for Older People Page 6 of 10 The home has demonstrated and evidenced compliance with all the requirements made at the previous key inspection in September 2009. The home provides a homely environment for people living there. People are supported to remain as independent as possible with their personal and health care. Details of how to support people with regard to this are included in the care planning processes. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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