Care Home: Ann Challis Residential Home

What the care home does well The service works well with the people living in the home and their relatives and their is an emphasis on listening to the views of the people using the service. Good professional relationships are maintained with health care professionals and people living in the home can be confident that their health care needs will be met. There are a variety of activities available for people living in the home, and plans to develop this area of practice further by arranging more outings. The physical environment of the home is kept clean and tidy and safe and offers a variety of communal and private areas for people living in the home and their relatives to enjoy. The service has prioritised the general refurbishment of the home, and the addition of three single rooms has been tastefully completed. The furnishings and decor are of a high standard. The providers have told us that this is part of an ongoing programme of refurbishment where they hope to continually improve the environment for the benefit of the people who live there. Staffing levels during this visit were sufficient to meet the assessed needs of the people in the home. The staff team maintained appropriate and relaxed relationships with people and this created a warm and friendly atmosphere. People we spoke to about the staff team and the home were very positive. Comments included: "The staff make the home friendly and nice". "I think they ( the staff ) are sensitive in the way they look after people". "The staff and the manager are very approachable". "The carers are very good, they listen to you". There was evidence to show that the manager was working hard to develop auditing and monitoring systems in the home and to establish good supervision and training programmes for staff. The information we have about this service is that it is committed to developing the home in a way that serves the best interests of the people living there. What has improved since the last inspection? This is the first inspection of this service since it was registered as a new service. What the care home could do better: Some improvement could be made to care plans to obtain more background information so that staff can support people appropriately. Care plans need to be updated to reflect any changes so staff can meet individual needs in a safe way. Lockable units should be provided in bedrooms so that people have more privacy. Key inspection report Care homes for older people Name: Address: Ann Challis Residential Home 128 Stretford Road Urmston Manchester Lancashire M41 9LT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ann Connolly     Date: 1 1 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ann Challis Residential Home 128 Stretford Road Urmston Manchester Lancashire M41 9LT 01617483597 01617498887 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): J.E.M Care Ltd Name of registered manager (if applicable) Mrs Margaret Madden Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category/ies 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 Date of last inspection Brief description of the care home Ann Challis is a large Victorian property that has been extended and adapted into a residential care home. The house is set back from the main road and is situated on a main bus route.The accommodation has been recently improved and new single ensuite bedrooms have been added. At the time of this visit the maximum numbers of people who could be admitted is 23. The accommodation consists of a large dining Care Homes for Older People Page 4 of 27 Over 65 23 0 Brief description of the care home room, large lounge and smaller lounge area and a hairdressing salon. The home is equipped with with ramps and specially adapted bathrooms. A passenger lift provides access to all floors. There are pleasant garden facilities and ample car parking to the front of the building. Fees for this service range from three hundred and sixty four pounds and thirty pence to four hundred and fifty pounds per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this care home is a two star good service. This is the first inspection of this service since registration six months ago. This was a key inspection which included a visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. The inspection looked at all the key standards and included a review of all available information received by the Commission about the home. During the visit, a selection of records, care plans, policies and procedures were looked at. Discussion took place with the manager, the provider, staff working in the home and some relatives and friends who were visiting. We spoke with people living in the home to find out what they felt about the service and how staff supported them. A tour of the building took place and people were asked for their views about the environment. Before the inspection we asked the service to complete a form called the Annual Care Homes for Older People Page 6 of 27 Quality Assurance Assessment (AQAA) to tell us what they felt they did well and what they needed to do better. The information in this document was limited and needed to be in more detail and this has been addressed in the management section of this report. Surveys were sent out to people living in the home. At the time of this visit we had not received any returned surveys. The home has good systems for managing complaints. They have received several concerns of a minor nature which shows that they take all concerns and complaints seriously. The Commission has not received any recent concerns about this service. There have been no recent safeguarding referrals. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Some improvement could be made to care plans to obtain more background information so that staff can support people appropriately. Care plans need to be updated to reflect any changes so staff can meet individual needs in a safe way. Care Homes for Older People Page 8 of 27 Lockable units should be provided in bedrooms so that people have more privacy. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual care needs are assessed to ensure that staff are able to confirm that they can meet identified needs in an appropriate way. Evidence: Information about the home is available on request and a copy of the service user guide is available in each bedroom. Some recent alterations and improvements have been made to the environment and the service user guide was in the process of being updated to reflect these changes. The details in the service user guide provides good information to help people to make an informed decision about their future care and support arrangements, and to see whether the home is appropriate for them. One person told us that they visited the home twice before making a decision to move there. One person said, I came to look round twice and on the second visit I had a meal. It had a nice feel and I have never regretted moving here. Care Homes for Older People Page 11 of 27 Evidence: Three care plans were looked at and two of these included an assessment of care needs. The manager told me that one admission had been an emergency, but acknowledged that all needs assessments must be in place prior to arranging admissions into the home. This shortfall was addressed at the time of inspection. Risk assessments were in place with information for staff on how to manage and minimise risks. The pre- admission assessment considered all aspects of health and social care needs. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated with dignity and respect and their health, personal and social care needs are taken seriously. Evidence: Three care plans were looked at during this visit. Each plan was written in a person centred format which identified how the person wanted to be supported and what their person goals and objectives were. There was evidence to show that care plans were reviewed monthly. The files showed that people had access to medical and healthcare services and all visits from medical practitioners were recorded on file. Care plans would benefit from more information on background history, likes and dislikes so that staff have more information on lifestyle preferences and significant life events. This would help them to provide care in a meaningful way. One file showed us that an appropriate referral had been made to the General Practitioner for medical assessment. Detailed instructions were included in the daily recordings for managing the situation, but the care plan had not been amended to Care Homes for Older People Page 13 of 27 Evidence: reflect this change. This shortfall was addressed at the time of inspection. It is important that this is done consistently so that staff are kept fully updated in any changes in care needs so that they support people in a safe way. The daily records on care plans were not always relevant and didnt consistently show how staff had implemented the care plan. The manager was aware of this shortfall and said this would be looked at as part of the managerial task to review and audit care plans. People we spoke to were very positive about the support they received from staff. Comments included: The staff are very kind, they really help me. They help me if I am in difficulty and they have endless patience. The staff look after us very well, they are very good. Relatives who were spoken to said: The staff are very friendly and make the home feel homely and nice. I think the staff are very sensitive and they are very patient with people, nothing seems too much trouble for them. Policies and procedures were in place for the safe handling of medication. A sample of medication was looked at and staff were observed in the administration of medication. Staff followed procedures correctly for the safe administration of medication and recordings on the Medication Administration sheets (MAR) were filled in appropriately. Staff told us that they were only allowed to administer medication after they had received full training. Medication records were seen during the visit and were appropriately maintained. Systems were in place to carry out audits and monitoring of medication systems to ensure that good practice was consistently maintained. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the support they need to live their chosen lifestyle. Evidence: During this visit we saw numerous visitors to the home, ans they were made welcome by the staff. Most of the visitors were relatives of the people living in the home. There was an extensive activities programme in place which included art and craft, beauty and manicure, bingo, gentle exercises. Discussion with the manager showed that she had a creative approach to looking at different types of activities with an understanding that the focus should be on listening to the individual lifestyle preferences of individuals. The manager told us that there were plans to develop meetings with with residents and their relatives to obtain feedback about how the home should be run and improved. The meal in the home was sampled and was of a good standard. The home employs a cook who has responsibility for developing the menu and providing home baking. Although a choice of menu was not on display, there was evidence that people were offered choice. The main meal consisted of fish chips and peas, but some people chose an alternative of corned beef and mashed potatoes or egg and chips. The manager Care Homes for Older People Page 15 of 27 Evidence: told us that there were plans to develop the menus and provide written formats showing what alternatives were available. The mealtime was a pleasant relaxing occasion. Tables were well presented and staff were on hand to provide sensitive discrete support where needed. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring that people feel listened to. Evidence: Policies and procedures were in place to ensure the protection of people living in the home. The complaints procedure was included in the service user guide and information in the AQAA stated that all complaints would be responded to within five working days. The information in the AQAA told us that the service had not received any complaints in the last six months since registration. When we looked at the complaints book, it showed that a number of small complaints has been received by the home, and even though they were minor in nature, all of them had been listenend to and responded to appropriately. This shows that the service takes all concerns and complaints seriously, no matter how small. The action taken and outcome for the complainant was recorded and provided information to help the manager to review and monitor complaints made to the home. A large number of people living in the home, and some visitors were spoken to during this visit. All of them told us that they felt confident in raising concerns to the manager or the staff team. Comments included: There is no problem in raising a concern- they really do listen to you. Care Homes for Older People Page 17 of 27 Evidence: I have never had a complaint, but I know they would listen to me. They listen to our opinion and our point of view. Several staff were spoken to during this visit and they all had a good understanding of safeguarding procedures. The manager told us that all staff would be receiving updated training on safeguarding as part of the training and development plan that was due to be put into place. At the time of this visit there had been no safeguarding referrals and the Commission has not received any recent complaints about this service. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ann Challis provides a safe and comfortable home that is well maintained and decorated to a good standard. Evidence: During this visit a tour of the home took place. There were good standards of hygiene and cleanliness throughout the building. All parts of the home were clean and tidy and fresh smelling. There was evidence of ongoing maintenance and improvements, and the home has recently benefited from the addition of three newly appointed single bedrooms with tasteful fixtures and furnishings. Small attention to detail was evident with the addition of personalised photo frames for people to display their photographs of family and friends and some luxury items including curtains and bedding. Communal areas were bright and pleasantly furnished. The providers of the home told us of their ongoing plans for development of the building to improve the facilities for the people who live there. A new alarm call system was being piloted providing wireless connection and greater flexibility for the people living in the home and the staff team. Most rooms were fitted with a lock so that people could request a key to their room. Locks were of the type Care Homes for Older People Page 19 of 27 Evidence: that could be overridden in the event of an emergency. Not all of the rooms provided a lockable unit, and it was recommended that this was part of the ongoing refurbishment so the people could have a place to securely lock private documents or possessions. Some bedrooms were looked at and it was evident that people in the home were encouraged to bring their own possessions to personalise and individualise their private space. Facilities in the home included pleasant outdoor spaces for people to enjoy in the warmer weather. There were systems in place to monitor health and safety in the home, and evidence that infection control had been prioritised, there were soap dispensers and paper towels in bathroom areas. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are supported by a well trained staff team who have gone through a thorough recruitment process, so their needs are met and they are protected from poor practice. Evidence: During this visit there were sufficient staff on duty to meet the needs of people living in the home. There were positive interactions between staff and the people in the home, and staff were seen supporting people in a caring and sensitive manner which promoted the privacy and dignity of the individual. People in the home and their visitors were very positive about the support they received from the staff. They told us that the staff were always on hand to help them and that nothing was too much trouble for them. A sample of staff files were looked at and all of them contained appropriate checks and relevant documentation including enhanced Criminal Record Bureau Disclosures (CRB), and two written references. The home is under new management and information in the AQAA informs us that the management team have focused on building relationships with the team and improving the environment for the people living in the home. During discussion with Care Homes for Older People Page 21 of 27 Evidence: the manager and the providers we were told that as part of the ongoing development, training would be prioritised over the next few months. Staff who were spoken to told us that they were given good access to training and development opportunities. The manager told us that the training matrix was being developed, but was able to show us staff certificates for a number of courses that staff had recently attended. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people who live there and their welfare is promoted and protected. Evidence: The manager has 21 years experience of being in a management position, and has worked in the home for most of this time. Through discussion with the manager there was evidence of a commitment to maintaining robust procedures for auditing and monitoring care practice in the home, and she outlined plans on how she intended to develop this. She told us that her priority was to ensure that staff had the right kind of support, supervision and training so that people living in the home could be confident that the staff had the right skills to meet their individual assessed needs. The manager acknowledged that not all staff supervision was up to date, but had clear plans for establishing a system to ensure that staff received this support. Staff who were spoken to told us that the manager and providers were very positive Care Homes for Older People Page 23 of 27 Evidence: and were very approachable. We looked at some policies and procedures which confirmed that routine checks were carried out in relation to maintaining health and safety in the home. There was evidence during this visit to show that people in the home were consulted , and that their views and opinions influenced the way the home was run. The manager outlined plans to develop the quality auditing systems in the home including regular audits of medication, which were seen, care planning and care practice evaluations. There was evidence through discussion with the manager to show that this was a service that was committed to ongoing improvements to ensure that people living there benefited from the way the home is run and the environment. We spoke about the recent AQAA that was submitted to us, and there was a recognition that this needed to be completed in more details so that the service could clearly demonstrate what they felt they were doing well and where they needed to make improvements. From discussion, it was evident that the manager and providers had a clear vision for development and improvement, but that this had not been fully reflected in the recently submitted AQAA. We were given assurance that this would be addressed and any further documentation would be in more detail. Care Homes for Older People Page 24 of 27 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans should include background information about lifestyle preferences so that staff can provide care and support in a way that meets individual needs. Recording in care plans should reflect the identified needs to demonstrate that staff have provided support to meet any assessed needs. The provision of a lockable unit would ensure that people living in the home had access to a private place to secure private documents or possessions. 2 7 3 19 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!