Care Home: Annandale

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well We found that the manager and the staff team have worked at the home for a very long time. As the home only provides care and support to ten people this mix helps to give a family atmosphere. The home is decorated in a homely way and each person has an individualised bedroom, which also added to this. People who live at the home told us that they knew the staff well, trusted them and believed that they received very good care and support. They also told us that " I`m very happy here- It`s my home", And "I`ve never had to worry about anything since the day I stepped over the door", And" the staff are marvellous- nothing is too much trouble and they take very good care of you if you`re ill". We saw that each person has a set of care records, which are started during their first meeting with the manager before they move into the home. We saw that people were involved in the development of these records at every stage which is very good practise. This helps people to feel in charge of their own lives. We found that staff can easily access these records and that they are kept up to date. This means that staff have current, written instructions to follow about each persons needs and how they would like to receive care and support. This helps to ensure that each member of staff delivers the same care to each person so that the risk of the wrong care being given or missed is reduced. We found that the staff team manage medications very safely and that they have had training on how to do this. We found that the manager understands the importance of enabling people to feel in control of their lives by ensuring they know and continue to have their rights. For example one person has a key to their bedroom, another person is registered to vote via postal voting and everyone is offered the opportunity to manage their own medication if they wish and are able. We found that the people who live at the home regularly meet with the manager to discuss suggestions to develop the home, the provision of food and activities or to raise any concerns. We also found that the manager acts on peoples opinions following the meeting, which helps people to feel as though the home belongs to them just as people would feel who live in domestic homes. We found that staff have had training to make sure that they have the right skills and experience to care and support the people who live in the home. People spoke highly of staff teams ability and told us " They re very kind- all of them", and " I never have to wait, I ring my buzzer and someone comes- even at night time" and " Pam (registered manager- Mrs Pamela Dunn) does a very good job she always comes to see me if I`m unwell or have a problem and she has a get together with us all every week in the lounge". What has improved since the last inspection? We found that activities have been improved by using large print cards for games so that everyone can join in and reminiscence afternoons have been introduced to help people who suffer with memory problems. We saw that improvements have been made to the home through redecorating some bedrooms, installing a new kitchen, providing a new seating area in the garden and installing a walk in shower. We saw that all staff have enrolled and completed a national vocational in care award, which means the staff team have up to date skills on the right way to care and support people. This training also included training on how to protect people from abuse, which address a requirement that we made last time we visited. We also found that more staff are available at night time which means people will not have to wait if they require care and support. This also helps to improve the security of the home. What the care home could do better: We think that the manager should introduce risk assessment forms to help to identify when people are at risk of losing weight, developing pressure ulcers (bed sores) and of having trips and falls. We did find that staff were managing these areas well however the introduction of these records would help to show why staff have reached decisions to change peoples care and support. We had some concerns about access for people at the front and the back of the home. We found that the front of the home has a set of long, low steps, which could restrict access for people who have mobility problems or who use wheelchairs. The manager told us that she is aware of the problem and is investigating a solution. We believe this work should be carried out as this problem could cause isolation or a reliance on staff support for some people who live at the home and also for some visitors who may wish to visit. We have also made a requirement that the stone steps at the back of the home which are used to access the garden are fixed as we saw that they had an uneven surface. This could pose a health and safety risk as some people may be in danger of tripping and falling if they wanted to use them. People canstill access the garden by walking around the side of the home but this would involve using the front steps which are also causing a problem. We were told that people seldom go on organised outings as only a few people are willing to go out and when they do is on very short journeys- for examplewalking to feed the ducks at the local pond. We think that the manager should record any discussions she has with people about whether they want to go out or not. This would help to show that the home is offering people outings and that it is their choice that is preventing outings from taking place rather than outings not occurring due to restrictions made by the home. We found that staff have the skills to keep people safe from abuse. However we think this could be improved by making sure that staff have a simply written procedure, which tells them the steps to follow should they suspect that some one has been abused. We found that staff were very fond of people who lived in the home and that trusting relationships had developed. These same staff would be responsible for reporting abuse to authorities if they suspected it had occurred and may find the experience distressing. Written guidelines would help to make sure that staff would focus on what they needed to do to ensure that people were protected and that people`s rights were upheld. We found that the home was clean and tidy but that this could be improved by making sure that liquid soap and disposable paper towels were available at all sinks that are used for hand washing. Cloth towels and bars of soap are known to harbour bacteria so removing these products would help to reduce the risk of infection spreading. CARE HOMES FOR OLDER PEOPLE Annandale 1 Victoria Road West Crosby Liverpool Merseyside L23 8UG Lead Inspector Mrs Joanne Revie Key Unannounced Inspection 09:30 6 and the 8th of May 2008 th 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 Annandale DS0000005370.V362208.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. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Annandale Address 1 Victoria Road West Crosby Liverpool Merseyside L23 8UG 0151 924 3162 0151 931 1569 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 Eila Henny Voce Mrs Pamela Veronica Dunn Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Personal care to ten service users only Date of last inspection 13th April 2007 Brief Description of the Service: Annandale is a care home registered to provide support to 10 elderly people. The home is owned by Mrs. E. Voce and the registered manager is Mrs. Pamela Dunne. Annandale is situated in a residential street, close to a bus route and shops. The building is a converted Victorian villa with well-maintained front and rear gardens, having steps to the two entrances. Communal areas include a large lounge and a separate dining room. There is a chair lift to upper floors where most bedrooms are situated. The accommodation consists of eight single and one double bedroom. There is a toilet on the ground and one on the first floor. Additionally the home has an assisted bath, and a shower. Grab rails and call buttons are placed throughout the home for peoples’ convenience. The home is staffed throughout the day and night and the service includes personal care and support, home cooked meals and an in-house laundry service. The cost of living at the home is £379.50 per week. This includes the cost of toiletries, hairdressing and activities. Annandale DS0000005370.V362208.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 2 star. This means the people who use this service experience good quality outcomes. The visit was unannounced and took place over two days. Before the visit took place we (the commission) asked the manager to complete a document called an AQAA. This is a document, which tells us about the services strengths and weakness, and future plans for the service to develop further. Once the AQAA was received, we sent out surveys to the people who live at the home. Two of these were returned completed to us and both showed that people were pleased with the care and support that they received. During the visit, we met with people who live at the home, staff who work there and the manager. Their views have been included within the report. We looked at a lot of records, which refer to the health and welfare and care received by the people who live at the home. This review also included viewing staff records. Observations were carried out to assess how well staff interact with the people who live at the home and how staff deliver care. We saw examples of care and support that showed that the manager and the staff team have a good understanding of how to treat people as individuals and how to meet their diverse needs. Staff have also have had training in how to do this. However further improvements need to be made to the building so that the home is easy to access for people with difficulty walking who wish to walk without staff support and for people who use wheelchairs. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 6 What the service does well: We found that the manager and the staff team have worked at the home for a very long time. As the home only provides care and support to ten people this mix helps to give a family atmosphere. The home is decorated in a homely way and each person has an individualised bedroom, which also added to this. People who live at the home told us that they knew the staff well, trusted them and believed that they received very good care and support. They also told us that “ I’m very happy here- It’s my home”, And “I’ve never had to worry about anything since the day I stepped over the door”, And” the staff are marvellous- nothing is too much trouble and they take very good care of you if you’re ill”. We saw that each person has a set of care records, which are started during their first meeting with the manager before they move into the home. We saw that people were involved in the development of these records at every stage which is very good practise. This helps people to feel in charge of their own lives. We found that staff can easily access these records and that they are kept up to date. This means that staff have current, written instructions to follow about each persons needs and how they would like to receive care and support. This helps to ensure that each member of staff delivers the same care to each person so that the risk of the wrong care being given or missed is reduced. We found that the staff team manage medications very safely and that they have had training on how to do this. We found that the manager understands the importance of enabling people to feel in control of their lives by ensuring they know and continue to have their rights. For example one person has a key to their bedroom, another person is registered to vote via postal voting and everyone is offered the opportunity to manage their own medication if they wish and are able. We found that the people who live at the home regularly meet with the manager to discuss suggestions to develop the home, the provision of food and activities or to raise any concerns. We also found that the manager acts on peoples opinions following the meeting, which helps people to feel as though the home belongs to them just as people would feel who live in domestic homes. We found that staff have had training to make sure that they have the right skills and experience to care and support the people who live in the home. People spoke highly of staff teams ability and told us “ They re very kind- all of them”, and “ I never have to wait, I ring my buzzer and someone comes- even at night time” and “ Pam (registered manager- Mrs Pamela Dunn) does a very Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 7 good job she always comes to see me if I’m unwell or have a problem and she has a get together with us all every week in the lounge”. What has improved since the last inspection? What they could do better: We think that the manager should introduce risk assessment forms to help to identify when people are at risk of losing weight, developing pressure ulcers (bed sores) and of having trips and falls. We did find that staff were managing these areas well however the introduction of these records would help to show why staff have reached decisions to change peoples care and support. We had some concerns about access for people at the front and the back of the home. We found that the front of the home has a set of long, low steps, which could restrict access for people who have mobility problems or who use wheelchairs. The manager told us that she is aware of the problem and is investigating a solution. We believe this work should be carried out as this problem could cause isolation or a reliance on staff support for some people who live at the home and also for some visitors who may wish to visit. We have also made a requirement that the stone steps at the back of the home which are used to access the garden are fixed as we saw that they had an uneven surface. This could pose a health and safety risk as some people may be in danger of tripping and falling if they wanted to use them. People can Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 8 still access the garden by walking around the side of the home but this would involve using the front steps which are also causing a problem. We were told that people seldom go on organised outings as only a few people are willing to go out and when they do is on very short journeys- for examplewalking to feed the ducks at the local pond. We think that the manager should record any discussions she has with people about whether they want to go out or not. This would help to show that the home is offering people outings and that it is their choice that is preventing outings from taking place rather than outings not occurring due to restrictions made by the home. We found that staff have the skills to keep people safe from abuse. However we think this could be improved by making sure that staff have a simply written procedure, which tells them the steps to follow should they suspect that some one has been abused. We found that staff were very fond of people who lived in the home and that trusting relationships had developed. These same staff would be responsible for reporting abuse to authorities if they suspected it had occurred and may find the experience distressing. Written guidelines would help to make sure that staff would focus on what they needed to do to ensure that people were protected and that people’s rights were upheld. We found that the home was clean and tidy but that this could be improved by making sure that liquid soap and disposable paper towels were available at all sinks that are used for hand washing. Cloth towels and bars of soap are known to harbour bacteria so removing these products would help to reduce the risk of infection spreading. 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. Annandale DS0000005370.V362208.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 Annandale DS0000005370.V362208.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive enough information (including spending time at the home) to make a decision about whether the home is the right place for them to live. EVIDENCE: We saw that since we last visited the home one person had moved in. We looked at their care records and spoke with staff. The person told us that they liked the home and that they were happy. Staff told us that the manager had met with the person before they moved in and when we looked at their records we saw that this was true. The records also showed us that discussions had taken place with the person so that the manager could find out about their needs and wishes so that a decision could be made about whether the staff at the home would be able to Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 11 provide the support that was needed. Part of this assessment included getting information from other people such as hospital staff and the person’s social worker. We looked at a booklet called a “ service users guide”. Staff told us that a copy of this is provided to all people who are interested in moving into the home. We saw that the person who had moved in had a copy of this booklet in their bedroom. When we looked at the booklet we saw that it contained an overview of the main policies of the home and that it told the reader what they could expect if they decided to move in. The records that we looked at also showed us that the person had spent a day at the home so that they could meet with staff and see if they liked it or not. This means that people are given the opportunity to decide whether they would like to live at the home or not. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health care needs are met and staff have clear instructions to follow about the care and support that each person needs and wants. Staff manage medications safely and people are encouraged to manage their own medications if they wish. EVIDENCE: We looked at records called “ Care plans”. These records are a list of instructions, which tells the reader what care, and support people need and how they would like to receive this support. The plans are used by staff so that staff know how to care for people. We found that the plans that we looked at were written in clear, plain language so that they were easy to read. We saw that the instructions are regularly checked to make sure that they are up to date and we also saw that people Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 13 are asked if they agree with any changes. This is important as its helps people feel involved and helps to empower them. We looked at how people are supported to stay healthy. Lots of professionals visit the home such as G.P s, Community Psychiatric Nurses and district nurses and people are supported to attend hospital appointments. We also saw that people are supported to have regular checks such as sight and hearing tests and dental visits. People told us that they believed they were very well cared for. Records showed us that staff have the skills to help people with specific health problems such as diabetes and that staff understand how to heal pressure ulcers (bedsores). We concluded that people’s health care needs are met but that paperwork in this area could be improved by introducing pressure sore, falls and nutritional risk assessments. The introduction of these records would help to show why staff are making changes in peoples care and how they are making these decisions. People told us that they were consulted about what goes on in the home and that they believed that staff were respectful to them. We saw that some people have keys to their bedroom so that they can have privacy. We heard staff talking to people in a respectful way. This helps to show that staff understand the importance of respecting peoples privacy and dignity. We saw that staff have recently completed training towards National Vocational Qualification care awards. We discussed this with the manager and looked at the training for this award. This showed that staff had undertaken training on Equality and Diversity as part of the award. This means that staff have had training on how to treat people as individuals. We looked at how staff manage peoples medication. We saw that before people move in, discussions are held and a decision is reached about whether people can manage their own medication or whether they require support from staff with this. We watched staff giving out medications to people and looked at how tablets are stored and the records that staff keep. We saw that the homes pharmacist has recently checked how the staff are managing medications and that they drew the conclusion that the service was “excellent”. We also saw that the manager checks medications every month to make sure that staff continue to manage them safely. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel in control of their lives and are offered activities and food, which matches their expectations. EVIDENCE: We saw that staff provide an organised planned activity each day and this activity is chosen according to what people have said that they want to do. We saw that sometimes the daily planned activity changes if people say they want to do something else. This is good practise as is shows that staff are trying to give people what they want and that they are talking and acting on peoples opinions. We saw that staff have written a life history about each person with their help. Staff told us that they found these useful as they could use the information to encourage people to talk about their past lives. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 15 We saw that activities are discussed with the people who live at the home as part of the monthly meeting. We were told that the home has a variety of board games and large print items such as books and games and we saw some of these being used. We were told that efforts have been made to include reminiscence as an activity by purchasing books on the local area. We saw these books and discussed their use with the manager. Some people who are more independent told us that they come and go as they please. For example one person arrived home with shopping during the visit and also told us that they visit a local bridge club twice a week. Another person told us that she regularly visits a relative at their house. We looked at records and had a discussion with staff. We found that two different denominations of clergy visit the home each week. A Sunday service takes place on a Sunday morning for those people who want to attend and other people are supported to visit the local church. When we spoke with the manager and with staff they told us that they were struggling to organise any outings outside the home as people changed their mind on the day of the trip out. We spoke with a person who live in the home that told us this was true. We looked at records and we saw that although activities had been discussed with people there was nothing to show that outings had been discussed as part of the meeting. This should be addressed so that staff can show that they are offering outings as part of the activities within the home. Staff, the manager and people who live at the home told us that they like to visit the local duck pond, sit in the garden or visit Crosby marina for ice cream. During our discussions people told us that they believed they were in charge of their own lives. We looked at records, which showed us that people are consulted and involved in what goes on in the home, and what care and support they need. One person told us “ I can do as I please”. We looked at menus and minutes of meetings, which showed us that the choice of food provided for people is a regular topic. Staff keep a file of everyone’s likes and dislikes which is updated as peoples tastes change. This is good practise as it reduces the risk of someone being offered food that they don’t enjoy. We saw that the main meal is offered at lunchtime and this looked attractive and tasty. People told us that they thought the food was” excellent”. Staff explained that if people change their mind just before a meal takes place then they are able to offer a range of hot snacks on toast, omelettes soup etc. People told us “ they always make you something else if you’re not up to eating- They’re very good”. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and believe staff will listen and act on their behalf. People feel safe and staff have the skills to protect people from abuse. EVIDENCE: We looked at the homes service file, which contains information that we store about the home. We saw that no one had raised any complaints or concerns about the service since the last time we visited. We looked at the records that the home is keeping about any complaints and concerns, which people have made. We found that one person had complained since the last visit and that staff had kept clear records about what the complaint was and what they had done to address it. The manager explained that all staff complete records on concerns which is good practise and that they also told her when complaints had been made. The manager should consider signing staffs records to show that she is aware of any concerns and that she is happy with any action staff have taken. Since the last visit we found that when we looked at staff training records, all staff had enrolled and completed a national vocational qualification in care. We saw that part of this training involved learning about Abuse and how to Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 17 prevent it. This means that staff have now had training on how to keep people safe. This is an improvement as requirements have been made in the past that staff have this type of training. During the visit we looked closely at how people are safeguarded (protected from abuse). This involved talking to people, staff and the manager and looking at the policies and procedures that the home has on how to do this. People told us that they feel safe, and staff and the manager showed us that they knew what to do if they suspected abuse had occurred. The manager has written a clear easy to read policy on how to prevent abuse but this could be developed further by writing a procedure for staff to follow should they suspect abuse has occurred. We saw that staff do have a copy of the local authorities procedures on what to do, however the home should have their own policy so that staff (who may be upset themselves if they find someone in a distressed state) have clear guidelines to follow and do not miss essential steps to make sure people are safe. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is a comfortable place to live however access for people who use wheelchairs is limited. EVIDENCE: We walked around the home and looked at people’s bedrooms, the lounge, the dining room and the laundry. We saw that all of these were clean and tidy and that efforts had been made to make the home appear a comfortable place to stay. We saw that people’s bedrooms contained personal belongings and photographs and each was decorated differently which helped add to the homely feel. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 19 We saw that a new kitchen has been installed since the last visit and that plans are underway for a new floor to be fitted also. We saw that both the kitchen and the laundry room were clean and well organised. We noticed that there is no ramp to gain access up the steps to the front door of the building for people who use wheelchairs. Staff explained that as the steps were low and wide they were able to assist people to do this. The manager explained that quotes had been obtained and that she was hopeful that solution to do this could be found in the near future. This should be addressed, as people should be given the opportunity to move freely about the home without staff support. Not providing wheelchair access could also restrict some visitors to the home. We saw that the home has a garden at the rear, which is nicely maintained and that a seating area has been added to this since the last visit. However access is via some steep stone steps. We saw that the surface of these were very uneven. The manager told us that this work was also occurring in the near future and that people could access the rear garden by walking around the side of the home. This must be addressed as the uneven surface could cause people to trip and possibly fall. We looked at how staff reduce the risk of infection spreading within the home. We saw that staff have had training on this subject and that they have supplies of disposable products to reduce this risk. We saw that antibacterial liquid soap was available at all hand washing sinks but that in some instances hand towels were being used rather than disposable paper towels. This should be addressed as infection can spread from person to person if correct hand washing techniques are not used. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive care and support from staff who they like and know and who have the skills to provide the care and support that they need. EVIDENCE: We looked at staff rotas and these showed us that two staff are available 24 hours per day. This is an improvement since the last visit as one staff used to “ sleep in “ at night time and was available for emergencies only. We found the majority of the staff team have worked at the home for a number of years. The manager told us that one member of staff is employed on a “ bank basis” which means that they cover shifts when the regular staff are on holiday. This means that the people who live at the home receive care and support from staff that they know. We looked at staff training records and had a discussion with staff and the manager. Staff told us that they were happy in their work and that they found the quality of training offered was good and interesting. Records showed us that all staff have enrolled and completed a National Vocational Qualification in care since we last visited. Records also showed us that staff have undertaken training in manual handling, fire training, Health Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 21 and safety, Dementia care and refresher training in management of medications. People who we spoke with told us that they liked the staff and that they trusted them to provide the right care and support. We looked at the records that the home keeps for each member of staff. We saw that the manager carries out necessary checks to make sure new staff are suitable to work with vulnerable people before they start work at the home. We looked at a staff file for new member of staff. This also contained records of necessary checks and also showed that the member of staff had been supported to learn her role and get to know the needs and support required by the people who live in the home. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 22 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe home, which is well managed. They are consulted about their expectations of life at the home and staff try to match these. EVIDENCE: We met with the manager and held discussions with staff and the people who live at the home. Everyone told us that they were confident in the manager’s ability to manage the service well. They also commented that she was approachable and that she came to see them if they were unwell or unhappy. Over recent years the manager has achieved qualifications to ensure that she is up to date and has the skills to manage the home. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 23 We looked at minutes of meetings, which are held with people who live at the home. The manager told us that these are used to encourage people to raise any concerns that they may have and to involve them in how the service is run. People explained that smaller informal meetings occur more often than this as the manager “likes to make sure we are happy”. We looked at surveys, which have been developed by the manager to send out to people who live at the home and their relatives. These have been made in a simple way using pictures so that they are suitable for all people who live in the home to complete, which is good practise. The results of these surveys are fed back to people during the monthly meetings. The home also pays for an outside independent assessor to visit once a year and to give the home a “ star” rating. We saw the most recent report, which showed that the home had achieved the top award of five stars. We looked at records and held discussions with people, which showed us that people are supported to manage their money safely. We looked at a variety of records and contracts, which showed us that the home complies with Health and safety. This included ensuring the home is equipped to fight fire and that there is sufficient equipment to do this. We also saw that the manager carries out a variety of checks to make sure that the home is a safe place for people to live. Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23. -(2), (a), (b) Requirement The uneven surface of the rear steps must be repaired to reduce the risk of an accident occurring. People should be discouraged from using these steps until the work is completed. Timescale for action 30/06/08 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 OP8 Good Practice Recommendations The introduction of pressure sore, falls and nutritional risk assessments would help to produce a clear record of why staff have taken action. This would mean that an audit trail would be available for any changes in people’s health. Discussions around whether outings are to take place should be recorded along with the decision reached by the people who live at the home. This would help to show that people are being offered outings and that it is their choice if they refuse to take part A procedure should be written for staff to follow on what to do if they suspect abuse has occurred. This would mean that staff would have clear instructions to make sure DS0000005370.V362208.R01.S.doc Version 5.2 Page 26 2 OP13 3 OP18 Annandale 4 OP19 5 OP26 people are kept safe. A ramp should be provided at the front of the building to ensure that people have good access. Not providing a ramp could restrict some people’s mobility and prevent some visitors from visiting the home, which could isolate people who live at the home. Staff should be provided with proper hand washing facilities in all areas of the home. (i.e. disposable paper towels and antibacterial liquid soap). This would help to reduce the risk of infection spreading Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2 YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Annandale DS0000005370.V362208.R01.S.doc Version 5.2 Page 28 - 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!