Care Home: Annesley Lodge Care Home

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What the care home does well Assessments are carried out before people move in so that they can be assured their needs can be met at the home. Care is well planned so that people`s health and personal care needs are met in a respectful manner. People told us staff listen to them and support them when needed. Staff follow good practice in administering medication. People told us about an activities worker who arranged activities each day. Relatives said, "There`s always something going on each afternoon." Dietary requirements were noted and staff ask each person individually what they would like for dinner every day. We heard a lot of positives comments about dinner from relatives as well as people living in the home. "Its always lovely food here." "Food is really really good". There was a clear complaints procedure and complaints and concerns are taken seriously and investigated to people`s satisfaction. The building is clean, safe, comfortable and well maintained for people. The staff are well trained and sufficient in number. Recruitment procedures ensure people are safeguarded. Comments from relatives included: "All the staff are very considerate and caring." Overall, the home is well managed and run in the best interests of the people who live there. One of the relatives said,"They`re all very welcoming here and overall we are very satisfied with the care provided." What has improved since the last inspection? The manager told us that the activities programme has been made more comprehensive with extra staffing, so that care staff can carry out activities planned by the coordinator. Changes had also been made to improve the menu and people are now asked just prior to their meal what they would like for their dinner. Some of the floors have been replaced in people`s ensuite rooms and there were firm plans to replace the others. What the care home could do better: We recommend that the manager puts a system in place to automatically update a written care plan when a change in need has been identified. This is to clarify the action staff need to take to meet needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Annesley Lodge Care Home Annesley Road Hucknall Nottingham NG15 8AY     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Meryl Bailey     Date: 0 4 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 23 Information about the care home Name of care home: Address: Annesley Lodge Care Home Annesley Road Hucknall Nottingham NG15 8AY 01159555522 01159555522 karen.hutson@anchor.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Anchor Trust care home 51 Number of places (if applicable): Under 65 Over 65 51 old age, not falling within any other category Additional conditions: 0 Service Users shall be within category OP (51) The Manager completes the Registered Managers Award. Date of last inspection Brief description of the care home Located in a residential area and within a mile of Hucknall town centre, Annesley Lodge provides personal care for a maximum of 51 older persons. All rooms have en-suite facilities and they are mostly single rooms unless people choose to share. There are homely communal areas and a safe enclosed garden. Full information about services provided is available from the home. The range of fees are £395 to £418 Care Homes for Older People Page 4 of 23 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: three star excellent 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 focus of inspections undertaken by the Care Quality Commission is upon outcomes for people using the service and their views on the service provided. This process considers the providers capacity to meet regulatory requirements and minimum standards of practice and it focuses on aspects of service provision that need further development. We reviewed all of the information we have received about the home since the last report of our key inspection, which took place on 12 July 2006. Annual assessments and our surveys have shown us that the quality was maintained. Services are required to fill in a form called an Annual Quality Assurance Assessment (AQAA), in which the registered manager identifies from their own quality monitoring what the service does Care Homes for Older People Page 5 of 23 well and what they need to improve. We received a comprehensive AQAA form in May 2009. We considered this in planning the visit and deciding what areas to look at and the information has been taken into consideration within this report. We carried out the inspection visit with one inspector. It was unannounced and took place on one day in the daytime, including lunchtime. The main method of inspection we used during this visit is called case tracking which involved us choosing a sample of people who live at the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We looked at staffing records and other records connected with the running of the home. A partial tour of the premises included all shared areas and a sample of bedrooms. What the care home does well: What has improved since the last inspection? 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 4. Care Homes for Older People Page 7 of 23 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 8 of 23 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 9 of 23 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. Sufficient assessments are carried out before people move in so that they can be assured their needs can be met at the home. Evidence: Some people said they had visited before moving in and others said their relatives chose the home for them. We looked at the files of four people. Comprehensive assessments were on three files, but one consisted of a brief summary care plan from another home. The manager told us she had gathered more information in conversations by phone with staff at the and with a relative, and she felt the summary care plan covered sufficient areas to know that the persons needs could be met at the home. Further assessment was completed once people moved into the home. Care Homes for Older People Page 10 of 23 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. Care is well planned so that peoples health and personal care needs are met in a respectful manner. Evidence: We looked at the care planning for four people. Clear assessments of needs and risks led to descriptive care plans that informed the care staff of the action they should take to meet needs. Risk assessments included symbols on stickers that were numbered and highlighted the risk. The numbers corresponded to the appropriate plan. There were monthly care review record sheets, but where needs had changed, the plans had not always been updated. During the inspection a senior care assistant updated information on some plans so that there would be no confusion. There were weight charts and an assessment tool to check that people were not malnourished. There were other assessment tools related to the risk of developing pressure sores and there were records of visits from doctors, nurses and other health professionals. The care staff kept further daily notes and completed alert sheets if Care Homes for Older People Page 11 of 23 Evidence: there was something they needed to pass to other staff. Medication was stored securely and a trolley was used to take what was needed to people in the dining room. We observed one of the staff preparing and administering some medication and she followed good practice. We observed and heard staff interacting with people with respect and relatives said that they were always made very welcome at the home. Care plans gave detail of how staff were to help people with personal care, encouraging independence whenever possible and people told us their privacy and dignity were always respected. We observed good practise when people were being moved in their wheelchairs and staff were careful to ensure people knew what was happening at all times. People could have keys to their own bedrooms and there were lockable bedside cabinets within their rooms to keep personal belongings. Care Homes for Older People Page 12 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a lifestyle that matches their preferences and enables them to have control over their lives. Evidence: There were social histories in the care plan files that gave information about peoples interests. People told us about an activities worker who arranged activities each day. Relatives said, Theres always something going on each afternoon. The manager told us that the activities programme has been made more comprehensive with with extra staffing, so that care staff can carry out activities planned by the coordinator. There were individual and group activities. There was an interactive computer programme (Wii) used with the television, which gave people the chance to take part in tennis and golf. There were regular visits from a range of entertainers. There was a dedicated Hairdressers room and the hairdresser visited on two days each week. The kitchen was very organised. Dietary requirements were noted and colour coded. The menu choices were on a white board in the dining room. We heard staff asking each person individually what they would like for dinner. There was pork casserole, jacket potato, broccoli and peas or liver, mash potato, peas and cabbage. This was Care Homes for Older People Page 13 of 23 Evidence: followed by icecream or sherry trifle. Some people were helped discreetly with eating. We heard a lot of positives comments about dinner from relatives as well as people living in the home. Its always lovely food here. Food is really really good. One person was not completely happy with her choice and this was immediately changed to her satisfaction. Staff told us that if people go out during the day they are given the choice of having a meal saved or taking a packed lunch. Fresh fruit and hot drinks were available at any time during the day and there was a chilled water machine in the reception area. Records showed there were visits from relatives every day and on the day of inspection we saw six visitors. Questionnaires were used about activities so that the manager could respond to any suggestions. There were also monthly resident and relative meetings and people told us they were looking forward to the Summer Fayre in the garden. We saw two people going out into the community alone and this was monitored for there safety. A local church provided a service at the home every two weeks and a priest visited to offer Communion. Care Homes for Older People Page 14 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any complaints or concerns are taken seriously and investigated to peoples satisfaction. People are safeguarded from abuse. Evidence: There was a clear complaints procedure displayed and contained in the Service User Guide. A file contained records of eleven complaints since the last inspection in 2006. Four of those had arisen during the last twelve months. There was evidence, though, that people were satisfied with how complaints were handled. No one had contacted the Commission about any concern or complaints about the home. The people we spoke with, including relatives, told us they all knew how to make a complaint and who to speak to if they were unhappy about anything. One person told us that concerns were sorted out quickly. There were records to show that the recruitment procedure included pre employment checks and all staffed had received training about safeguarding people, with training courses available each month for any new staff. There was a copy of the local area Safeguarding Adults procedures. Care Homes for Older People Page 15 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe and well maintained environment. Evidence: There was an open plan dining room and lounge in different sections, so that people could choose where to sit. There was also a conservatory that overlooked a well laid out enclosed rear garden with water feature, that was safe and accessible to everyone. Most people had individual bedrooms with ensuite facilities. One bedroom was shared by people who had requested to share with each other. In addition to the ensuite showers, there were three separate bathrooms with assisted bathing facilities and one ordinary bath, which one person preferred to use. All areas were decorated to a high standard. A handyman was employed to ensure all areas were continually maintained. Relatives told us they always found the home clean and fresh. Infection Control training was available each month to ensure staff were trained. The laundry room had sufficient machines to deal with laundry for the number of people at the home and the door was locked. Care Homes for Older People Page 16 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a sufficient number of competent staff. Recruitment procedures ensure people are safeguarded. Evidence: There were six care staff on duty when we arrived in the morning and this was to care for the current 47 people in the home. The manager, administrator, kitchen and domestic staff were in addition to this. There were five care staff on the later shift and three were available over night. Comments from relatives included: All the staff are very considerate and caring. The Team Leader for each shift had was qualified to level 3 of the National Vocational Qualification (NVQ) in Care. 71 per cent of the care staff had achieved NVQ at level 2 or 3. There were records of Induction Training for new staff. We looked in detail at the files of three staff and each contained a completed application form, result of a check through the Criminal Records Bureau and two written references that were received before they started working at the home. Staff told us they received regular training in addition to their NVQs and we saw certificates of training that had been given. This training included Philosophy of Care, Dementia, Medication, Diabetes. All staff were up to date with the mandatory health and safety Care Homes for Older People Page 17 of 23 Evidence: training. Some training was via computer with E learning. There were records of individual staff supervision meetings every six to seven weeks and a Personal Performance and Development discussion was held with each of the staff on an annual basis. Recorded staff meetings were held every two to three months. Care Homes for Older People Page 18 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the people who live there. Evidence: The Registered Manager and the Deputy Manager had both completed the Registered Managers Award and were qualified NVQ Assessors. An area manager from Anchor Trust visited regularly and completed monthly reports. Training officers from Anchor Trust were also in regular contact. The Annual Quality Assurance Assessment (AQAA) form was comprehensively completed and sent to the Commission prior to this inspection. It gave us all the information we asked for and has assisted in judging the quality of the service. The quality assurance programme for the home included regular monthly residents meetings and six monthly questionnaires for residents and relatives. We spoke with relatives who confirmed they had attended meetings. One of them told us,Theyre all very welcoming here and overall we are very satisfied with the care provided. We saw Care Homes for Older People Page 19 of 23 Evidence: a record of the recent discussion about food. There were also separate staff surveys carried out. Small amounts of peoples money was looked after securely using a banking system. This was managed by the Administrator, who ensured that all transactions were recorded clearly with witness signatures. Money was deposited in a non interest paying account for safe keeping, with a small amount held securely in the home to be available should people need it. All staff had been trained in Health and Safety, Moving and Handling, Infection Control and Fire Safety. The AQAA form gave us the dates of servicing of equipment, which had all been serviced within the last year. Care Homes for Older People Page 20 of 23 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 21 of 23 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 Put a system in place to automatically update a written care plan when a change in need has been identified. This is to clarify the action staff need to take to meet needs. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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