Care Home: Anville Court Nursing Home

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What the care home does well Staff assess and plan care to take account of peoples` likes/dislikes and preferences. Care planning and risk management is effective and provides staff with the guidance necessary to meet care needs. The home is effectively managed and staff have well defined roles and responsibilities to provide a good quality service to the people accommodated. People can choose to participate in social activity and are encouraged to maintain contact with their family and friends. Meals within the home are good, menus provide choice and variety which take into account special dietary needs and personal preferences. The home ensures that people have access to a clear complaints procedure, which enables concerns or complaints to be dealt with promptly and professionally. The home is well staffed with adequate numbers and skill mix of staff, and training opportunities for staff are good. What has improved since the last inspection? An ongoing plan for refurbishment of the home has resulted in improvements in the environment, such as replacement of carpets, and redecoration of bedrooms. The home has a good process of giving people opportunity to comment on the care provided and other aspects of the service. The home ensures that when staff are appointed prior to receipt of a full CRB Disclosure, all other pre-employment checks have been undertaken and are satisfactory, including a POVA First check. The home ensures that staff do not work unsupervised until the full CRB Disclosure is obtained. What the care home could do better: No requirements or recommendations for improvement were made as a result of this inspection. CARE HOMES FOR OLDER PEOPLE Anville Court Nursing Home Anville Court Goldthorn Hill Penn Wolverhampton West Midlands WV2 4PZ Lead Inspector Rosalind Dennis Key Unannounced Inspection 8th January 2008 09:30 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 Anville Court Nursing Home DS0000017176.V352617.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. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anville Court Nursing Home Address Anville Court Goldthorn Hill Penn Wolverhampton West Midlands WV2 4PZ 01902 621771 01902 621498 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) www.bupa.com BUPA Care Homes (BNH) Ltd Ms Elizabeth Ann Bevan Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (50), Terminally ill (5) of places Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No number division between categories (except 5(only) beds Palliative Care) 13th October 2006 Date of last inspection Brief Description of the Service: Anville Court is registered with the Commission for Social Care Inspection (CSCI) to provide nursing and/or personal care for fifty people, including people with who have a physical disability. Anville Court is located near to a bus route, shops and a library and Wolverhampton city centre is nearby. There is a passenger lift, which provides access between floors and there is level access into the home and to the garden. Bedrooms are spacious with en-suite facilities in each room. People can obtain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on CSCI’s website at www.csci.org.uk The home produces a range of information to assist with choosing a care home, including detailed information on the arrangement and payment of fees. At the time of this inspection the manager reports that the current weekly fee ranges from £444 to £700, according to the needs and dependency of the individual and the type of room. The reader may wish to obtain more up to date information from the care service. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 8th January 2008 and lasted for around six hours. A further two hours were spent at the home on the 15th January 2008 to conclude the inspection and to provide feedback to the manager, who was not on duty on the first day of inspection. All ‘key’ standards were assessed over these days- that is those areas of service delivery that are considered essential to the running of a care home. The inspection involved speaking with staff, management, people living at the home, as well as looking at records and observing staff in their work. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the home for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed-Anville Court returned their completed AQAA to CSCI within the given timescale. Information within this document demonstrates that the manager recognises the strengths and weaknesses within the service and is able to plan for improvement. The AQAA provided information to supplement the inspection process. The inspection found the home functioning well, people living at the home appeared content and eager to provide their views on how their needs are met at Anville Court. People also spoke positively about the Registered Manager, Ms Liz Bevan and her ongoing commitment to ensure that people receive good quality care. People who were unable to communicate their views appeared to be looked after well. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes What the service does well: Staff assess and plan care to take account of peoples’ likes/dislikes and preferences. Care planning and risk management is effective and provides staff with the guidance necessary to meet care needs. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 6 The home is effectively managed and staff have well defined roles and responsibilities to provide a good quality service to the people accommodated. People can choose to participate in social activity and are encouraged to maintain contact with their family and friends. Meals within the home are good, menus provide choice and variety which take into account special dietary needs and personal preferences. The home ensures that people have access to a clear complaints procedure, which enables concerns or complaints to be dealt with promptly and professionally. The home is well staffed with adequate numbers and skill mix of staff, and training opportunities for staff are good. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 7 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 Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 8 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. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good assessment and admission procedure, which ensures that the home is able to meet people’s needs. EVIDENCE: Observation of a selection of care records shows that people’s care needs are comprehensively assessed prior to and on admission to Anville Court. The assessment process shows that the home seeks detailed information about the person’s needs and any other matters that are important to them, including recognition of communication restrictions such as whether a person’s first language is not English, safety needs, assessments of nutritional and personal care needs, religious needs. Two people recently admitted to Anville Court spoke of how a senior member of staff had been to see them prior to their admission and both people Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 9 described how they were made to feel welcome at the time of their admission to the home. The home produces a range of information to assist with choosing a care home, including detailed information on the arrangement and payment of fees. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is clear and consistent care planning in place, which focuses on the individual needs of people living at the home and provides staff with the information they require to meet people’s needs. EVIDENCE: Throughout the inspection people spoke positively about the care they receive and their general satisfaction with all aspects of the home. Comments included: - ‘I’m ’very pleased with my care, staff know when I like to get up in the morning and help me’, ‘the staff are kind, give you a hug if you’re not feeling well’ ‘the staff look after me well, but I’m looking forward to going home’’. People who were not able to communicate their views appeared comfortable and well-cared for by a staff group who showed kindness in their approaches. Visitors to the home spoke of their satisfaction with the care of their relative and how staff keep them informed of any changes to their relatives condition. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 11 Since the last inspection the home has introduced new care and assessment documentation, with evidence available to show that staff have been provided with training to ensure effective use. Observation of three care records showed that these are very much ‘working documents’, with care plans written to provide detailed information to staff on how the person wants their needs met. A range of risk assessments were present on the files seen which shows that the home looks at ways to reduce any risks to the health and welfare of people living at the home. Care plans and risk assessments had been reviewed on a monthly basis and when people’s needs changed. Care records also showed regular meetings with the person and/or their significant other to discuss and review the person’s care. The home seeks prompt advice from medical and health care professionals such as GP’s speech and language therapists and dieticians. Sufficient and appropriate equipment was seen available throughout the home to promote tissue viability and to move people safely. Observation of the home’s two medication rooms shows that medication is stored appropriately and at the correct temperature. Examination of a random selection of individual Medication Administration Record (MAR) sheets demonstrates good recording, with all medication signed and accounted for. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 12 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Anville Court are able to enjoy a range of activities, which are based on their capabilities and preference. Meals at the home are good, offering variety and catering for different nutritional needs. EVIDENCE: Anville Court continues to offer people a comprehensive and varied activity programme, which includes recreational and social activities in and outside of the home. There is a full-time designated member of staff who organises activities and people spoke fondly about this member of staff. A ‘timetable’ of planned activities is available in the reception area, people spoke of how they enjoy different activities and trips out and also how staff acknowledge and respect their decision if they choose not to participate. Observation of care records shows that the activities organiser also spends time with people on a 1:1 basis, including people who because of their illness may find group activities difficult. The manager spoke of how she would like to increase the amount of hours Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 13 available to provide additional 1:1 involvement and it is considered that this would enhance the home’s excellent activities provision and further benefit people living at the home. Observation of menus shows that the home provides a variety of meals with opportunity for people to request alternatives to the menu if they choose. Anville Court encourages people to eat a well-balanced diet, people were observed being offered fresh fruit and the manager described how fresh fruit is offered several times daily and consideration given for people who find chewing fruit difficult through the provision of fruit ‘smoothies’. The home has introduced a ‘night bite’ system to ensure food is available 24 hours a day, with specific staff allocated to this role. Most people commented very favourably about the food offered and different choices available. Throughout the inspection people were provided with regular drinks and for those people who needed help with eating and drinking, staff were seen to give sensitive assistance. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that people have access to a clear complaints procedure, which enables concerns or complaints to be dealt with promptly and professionally. Staff are provided with training to equip them with the knowledge and skills to safeguard adults from the risk of abuse or neglect EVIDENCE: People and their visitors confirmed their awareness of the home’s complaints procedure-a copy of which is clearly displayed in the Reception area as well as the Service User Guide. People felt confident that if they had any concerns senior staff would act quickly to put things right. Information provided by the manager shows that the home has received 12 complaints in the past twelve months, 8 of which were upheld by the home. Observation of the process used to record and respond to complaints shows that the home has a robust process in place, responding to complaints promptly and putting in action plans, when appropriate to improve practice. For example the action taken in response to a complaint received in 2007 involved staff being provided with additional training and updates in the use of ‘fluid thickeners’ during individual staff supervision sessions. Observation of training records shows that staff receive training in adult protection and an ‘in-house’ training session was in progress at the time of inspection. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 15 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Anville Court is well maintained and provides a comfortable, spacious environment for people living at the home. EVIDENCE: Anville Court offers spacious individual bedrooms, all of which have an en-suite facility. Some bedrooms originally designed for shared use are available for single occupancy and these rooms are large and the people within these rooms were very pleased with the space and layout. People are encouraged to bring personal possessions to the home and this helps to create a ‘homely’ atmosphere. Observation of a random selection of rooms found most to be decorated to a good standard, other rooms will benefit from planned re-decoration-one room was being re-decorated on the day of inspection. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 16 People spoke of how they enjoy looking at the gardens and the trees surrounding the home, and also watching birds feeding from the different feeding stations around the gardens. The manager described how the home intends to build a ‘sun room’ so that ‘people get a sense of being in the garden even if it is not possible to go outside’. The home has lounges and dining areas -some people spoke of how they prefer to eat in their own room and staff were seen taking meals and drinks to them. Staff confirmed that people can choose where they like to spend their day and eat their meals. Training records show that staff receive training in infection control and observations show that this is put into practice as staff were seen using protective clothing appropriately during care activities and at mealtimes. Communal areas and individual bedrooms were observed to be very clean, apart from one room which needed cleaning and this was brought to the attention of the manager for action. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well staffed with adequate numbers and skill mix of staff, which ensures that sufficient staff are available to meet people’s needs. Training opportunities within the home are good which ensures that staff are appropriately skilled and competent to carry out the duties for which they are employed. Recruitment practices are robust and safeguard people from the risk of employment of inappropriate staff. EVIDENCE: People living at the home commented that they consider sufficient staff are usually on duty to meet their needs and staff also spoke of how staffing numbers are adequate to provide and meet current care needs. The staff team is culturally diverse and some staff speak a variety of languages, which helps with communicating with people from different ethnic backgrounds should this be required. A member of senior staff who has taken on the role of overseeing staff training, appeared knowledgeable and well-organised in ensuring staff receive the training and updates they need. Training records and a training matrix show that staff receive training and updates in safe working practice topics and Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 18 training specific to meeting the needs of people living at the home, including:communication and interactions, ear care, mental capacity act and dementia awareness. Care staff spoke of how regular training opportunities are available and that there is ongoing support to study for a nationally recognised qualification in care (NVQ) and information provided by the manager shows that 76 of staff have achieved NVQ Level 2 in care. At this inspection two staff files were checked, these contained all the required pre-employment checks and this confirms that the home operates a robust recruitment procedure. New employees receive comprehensive induction training and evidence was available to show that staff have regular appraisals and access to formal supervision. The effective staff supervision process enables staff to reflect and improve on practice and identify training needs. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 19 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, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager, Ms Elizabeth Bevan is an effective leader who is focused on achieving positive outcomes for people living at the home. The home is continually monitoring and reviewing processes to ensure that people receive a good range of quality services. EVIDENCE: People living at the home spoke of how Anville Court appears well-run and the management and the staff approachable. People also spoke of how the manager, Ms Liz Bevan speaks with them on a regular basis and listens to what they have to say. Ms Liz Bevan has considerable experience of caring for older people and has the supportive qualifications and skills to manage the home. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 20 At the time of inspection the manager was not on duty, however the senior nurse on duty demonstrated a good awareness of information needed for the running of the care home and all staff appeared eager to contribute to the inspection. The home encourages people to comment on different aspects of the service and observation of ‘satisfaction surveys’ completed in July 2007 showed that most people were very satisfied with all aspects of the service at that time. A range of audits are also undertaken and these are then discussed at staff meetings, for example minutes for a staff meeting in October 2007 showed that the results of a medication and care planning audit were discussed. Senior representatives from BUPA undertake regular unannounced visits to the home to monitor and audit the home. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the home for completion. The AQAA is a selfassessment and a ‘dataset’ that needs to be filled in once a year by all providers. The manager completed the AQAA and returned it the commission within the timescale given. Information contained within this document shows that the manager is able to recognise the home’s strengths, weaknesses and plans for improvement. Observation of a selection of computerised individual financial records demonstrates that the home has robust systems in place to safeguard people’s financial interests and regular audits are undertaken of financial records to confirm accuracy. Examination of maintenance and servicing records show a well-organised process with all necessary checks being undertaken. Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 21 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 N/A 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Anville Court Nursing Home DS0000017176.V352617.R01.S.doc Version 5.2 Page 24 - 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. 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