Care Home: Aquarius Residential Care Home

What the care home does well The people that live in the home tells us that they are happy there and that they receive the care and support they need. The home has a stable staff team whom residents say treat them with kindness and respect. Everyone has an assessment of their needs before they move into the home and a care plan that identifies how these needs will be met. The manager of the home seeks the views of the people that live there through informal discussions, residents meetings and surveys. Residents are happy with the meals and have a varied menu to choose from. What has improved since the last inspection? Since the home has been registered some effort has been made to clean the home and the carpets. New dining furniture and new curtains have been purchased. The registered provider has obtained quotes and scheduled a programme of refurbishment and redecoration of the home to start on 22nd February 2010. What the care home could do better: The environment of the home is in a poor state of repair and decoration and requires urgent attention. The registered provider has told us this is scheduled for 22nd February 2010. The Statement of Purpose currently provides misleading information as it refers to facilities that are not yet available in the home. Some of the records that relate to residents care are not being completed consistently, for example records of their meals and their social activities, and this makes it difficult for the manager to effectively monitor that their needs are being met in these areas. The registered provider must ensure that there are enough staff on duty at the weekend to cook the meals without staff being taken away from their care duties. Key inspection report Care homes for older people Name: Address: Aquarius Residential Care Home 8 Watson Avenue Chatham Kent ME5 9SH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jo Griffiths     Date: 2 7 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Aquarius Residential Care Home 8 Watson Avenue Chatham Kent ME5 9SH 01634861380 01634200972 eileenshaw.aquarius@gmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Usha Chottai Name of registered manager (if applicable) Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum nimber of service users who can be accommodated is:18 The registered person may provide the following category/ies of service only: Care home only (PC) To service users of the following gender: Whose primary care needs on admission to the home are within the following category/ies: Old age, not falling within any other category (OP) Either Date of last inspection Brief description of the care home Aquarius is a residential care home for older people situated in Chatham. The home is registered for 18 people, but the owner states that they will currently only accomodate 16 people to avoid the use of shared bedrooms. The home has been recently purchased by new owners and requires some refurbishment and updating to provide a quality standard of accomodation for residents. The owner has informed the Commission that this work is to begin on 22nd February 2010. Care Homes for Older People Page 4 of 26 Over 65 18 0 Brief description of the care home The fees for this service range from £350 to £400 per week. Care Homes for Older People Page 5 of 26 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: one star adequate 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: This was the first key inspection of Aquarius residential home. The home was purchased by the new owner in July 2009 and was registered on 20th August 2009. Prior to the inspection the manager of the home completed and returned the Annual Quality Assurance Assessment (AQAA). This provided information about the services provided at the home and any improvements made since the home has been registered. Surveys were sent to residents of the home and some of the staff that work there. We received 5 completed residents surveys and 3 staff surveys. A visit to the care home was conducted by Jo Griffiths, Regulatory Inspector, on 27th January 2010 between 10.00am and 3.00pm. At this visit the inspector had a look around the home, spoke with staff and residents, spoke with the manager and viewed a number of documents and records kept for the purpose of running the home. Care Homes for Older People Page 6 of 26 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 26 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 8 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are not currently provided with accurate information about the standard of the environment and the facilities available within the home. Residents have an assessment of their needs and are assured these can be met before they move into the home. Evidence: The Statement of Purpose and Service User Guide were seen. These contained information about the aims of the service and the care people can expect to receive. The registered provider has told the Commission about plans to improve the decoration and facilities in the home, but this had not yet been actioned. However, the Service User Guide and Statement of Purpose stated that these planned facilities are already available, for example 18 bedrooms and tea and coffee making facilities in the conservatory. The registered provider must ensure that prospective residents are provided with accurate information about the standards of the environment and the Care Homes for Older People Page 9 of 26 Evidence: facilities available until the changes are made. The assessment documentation was seen for two residents. The assessments had been completed before the person moved to the home and covered all areas of need, including their mobility and nutritional needs. The home does not provide an intermediate care service. Care Homes for Older People Page 10 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a plan of care that identifies their needs and how these will be met. They have their health needs met in a timely manner and are supported to take their prescribed medication when they need it. People that use the service feel that their privacy is maintained and that they are treated with dignity by the staff in the home. Evidence: Two residents care plans were examined during the inspection. The plans had a clear layout with an assessment of each area of need and actions for staff to take to meet the need. The plans had been reviewed monthly by the keyworker and an overview report provided about their wellbeing. The records in place to demonstrate that the persons assessed needs are being met had not always been completed consistently, for example, it was not clear to see when a person last had a bath as there were gaps in the records. The menu records for each person had not been completed for every meal and there was no record of any Care Homes for Older People Page 11 of 26 Evidence: evening supper being provided for many residents. This makes it difficult for the manager to monitor whether people are being provided with snacks and drinks in the evening or whether they are going from teatime at 5pm until breakfast without being offered this. One persons care plan stated that it is important to them to have a sandwich and a milky drink every evening but the records did not evidence that this was happening. One residents nutritional assessment stated that they must have the amount of meal that they eat recorded. This had been recorded on some days, but not others. Another persons care plan stated they they would like to be able to go to the pub and to have a dartboard in the home, but there was no evidence in the care plan to show how this had been actioned for the person. The records of peoples health needs, for example, doctors visits had been kept up to date. Residents that were spoken with during the inspection said that they can always see a doctor when they need to. Residents medication was being stored securely in the home and had been administered by staff that are trained to do so. The records of medication given were accurate. The manager was advised to ensure that any PRN (as required) medication entries on the M.A.R sheet includes clear guidelines for staff as to when they should give it. Residents said that the staff treat them with respect and that they are available when they need them. They said that they are supported with their personal care in private and are not rushed. The completed surveys from residents confirmed that they felt their needs were well met. Care Homes for Older People Page 12 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the opportunity to participate in a range of activities provided in the home, but would benefit from clearer recording of their individual social needs to ensure these are met. They are supported to maintain contact with family and friends. People using the service are provided with a varied and balanced diet. Evidence: Residents said that some activities are provided in the home, including games and quizzes, and that they enjoy these. Feedback in the surveys confirmed that they would like more opportunities for activities and entertainment. The activity programme on the notice board stated that people have the opportunity for walks, knitting, movies, card games, art and armchair activities. The manager stated that following a residents meeting new activities had been introduced, including joining a DVD club and knitting. One resident had recently been supported to buy a guitar and some people now have weekly magazine subscriptions. The records of how peoples social needs are met were not being clearly maintained and therefore it is not possible for the manager to monitor whether individuals assessed social needs are being met. The care plan review for one person stated that Care Homes for Older People Page 13 of 26 Evidence: they would like to be able to go to the pub, but there was no evidence to show whether this had been actioned. People living in the home told us that they enjoy their meals and are happy with the choices available. The cook stated that a choice from the menu is offered to residents each day and the menu choices were displayed on a board in the dining area. The staff said that visitors are welcomed in the home at anytime and residents confirmed that they can see their visitors in private if they wish. An lounge/reception area is available for visitors to use. Care Homes for Older People Page 14 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service know how to make a complaint if they need to and can be assured they will be safeguarded from harm and abuse. Evidence: The home has a complaints procedure which is available in the Service User Guide. Feedback from residents in the surveys showed that they know how to make a complaint if they need to and feel comfortable to do so. A record was being maintained of any complaints received and this demonstrated that any concerns are responded to and dealt with quickly and efficiently. The registered provider must ensure that where safeguarding referrals are made a record of the referral and the outcome is kept in the home. Staff had undertaken training in safeguarding vulnerable adults, although further updates are planned, and the home has a robust system for recruiting new staff to ensure residents are safeguarded. Care Homes for Older People Page 15 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do not currently benefit from a comfortable and pleasantly decorated environment. The home is kept surface clean, but requires full redecoration and refurbishment to ensure it meets residents needs and expectations. There are sufficient bathrooms facilities for residents and they have access to appropriate shared and private space. Evidence: Since purchasing and opening the home the registered provider has taken some action to clean the property and to clean the carpets and new curtains and dining furniture have been purchased. However, the environment of the home still remains unsatisfactory in a number of areas. The carpets to the communal areas and one bedroom were heavily stained and worn, areas of paintwork and decoration were peeling and worn, both inside and outside the home, and the conservatory still urgently required repair and redecoration. The shower room was not in use as residents were not able to access it due to a step. At present there are only 16 bedrooms in the home and the home is registered for 18 people. The owner does not wish to retain the pre existing shared room arrangement and is therefore planning to add two additional rooms. Care Homes for Older People Page 16 of 26 Evidence: At the time of the inspection the dining area only had seating for 9 people, but could seat 11 if further chairs were added. This meets the needs of the current group of people living in the home, but the registered provider must ensure that sufficient dining space is provided as new residents move in. The manager told the inspector that the registered provider had arranged for new carpets to be fitted in the home on 29th January 2010, but later advised that this had been rescheduled to be completed after the building works had been completed. A schedule of works had been agreed with a building contractor that will include full redecoration of the entire home, extension of the dining room and refurbishment of the conservatory. It will also include adding two bedrooms and providing two existing bedrooms with ensuite facilities. The manager provided an email from the registered provider confirming that this work will begin on 16th February 2010 and will take 12 weeks to complete, however the manager has since spoken with the inspector and advised this has now been scheduled to begin on 22nd February 2010. The inspector discussed with the manager the need to undertake a full risk assessment in relation to the planned building works to prevent accidents. The manager also said that the home required a new boiler and that this is to be fitted week commencing 22nd February 2010. A new nurse call system is to be fitted early February. The bath hoists and moving and handling equipment had been serviced and signs had been added to the bathroom doors to help people to find their way. There was no lock on the shower room door, which also has a toilet for residents use. Residents bedrooms were personalised with their own belongings and those spoken with said they were happy with their rooms and felt they had enough space. The rooms were fully furnished and provided with comfortable beds and seating. Care Homes for Older People Page 17 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by staff that are trained and competent in their roles and are supported by the management team. They would benefit from staff undertaking further training, as planned, to update their knowledge and skills. Residents are safeguarded by the home procedures for recruiting new staff. Evidence: The manager confirmed that there were no staff vacancies and that a new deputy manager had recently been appointed. At the time of the inspection there were two carers, the manager, the cook and the cleaner on duty. The rota showed that this is the usual allocation of staff during the week, but that on a Saturday there is often no cook allocated. Staff said that this means they have to undertake cooking duties in addition to caring for residents. There are currently 11 residents living in the home. The manager stated that, although the majority of staff had undertaken the core training courses for the role under previous employment, refresher training courses are to be booked for 1st Aid, Fire safety, Food Hygiene and Moving and Handling. The manager had begun supervision sessions with staff and the majority of staff had recently had an appraisal of their performance and training needs. The cook had recently completed the NVQ 2 in catering. Two staff files were seen. These contained evidence that the required pre employment checks had been made to ensure that Care Homes for Older People Page 18 of 26 Evidence: residents are safeguarded. New staff have an induction using the Skills for Care workbook. Feedback from staff in the surveys confirmed that they had undergone the required recruitment checks and induction programme when staring work at the home. Feedback in the surveys completed by residents and through discussion with them during the inspection visit confirmed that they like the staff and feel that they are treated with kindness and respect by them. Care Homes for Older People Page 19 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run by an experienced person, but residents will benefit from the manager becoming registered with the Commission. The views of residents are sought as part of the ongoing monitoring of the quality of the home. The health and welfare of residents are generally promoted and protected, but they will benefit from the refurbishment of the home to provide a safer, cleaner and more pleasant living environment. Evidence: The manager of the home holds the Registered Managers Award and has 10 years experience in working in and managing similar care settings. The manager is not yet registered with the Care Quality Commission but has made an application for this. Residents and staff said that they feel the manager is approachable and easy to talk to. The surveys from residents confirmed that they feel they can raise any concerns Care Homes for Older People Page 20 of 26 Evidence: and these will be sorted. The surveys completed by staff confirmed that they feel supported in their roles. The fire officer had visited the home recently and made some requirements which manager confirms had now been met. This included fitting new emergency lighting. The manager had a number of weekly health and safety checks in place in the home. The home does not hold money on behalf of any residents. Secure storage is provided for items of value for individuals. The owner had carried out monthly quality audits of the service under regulation 26 and copies of some of these reports were available to be viewed in the home. The manager was advised that copies of all these visits must be kept in the home for the purpose of inspection and also to allow the manager to take action in respect of any identified shortfalls from the visits. Surveys had been sent out to residents and their families by the manager to get their views, but these had not yet been collated into a report with an action plan. A resident and relatives meeting was held in October 2010 and a number of actions taken in response to requests. Care Homes for Older People Page 21 of 26 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 22 of 26 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 1 1 5 The registered provider must ensure the Statement of purpose and Service User Guide accurately reflect the environment of the home and the facilities available. To ensure that prospective residents can make an informed choice about moving to the home. 05/03/2010 2 7 12 The registered provider must ensure that adequate records are kept in respect of the care provide to residents. To ensure that residents assessed needs are being met. 26/03/2010 3 12 16 The registered provider must ensure that systems are in place for monitoring that residents individual social needs are met. 26/03/2010 Care Homes for Older People Page 23 of 26 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 To ensure that people have their assessed social needs met. 4 18 17 The registered provider 26/03/2010 must ensure that a record is maintained in the home of any allegations of abuse and the action taken in respect of this. To ensure there is evidence to demonstrate action is taken to safeguard people using the service. 5 19 23 The registered provider must ensure that the planned works are completed to refurbish and redecorate the home. To ensure that residents are provided with a clean, comfortable and pleasant living environment. 6 27 18 The registered provider 26/03/2010 must ensure that there are sufficient numbers of staff on duty at all times to cover catering duties in addition to caring tasks. To ensure that residents needs are met in a timely manner. 11/05/2010 Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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