Care Home: Astley House

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What the care home does well There are good arrangements in place for people living at the home to maintain contact with their family and friends. There is a good standard of hygiene in the home. The home offers prospective people who want to live at the home whatever length of time they need to decide if they wish to live there. Detailed information is collected about a new person to ensure staff can provide the necessary levels of care and support to the person. People living at the home have the opportunity to pursue their religion if they wish to. What has improved since the last inspection? There is an ongoing programme of decoration and refurbishment around the home. There is a more varied programme of activities available for people to become involved in if they wish. There is a more varied diet for people living at the home. The environment is becoming better equipped to maintain the independence of people with memory loss. Staffing levels have increased to better meet the needs of people living at the home. Systems are in place to record the choices and involvement in daily decision making of people with memory loss in order to help them maintain some control in their lives. Meetings are taking place amongst people living at the home to be involved in the running of the home. Medication is being administered in the correct way, for people who may be unable to swallow,after consultation with the community pharmacist. What the care home could do better: The home`s Statement of Purpose and service user guide should be made available in a format suitable for people with memory loss or for people who are unable to read. Staff should continue to involve people living at the home in decision making about their daily living requirements. Surveys used as part of the inspection process should be completed by relatives, or people independent of the home, if people living at the home are unable to complete surveys themselves. Key inspection report Care homes for older people Name: Address: Astley House 1/2 Hartley Gardens Seaton Delaval Whitley Bay Tyne & Wear NE25 0AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karena Reed     Date: 0 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Astley House 1/2 Hartley Gardens Seaton Delaval Whitley Bay Tyne & Wear NE25 0AB 0191-2377209 F/P01912377209 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs M Powers,Mr R Powers care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category, Code OP, maximum number of places 5 Dementia, Code DE, maximum number of places 10 Date of last inspection Brief description of the care home Astley House is a large, detached house that used to be the village police station. The home is situated in a residential area in the village of Seaton Delaval, it is close to local shops, doctors and public houses. It is also very close to the Northumbrian coast and the nearby countryside. It is registered to provide personal care to fifteen residents, the categories of registration are for five older people and ten older people with memory loss. Bedrooms are all for single occupancy, some are situated on the ground Care Homes for Older People Page 4 of 27 Over 65 0 5 10 0 0 2 0 7 2 0 0 9 Brief description of the care home floor. There is a large lounge and a separate dining room that is also used as a quiet area when meals are not being served. Both living rooms overlook a well- maintained garden to the front of the building. There are two bathrooms both containing equipment that can be used to assist with getting in and out of the bath. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information about the services provided by the home and the relevant charges. Fees payable for living at the home at the time of inspection in January 2010 are 441 pounds per week. Additional charges are payable for hairdressing, private chiropody and personal newspapers. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this home is 2 star. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at risk of significant harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out: Before the visit: we looked at information we have received since the last inspection of September 14th 2009, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the views of the people who use the Care Homes for Older People Page 6 of 27 service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on January 7th 2010. During the visit: We talked with people who use the service, relatives, staff, the manager and proprietor. We looked at information about the people who use the service and how well their needs are being met. We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the manager and proprietor what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The homes Statement of Purpose and service user guide should be made available in a format suitable for people with memory loss or for people who are unable to read. Staff should continue to involve people living at the home in decision making about their daily living requirements. Surveys used as part of the inspection process should be completed by relatives, or people independent of the home, if people living at the home are unable to complete surveys themselves. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adequate procedures in place to ensure that people wishing to live at the home are making an informed choice about living at the home. Good arrangements are in place for assessing the needs of people before they are admitted into the home. Evidence: The Statement of Purpose and service user guide were examined. They contained the necessary information as required by the Care Homes Regulations 2001. They were not written in a way that might support people with dementia care needs.They were not available in a different format such as large print or braillle for people who may have difficulty understanding or seeing the written word. In surveys received people who live at the home and their relatives felt that they got enough information from the home and other agencies to make a decision about whether to use this home. Records for four people who live at the home showed that when they were admitted to the home an assessment of their care needs had been carried out before their Care Homes for Older People Page 11 of 27 Evidence: admission. A copy of the social services assessment and care plan for each person had been obtained before they moved into the home. The manager or senior staff carry out a pre-admission assessment to ensure that the home can meet each individuals needs. The person living at the home and relevant people are involved in the assessment.These initial assessments are used to create care plans. The home is trying to maintain and encourage the independence of the person who is suffering from memory loss. There were some meaningful photographs and pictures to aid reality orientation. The proprietor and manager are carrying out some research to look at signage which can be used to help identify important rooms and areas around the building to help maintain peoples independence. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective person who wishes to live at the home may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements in place to ensure the health and personal care needs of people living at the home are met by staff,this is carried out respecting the rights of the individual. Evidence: After a person has moved into the home a care plan is designed around their assessed needs so that staff know how to provide the right amount of support. Care plans detail the night time needs of people living at the home. Care plans cover areas such as continence, personal hygiene, mental health and social care needs. The sample of care plans examined were written in a respectful way. The sample showed that all care plans had been evaluated regularly. Records were in place to show how the medical and nutritional needs of people living at the home were being met. Care plans recorded information about their social and leisure needs. Health care records were available to show they are supported to have access to Care Homes for Older People Page 13 of 27 Evidence: health care services such as G.Ps,dentists,district nurses and continence advisors. Staff members commented:The staff care and look after the residents well. We are able to meet all our residents needs- because we are a small friendly homewe can get to know each resident as an individual-so you know the whole person. Care plans are very informative and helpful to refer to. Residents come first all the time. Staff give support when needed to residents. The home treats everyone as an individual and deals with their needs. Our residents are all very well cared for. Some people living at the home,due to higher levels of dependency,were assisted to complete surveys by staff. In order to maintain independence if people at the home are unable to complete surveys without a lot of support,assistance should be supplied by their relatives where possible. Comments include: We are treated well-Im looked after very well. Everything is alright ,I wouldnt change anything. I am happy here its nice to see people, I like to see the children when they are here. The home has a medication policy that is available for staff to read. All medication is stored in an appropriate locked cabinet to which only senior staff have access. All staff administering medication have received accredited training. Records were in place and risk assessments to show the procedure for administering medication to the person who was unable to swallow. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have some opportunities to make choices about activities, daily routines and menus so that they may lead a lifestyle that matches their social care needs. Evidence: The files of people living at the home contained personal histories and entries about their likes and dislikes and preferences regarding daily life. An activity file has been introduced which provides a daily record of any activities and events offered to people living in the home. This was informative and gave much more insight into the daily interactions between staff and people they supported.Comments from people include: I like to see the dog and tickle him and feed him biscuits. I like to sit in the garden when its warm and sunny. I read magazines sometimes and I like to sing along to musicals. I join in with activities if I can be bothered. I enjoy seeing Father Phil for Communion. Care Homes for Older People Page 15 of 27 Evidence: Its nice to see Father Phil- I used to go to church-but I cant manage to go now-so its good to be able to be part of the church still. There is a programme of activities available to people living at the home and these include;memory games, a memory box, dvds,board games,old time music,chair aerobics,sing a long,hairdressing and pamper sessions, a minister also visits. At Christmas people had enjoyed going out for a meal and other parties within the home. There was some evidence to show that peoples personal life histories were used to ensure activities were more individual and person centred. They could help staff to ensure that social and cultural needs of people living at the home are given as much attention as their health and personal care needs. This would also make reminiscence more personal and help staff engage and retain the involvement of people living at the home. Staff ask each person about their wishes, interests and choices. Staff have had training about memory loss. This training should help to ensure that people living at the home are given more choice in order to keep some control in their lives. A four weekly menu is used in the home. The home does provide for special diets and dietary requirements. On the day of inspection lunch served was bacon and vegetables or omelette followed by banana and custard. Tea was to be assorted sandwiches,cake and rock buns. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints and protection system, which helps to protect people who live at the home. Evidence: The homes complaints procedure is given to new people as they move into the home. The procedure assists and supports them and their relatives to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within the home. There is a complaints procedure on display within the home for the use of people living in the home and their relatives. The home keeps a record of complaints. There have been no complaints received about the home since the last inspection. There have been no safe guarding incidents reported or investigated using the council safeguarding strategy since the last inspection. Surveys returned stated people living at the home or their relatives knew how to complain if they needed to. The home has a copy of the Local Authorities Vunerable Adults procedure. This provides staff with clear guidance on how to deal with adult protection concerns. Staff training about Protection of Vulnerable Adults, the local authority multi-agency training,is planned to be up dated in February. Staff have received training about Care Homes for Older People Page 17 of 27 Evidence: behaviour that may be difficult to work with, this should help them understand the different support needs of individuals. Staff have received training about dementia care to give staff more insight into the needs of people with memory loss. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there and there is a good standard of hygiene. Evidence: The home is accessible to the local community and situated in a residential area in the centre of the local village. It is very near to the sea front and coast. A maintenance person is available at the home. There is an on going programme of decoration and refurbishment around the home. Since the last inspection some bedrooms have been decorated and re-carpeted, there are plans to replace the carpet in the halls,lounge and rear stairs. People living at the home all enjoy their own bedrooms apart from a married couple who share a bedroom, they also have a separate sitting room which they can use if they wish to. Peoples rooms were comfortable and personalized with some of their own belongings. Comments include: Bedrooms are well personalized with individual decor. I can have my own space when I need it. I also like to be with everyone else. The home has an appropriate amount of sitting, recreational and dining space. Care Homes for Older People Page 19 of 27 Evidence: Furnishings and fittings were domestic in design. There was emergency lighting around the home. The washing machine has the specified programme to meet disinfection standards. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff to meet the needs of people living in the home. They are appropriately recruited, and trained to meet the needs of the people currently living there. Evidence: Examination of staff rosters and discussion with the proprietor,manager and members of the staff team showed that staff numbers are as follows: 3 staff members 8:00am-1:00pm 2 staff members 1:00pm -4:00pm 3 staff members 4:00pm-7:00pm 2 staff members 10:00pm- 8:00am These numbers include the manager. The proprietor is also available at the home two days of the week. There is a senior staff member on each shift when the manager is not on duty. Other members of staff are employed for duties such as cleaning, food preparation and Care Homes for Older People Page 21 of 27 Evidence: maintenance work. A sample of staff files were examined and it was evident all the necessary checks are being carried out prior to workers being appointed or starting work at the home. Two written references were available on staff files examined. An application form had been completed for each staff member. Employment histories were available. CRB checks are carried out before a person is appointed. Staff photographs were available on staff files examined. Almost 100 of carers have achieved a National Vocational qualification at level 2. Six carers have achieved or are studying for an NVQ at level 3. Staff training is planned to up date some statutory training. Moving and handling and risk assessment training has been up dated. Developmental training such as literacy and podiatry training has also taken place for staff. Protection of Vulnerable Adult training and Deprivation of Liberty training is planned to take place in February 2010. Some developmental training is provided to give staff knowledge about the specialist support needs of some people. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home live in a home that is run in their interests and where the welfare of all is promoted. Evidence: The manager has the relevant qualifications and experience for managing the home. The home is becoming better equipped to provide care to people with memory loss at the same time systems are being put in place to help maintain the independence of the person with memory loss. The environment is becoming more suitable with the necessary and appropriate signage to help encourage and maintain the independence of the individual. There is more evidence available to show that people living at the home are involved in decision making about their daily living requirements. Staff and resident meetings take place. A system is in place for staff supervision and appraisal to help staff identify their training needs. There was good standard of record keeping and documents detailing fire safety and Care Homes for Older People Page 23 of 27 Evidence: other statutory records were all up to date. Lockable facilities are available for people living at the home to keep their monies if they wish. Staff training relating to health and safety was up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The homes Statement of Purpose and service user guide should be made available in a suitable format for people with memory loss to more easily understand. Staff should continue to involve people living at the home in decision making in their daily living requirements. 2 12 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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