Care Home: Autumn House Nursing Home

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What the care home does well It was recognised that the manager had provided an improvement plan and acted on the previous requirements and recommendations. The requirements relating to the care plans, PIN`s, heating, lockable facilities and doors, medication, complaints and staffing had been acted upon. Also recommendations had been considered. The medications had been well managed and this was supported by the visiting pharmacist. We received positive comments from people who lived at the service. "Some nice staff, we can`t complain, they do their best". "New lounge is lovely". We received surveys from the people who lived at the service. They identified that they were satisfied with the service and told us "I have made many friends", "Everything is fine". What the care home could do better: There had been an employment of a member of staff before obtaining a CRB. It was accepted a POVA check had been obtained and that the guidance had been followed regarding the person being supervised. however it would be best practice to plan recruitment so that staff start after a satisfactory CRB. All staff need to receive the required training and the service should be able to evidence that they employ competent trained staff. We discussed Adult Protection with a member of the senior staff who identified that they would investigate and inform us, but did not mention a referral to Social Services Safe Guarding. This was raised with the manager who agreed to address the matter. Random inspection report Care homes for older people Name: Address: Autumn House Nursing Home 2 Station Road Worsbrough Dale Barnsley South Yorkshire S70 4SY one star adequate service 06/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Ivan Barker Date: 1 4 0 4 2 0 1 0 Information about the care home Name of care home: Address: Autumn House Nursing Home 2 Station Road Worsbrough Dale Barnsley South Yorkshire S70 4SY 01226243057 01226247651 autumn.house@hotmail.co.uk None Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Davison Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Nurjahan Hossain,Mrs Vijay Kumari Singh care home 35 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Conditions of registration: 11 0 The maximum number of service users who can be accommodated is 35 The registered person may provide the following category of service Care home with nursing 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 Dementia Code DE Date of last inspection 0 6 0 4 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home Autumn House is a care home providing personal and nursing care for up to 35 older people. The home is situated in a residential area of Worsborough Dale, close to all local amenities and bus routes. The service has now been granted a variation to their registration. This was to provide a separate dementia unit. Accommodation is provided over two floors served by a passenger lift and stairs. The home has single and double rooms. Communal accommodation consists of two lounges and a dining room. Sufficient bathing facilities are available, with aids and adaptations in place. A central kitchen and laundry serve the home. The home is in an elevated position in its own grounds and is reached by a steep tree lined driveway. Car parking is available. Fee was £353.00. Hairdressing, toiletries and newspapers were not included in the weekly fee and were charged separately. The service user guide and inspection report that would give people information about the home was displayed in the entrance hall. Care Homes for Older People Page 3 of 9 What we found: Following examination of the information available to us, including an improvement plan provided by the manager we undertook a risk assessment. This assessment indicated that a Random Inspection could be undertaken rather than a Key inspection. It was recognised that the rating does not change following a Random inspection. Four care plans were checked and found to contain risk assessments and care needs. We discussed the care needs with the staff whilst monitoring the content of the care plans. The deputy manager advised us that nurses write the care plans on admission and ongoing. Named nurses update care plans on a monthly basis. Key workers were told to review care plans on a monthly basis. Key workers complete the bowel charts, bath records, weights charts and room tidy charts. Some residents were on food diaries. A carer who had 30 years experience, was spoken with and she had good awareness of the individuals needs and the care plans. There was a new carer who had started this month, who was still on their induction course and learning how to use care plans. There were discussions with staff regarding falls. They identified that they would complete an accident book, let relatives know, and referred people to the falls clinic as appropriate. Evidence of falls referrals were seen. Regarding medications: There was a staff signature sheet within the medication file. The medication administration records contained no blanks. All medication administration records had a photograph of the person. There was evidence that the manager had audited the medication administration records on 1 April 2010. We checked with the manager the processes for ordering, storage and the return of medication. The information she gave was satisfactory. The door to the medication room was secured by a 5 lever, anti saw lock. It was agreed that because of the security within the door, the chain attached to the medication trolley could be removed. When speaking with the deputy manager, she advised that the nurse in charge on each shift administers the medication. The manager assesses the competency of staff who administer medication. The pharmacist had undertaken checks on the medication and had recorded in their report that they were impressed with the treatment room. This evidences that medications were well managed. On analysis of the complaints files, it was established that all complaints had been investigated. On discussing complaints with the staff, we were advised that they would direct any complaints to the nurse in charge or the manager. Care Homes for Older People Page 4 of 9 On touring the building it was established that locks had been fitted to the bedroom doors, and lockable storage had been created within each of the rooms. On discussing the lockable facilities with the staff we are advised that there was a checklist which stated: I do/do not require keys to my room. On raising the issue with a person that lived in the home they identified that they did not want to have a key. Some areas of the heating were not working at the last inspection. The heating was now monitored by the handyman and we were shown evidence of his recordings. The manager advised that the system was working, however one of the boilers was not working as efficiently as the other two. The manager advised that the inefficient boiler was to be replaced. On examination of 3 staff records, it was established that the records contain all the necessary documentation except for one which did not have a CRB (Criminal Records Bureau) check. This was relating to a new starter. Regarding the individual who did not have a CRB it was established that they had commenced employment following a POVA (Protection Of Vunerable Adults) check and was being supervised. We spoke with this individual who appeared to be a very caring individual and interested in the job. The person had commenced on an induction training. This introduction was done by shadowing a member of staff and acted as an extra person for last week. The person identified that they had been shown how to operate the hoist and now felt confident to operate it. They also identified that they would ask other staff if unsure of anything. At the previous inspection there was no evidence that PIN (personal identification numbers) were up-to-date. We found that the PINs had been checked from the NMC (Nursing Midweifery Council) website and copies of the up-to-date PINs were printed off and stored in the file. Regarding the training of staff, we had difficulty quantifying what training had been undertaken. On discussing training with staff, we were advised that some staff had not undertaken first aid or safeguarding. On examination of the training matrix display in the managers office, this did not show that all staff had received training on an annual basis. On examination of the staff files we were unable to find certificates that matched with the matrix or the information provided by the staff. For example: Staff informed us that they had undertaken training. This was not on the matrix or in their file. Also staff informed us that they had not undertaken training but dates were indicated on the matrix. It was agreed that the manager and administrator should examine the training certificates and the matrix and establish what training had been undertaken, and produce a new matrix and act upon any shortfalls. The manager agreed to inform us in writing within a week that this exercise had been undertaken and that training had been planned for any shortfalls. We have received that confirmation. Care Homes for Older People Page 5 of 9 It was recognised that the manager undertook most of the training, and had teaching and assessor qualifications. We questioned that she should ensure that she is up to date as a trainer. The manager informed us that she had an appointment with us, to undertake the interview for registered manager. This has been confirmed by one of our registration inspectors. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 18 12 All staff, particularly staff 21/06/2010 likely to be in charge should have a clear understanding of the procedures to follow if they receive an allegation of abuse. To ensure the protection of people who live at the service. 2 30 19 There should be evidence that the staff have received the necessary training. To ensure that people receive care from trained competent staff. 21/06/2010 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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