Care Home: Autumn Leaves

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What the care home does well We spoke to people about their experiences living in the home and were told they were being well cared for by a group of staff who are friendly and kind. One person commented, "I only need to ask the carers if there is anything I need" Visiting arrangements at the home are informal and family and friends of people who live there are encouraged to maintain contact. One person said, "My daughter visits me daily and she tells me the staff are always friendly and welcoming. I know they keep her informed about my care". People spoken to said they enjoyed the quality and variety of food being provided and activities organised. One person commented, "Always enjoy the meals. I never leave anything". Staffing levels were sufficient for the number of people being accommodated. The staff were observed throughout the visit having enough time to deliver care and support without being hurried. People we spoke to said the staff were very quick to respond to requests for assistance. What has improved since the last inspection? Care plan records were well maintained and being kept under review to ensure the information was up to date and relevant to the care being provided. The staff members we spoke told us they always have access to information about the needs of the people they support. One staff member said, "The care plans are always up to date and we are provided with full information on the people we support at the start of each shift". The home owner has implemented a refurbishment programme. When we visited the home a vacant bedroom was being completely refurbished with new furniture and the en-suite facilities upgraded. The owner told us the refurbishment of the home was ongoing to ensure the present standards being provided are improved. What the care home could do better: Although a refurbishment programme has been implemented several areas of the home require attention particularly the front lounge, hallway and corridors which are badly in need of redecoration. Improvements to the environment would make the home a more pleasant and comfortable place to live. One person we spoke to said, "The home is very fresh and clean. The staff work hard to make sure of this. It is however, ready for some redecoration." Staff employed by the home should complete National Vocational Qualifications and have access to a structured training programme to ensure their knowledge and skills are up to date. This will ensure the people in their care are being supported by a well trained and competent staff team. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Autumn Leaves 502 Devonshire Road Blackpool Lancashire FY2 0JR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wesley Cornwell     Date: 2 8 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Autumn Leaves 502 Devonshire Road Blackpool Lancashire FY2 0JR 01253354595 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Autumn Leaves UK Limited care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies 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 The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home Autumn Leaves is situated on Devonshire Road in Bispham, Blackpool. The home is an extended detached property and provides accommodation for a maximum of 20 people of both sexes. Accommodation is provided in 14 single and 3 double bedrooms. The double rooms are mainly used for single occupancy. Communal facilities include two lounges and a dining room. There is a patio and garden at the rear of the home which overlooks the golf course. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications of the owners and staff and the services people can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is available from the manager to help people make an informed choice whether to move into the home. The Care Homes for Older People Page 4 of 26 1 1 1 2 2 0 0 8 Brief description of the care home current weekly fee charged by the home is four hundred and eleven pounds per week covering all aspects of care, food and accommodation. The deputy manager provided this information on 28th April 2009. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced visit was undertaken as part of the homes key inspection. The visit commenced at 9.00am and took place over 5.5 hours. Prior to the visit the deputy manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. The AQAA is a self assessment and data set, which providers are asked to complete each year and is one of the main ways that we obtain information about how they are meeting outcomes for people in their care. A number of people living in the home and staff members were contacted prior to the visit and their views about the home have been Care Homes for Older People Page 6 of 26 included in the report. Staff, care, maintenance and financial records were examined during the site visit and a full tour of the premises was undertaken with the deputy manager. The last key inspection on this service was completed on 3rd May 2007. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 26 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 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of people were met. Evidence: There have been no new admissions into the home since the last inspection which took place in December 2008. We looked at the care plan records of two people who moved into the home before the last inspection and found they had full assessment information in place including their religious/cultural and relationship needs. The assessment had identified the nutritional needs of the people and risk assessment information advising staff members of the action to be taken to minimize identified risks and hazards. The staff member responsible for the preparation of meals told us they are provided with information about people with special dietary needs and these are accommodated. Care Homes for Older People Page 11 of 26 Evidence: The people we spoke to said they were very happy with the care being provided and told us their needs were being met. One person said,I had a very close friend who lived at Autumn Leaves several years ago. I visited her often and she was always happy here and spoke highly of the care she received. When my health deteriorated and I needed looking after I never thought of looking elsewhere. I havent been disappointed. This home doesnt provide intermediate care. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously and peoples welfare is closely monitored and were met. Evidence: Individual records are kept for each person with a plan of care setting out the action that is to be taken by support staff to ensure all aspects of health, personal and social care needs of the people living at the home were being met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed regularly and updated to reflect any changes needs and these were being actioned as required. We looked at the records of two people and these described their healthcare needs. Discussion with the manager and staff members confirmed they were fully aware of the healthcare needs of people living in the home and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. Daily entries made on the care plans Care Homes for Older People Page 13 of 26 Evidence: confirmed staff members were following the instructions of healthcare professionals and an appropriate level of care was being provided. We spoke to people about the care they were receiving and were told they liked living at the home and were being well treated. One person who was attending a hospital appointment told us she was very satisfied with her care. The person said, I attend hospital every other day for treatment and often feel unwell on my return. I am always well looked after and know the staff will be attentive to my needs. I am very happy with my care and always treated with dignity. Another person said, I am very contented living at Autumn Leaves. The staff are cheerful, kind and caring with everyone who lives here. The medication practices we observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received accredited training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. People we spoke to told us the staff team respected their privacy and they could spend time on their own if that was their wish. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation for people living in the home. Evidence: People spoken to said routines in the home were flexible and they were able to make their own decisions about how to live their lives. One person said, I mainly sit in the front lounge with my friends where you can talk and enjoy a laugh with the staff. If I want some quiet I go to my room to read. People we spoke to told us they were happy with arrangements in place for receiving visitors who are always made welcome. One person said, My daughter visits me daily and she tells me the staff are always friendly and welcoming. I know they keep her informed about my care. People spoken to confirmed they enjoyed the food provided by the home. The staff member responsible for the preparation of meals was able to confirm they had information about people with special diets and personal preferences. One person commented, I enjoy all meals at Autumn Leaves. We are lucky to have two very good Care Homes for Older People Page 15 of 26 Evidence: cooks so the meals are all home made. They are tasty, varied and nutritious. Meal times were served in a relaxed and unhurried manner. Staff members were observed being very attentive to the needs of people. We spoke to people about the social activities organised by the home and they told us there is always something being organised to keep them occupied . These were varied and arranged individually and in groups. One person said, When the weather is good we are sometimes taken for a drive to local places. We also have entertainers and parties. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The home has a detailed complaints procedure, which is made available to everyone on his or her admission. People spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. One person said, I have had very few complaints to make but any concerns I may have raised are always dealt with by the senior staff. At the time of this visit no complaints had been referred to the Care Quality Commission. The home has a procedure in place for dealing with allegations of abuse. The staff members spoken showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members spoken to said they wouldnt hesitate to report any concerns they had about care practices to ensure people living at the home are protected from potential harm or abuse. At the time of this visit the Care Quality Commission had not received any safeguarding referrals about staff working at the home. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, homely, clean and safe environment Evidence: The home is generally being maintained to a reasonable standard and although some furnishings were looking tired and would benefit from being replaced they were meeting the needs of the people living there. The deputy manager told us there are plans for the front lounge, hallway and corridors to be decorated. The people we spoke to told us they happy with accommodation being provided. A tour of the building confirmed people had been encouraged to personalise their bedrooms with their own belongings. People we spoke said they were happy with their rooms and said they had the choice of spending time on their own or in the lounge areas. Hot water temperatures were checked throughout the home and found to be delivering water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic ensuring a pleasant environment in which to live. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 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. Staffing levels are sufficient to meet the needs of people living at the home. Evidence: Staffing levels were sufficient for the number of people living at the home. People spoken to said they were happy with the care they were receiving and they were well treated by the staff. One person commented, I am very contented at Autumn Leaves. The staff are cheerful, kind and caring The Staff members we spoke to said they were clear about their role and work well as a team to ensure the individual and collective needs of the people in their care are met. One staff member said, There are always enough staff to provide good holistic care for the people we are looking after. Records show four of the fourteen staff employed by the home have achieved National Vocational Qualifications (NVQ) and we were told there are two staff members waiting to commence this training. The deputy manager told us she is presently completing NVQ D32/33 assessors and verifiers award which will enable her to support staff receiving this training. The staff members we spoke to felt the training they had received was sufficient for them to be able to meet the needs of the people in their care. One staff member commented, Training is ongoing and when a topic comes to Care Homes for Older People Page 20 of 26 Evidence: light we all sit down to discuss it. However, the training being provided is informal and a more structured training programme needs to be implemented with certificates being issued confirming the training has taken place. This will ensure the people in their care are being supported by a well trained and competent staff team. There has been no new staff members appointed to work at the home since the last visit. We looked at the records of two people who were in the process of being recruited to work at the home and these confirmed thorough and robust systems were in place for recruiting staff members ensuring the protection of people living there. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and ensures the health and safety of staff and people living there are promoted and protected. Evidence: The home is presently being run on a day to day basis by the daughter of the owners who is the deputy manager. She has many years experience in caring for elderly people and is presently working towards achieving a recognised management qualification. She has access to training to ensure her knowledge and skills are updated and the home continues to be well run and for the benefit of the people who live there. We discussed the present management arrangements in place with one of the home owners and deputy manager and suggested this arrangement be formalised with the deputy manager being put forward for registration with the Care Quality Commission as the registered manager. The registration process will ensure the person managing the home is of good charachter and will run the home in the best interests of the people in their care. Care Homes for Older People Page 22 of 26 Evidence: People we spoke to were very positive in their comments about the manager and her staff who were described as being very caring, friendly and helpful. They told us they always receive the care and support they need and the staff act and listen on what they say. One person said, Everybody is very helpful. I am very happy living here. The home has effective quality assurance systems in place to monitor the level of service they are providing. An annual quality assessment is undertaken by a professionally recognised organization who complete an audit of the care being provided and seek the views of the people who live at the home and their relatives. In addition the home has in place its own quality assurance systems to gather the views of people and keep them informed about events being organised. People spoken to confirmed they are consulted about changes taking place within the home and kept fully informed about forthcoming events being organised. The manager told us she does not retain money on behalf of people in her care. We were informed relatives are always encouraged to accept responsibility for the personal finances of people moving into the home. The manager said this policy ensures the financial interests of people in their care are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation providing a safe environment for people to live. Care Homes for Older People Page 23 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 24 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 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 19 A refurbishment programme should be implemented to ensure people live in comfortable and pleasant surroundings. A structured training programme should be implemented to ensure people are supported by a well trained and competent staff team. Fifty percent of the care staff team should complete National Vocational Qualifications to ensure the people they support are in safe hands. 2 30 3 28 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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