Care Home: Avon Manor Care Home

What the care home does well Avon Manor is an established care home providing a good standard of care. It provides a friendly, supportive and homely environment for the residents. The home has several animals including cats, budgies and tortoises. The home ensures that residents` needs are met through thorough pre-admission assessments and detailed care plans. Staff are well trained and have received specialist training in dementia care. They show a good level of knowledge about the needs of individual residents. The home is very clean and maintained. The staff and residents feel supported by the manager who keeps up to date with current practice and passes this onto the staff of the home. Maintaining and promoting independence and dignity are a strong ethos in the home. The home has a varied and activity programme and residents enjoy the food provided. The home is good at monitoring and looking after the nutritional needs of the residents. Comments we received from residents include; "They do everything well." "I`m just very happy." "Very pleased with it here." "They are good staff here." Visitors and relatives told us; "Its a lovely home, staff are very good with residents, nice atmosphere. I would put my mum in here. Residents are cared for very well." "Have never come across staff who don`t care well for the residents." "I sit with mum for about two hours twice a week in the lounge so I see everything that goes on in there, how the residents are treated. The staff are so respectful, they have something extra that other staff in other homes do not have." What has improved since the last inspection? Since the last inspection Avon Manor has improves its pre-admission assessments and care plans to enable them to meet the needs of residents. They request information on the history of new residents to assist them in providing individually based care. Staff handovers at the end of shifts are more in depth to enable staff to keep up to date with residents` changing needs. There is an ongoing programme for improving the environment of the home. Since the last inspection many bedrooms and the dining room have been redecorated and new furniture bought for them. The bathrooms have also been updated to meet the needs of residents. The gardens have been improved by the addition of a secure area and a rock garden. What the care home could do better: The home provides a well managed service. Ongoing improvement and development should continue to be maintained. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Avon Manor Care Home 50 Manor Road Worthing West Sussex BN11 4SH     The quality rating for this care home is:   three star excellent 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: Jo Hartley     Date: 2 2 0 5 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: Avon Manor Care Home 50 Manor Road Worthing West Sussex BN11 4SH 01903230049 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) : Cobham Care Ltd care home 24 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 24 The maximum number of service users to be accommodated is 24 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admisison ot the home are within the following category: Dementia (DE) Date of last inspection Brief description of the care home Avon Manor is a Care Home, which provides care and support to elderly people who have dementia. It is currently registered to accommodate up to twenty-four residents. The home is a detached property situated in a residential area of Worthing with local shops and other amenities within walking distance. The seafront and beach are nearby. Communal facilities include a lounge, dining area and a smaller dining area, which leads out onto a conservatory. There are twenty-four single bedrooms, which meet or exceed the national minimum standards for individual accommodation in care homes for older people. Six bedrooms are located on a mezzanine floor accessed by steps. There are gardens for residents to use that include a safe decking area. Care Homes for Older People Page 4 of 26 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: three star excellent 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 service is 3 star. This means the people that use this service experience excellent quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, surveys received from eight residents, one health professional, and seven staff, and an unannounced visit to the home, which was carried out on the 22nd May 2009. During the visit we looked at policies and procedures, and records kept at the home including staff recruitment and training, residents records and health and safety Care Homes for Older People Page 6 of 26 information. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Care Quality Commission and its predecessor, the Commission for Social Care Inspection. The last inspection on this service was completed on the 25th May 2007. What the care home does well: What has improved since the last inspection? What they could do better: The home provides a well managed service. Ongoing improvement and development should continue to be maintained. Care Homes for Older People Page 8 of 26 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. 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. Prospective residents receive enough information to decide whether the home is suitable for them. Comprehensive pre-admission assessments are carried out prior to admission to ensure the home can meet individual needs. Evidence: We looked at the files for three residents and found that pre-admission assessments had been undertaken to ensure that the home can meet their needs. We were told by the manager that new residents are given a Service User Guide, Statement of Purpose, a dementia information booklet, terms and conditions of residence and a scale of charges before they move in. They are also welcomed to visit the home to see if they think they would like to live there. This was confirmed by a relative who was visiting the home. All of the eight residents who returned surveys said that they have a contract and they received enough information prior to moving Care Homes for Older People Page 11 of 26 Evidence: into the home to decide it was the right place for them to live. We were told that the statement of terms and conditions have been reviewed recently and are available in large print. Residents are given a Welcome Booklet when the move in that has been compiled with the assistance and input of the people who live in the home. 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. Residents health, personal and social care needs are set out in a plan of care that is reviewed monthly. They are treated with respect and their health care needs are met by the home. Evidence: The care plans that we looked at during the visit had clear details of how staff are to meet the individual needs of residents. They are initially completed from the preadmission assessment and then filled in in more detail during the first six weeks of the residents stay. This gives the home chance to get to know the residents likes, dislikes, routines and preferences in more detail. A care plan diary is completed at the end of each shift with details of each residents day/night care, visitors, medical appointments and activities. We saw that care plans are reviewed every month or more frequently if needs change. Eight of the residents who returned surveys said that they always receive the care and support they need, one said they usually do. A GP who returned our survey said, Residents are cared for individually according to their needs. Care Homes for Older People Page 13 of 26 Evidence: Daily records and care notes show that residents receive the support from health care professionals such as General Practitioners, District Nurses, continence advisers and opticians that they need. A GP told us, During our visits a private place is available for examinations and to talk. All the residents who responded to our survey said that they always receive the medical support they need. Risk assessments are in place for residents who are at risk of falls or developing pressure areas. Each resident has assessments for mental health physical health personal risk , moving and handling, behaviour, pressure area, nutrition, and falls. The medication storage was seen and found to be tidy, clearly labeled and with no over stocking. The recording of the administration of medication was accurate with no gaps. All staff who administer medication receive training. A member of staff who showed us the medication cabinet and records was very clear about what the homes procedure for the administration of medication entails. Throughout the visit staff were seen and heard treating all residents with dignity and respect. A visitor told us, Mum is treated with respect at all times. Staff ensure that the door is shut when she is using the loo and that her dressing gown is done up completely when moving her from the bathroom to her bedroom. 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. Residents are offered a variety of activities and enjoy the food provided. Visitors are made welcome. Evidence: Observation during the visit, care plans and daily records showed that residents experience choice about how they live. For example they get up and go to bed when they choose, join in the activities they like and choose what they would like to eat. A member of staff described how they offer choice to residents who get confused or do not understand open questions such as what would you like to wear?. She said that in these circumstances staff offer two choices of appropriate outfits and ask which one they would prefer. A variety of activities are provided by the home. On the day of the visit residents were listening and singing along to a musical entertainer. Other activities available include games, Pets for Therapy, outings, musicians, reminiscence and motivation classes. A piano has recently been bought for everyone in the home to use. The home also has two cats, five budgies, one canary and three tortoises. The manager told us that they can provide a carer to accompany relatives taking residents out for outings if they are Care Homes for Older People Page 15 of 26 Evidence: given enough notice. During the day staff were seen welcoming guests to the home and offering them drinks. The entries in the visitors book shows that visitors are welcome at all reasonable times. We spoke with two relatives who both said they are always made welcome. Residents told us that they enjoy the food provided at the home. In the survey responses seven residents said they always enjoy the food and one said they usually do. We saw that the meals are prepared using fresh ingredients. A resident who has diabetes is provided with an appropriate diet. The home is encouraging residents to participate in a Five a Day healthy eating plan that includes fresh fruit and vegetables, fruit juices and smoothies. 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. Residents know how to make a complaint if they need to. They are protected from abuse from by homes policies, procedures and staff training. Evidence: The complaints procedure is displayed in the hall of the home and is also printed in the Service User Guide and Statement of Purpose that all residents receive. All the residents who returned the survey we sent out said that they know who to speak to if they are not happy and they know how to make a complaint. The complaints procedure is available in a pictorial format for residents who need it. Staff and training records confirmed that staff receive training in Adult Protection. The new Sussex Multi-Agency Policy and Procedure for Safeguarding Vulnerable Adults is available in the office. There are also robust policies and procedures for staff to follow. The three staff we talked with knew what to do if they had any concerns about the safety of residents. 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. Residents live in a safe, well maintained environment that is clean and hygienic. Evidence: Avon Manor provides a homely, clean and comfortable environment for residents. Seven of the residents who responded to the survey said that the home is always fresh and clean, one said it usually is. Furnishings and fittings are of a good quality and in good condition. Residents bedrooms were personalised with their own belongings. The home has well tended gardens with tables and chairs so residents can enjoy it in fine weather. A rock garden has recently been completed. There is also an enclosed decked area in the front of the house. Since the last inspection the dining room has been redecorated and new dining room furniture has been bought. The home has an action plan in place to upgrade all of the bedrooms, communal areas and the exterior of the home. At the time of the visit the exterior of the building was being repainted. New furniture has been bought for the bedrooms that have been redecorated and all the bathrooms have been refurbished. Radiators are covered and windows restricted for safety throughout the home. There is a lift to the upper floor for residents whose rooms are upstairs. Equipment such as ramps, bath seats and rails are situated throughout the home where needed. The Care Homes for Older People Page 18 of 26 Evidence: laundry facilities are situated away from food preparation areas and are easy to clean. Staff have received training in infection control, and fire safety. Health and safety risk assessments are in place for all areas of the home. 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. Residents are supported by well trained, experienced staff who are competent to do their jobs. Evidence: The level of staffing at the home is sufficient to enable the staff to meet the care needs of the residents and spend time chatting, and giving individual attention. There are five care staff on duty during the mornings and lunchtime, and four during the afternoon and evening. The home does not need to use agency staff as there are enough staff to cover sickness and holidays. As well as care staff the home employs a cook, supper cook and domestics. In the surveys we received from staff and residents, all seven staff said that there are always enough staff to meet individual needs. Seven residents said there is always staff available when needed, and one said there usually is. The home has a thorough induction and staff training programme in place. All seven staff who replied to our surveys said that they receive training that is relevant, helps them meet the needs of residents and keeps them up to date with current practice. Six said the induction they received when they started their jobs covered everything they needed to know very well, one said it mostly did. Staff also complete the Foundation Level Skills for Care Course. Mandatory training includes Adult Protection, Infection Care Homes for Older People Page 20 of 26 Evidence: Control, Medication Administration, Fire, Moving and Handling and Food Hygiene. The home has over fifty per cent of staff with a National Vocational Qualification in Care at Level Two or above. Additional training available to staff includes ASET level one and two Dementia Care, Managing Challenging Behaviour, Nutrition and Health, Palliative Care and Recording and Reporting. We looked at the recruitment records for three members of staff and found them to include all the required documentation including Criminal Records Bureau Checks, two written reference and application forms. Comments from professionals that we spoke with during the visit include, Its a lovely home, staff are very good with residents, nice atmosphere. I would put my mum in here. Residents are cared for very well. Have never come across staff who dont care well for the residents. A visiting relative told us, I sit with mum for about two hours twice a week in the lounge so I see everything that goes on in there, how the residents are treated. The staff are so respectful, they have something extra that other staff in other homes do not have. 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 excellent 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 managed and provides a safe environment for residents. Staff say they are well supported by the manager. Evidence: The registered manager has a National Vocational Qualification in Care Level Four and the Registered Mangers Award. Staff said they feel supported by the manager. One comment we received from a member of staff said, The manager and owner are very good at their jobs, very compassionate. We saw evidence that the manage and senior staff attend training courses, particularly those related to dementia to enable them to keep up to date with current practice. The manager meets weekly with the directors of the home to discuss all aspects of the home including the care needs of the residents. A visiting professional told us, I have been coming here for over two years and seen Care Homes for Older People Page 22 of 26 Evidence: improvements since Lisa became manager. The home is coping with increasing challenging behaviour of some residents. Lisa is very responsive to suggestions, for example, when she heard about the National Dementia Strategy she sent away for copies and gave them to staff. The manager of Avon Manor organised a Dementia Information Evening for the family of residents of the home to enable them to understand how dementia effects people. Comments from relatives after the event were very positive. Some people asked for another similar event to be held. The home has a Quality Assurance system in place that seeks the views of residents, visitors, staff and other stakeholders. The outcomes from the last Quality Assurance audit were viewed and seen to be very positive about the home, staff and manager. The owners make unannounced monthly visits to the home to make quality checks that include talking to residents and staff, inspecting the premises and records kept by the home. Residents or their representatives manage their own money. Staff confirmed to us that they receive regular supervisions and a yearly appraisal. The home has robust health and safety procedures in place. Any accidents and incidents are recorded thoroughly. Checks on equipment and services such as hoists, lifts, gas, electricity and fire systems were seen to be up to date. 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 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. 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. 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