Care Home: St Albans Nursing Home

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What the care home does well The home had a thorough approach to assessing the needs of prospective residents so that they could reach a decision as to whether the needs of the resident could be met at the home. Wherever possible residents were encouraged to visit the home before they made a decision to move there. Care plans were developed with the involvement of the residents and took into account all the residents` assessed social and health care needs. Daily routines within the home were relaxed and the residents can become involved in the different organised activities if they wish. The residents praised the food that was served at the home and were appreciative of the different options that were available at all times of the day. The health and personal support needs were clearly detailed in their care plans. They gave staff clear guidance as to how residents were to receive care and support. Records and information from the residents showed that the home worked hard to attend to the health needs of the residents and a range of health and social care professionals visited the home to provide care, support and advice. Medication was generally well managed within the home. The manager was fully aware of her responsibilities in managing any concerns, complaints or allegations raised in the home. There were good records kept in relation to any concerns or complaints received and the action the home took to resolve them. The manager said that she was keen to learn from any mistakes to ensure that they would not be repeated. The home had been involved in one safeguarding adult enquiry since the last inspection when they co-operated fully with the involved agencies. The allegation was not upheld. Surveys were returned by residents who all said that they knew how to raise a concern or complaint if they needed to. The home itself was clean and tidy and had a homely feel to it. Residents are encouraged to personalise their rooms with their own possessions. The staff at the home are safely recruited with all of the necessary checks and references being taken up. The staff team have good training opportunities and as a whole are well trained, enabling them to meet the support needs of the residents living at the home. They were observed to interact sensitively with the residents and they had a good knowledge of the support needs of the residents. Residents wrote that they found the staff to be friendly, helpful and courteous and that they listened to residents and acted upon what they said. The staff said that they were happy with the support that they received from the management team The home was well managed by a manager who had the relevant training and experience to fulfil her duties. She had shown, through the completion of the Annual Quality Assurance Assessment, that she recognised the strengths and weaknesses of the home but also had a clear idea as to how any improvements could be made to improve the service that the residents received. What has improved since the last inspection? As this is a newly registered service no improvements could be noted. What the care home could do better: Although the medication was generally well managed within the home, which had some good procedures in place, the manager should make sure that medication record sheets are accurately completed to give a clear record of the medication administered to residents. This will help the home and associated health professionals to keep the residents well. The staff team should receive refresher training in safeguarding vulnerable adults to help ensure that their knowledge is up to date and the residents are fully protected. The home could be better redecorated and furnished, however the new owners have recognised this and have started to make to make improvements. It was recommended that the home date all correspondence in relation to the recruitment and appointment of staff. This will create a clearer audit trail so that it can be demonstrated more easily that staff are recruited safely. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Albans Nursing Home Clarence Avenue Knott End On Sea Poulton - le -Fylde Lancashire FY6 0AG     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: Val Turley     Date: 0 1 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 25 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: St Albans Nursing Home Clarence Avenue Knott End On Sea Poulton - le -Fylde Lancashire FY6 0AG 01253810292 01253812546 administration@stalbansnursinghome.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Alison Lynne Anderton Type of registration: Number of places registered: Zion Care (St Albans) Ltd care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N To people 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: 33) The maximum number of service users who can be accommodated is: 33 Date of last inspection Brief description of the care home St Albans is situated at Knott End on Sea close to a regular bus route, shops and facilities. The home is registered for the care of 33 people in single room accomodation. There are no en-suite facilities. It is built over two floors and has a lift for ease of access. The home is furnished to a satisfactory standard, has a friendly ambience and is non-smoking. The home has a seperate hair dressing salon, two lounges and a sun lounge and enjoys sea views. There are parking facilities to the side of the home. Information about the home plus a copy of the latest inspection report Care Homes for Older People Page 4 of 25 Over 65 33 0 Brief description of the care home can be found in the reception area of the home. Ths information tells you about the service the home provides and what a resident can expect if they decide to live at the home. At the time of this inspection the fees ranged from £372 to £505 per week. There are additional charges for any newspapers, hairdressing etc. Care Homes for Older People Page 5 of 25 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: This inspection included an unannounced site visit to the home. This was carried out by one inspector over one day. During the visit we spoke to residents staff and the manager. We looked at documents and records that must be kept at the care home including care plans, staff files and policies and procedures. A case tracking exercise was undertaken. This involved the inspector closely examining all aspects of the care and support needs of two of the residents. A tour of the home was undertaken and time spent with the residents in the communal Care Homes for Older People Page 6 of 25 areas. Before the site visit we asked the manager to complete an Annual Quality Assurance Assessment (AQAA). This gave the manager the opportunity to tell us what the home did well and what the home needed to do better. This helped us to determine how well the home is managed. We also looked at the completed surveys returned by 3 residents and 6 members of staff. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 25 As this is a newly registered service no improvements could be noted. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 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 25 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 home has a good approach to assessment making sure that a full assessment of a prospective residents needs is undertaken and that their needs can be met, before the resident moves into the home. Evidence: The home had a thorough approach to assessing the needs of prospective residents. Detailed information was collected to enable them to make a decision as to whether the home could provide the care and support that they needed. Whenever possible prospective residents are encouraged to visit the home as part of the admissions process, allowing them to see the home itself and talk to the staff. The admission process for one recently admitted resident was tracked. From the documentation available it was clear that the home had spent a considerable amount of time with the lady to determine her health, personal and social care support needs. Care Homes for Older People Page 11 of 25 Evidence: The information collected as part of this assessment process had been developed into a care plan that gave support staff clear guidance as to the care and support that she needed. The care plan had been discussed with the resident who had signed to indicate that she was in agreement with it. Care Homes for Older People Page 12 of 25 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. The health, personal and social care needs of the residents were assessed and monitored with staff providing the necessary care and support. Evidence: While visiting the home we tracked the care of two of the residents in detail and looked at the care of another resident in less detail. The care plans clearly outlined the health, personal and social care needs of the residents, giving the staff team clear guidance as to how the care and support should be provided. The files showed that the health needs of the residents were attended to and that a range of health professionals provided support to the home. These included GPs, District Nurses, opticians and physiotherapists. The care plans had been drawn up with the involvement of the residents and the plans had been reviewed on at least a monthly basis. We spoke to both residents whose care we had looked at in detail and both said that they were very happy with the care provided. One resident wrote that the medical support received was excellent and that doctors are available on request. Hospital Care Homes for Older People Page 13 of 25 Evidence: appointments are arranged efficiently and staff accompany me whenever possible. We looked at the way medication is managed in the home. On the whole this was done well although on occasions the staff had not recorded the administration of medication on the medication administration record (MAR sheets). It is important for this record to be accurate to help make sure that the residents remain in good health. Care Homes for Older People Page 14 of 25 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. The routines within the home are flexible allowing residents to make choices and decisions as to how they wish to spend their time. Evidence: Routines within the home are flexible and are dictated by the wishes and preferences of the residents who decide themselves what they would like to do each day. A number of activities are arranged including quizzes, singalongs, parties, entertainers and relaxation classes. A programme of events had been arranged for the Christmas period. A mobile library visits monthly and there was involvement in the home from representatives from local churches. One resident was supported to attend a local church. Surveys returned by both residents and staff suggested that there could be an improvement in the activities especially in terms of trips out. The manager also acknowledged that there could be an improvement here and that this was an area that she was looking at. The home was actively looking for additional staffing to extend organised activities from two to three days a week. During the course of the visit to the home visitors were observed to be made to feel welcome. Residents and staff said that visitors were welcome at any reasonable time Care Homes for Older People Page 15 of 25 Evidence: and this information was also included in the service users guide. Discussion with residents on the day of the site visit indicated that the meals at the home were very good with individual dietary needs being catered for. A menu was in place showing the residents what was available each day, however staff and residents said that alternatives were always available. One resident wrote I cant fault the meals at all, even requests at unusual hours are fulfilled. The presentation is excellent. Mealtimes were observed to be unhurried giving residents plenty of time to eat their meals with staff offering assistance sensitively were it was needed. The home encourages the residents to make decisions and choices themselves wherever possible. There were examples of residents managing their own finances and medication. Information was provided about the local advocacy agency for those residents who may need external help from someone who will act in their best interests. Residents are able to bring personal possessions into the home to personalise their rooms and make them feel more homely and comfortable. Care Homes for Older People Page 16 of 25 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 residents are well protected by the policies and procedures of the home. Evidence: The home had good policies and procedures in place that deal with the protection of the residents. A complaints policy was displayed around the home giving the residents and visitors information on how they could make a complaint or raise a concern. Completed surveys returned by residents indicated that they knew how to raise any concern or complaint they may have about the home. A record was kept of any complaints received, how they were managed and the outcome of any complaint investigation. The manager said she tried to learn from these to ensure that they did not happen again. There had been one safeguarding investigation since the last inspection. The home co-operated fully with other agencies during the investigation. The allegation was not upheld. Care Homes for Older People Page 17 of 25 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 is clean, homely and well equipped and maintained for the benefit of the residents who live there and the staff who support them. Evidence: St Albans Nursing Home presents as being comfortable, clean and homely. There is a need for the environment as a whole to be refurbished but the new owners have started to do this. They have extended the sun lounge providing an extra seating area for the residents and have started to redecorate bedrooms and replace furniture. Those staff and residents spoken to all said that the home was always clean, tidy and smelt fresh. A handyman is employed to attend to most repairs in the home. There are plans to build a new outside seating area for the benefit of the residents and a bathroom was in the process of being converted into a shower room to give residents easier access. The laundry was clean and well organised and was able to meet the needs of the nursing home. Care Homes for Older People Page 18 of 25 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. Staff are safely recruited and have good training opportunities enabling them to support residents safely. Evidence: We looked at the files of two members of staff who had been recently recruited. From these it was clear that the home recruited staff safely making sure that all references and checks were undertaken before a new member of staff started work at the home. It was recommended that the home always ensure that references are signed and dated so that it is clear that these have been received prior to someone starting work at the home. The staff were given good training opportunities with both mandatory and specialist training being provided. Fifty eight per cent of the work force had achieved a nationally recognised qualification in care which means that the staff team have the skills to enable them to provide the care and support the residents need. The home had a trained nurse on duty at all times and the manager and those members of staff spoken to all said that, except at times of staff sickness, the home was usually well staffed. All of these staff, as were those staff who had completed and returned surveys, were happy with the way the home is run and the support that they Care Homes for Older People Page 19 of 25 Evidence: receive from the manager and senior members of staff. A resident wrote in a survey that staff were on the whole friendly, caring and courteous and that they listened to residents and acted on what they said. Care Homes for Older People Page 20 of 25 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 managed in the best interests of the residents. Evidence: The registered manager has been in the post at St Albans for three years. She is a qualified nurse who has kept her skills up to date by attending appropriate training courses and has completed the registered managers award. External assistance is available from the owner of the home and on a day to day basis the manager has the support of an administrative assistant and a deputy manager. The manager had completed the homes annual self-assessment in detail and it was clear from this that she was aware of the strengths and weaknesses of the home and had goals for the future which would help to further improve the quality of care and support that the home provides. There were a number of quality assurance checks undertaken on at least a monthly basis. These included checks on infection control measures within the home, Care Homes for Older People Page 21 of 25 Evidence: maintenance checks, medication audits, an accident and incident analysis, care plan and pressure care. Surveys were sent out to residents, relatives and involved health professionals on a six monthly basis. The returns from these surveys indicated that there is a general satisfaction with the service that the home provides. The policies and procedures at the home are reviewed regularly and are available for staff to refer to for up to date information as to how the home should be run. Health and safety issues are addressed and equipment and systems are serviced appropriately helping to provide a safe environment for both the residents and the staff. The residents money is managed well at the home. A minimum amount of money is held on behalf of residents to cover any day to day expenses such as hairdressing and newspapers. The financial records of two people living at the home were checked and these were found to be accurate. Care Homes for Older People Page 22 of 25 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 23 of 25 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 9 The registered manager should ensure that medication administration records (MAR sheets) are accurately completed. This will help to ensure that the residents remain in good health. Staff should receive refresher training in issues relating to safeguarding vulnerable adults. This will help to ensure that they are fully aware of the policies and procedures that the home have in place to protect the residents. The registered person should ensure that any references received in respect of prospective members of staff are dated and signed creating a clear audit trail that shows that staff are safely recruited. 2 18 3 29 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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