Inspection on 01/05/08 for Abbey House

This is the latest available inspection report for this service, carried out on 1st May 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Abbey House Abbey House 455 Hill Cross Avenue Morden Surrey SM4 4BZ Lead Inspector Liz O`Reilly Unannounced Inspection 1st May 2008 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey House Address Abbey House 455 Hill Cross Avenue Morden Surrey SM4 4BZ 020 8542 5065 020 8542 5065 s.abbeyhouse_455@hotmail.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sivanithy Krishnabala Sivanithy Krishnabala Care Home 5 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (3) Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2007 Brief Description of the Service: Abbey House is a registered care home providing accommodation and care for up to five older people, two of whom may have mental health needs. Mr and Mrs Krishnabala are the Registered Providers. The building is a three storey converted domestic property with two single bedrooms on the ground floor and three single bedrooms on the first floor for residents use. The top floor of the home is staff accommodation. The home is located in a residential area of Morden close to local shops, pubs and public transport. Current fees for this home are £505.00 per week. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection was carried out by one regulation inspector over one day. We spoke to three of the five people using the service, one member of staff and the manager on the day of inspection. We received completed surveys from all five people who use the service, two relatives and four staff. The manager completed their own self assessment of the service (AQAA) setting out what the service does well, what could be done better and plans for improvements over the next twelve months. We have used information from all of these sources as well as observations to reach the judgements made in this report. What the service does well: What has improved since the last inspection? Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 6 Since the last inspection more focus has been placed on supporting people to spend more time in the community with attendance at a community centre, swimming and gym class for some of the people who use the service. The environment has improved with the installation of radiator covers which reduces the risk of scalding. New carpets have been fitted and the garden area has improved. Care planning has improved with more of a focus on individual needs and wishes. Staff records have been updated to include all the necessary checks required to assist in safeguarding people who use the service. To ensure that sufficient staff are on duty, staff at night are keeping a record of any incidents. What they could do better: To make sure the health and welfare of people who use the service is protected more information needs to be available to staff where individuals are prescribed medication to be given “as required”. A medication profile for each person has been recommended. Staff need to provide evidence that people who use the service and or their representatives have been consulted and agree the care plans. Consideration should be given to translating key procedures and documents into the first language of individuals who use the service. The manager should review the way food is ordered to make sure the service does not run out of basic food items. A photograph of each member of staff should be kept on file to further safeguard people who use the service. Fire drills for staff should be done on a regular basis so that staff have an opportunity to practice what they would do in the event of a fire. This should include all staff day and night. Please contact the provider for advice of actions taken in response to this Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Assessments are carried out to make sure that the needs of individuals are known, and can be met, before they move in. EVIDENCE: People who use the service are provided with a copy of their contract which sets out the terms and conditions of living in the home. A copy of the contract is held on each persons file. Before anyone moves into the home, if they are supported by a local authority, a care manager will carry out an assessment of their needs. A copy of this assessment is provided to staff in the service and the manager will also visit any prospective resident to carry out her own assessment. These assessments make sure that the service can meet the needs of the individual. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 10 The information provided from these assessments is used to set up an initial care plan so that staff have a basic understanding of the needs of the person from day one of their stay. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care plans are person centred and contain clear information on the needs, strengths and preferences of individuals. Staff respect the privacy and dignity of people who use the service. Individuals have access to healthcare services. EVIDENCE: We looked at the files for two of the five people using the service. We found good information for staff on the individual needs, strengths and wishes of people who use the service. Staff are provided with clear information on; the support people need, what is essential and important to the individual, what they like, don’t like, what they can do unaided, what they need to remain healthy and what is important for them to remain safe. Plans covered the Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 12 physical, social, emotional, cultural and religious needs and wishes of individuals. Support plans were seen to be reviewed on a regular basis. The manager should make sure that care planning documentation is signed by the person using the service and or their representative. This will show that plans have been drawn up and or changed in consultation with people who use the service. A health action plan is produced for each person using the service. A record of health care checks such as hearing tests, chiropody and dental check ups, is kept. This ensures that people who use the service receive regular assessments. Staff keep a monthly check on each persons weight as part of their health monitoring. People who use the service told us through the survey that they ‘always’ received the medical support they needed. We observed people who use the service being supported to maintain their independence, offered support in a discreet manner and offered choices in their day to day lives. Staff were observed to spend time communicating with people who use the service throughout the inspection. Some of the people using this service do not have English as a first language, others are living with dementia and staff were seen to communicate effectively with people verbally, through signs and touch. Consideration should be given to translating some of the key information on the home into other languages and or pictorial formats. We found medication to be mainly well managed. All medication was stored securely and medication administration records were well maintained and up to date. Where medication has been prescribed to be taken “as required” there was not enough information for staff. Staff need to be provided with clear information about; in what circumstances the medication should be given, how frequently and the maximum dose. We have recommended that a medication profile is produced for each person with the medication they are prescribed, the date prescribed and the date discontinued if appropriate. This will provide a clear record of all medication prescribed for each individual. Risk assessments both general and individual are in place and reviewed on a regular basis. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service have the opportunity to develop or maintain their independence. Where appropriate people are involved in the day to day domestic routines of the service. Activities are based around individual wishes and strengths. People who use the service like the food provided. EVIDENCE: We found that since the last inspection staff have been working towards improving the activities available in the community. One person is now attending a community centre on a regular basis. Staff have supported another person to go swimming. Other activities have included attending a gym, going out for walks, meals out, attending church and people regularly use the local shops. Within the service one person is particularly involved in carrying out many of their own daily living activities such as keeping their room tidy, cooking, ironing and doing their own shopping. People who use the service can get hand and foot massages, watch TV, read, listen to music, play games and sit in the garden. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 14 People who use the service said through the survey that there was ‘always’ or ‘usually’ activities which they could take part in. We observed people making their own choices about where they spent their time either in their own room or in the communal areas of the lounge or garden. One person told us that they “enjoy the activities” and “like going out”. The service produces a four week menu which shows a good variety of food on offer. The needs of people with special diets can be catered for and people are supported, by staff to use the kitchen if they wish. People who use the service told us that the food was “very good” and that they thought “staff are good cooks” one person told us they “were never left feeling hungry”. Through the survey people who use the service told us that they ‘always’ or ‘usually’ enjoyed the food on offer. One relative felt that more attention needed to be paid to staff providing snacks for people who may not necessarily ask for them. These issues should be addressed by the manager through a review of the care planning in consultation with families and people who use the service. It was also brought up through the relative survey that at times basic foods particularly for breakfast sometimes ran out. The manager needs to address this issue. Visitors to the home told us that they were “always welcomed by the staff”. The service does not have set visiting times. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Concerns about the care provided are listened to and acted on. The home understands the procedures for safeguarding adults and trains staff in how to do this. EVIDENCE: The service has a clear complaints procedure which is provided to each person who uses the service. All of the people who use the service and visitors who completed a survey told us they knew how to make a complaint. Systems are in place to record any complaint along with outcomes. The Commission have received no complaints about this service. We found staff to have a good understanding of what would be classed as abusive behaviour. Staff understood their role and responsibility in reporting any concerns, allegations or suspicion of abuse. All staff have received training on safeguarding adults. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a comfortable, homely environment. The home is clean and well maintained. EVIDENCE: Abbey House is a domestic style property where each person who uses the service is provided with their own single bedroom. There are two bedrooms on the ground floor with three on the first floor. The service does not have a lift. Furnishings and fittings are of a good quality but it was noted that some over head lights were did not have lampshades and these should be provided. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 17 Since the last inspection radiator covers have been installed which reduces the risk of scalding for people who use the service. A garden to the rear of the home has been improved over the last year. One person who uses the service told us they enjoyed sitting out in the garden in the warmer weather. The manager informed us that over the next twelve months they were planning to add a conservatory which will provide more communal space. People who use the service told us that they home was “always very well kept” and that staff “work hard to keep the place clean”. All areas of the service which we saw were clean and fresh. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Staff are provided with good opportunities for training. In order to safeguard people who use the service appropriate checks are carried out on staff before they start working in the home. EVIDENCE: We observed sufficient staff on duty to meet the needs of the present group of people living at the service. We found the manager monitors the staffing levels and additional staff are on duty when people who use the service are going out. The manager has also made a request to placing authorities for additional staffing hours to meet the needs of people who want to spend more time in activities outside the home. We looked at a sample of staff files and found these to be well maintained. Checks, including Criminal Records Bureau checks and references are sought before anyone starts work at the home. This assists in safeguarding people who use the service. An up to date photograph of each member of staff needs to be kept on file. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 19 Staff take part in a variety of training courses. Recent training has included; fire safety, safeguarding adults, food hygiene, medication and first aid. The manager informed us that all staff, bar one, are in the process of completing or have achieved NVQ level 2 in care. One member of staff is in the process of NVQ level 3 training. New staff take part in two days induction training where they are ‘extra’ to the staff on duty. Staff are provided with copies of the service policies and procedures to read and they sign to evidence that they have done so. This induction assists in making sure that people who use the service receive consistent levels of care. We found staff had a good understanding of the individual strengths and needs of the people they supported. We observed good interactions between staff and people who live in the home. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager has the skills and experience to run this service. People who use this service feel they are listened to. Staff make regular checks to ensure the health and safety of people who use the service and visitors. EVIDENCE: We received positive comments from staff and people who use the service about the manager. People who use the service told us “she is very good” and “a nice person”. Staff told us that the service was “well managed”, that the Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 21 manager is “very friendly” and that she “makes sure that choices and preferences (of people using the service) are always respected”. The manager ensures that regular meetings are held with people who use the service and staff. We saw the minutes of these meetings which included people who use the service talking about activities they would either like to try or continue. The manager informed us that part of the quality monitoring included surveys to people who use the service and visitors. This is carried out once a year. We have recommended that the results of these surveys and any action taken is included in the service user guide so that people who use the service and or people thinking about using the service can see feedback on the home. We looked at a sample of the health and safety checks. Staff keep a record of hot water temperatures to assist in safeguarding people from scalding. A record of fridge and freezer temperatures is maintained to ensure that food is kept at a safe temperature. Fire alarms are tested weekly and professionals maintenance checks were last carried out on the fire alarm system in March of this year. We have recommended that fire drills are carried out on a regular basis throughout the year to ensure that all staff can practice what they need to do should there be a fire, day or night. Facilities are available for people who use the service to deposit small amounts of money with the manager for safekeeping. We looked at the records for this money and found them to be well maintained, up to date and accurate. Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) In order to protect the health and welfare of people who use the service the manager must ensure that where medication has been prescribed to be taken “as required” the following information is available to staff:• The reason for giving the medication • The dosage to be given at any one time • The maximum dose to be given in any twenty four hours • Any possible side effects • Action to be taken if the medication is not effective Requirement Timescale for action 10/07/08 Abbey House DS0000068551.V363147.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP7 OP7 OP9 OP15 OP29 OP33 Good Practice Recommendations People who use the service and or their representatives should be asked to sign care planning documents to show that they have been consulted and agree the plans. Consideration should be give to providing copies of key documents translated into the first language of people who use the service. In order to retain a record of medication it is recommended that a medication profile is produced and maintained for each person who uses the service. The manager should review the way in which food is ordered to make sure that the service does not run out of basic items. In order to further safeguard people who use the service a recent photograph of each member of staff should be kept on file. Consideration should be given to including the results of surveys on the Service User Guide to provide people who may move in with information on how people who live in the home view the service. In order to ensure the health and safety of people who use the service, staff and visitors the manager should carry out regular fire drills which over each year include all members of staff both day and night. 7. 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