Inspection on 25/06/08 for Abbeydale Nursing and Residential Care Home

This is the latest available inspection report for this service, carried out on 25th June 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Abbeydale Nursing and... 02/01/07

Abbeydale Nursing and... 12/06/06

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Abbeydale Nursing and Residential Care Home Croylands Street Kirkdale Liverpool Merseyside L4 3QS Lead Inspector Jeanette Fielding Unannounced Inspection 25th June 2008 10:30 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 DS0000067386.V363539.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. DS0000067386.V363539.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeydale Nursing and Residential Care Home Address Croylands Street Kirkdale Liverpool Merseyside L4 3QS 0151 298 2218 0151 2982665 janicestamper@btconnect.com 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) Doson Limited Mary Bernadette Ceraolo Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36), Old age, not falling within any other category (36), Physical disability over 65 years of age (36) DS0000067386.V363539.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 36 service users to include: *up to 36 service users in the category of OP (Old age, not falling within any other category). *up to 36 service users in the category of MD(E) (Mental Disorder, excluding learning disability or dementia over 65 years of age). *up to 36 service users in the category of PD(E) (Physical Disability over 65 years of age). *up to 36 service users in the category of DE(E) (Dementia over 65 years of age). 11th January 2008 Date of last inspection Brief Description of the Service: Abbeydale is a care home registered to provide residential or nursing care for 36 older people. The ownership of the home changed on 31st March 2006. The home remains privately owned. The home is located in the Kirkdale area of Liverpool and has easy access to bus routes, churches, shops and other local amenities. Abbeydale was originally a school and retains the outward appearance of a school building. Converted into a care home some twelve years ago it has car parking to the front and an enclosed rear garden. Accommodation is provided in single bedrooms on three floors. Access to all floors is provided via a passenger lift and stairways. Fees at Abbeydale Nursing and Residential Care home range from £322 to £495.39 per week depending upon level of care required. DS0000067386.V363539.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 that people who use the service experience good quality outcomes. This inspection took place over a period of seven hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans for five service user were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the manager, nurses, care staff, service users and visitors to the home to obtain their views and opinions of the service. If this was not possible due to communication difficulties, then through observing people using the service. The manager had completed an Annual Quality Assurance Assessment which gave further insight into the home. What the service does well: What has improved since the last inspection? What they could do better: The home should strive to continue to improve through regular review. DS0000067386.V363539.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this 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. DS0000067386.V363539.R01.S.doc Version 5.2 Page 7 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 DS0000067386.V363539.R01.S.doc Version 5.2 Page 8 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): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with full information regarding the home and the services offered to enable them to make an informed decision regarding their care provider. EVIDENCE: The service user guide has been updated since the last inspection and now includes information regarding independent advocacy. The document is well presented and easy to read and contains sufficient information to enable prospective service users to make an informed decision regarding their care provider. Copies of the service user guide have been placed in each bedroom to provide full information to service users and their visitors. DS0000067386.V363539.R01.S.doc Version 5.2 Page 9 Prospective service users are assessed prior to their admission by the manager or one of the senior nurses. This is to ensure that the home can meet their individual care needs and also provides the opportunity to identify any specialist equipment necessary and to enable the home to ensure that this equipment is put in place prior to the admission. The assessment involves gathering information from the service user, their family and any other person involved in their care and includes details about individual preferences. The documentation for recording the information gathered during the assessment has improved since the last inspection. Sufficient information is gathered to enable the initial plan of care to be prepared. The home does not offer intermediate care. DS0000067386.V363539.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed and informative care plans are in place to enable staff to provide the appropriate level of care to each service user whilst also meeting their individual preferences and choices. EVIDENCE: Individual care plans are prepared for all service users. The Standex System for care planning is now fully operational and all staff have been given training in the use of the system to ensure that the documentation is completed accurately. Full information regarding service users care needs is documented to provide staff with details of the care they are to give. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each service user’s plan; they give a comprehensive overview of their health needs and act as an indicator of change in health requirements. The records provide evidence of visits to and by health care professionals DS0000067386.V363539.R01.S.doc Version 5.2 Page 11 which includes dentists, opticians, tissue viability specialists and doctors. Details of individual choices, wishes and preferences are also recorded on care plans to ensure that all needs can be met. Daily records completed by the staff provide evidence of the actual care given by the staff, together with information as to how the service users spent their day, what they did with their time and how this impacted on their daily life. Charts are in place, where necessary, to maintain a record of fluid and dietary intake and for the regular turning of service users who are at risk of developing pressure sores. None of the service users currently accommodated have pressure sores. All care plans are reviewed and updated on a monthly basis or as the needs of the service users change. Medication Administration Record sheets are clearly and accurately completed by the staff. Handwritten entries now contain full information to ensure that medications are administered correctly. All medications are ordered, stored, administered, recorded and disposed of in accordance with the home’s policy and procedure. Additional training has been given to all staff who are involved with the administration of medications to update their knowledge and skills. Records of this training is held on the staff’s files. Regular audits are undertaken on medications. Personal care is given to service users in the privacy of their bedroom or in the bathroom as appropriate. Staff were observed to knock on bedroom doors prior to entering to protect their privacy and dignity. DS0000067386.V363539.R01.S.doc Version 5.2 Page 12 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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A high number of activities are provided for service users to provide them with a range of social opportunities and stimulation. EVIDENCE: The care files now include details of service users social preferences together with details of the activities they enjoyed prior to their admission to the home. The home now employs an activities co-ordinator to organise and arrange the high number of events, which take place. The staff are actively involved with the activities and spend time with service users on a one to one basis as much as possible. The includes painting nails, reading books, magazines or newspapers to them or just chatting. On the day of this unannounced key inspection, a group of local schoolchildren were filling pots and tubs with plants, under the supervision of their teachers. A local singing group provided a high level of entertainment during the DS0000067386.V363539.R01.S.doc Version 5.2 Page 13 afternoon which was observed to be thoroughly enjoyed both by service users and the visiting children. A programme of activities has been prepared and covers a wide range of social opportunities for the service users. Clergy visit the home on a regular basis and provide services for those who wish to partake of this. Visitors are welcome at the home at any time and were observed to take an active part in the care planning. Service users may meet with their visitors in the privacy of their own bedroom or in one of the communal areas as they choose. All service users are accommodated in single bedrooms to promote their privacy and dignity. The care files provide details of the individual preferences of the service users including the time that they wish to go to bed and rise and of the foods that they particularly like or dislike. The menus provide evidence that a varied and balanced diet is offered. Meals are served in the dining room or in the service users own bedroom as they wish. All are encouraged to use the dining room to promote social interaction. Dining tables were attractively laid with cloths and table centres. Meals are prepared using fresh goods as much as possible with some frozen vegetables used to offer a greater range and choice. Special diets can be provided on the advice of the dietician, GP or at the request of the service user. A choice of meals is offered and special events i.e. birthdays are celebrated. The meals served on the day of the site visit looked and smelled appetising and service users spoken to confirmed that they tasted good. For service users who need support during mealtimes, including those who have swallowing or chewing difficulty staff give assistance They are discrete and sensitive to both the person they are helping and also to other peoples’ feelings. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. Snacks and drinks are available at all times of day and night on request. The main kitchen is clean, organised and well equipped and a good stock of foods were held. DS0000067386.V363539.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All staff have been given training on the Protection of Vulnerable Adults and have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a robust complaints procedure. Details of this are displayed on the notice board in the hallway and information is also documented in the service user guide within each bedroom. No complaints have been made to the home or to CSCI since the last inspection. All staff have now been given training on the Protection of Vulnerable Adults and the registered manager has undertaken the Alerter’s training course. Discussion with staff confirmed that they had a full understanding of the different types of abuse and knew of the action to be taken in the event of it being suspected. All staff have been made aware of the whilstleblowing policy to further ensure the protection of the service users. Two relatives spoken to confirmed that they would feel confident in raising any concerns with the manager and that matters raised would be addressed effectively. DS0000067386.V363539.R01.S.doc Version 5.2 Page 15 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, 20, 21, 22, 24 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a bright, welcoming and homely environment for service users to give them a safe and comfortable place in which to live. EVIDENCE: Improvements continue to be made to the home and the planned programme of redecoration and refurbishment continues. The home has four lounges and dining areas and all have been redecorated and refurbished since the last inspection. New carpets have been fitted in these rooms which are now bright, welcoming and homely. Furnishings are domestic style. New curtains and bed covers have been ordered and their delivery is awaited. New pillows and towels have been provided since the last inspection. Liquid soap dispensers have been fitted in all communal toilets and bathrooms. DS0000067386.V363539.R01.S.doc Version 5.2 Page 16 Two new shower rooms have been provided to replace former bathrooms. Service users confirmed that they preferred the showers and that the specialist chairs in these areas were comfortable and practical. Changes have been made to the hot water system within the home to ensure that a plentiful supply of hot water is available at all times. A passenger lift provides full access to all areas of the home. Aids and adaptations are provided to assist service users who have mobility difficulties or require a wheelchair. A ramp is provided at the front of the home to give full access to the building. At the rear, easy access is available to the garden. Improvements have been made to the garden and new seating provided. Trees and shrubs surround the garden and the patio area improved. Service users confirmed that they used the garden in the recently warm weather and that they sat under the large umbrella to protect them from the sun. Service users bedrooms are bright and welcoming and furnished to a good standard. Some families have been heavily involved with personalising bedrooms and have brought in small items of furniture, pictures, photographs, ornaments and items of memorabilia. Staff have strived to provide all service users with a homely environment. The home is well maintained with all issues addressed as quickly as possible and safety issues addressed immediately. The home was clean and tidy and smelled fresh throughout. The laundress attends to personal laundry and linens carefully. Full COSHH information is held in the home and training given on the use of products where necessary. The laundry was clean and organised with service users personal clothing placed in individual, named, baskets for being carefully put away in their bedrooms. DS0000067386.V363539.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training continues to develop knowledge and understanding and ensure that service users needs are met effectively. EVIDENCE: The home employs qualified nurses and care assistants to provide care to the service users. The staff rota provides evidence that sufficient staff are employed and that they are deployed appropriately. The home has a robust recruitment procedure and files inspected showed that the procedure has been followed. All prospective staff are required to complete an application form prior to being called for interview. Two references are taken and checks made with the Criminal Records Bureau and the Protection of Vulnerable Adults Register. A full induction training programme is followed by all new staff and evidence of this is held on their individual file. All checks have now been made on other persons working in the home i.e. hairdresser, aroma therapist and volunteers. DS0000067386.V363539.R01.S.doc Version 5.2 Page 18 A high level of training has been provided for staff and further training is planned to promote good working in the home and to develop staff’s knowledge and understanding. Over 70 of the care staff now hold NVQ qualifications. Recent training includes pressure area care, continence, infection control, food hygiene, moving and handling, dealing with challenging behaviour, dementia care, health and safety, first aid, POVA and fire prevention. Updates on some of these training events have been planned with further training opportunities being made available. Staff meetings are held on a regular basis and provide a forum for the dissemination of information. Some changes have been made to the staff team since the last inspection to provide service users with a well trained and effective staff team although the diversity of the night staff team does not reflect the cultural needs of the service users accommodated at the home. Service users and relatives spoke extremely highly of the staff team, the care they gave and their commitment to their work. DS0000067386.V363539.R01.S.doc Version 5.2 Page 19 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents, relatives and other healthcare professionals are sought on a regular basis to enable improvements to continue. EVIDENCE: The registered manager of the home is a qualified nurse who has many years experience in managing care home for elderly people. The improvements made by the manager at the last inspection have continued and she now has the support of the staff team who confirmed that she is DS0000067386.V363539.R01.S.doc Version 5.2 Page 20 supportive and available for them at all times. One member of staff said that the manager is approachable and knowledgeable. The manager is well supported by the owner who visits the home on a regular basis. The management of records within the home has improved considerably since the last inspection and information was readily available. Formal supervision is given to all staff every two months. Records of supervision are held securely in staff’s individual files. Staff meetings are held on a regular basis although a number of staff choose not to attend. Relatives meetings are held on a regular basis and provide relatives with the opportunity to meet with the manager and staff and to obtain information about the improvements within the home. Annual quality assurance audits are undertaken through Satisfaction Survey Questionnaires which are issued to service users, relatives and health care professionals. A separate bank account is held for service uses money where no relatives are available or willing to deal with their money. This is a non-interest bearing account and information regarding this is detailed in the Service User Guide. Monthly visits are made to the home by the registered person who makes a written report of his findings. Health and safety of staff and service users is assured through regular checks and issuing of safety certificates. All safety certificates were in place and were up to date. DS0000067386.V363539.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 X 4 X 4 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 4 X 3 X 3 X X 3 DS0000067386.V363539.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000067386.V363539.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: 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 © 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 DS0000067386.V363539.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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