Inspection on 10/03/08 for Abacus House

This inspection was carried out on 10th March 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abacus House 30/04/07

Abacus House 12/05/06

Abacus House 14/12/05

Abacus House 16/06/05

Abacus House 14/03/05

Abacus House 28/09/04

Abacus House 28/04/03

Abacus House 28/04/03

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Abacus House Abacus Street 8 Princes Street Dunstable Bedfordshire LU6 3AX Lead Inspector Mrs Louise Trainor Unannounced Inspection 10th March 2008 10:30 Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 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 Abacus House DS0000029303.V360608.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 Adults 18-65. 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. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abacus House Address Abacus Street 8 Princes Street Dunstable Bedfordshire LU6 3AX 01582 478998 01582 666667 No email on 3/7/2007 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) Mr Chalvanayagam Menna Mr Sinnathamby Sivanesan Manager post vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That no admissions be made to the home without the prior written approval of the Commission For Social Care Inspection 30th April 2007 Date of last inspection Brief Description of the Service: The home is a detached property that had formerly been a private residence. It is located in a residential area of Dunstable within walking distance of the towns amenities. The house has four storeys, the upper floor being reserved for administrative purposes. Bedrooms for single occupancy are located on the ground and first floor. A kitchen-diner is located on the ground floor as is an all weather conservatory that is used as a sitting room. There is a small front garden and a large back garden to the side and rear of the building. The basement houses the laundry and a room that is occasionally used for activities and other storage areas. Parking for two cars is available at the front of the building. This home is presently not operational, and all documents are presently under review. Abacus House DS0000029303.V360608.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 0 star. This means the people who use this service experience poor quality outcomes. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which require review of the key standards for the provision of a Care Home for Younger Adults. Evidence used and judgements made within the main body of the report include information from this visit. Following a fatal incident in August last year the people who lived at the home were moved to the sister home Westways. This home is registered to look after Older People, however we agreed that the Younger Adults with Mental Health problems from Abacus House, could stay there for a short interim period as a place of safety and emergency measure, until other more appropriate accommodation could be found for them. Conversations that took place between the Provider, Mr. Menna, and CSCI, indicated that he was actively, working with the funding authorities, helping to arrange the moves for these people, however when we spoke with the funding /placing authorities, they informed us that Mr. Menna had led them to believe that this was not necessary and that he would keep these people at Westways until he could move them back to Abacus House. At this point we decided to apply to the magistrates court for two urgent orders to impose conditions on the registration of Westways and Abacus House, one to ensure that the people from Abacus House did not stay at Westways and one to ensure they did not move back to Abacus House until this was agreed with CSCI. We did not pursue our application to the court in relation to Westways as social workers found alternative accommodation for all the people from Abacus House on the day the case was presented to the court, however we were successful in gaining an order to stop anyone moving into Abacus House without our agreement. Initially Mr. Menna appealed this decision to the Care Standards Tribunal however withdrew before it took place. Mr Menna then said he would apply to us to remove the condition relating to Abacus House but so far has not done this. This was the second Key Inspection for this home this year. It was carried out by Regulatory Inspector Louise Trainor. This home has not been operating since the end of August 2007 when the fatal incident occurred in the home. The main focus of the visit was to establish what progress had been made in preparation for the home to re open. We arrived at Abacus House at 10:30 hours on the 10th of March 2008. As we were unable to gain access to the home, we went to Westways, the sister home, which is located close by. The Manager of Westways, Gwendoline Rose, Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 6 contacted the Provider Mr Menna by telephone, and then accompanied me to Abacus House, where Mr Menna joined us. Following a brief tour of the premises we returned to Westways where we were able to view recruitment documentation for two prospective staff for Abacus House that had been recruited. This was the only documentation relating to Abacus House that it was possible for us to access. Mr Menna informed us that all other documentation relating to Abacus House is presently with the police. It was seized in September 2007 pending investigation. We left the Westways premises at 12:30 hours. We would like to thank all those involved for their assistance with this inspection. What the service does well: What has improved since the last inspection? What they could do better: Present information documents have not been reviewed therefore are insufficient to ensure that prospective residents are able to make an informed choice about where they live. There is a ‘clean up operation’ planned for this home, however until this is completed its’ suitability for purpose cannot be fairly assessed. This home has been non operational for six months, however has been without a registered manager for more than a year. The manager who is presently accountable for this home has failed to identify and follow up some crucial elements in the recruitment of staff, so that people using this service may not be protected. The recruitment processes are insufficient with shortfalls in recording and processes being evident, so that people who live in this home may not be protected. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 7 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. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1. Quality in this outcome area is poor. Present information documents are insufficient to ensure that prospective residents are able to make an informed choice about where they live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was not possible to view any documents during this visit, as all documentation relating to this home, is presently being held by the police. However the Provider informed us that, to date the Statement of Purpose has not been reviewed in preparation for the home to re open. The Provider stated that this is work in progress, and he will submit it to The Commission for Social Care Inspection (CSCI) when it is complete. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area was not assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are presently no residents in this home, and there was no documentation available for inspection due to a pending police investigation following a fatal incident in this home in August 2007. It was therefore not possible to make a judgement for this outcome area. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area was not assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are presently no residents in this home, and there was no documentation available for inspection due to a pending police investigation following a fatal incident in this home in August 2007. It was therefore not possible to make a judgement for this outcome area. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area was not assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are presently no residents living in this home, and there was no documentation available for inspection due to a pending police investigation following a fatal incident in this home in August 2007. It was not possible to make a judgement for this outcome area. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Quality in this outcome area is poor. Poor recruitment systems indicate that people in this home may not always be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are presently no residents in this home, and there was no documentation available for inspection due to a pending police investigation following a fatal incident in this home in August 2007. The inspection of two recruitment files identified concerns regarding this process, which may leave the people living in Abacus House at risk of abuse. (See Staffing Outcome Area for details) Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is poor. There is a ‘clean up operation’ planned for this home, however until this is completed its’ suitability for purpose cannot be fairly assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the incident that occurred in this home in August 2007, some work has been completed in this home. The kitchen has been fitted with new units, a new window has been installed in the kitchen, and the kitchen table secured to the floor. New furniture has been bought, and blinds and a new carpet have been fitted to the conservatory. New curtains have been purchased for the rest of the house however these are not yet in place. A new heating system has been installed and repair work to ceilings has been carried out. However some decorating and a thorough ‘clean up operation’ are still required before this home could be considered fit for operations again. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 15 None of the bedrooms inhabited prior to the incident, have received any attention since they were vacated in early September 2007. They appeared to be in total disarray, and many still contain belongings from the previous tenants. The manager informed us that these belongings were either no longer required, or that individuals had asked to leave them, as they hoped they could return to live in the home in the future. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 34. Quality in this outcome area is poor. The recruitment processes are insufficient with shortfalls in recording and processes being evident, so that people who live in this home may not be protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two of the staff who were previously working in this home are now working at the sister home Westways. The remainder of the staff have either left the service or have remained on leave since the incident occurred seven months ago. Although this home is not presently operational, the provider and the manager from Westways have started to recruit staff ready for when the home is re opened. Two staff have commenced induction at Westways with a view to moving to Abacus House when it re opens. The files of these two individuals were inspected. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 17 Both contained completed application forms, however we raised some questions relating to one of them. This persons ‘work history’ only declared warehouse / factory work, there was no detail of any previous ‘care work’ declared. However the application made reference to Moving and Handling training with a local care agency in 2001. We traced this individual through the agency who confirmed that they had employed her. We question why this was not declared on the application form. The Criminal Records Bureau Check (CRB) for this applicant, detailed last known occupation as ‘child carer’. The date of birth on the CRB, did not match the one on the application form, and it also detailed an ‘alias date of birth’. The manager had not identified any of these anomalies and was unable to explain them. We advised the manager to investigate these matters further. We contacted the manager on the 14/03/08. She had contacted the CRB, and was waiting for a response, however had not taken any steps to investigate further this persons previous employment as an agency carer. Although the manager informed us that this individual had not worked in Westways since the inspection, she has not been formally suspended. An Immediate Requirement has now been issued regarding this matter. The Provider had assured CSCI that when appointing staff for Abacus House, he would be making sure they had the appropriate experience to work with people with Mental Health problems. We were therefore concerned to see that one of the recently appointed applicants obviously thought that they were being appointed to work with old people with dementia, not younger people with Mental Health problems. In her interview notes, when asked what skills she could bring to the job she had written. “I don’t have much skills in this area but I’m a loving, caring person and all elderly people need love and care”. There is presently no specialist training programme in place for staff recruited to work in Abacus House. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 43. Quality in this outcome area is poor. This home has been non operational for six months, however has been without a registered manager for more than a year. The manager who is presently accountable for this home has failed to identify and follow up some crucial elements in the recruitment of staff, so that people using this service may not be protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We have concerns regarding the transparency and openness of the provider of this home, as detailed in the summary of this report. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 19 This home has been without a registered manager for more than a year. The Provider stated that the manager, Ms Gwendoline Rose, from Westways, the sister home, would be submitting an application for this role in the near future. We were unable to view any policies, procedures or records relating to this home during this inspection, as the police have seized all documentation from this home, pending an investigation. As detailed in the ‘Staffing Outcome Area’, we have concerns regarding the management of the recruitment of new staff for Abacus House. Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 1 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 1 32 X 33 X 34 1 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X 1 X Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4&5 Requirement A statement of purpose and service user guide containing all matters detailed in the relevant regulations, must be made available to all prospective residents so that they know what services the home can and will provide. Requirement remains unmet 31/07/07 – the home is non-operational new time scale applied. This home must provide a safe and comfortable environment that is suitable for achieving the aims and objectives set out in the statement of purpose for the people who are assessed to live here. The recruitment process must protect people who are to live in this home. Immediate Requirement issued. The registered person shall not employ a person to work at the care home DS0000029303.V360608.R01.S.doc Timescale for action 30/04/08 2. YA24 23(1)(a) 30/04/08 3. YA34 19(1)(b) 19/03/08 4. YA42 19(5)(b) 19/03/08 Abacus House Version 5.2 Page 22 unless she has obtained in respect of that person, the information and documents specified in paragraphs 1-7 of schedule 2. Immediate Requirement issued. 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 Abacus House DS0000029303.V360608.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection 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. 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