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Inspection on 14/12/05 for Abacus House

Also see our care home review for Abacus House for more information

This inspection was carried out on 14th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Albeit a small team, the majority of personnel had worked in the home for a significant time and were well acquainted with service users` needs and the strategies required to manage challenging behaviours that occurred from time to time. There was only one other member of staff on duty with the manager at this inspection. Both were observed to treat service users with respect and skill that was sensitive to each service user`s capabilities and needs. All of the staff in the home but one had achieved NVQ awards in care. The manager was well qualified to administer the home. She held an award in care management and had also achieved a Diploma in Mental Health Psychiatry since the last inspection. It was unfortunate that this inspection identified for the CSCI that the manager had resigned her position some time previously and was scheduled to leave at the end of January 2005. She was not aware of any arrangements as yet to employ someone to take over her position.

What has improved since the last inspection?

Staffing arrangements had improved so that the manager had been able to work at least 3 shifts each week on management tasks. Members of staff from the adjacent home which was also owned by the provider were no longer used to cover vacant shifts. Agency personnel were used for this purpose. The manager reported that she had arranged for the agency to supply the same two employees to ensure the continuity of service. There had been progress in the development of training programmes tailored to meet service users` needs. This was planned for introduction in the new year. Arrangements had been set up with a local provider of further education for a computer to be supplied to the home. A tutor had visited to carry out preliminary assessments with a view to organising individual development programmes about IT systems for service users. Some aspects of the environment had improved by the cleaning and replacement of carpets and the repair of a broken window.

What the care home could do better:

The home had a locked front door policy that had been qualified through risk assessment. However, given the implications for the need to evacuate in the event of a fire, such arrangements must be agreed with the fire officer. It reported that action had been taken on the previous requirement to repair or replace broken chairs. The repairs had evidently not been sufficient as one had broken again and another had torn upholstery that constituted a fire hazard. It was also noted that there had been no progress to supply blinds to the ceiling of the conservatory. Given that this room becomes hot in summer temperatures, action must be taken before next summer on this issue. The garden was completely overgrown. Whilst service users and members of staff had maintained the garden during the summer the clearing up task was more than could be expected from either group of people. The proprietor must therefore employ someone to undertake an overhaul of the garden so that service users can make use of this facility when the weather improves. The most recent certificate of registration had not been displayed in the home, as is a legal requirement. The previous certificate, which was displayed, was not an accurate reflection of the current registration details.

CARE HOME ADULTS 18-65 Abacus House Abacus Street 8 Princes Street Dunstable Bedfordshire LU6 3AX Lead Inspector Leonorah Milton Unannounced Inspection 14th December 2005 13:50 Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 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.V273662.R01.S.doc Version 5.0 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.V273662.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abacus House Address Abacus Street 8 Princes Street Dunstable Bedfordshire LU6 3AX 01582 478998 01582 666667 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 Mrs Delia Williams Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 adult aged 35 - 70 years Date of last inspection 16th June 2005 Brief Description of the Service: Abacus House was registered to provide for six adults with a mental disorder. The home had been owned and managed by Mr Menna for a number of years. The management had subsequently passed to Mrs Delia Williams eighteen months ago. The home was a detached property that had formerly been a private residence. It was located in a residential area of Dunstable within walking distance of the towns amenities. The premises had four storeys, the upper floor being reserved for administrative purposes. Bedrooms for single occupancy were located on the ground and first floor. A kitchen-diner was located on the ground floor as was an all weather conservatory that was used as a sitting room. There was a small front garden and a large back garden to the side of the building where service users had been supported to grow vegetables. The basement housed the laundry and room that was occasionally used for activities and storage areas. The garage that was accessed from the side garden had been converted into a gym for the use of the service users. Parking for two cars was available at the front of the building. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of the statutory two inspections that the Commission for Social Care Inspection (CSCI) is required to carry out each year. This inspection was carried out in accordance with the CSCI’s procedures to assess core care standards within the two inspections as detailed on this report. This inspection therefore focused on the progress to meet requirements from the previous inspection and the core standards not assessed at that visit. During this inspection the arrangements for the care of one service user were assessed in consultation with him and then with the manager. His private accommodation was inspected. Three other service users were seen in the home as they went about the business of daily life. Sundry records relevant to the operation of the home were reviewed. A partial tour of the building took place. It is recommended that this report be read in conjunction with the report of the inspection carried out in June 2005 for a complete overview of the standard of the operation between these dates. What the service does well: What has improved since the last inspection? Staffing arrangements had improved so that the manager had been able to work at least 3 shifts each week on management tasks. Members of staff from the adjacent home which was also owned by the provider were no longer Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 6 used to cover vacant shifts. Agency personnel were used for this purpose. The manager reported that she had arranged for the agency to supply the same two employees to ensure the continuity of service. There had been progress in the development of training programmes tailored to meet service users’ needs. This was planned for introduction in the new year. Arrangements had been set up with a local provider of further education for a computer to be supplied to the home. A tutor had visited to carry out preliminary assessments with a view to organising individual development programmes about IT systems for service users. Some aspects of the environment had improved by the cleaning and replacement of carpets and the repair of a broken window. What they could do better: 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. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 7 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.V273662.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Sufficient information was available to prospective service users to enable them to make an informed choice about a move to the home. EVIDENCE: A comprehensive service user guide that incorporated the home’s statement of purpose had been developed. It contained pictures of the environment and various activities as visual aids. Minutes of a meeting with service users showed that service users had been updated about the service user guide. The manager reported the format for contractual arrangements had been reviewed and that revised copies had been forwarded to placing authorities and that the return of signed copies was anticipated. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These care standards were not assessed as they had been reviewed at the previous inspection. EVIDENCE: Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 The arrangements for service user’s nutritional needs were satisfactory. EVIDENCE: Service users who contributed to the inspection expressed satisfaction with the provision of meals. Minutes of meetings showed that service users had been consulted about menu planning. The actual pre-printed menus were used for guidance purposes only as service users’ preferences were taken into account on a daily basis. Records had been maintained on a daily basis of the food provision and showed a nutritious choice. Satisfactory arrangements were in place for the service user who had special dietary requirements. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The actual arrangements for the administration of medications were satisfactory. EVIDENCE: Staff had received training in safe medication procedures. Assessment of documents showed that appropriate records had been maintained in relation to the receipt and administration of medicines. The home’s written medication procedures did not show what must happen to unused/discarded medicines. The manager reported that unused medicines had been returned to the pharmacist. Medicines were stored in an appropriate lockable wall cupboard. However safety had been compromised because this cupboard had been accessed more often that need be because it had been used to store non-medical items Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Satisfactory arrangements were in place for the protection of service users. EVIDENCE: The home had ceased to use personnel from another home in the organisation that had experienced on-going issues in relation to inappropriate staff conduct towards service users. The permanent team at Abacus House had received training in protection issues. The organisation had verified the CRB checks for agency personnel. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home provided a clean and comfortable environment with few omissions to service users’ comfort. EVIDENCE: Areas of the building seen at this inspection were clean and orderly. Satisfactory written procedures, risk assessments and staff training were in place to maintain hygiene standards and prevent the spread of infection. It was reported that carpets to replace those in 3 bedrooms were on site to be fitted. The bedroom seen at this inspection required redecoration. The carpet on the staircase was worn and will require replacement in the near future. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35,36 Service users benefited from a well-supported and supervised team. EVIDENCE: There were some omissions in relation to training in the skills to care for those with a mental disorder. However this inspection identified that the knowledge of the manager, who had a hands on approach to her role, had ensured that the team had received appropriate supervision and support to enable them to properly care for service users. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 The home had been skilfully managed and administered to the benefit of service users. EVIDENCE: As detailed in the summary to this report the manager had continued to develop her knowledge in relation to the care of those with a mental disorder. Records had been well maintained to a professional standard. Proforma documents and written procedures had been reviewed on a regular basis to ensure that the home operated in accordance with current best practice. The manager had strategies in place to audit the quality of the service and safety matters on a regular basis. An external agent had been employed to assess the service on a monthly basis on behalf of the proprietor. Copies of the resulting reports had been forwarded to the CSCI. Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 16 Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 2 x 2 Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Abacus House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 2 x DS0000029303.V273662.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? 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 2 Standard YA3 YA20 Regulation 12(1)(a) 12(1)(a) 13(2) 12(1)(a) 13(2) 15(1) Requirement The most recent registration certificate must be displayed in the home. The written medication procedures must include reference to the safe disposal of unused medication. The medication cupboard must not be used to store nonmedical items. The care plans must have a care intervention for all the needs identified in the service users assessment plans (16/06/05-previous timescale of 30.05.05 had not been met. 14/12/05- not assessed in full) Arrangements must be made to replace or refurbish the broken chairs in the conservatory (16/06/05-previous timescales of 30.12.04, 30.05.05 had not been met. 14/12/05- action taken but chairs broken or torn again) The garden must be tidied up. A member of the care team must not carry this out as part DS0000029303.V273662.R01.S.doc Timescale for action 31/12/05 31/03/06 3 4 YA20 YA6 31/12/05 30/09/05 5 YA24 16(2)(c) 31/01/06 6 YA24 12(1)(a) 16(2)(c) 31/03/06 Abacus House Version 5.0 Page 19 of their rostered care hours. 6 YA24 Blinds must be fitted to the ceiling of the conservatory. (Previous timescale of 31/08/05 had not been met) 12(1)(a) The registered person must 39(b) inform the CSCI about any proposed changes to the management of the home 35 All personnel working in the home must commence induction and training that is relevant to meeting the needs of service users with a mental disorder. (Previous timescale of 31/08/05 had not been met but implementation of the programme was in hand) 23(4)(c)(iii) The fire officer must approve the home’s locked door policy. 16(2)(c) 31/05/06 7 YA33 31/12/05 8. YA18 31/03/06 9 YA42 31/01/06 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.V273662.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 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 Abacus House DS0000029303.V273662.R01.S.doc Version 5.0 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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