Inspection on 25/04/06 for Abafields Residential Home

This inspection was carried out on 25th April 2006.

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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Abafields Residential Home 3-9 Bromwich Street Bolton Lancashire BL2 1JF Lead Inspector Rukhsana Yates Key Unannounced Inspection 25th April 2006 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 Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 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. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abafields Residential Home Address 3-9 Bromwich Street Bolton Lancashire BL2 1JF 01204 399414 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) Coulson & Collins Care Home Ltd Mrs Anne Collins Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 35 service users, to include: Up to 35 service users in the category of OP (Older People). The service should employ a suitably experienced and qualified manager who is registered with the Commission for Social Care Inspection. Not applicable Date of last inspection Brief Description of the Service: Abafields is a spacious Victorian building situated close to Bolton town centre. The home has been extended and modernised to create a bright, comfortable, homely environment. The home provides personal care and support for up to 35 people over the age of 65 years. Accommodation is provided in 5 shared rooms and 30 single rooms, 12 of which have en-suite facilities. Residents have a good choice of communal areas, including a conservatory overlooking a large, well kept enclosed patio. There is limited on-street parking outside the home. The current weekly fees range from £360 to £400. Further details regarding fees are available from the manager. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over two days, with a total of 16 hours spent at the home. During the inspection, discussions took place with four residents on their own, two staff members and the manager. Several people completed survey forms to give their views of the home. Surveys were received from six residents, seven relatives, two GPs and the District Nursing Team. The visiting pharmacist also provided written comments. A meal was taken with the residents, and half of the inspection time was spent watching the way in which staff supported residents, and in talking with them individually and in groups. Paperwork was looked at that related to the care and safety of everyone living or working at the home. The inspection covered all of the key standards. These standards cover moving in, the care provided, routines and social activities, complaints and protection, comfort, safety and cleanliness, how staff are employed and trained, and how the home is managed. What the service does well: Residents or their relatives are able to visit the home and look around any time, and the manager will answer any questions they have, to make sure they are making the right choice. One new resident said The staff are nice and help me. They make sure I am comfortable and a relative said “I feel I have been very fortunate in finding such a lovely home”. Residents feel they are well looked after and that they are treated with respect, describing “good care and support” to help them with the physical and mental health. The manager is very good at making sure there is an excellent range of activities, outings and holidays that residents appreciate and enjoy. Residents have choices about how they spend their time. As one resident said, “We can please ourselves. There are no restrictions”. All the comments from residents showed that they enjoy their meals at the home and are always given choices at mealtimes. Residents and relatives have confidence in the owners and manager to properly deal with any problems they may have. One resident said “They genuinely listen to us”. They feel safe and cared for. Residents are happy that the home is clean and comfortable and like the improvements taking place through redecoration. The staff enjoy working here because they get good support. They said We get loads of training”. The manager always carries out checks on staff before they can start working at the home. Residents like the fact many of the carers Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 6 have worked there a long time and have got to know them. One said “They always do their best”. The home is well run and managed, and the owners and manager are keen to keep making improvements so that the residents have the best possible service. What has improved since the last inspection? 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. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 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 Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person considering moving to Abafields has their needs assessed, and is given information about the home by the manager, before admission. The admission process ensures that those new to the home know what to expect of the service from the outset. EVIDENCE: The manager described the admission process, stating that she visits each prospective resident to assess their needs, usually accompanied by another member of staff, a senior or carer in order to get their perspective. The manager considers the available information from the social worker, talks to the prospective resident and completes assessment documentation. If the prospective resident is privately funded, most of the information is gained through liaison with family members. The resident or their relatives can visit the home at any time to have a look around, but the manager prefers to make an appointment so that she can see them and answer questions personally. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 9 Prospective residents are offered an introductory visit, may stay for a meal or come in for a full day to be assessed. Relatives are given a copy of Statement of Purpose and Service Users’ Guide. Discussions took place with two residents new to the home. One resident admitted two days ago was beginning to adapt and said The staff are nice and help me. They make sure I am comfortable. Both chose to let relatives have a look around homes and make the choice for them. The said they were assisted by staff and the manager to settle in, had routines explained to them and were asked about their food preferences. They felt that staff attend to their needs and the home was suitable. One relative commented “I feel I have been very fortunate in finding such a lovely home for mum. The staff are extremely caring and professional.” A senior carer said that she is often involved in the pre-admission assessment and the information gained is used to produce the care plan. All care staff are informed of the new persons needs verbally, and through written information via daily reports and the written plan. Records showed that a pre-admission assessment form is completed that contains the headings of basic details, medication, physical health, allergies, eyesight, hearing, sleep pattern, mental health and religion. Some areas had not been completed and therefore did not provide sufficient information about the person’s needs. However, it was noted that that initial care plan was produced on the day of admission and contained greater detail. The manager said that social workers do not always provide a community care assessment prior to admission as they should. The manager was advised to ensure that she makes the homes expectations clear to social workers on referral. In the meantime, in light of delays currently experienced and in the absence of a community care assessment, a pre-admission form should be devised that covers the headings indicated under standard 3. This should be completed, dated and signed, to demonstrate due consideration of needs and the ability of service to meet them. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. Care plans generally reflect the needs of residents, and along with good communication systems ensure that those needs are met. Residents’ wellbeing is promoted through excellent attention to physical and psychological health matters and safe medication arrangements The ethos of the home is to make sure that residents’ needs comes first, resulting in residents feeling they are treated with respect and their right to privacy and dignity is upheld. EVIDENCE: The care plans and daily reports of four residents were examined. The care plan format covers the areas of the resident’s personal profile, social and leisure, physical health needs, mental health and physical health dependency score; personal risk assessment, moving and handling assessment, behaviour, pressure sores, nutrition, falls, needs and preferences and the care/action plan. There were instances of needs, and actions to be taken to meet them, not clearly identified. For example the needs of a resident with poor eyesight and registered blind should be reflected in the plan, such as the provision of Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 11 talking books. Social and religious activities were not always completed. Another example was a resident’s plan that noted a pressure sore in January, but subsequent reviews carried out by senior made no mention of progress in pressure area care. Care plans reasonably reflect needs, but the manager was advised that needs and actions to meet needs could be improved. Subsequent monthly reviews should show progress or otherwise in meeting identified needs and include the views of relevant others. Residents and their relatives were very happy with the care provided. Two residents consulted were aware of having a care plan but did not want to access it. When asked about the care, they talked about having familiar staff because of low turnover. One said they get used to knowing what we need and like. A relative commented “We are well satisfied with the home and care that my mother is receiving at Abafields. No complaints at all”. The staff consulted were able to demonstrate a good knowledge of the needs of residents. Seniors begin to complete care plan from the date of admission. Care staff maintain daily reports and have good handover systems so that relevant information is passed on. Various aspects of healthcare were discussed with the manager, staff and residents. In respect of skin care, district nurses treat pressure sores, and staff recognise that any red areas are to be reported immediately to prevent pressure sores from developing. They reported a very good working relationship with district nursing service, describing it as very efficient. The district nursing team feels that staff are knowledgeable and the home provides a good standard of care. Pressure relieving equipment was seen to be provided, eg, special mattresses for those needing them. Residents are assisted with frequent toiletting, and pads are only used if necessary. The manager consults the Continence Advisor if there are any problems. Double staffing between 7 and 8am means that anyone who is incontinent during the night can have a bath or shower. Chiropody services are provided every 10-12 weeks. Two residents pay privately through choice. Obtaining a dentist for new residents is proving to be problematic at this home as for others. In terms of psychological health, there were examples of consultant referral and input when the home has been worried about a residents mental health and the effect of this on their wellbeing. With regard to nutrition, the home has a good relationship with the community dietician to whom a referral is made, via the GP, when concerns arise. Intake charts are maintained for residents at risk of poor nutrition and residents’ weight is monitored. Audiology services are accessed for residents. Eye tests are carried out 6monthly at the home by the optician. The manager seeks to achieve continuity of care and avoid hospital admission where possible in line with residents wishes through the use of the Rapid Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 12 Response service. This has lead to better outcomes for residents than would have been achieved through admission to hospital. In adddition, the manager has attended palliative care training and is looking to use the Generic care home pathway assessment and planning documentation for people who become seriously ill and want to remain at the home. Staff consulted confirmed receipt of a good range of training. Induction covers health issues including skin care, continence management and nutrition. These are covered further in NVQs. Discussions with residents and observations confirmed that any concerns about health are reported to seniors or the manager and referred straight away to the GP or for input from the relevant health professional. Records are kept of visits by health professionals, their purpose and outcome. Medication is well managed. The home started using the Boots MDS system in february 06. The contract with Boots provides for an initial review of medication arrangements, training for staff on the system, and pharmacist advice on any medication enquiries and the safe and effective use of the Boots MDS. The Senior Dispenser at Boots provided a letter for CSCI on the second day of the inspection stating Following a visit to Abafields on 3.4.06 I am writing to say how knowledgeable the staff were as regards their residents medication. Training was completed to assist them in ordering their next months medication scripts and all queries raised by both myself and my Pharmacist were answered very satisfactorily. Records of medication dispensed were accurate. New residents were awaiting photos to go on the medication file. The medication round was observed and correct procedures seen to be followed. Controlled drugs were securely stored and a separate recording book maintained with entries double signed. Quantities of controlled drugs were checked and in order. Drugs are stored in two trolleys, both locked in the office at night. The main dispensing trolley is locked and chained to wall in the dining area during day. Only senior staff administer and have attended a medication awareness course as well as a half day on new methods with this system. Seniors monitor the effects of medication and report changes or concerns. GPs review medication on request. Written medication procedures have been under review, and some additions and elaboration will ensure that the range of procedures are comprehensive, ie to cover receipt, recording, storage, disposal, self medication / risk and homely remedies, and individual guidelines for PRN. Discussions with residents, along with observations indicated that residents’ privacy is respected by staff when assisting with all aspects of personal care. Showers and baths are offered at each person’s preferred frequency and as required. Residents are enabled to see their GP, health staff and visitors in private. Residents may have telephone installed in own room. They may also have a lock on their bedroom door if they want one and their risk assessment supports this provision. Good housekeeping and laundry arrangements ensure that residents always wear own clothes. Staff confirmed that the principles of Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 13 privacy, respect and dignity are covered during induction and through ongoing discussions and reminders. Proper terms of address are encouraged rather than pet names. Screens are provided and used in shared rooms. The manager meets with seniors every Friday to discuss any issues and training needs of staff based on their continuous observations, eg Moving and Handling training needs. Patient and sensitive attitudes were observed during mealtimes and when assisting residents to the toilet. In respect to people wanting to stay at the home when terminally ill, the manager is developing knowledge and good practice in palliative care which will serve to enhance residents’ dignity in their final days. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. 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. Residents’ needs and preferences are reflected in an excellent range of activities and outings that they appreciate and enjoy. Residents feel they have flexible daily routines and are encouraged to make choices in their day-to-day lives. The attention to dietary needs, preferences and healthy choices ensures that residents enjoy their meals. EVIDENCE: Residents consulted reported a wide range of recreational activities at the home. These included music, singing, and activities as recorded in the activities book, such as movement to music, crafts, bingo and dominoes. Structured craft sessions are run by external person. Two trainee social workers were helping with activities and being encouraged to spend time talking to residents. Observations confirmed that people are given a choice as to whether they want to join in, sit in, or not participate at all. Talking books were available. The home holds parties 5 or 6 times a year, the most recent being an Easter party. Friends and relatives are always invited and food is provided in the form of a hot and cold buffet made on the premises. There is Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 15 always an entertainer and bar for each party. As a matter of course, some residents have alcoholic drinks in their rooms through choice and where there is no risk in this being facilitated. The layout of lounge has been altered and used to create smaller lounge areas so residents now interact better as they are sitting in small groups, and also have access directly to enclosed patio and garden area. The home also facilitates a range of community activities. Holy Communion is given fortnightly in the home, but the manager does take residents to church if they wish to go. The manager also regularly offers to take individual residents shopping in town. Staff escort and accompany residents to family parties, funerals, etc. Staff sometimes take residents to local shops or the post office. Day trips take place regularly. Residents were looking forward to forthcoming trips to the Rivington Lunch and Tea Dance, and the Rose of Parbold barge trip. Residents also go away on holiday 2 or 3 times per year. The last holiday was in March this year when 14 residents and 6 staff went to Morcambe for 5 days. Some places are always offered to residents from other homes. The next holiday is to Southport in September, to a hotel with good facilities including nurse calls, tea trolleys and choices of meals. There was evidence from discussions with residents, and records that residents’ choice is promoted. Care plans note the times people want to get up and go to bed and these are respected. Residents may handle their own finances if they are able to and wish to. Information is available pertaining to advocacy services, and there was evidence of residents personalising their rooms with personal possessions. One resident said “we can please ourselves. There are no restrictions”. With regard to meal provision, there is a cook on duty in the kitchen between 8am and 6pm through the employment of 2 full time cooks. The cook always goes to see new residents and talks to them about their dietary needs and preferences. She said she tells them anything they want, its not a problem as there is always a good choice of foodstuffs in. Comments by residents about food preferences from the owners’ monitoring visits are always passed on to her. No resident is on a pureed diet at present. One person has an intake chart. Menus are varied and nutritious. There is a good choice at breakfast time. A resident said “We can have what we want for breakfast. I have grapefruit, toast and marmalade and cereal. Fresh fruit is offered twice a day, and another resident said We are always given snacks at night, such as potato cakes. Residents also confirmed that they are regularly asked what they would like that the home does not presently provide. Observations over lunch highlighted good staff attitudes and assistance provided as required. Plateguards were provided for those who needed them. Staff were on hand to assist and encourage. The menu choice on the first day was chicken pie or pork steaks then strawberries and cream and alternatives were offered. Tea, Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 16 coffee, water and juice were available. The dining room was suitable and pleasant, with dining space extending to the attached conservatory area. The kitchen was clean and well organised. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 17 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 inspected at least once during a 12 month period. 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. Residents feel able to air their views and are confident that the owners, manager and staff will listen and respond to their satisfaction. Written guidelines and staff training help to ensure the protection of residents from abuse. EVIDENCE: Information about how to complain is included in the service users’ guide which is given to all residents and their relatives. Residents confirmed that there are residents’ meetings where they can ask questions or make suggestions. There have been no complaints received since registration. All of the survey responses received from residents and their relatives indicated confidence in the home’s ability to manage complaints, and highlighted the approachability of the senior staff and manager. Residents consulted also confirmed that the owners visit regularly and speak to each resident. One commented “They genuinely want to know what we think and make sure we are happy”. Staff members consulted showed a good understanding of the home’s adult protection and whistle-blowing guidelines. All staff have attended adult protection training and new starters are booked to attend at the earliest opportunity. A copy of the local multi-agency protection procedures is available and accessible to staff and team meetings have been used to talk about what Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 18 constitutes abuse and to reinforce good practice. The manager and senior staff gave examples of challenging and guiding staff whose attitude needs to improve. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Abafields provides a clean, comfortable and safe environment for residents. EVIDENCE: Abafields is maintained to a satisfactory standard throughout, and provides homely, clean and comfortable surroundings. Since the change in ownership, new carpets have been fitted to 16 bedrooms and one staircase, hall and landing. The conservatory has been redecorated, and there is clearly an ongoing redecoration programme being implemented. A gardener attends to the grounds every fortnight, and the manager is considering introducing garden projects for the residents. The fire precautions register shows that all necessary checks are carried out at the required frequency. Fire training was undertaken by all staff during two sessions in April. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 20 The home has a well organised laundry. There are two washers with a sluicing facility and drying room. A housekeeper is responsible for laundry and works 7 days a week for 5 hours per day. A part-time housekeeper is employed for 10 hours per week to assist. The home is clean and hygienic. 2 domestics carry out cleaning duties each morning 7 days per week. The following measures were seen to be in place: a clinical waste contract, liquid soap and paper towels, barrier gels for all staff, blue aprons for personal care, white aprons for serving meals, gloves, clinical wipes, and disposable wipes for face washing. All residents consulted were positive about the environment and recent improvements. One said “The home is kept very well, and it’s clean”. Another commented “I like my bedroom and I like the lounge that I sit in”. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 21 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 at least once during a 12 month period. 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. Residents’ needs are effectively met by the numbers of staff. The staff group has the knowledge, skills, training and management support it needs to ensure good standards of care for residents. The careful recruitment process ensures that care staff employed are suitable, and the welfare of residents protected. EVIDENCE: All survey responses showed that residents, relatives and visiting health professionals are satisfied with staffing levels and the competence of the staff. The staff rota shows that there are suitable numbers of staff on duty. The home does not use bank staff as there are good arrangements for covering absences through the existing staff group. This provides good continuity for residents. The manager, deputy, a senior carer and three care staff are on duty during the day. There are four carers in the evening and three at night. Double staffing between 7 and 8am helps to ensure residents receive the personal support they need at this busy time. The manager is supernumerary and on-call. Staff members interviewed felt able to carry out their duties effectively within these staffing levels and confirmed that their training needs Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 22 are met. One senior said she “loves working here - the staff work well together”. The home employs a range of ancillary staff, and this allows care staff to concentrate on supporting residents. Residents’ comments about staff include “staff have been very good”, “They always do their best” and “they gave me good care and support, especially after losing my husband. The staff looked after me very well”. 75 of the staff have achieved NVQ qualifications to level 2 or above. Two seniors have started the NVQ4 in care. 4 staff have NVQ3. Records show that all mandatory training is updated as necessary, and the home is working towards computerised training records. Staff records showed that the manager carries out all necessary checks before employing a new staff member. The files of the most recent staff recruited contained an application form, 2 references and an ongoing induction record. POVA and CRB checks had been obtained. The manager stated that she always seeks two written references to include the most recent employer. When a satisfactory POVA check has been received, the new worker starts the induction process and shadows an experienced worker. The manager has obtained a pack on new Skills For Care induction standards and is introducing these. One staff member said We get loads of training” and listed recent courses attended including palliative care, dementia care, diabetes and bereavement. The manager carries out interviews alone, and it was suggested that another person be present to assist with the interview and take notes. All staff are given a code of practice, terms and conditions and handbook. The manager stated that new job descriptions are being drawn up. The manager was advised to alter the application form to include more space for information about qualifications and experience, and to add a declaration of fitness to work. Recruitment information, to include the POVA/CRB reference number, outcome and date obtained should be kept where only the manager and owners can access it. The level and organisation of information in staff files varied. It was suggested that these contain certificates, training and development information and appraisals, and that individual staff could have some ownership and responsibility for keeping their file updated. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 23 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 at least once during a 12 month period. 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 way in which the home is run and managed promotes a good quality of care for residents and positive motivation for staff. The excellent quality assurance systems allow residents and staff to make their views known so that they feel valued. Residents’ financial interests are safeguarded. A wide range of regular health and safety checks ensure that the environment is safe and suitable for those who live and work at the home. The manager needs to ensure incidents are notified to the CSCI. EVIDENCE: The manager is highly experienced, competent, and fosters an open approach and commitment to good standards of care. She has a Diploma in Dementia Care, has completed mandatory training and re-started the Registered Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 24 Managers’ Award, with a view to completing this in 6 months. The manager has also attended a course in palliative care and is due to attend a course for managers on infectious diseases. She does not carry out hands-on duties, but keeps abreast of training to enable her to monitor staff practices. Although records in the home are generally in order, a requirement was made for the manager to ensure notifiable incidents are reported to the CSCI in accordance with regulations, as no notifications have been received since registration. Staff reported that the manager is easy to approach, works well with them on taking on new ideas and hold regular meetings with them. In terms of listening to staff the manager said I have to take their views into account because theyre on the floor doing the work and her approach has resulted in a staff group that feels valued. The owners have also made a great contribution to the commitment of the staff group through listening to their views and talking with them individually on a regular basis. Very good work has been done in respect of Quality Assurance in recent months. There are quality questionnaires for residents and relatives that cover staff, care, food, cleanliness, decoration, maintenance, activities, holidays and a section for other comments. Results of these have been collated in April 06 and will be included in a forthcoming newsletter. Individual letters have have gone out to all residents informing them about the new owners. Monitoring visits by the owners cover the topics of meals, care staff and quality of care, entertainment, environment, concerns, complaints and any other comments. These visits also canvas staff views on topics that include training, performance, management, facilities,concerns and other comments. Specific reviews culminate in action plans that are implemented. For example an action plan was put in place in October 05 following a kitchen review of hygiene and cleaning standards. Records of weekly conference calls between the responsible individuals and the manager or senior in charge show that all relevant issues are addressed. Residents’ personal finances were checked. Only the senior staff have access to residents monies. A clear and simple record of credits, debits and balances is maintained. Health and safety matters are properly addressed. The test certificates were seen to be current for the following: Bacterial analysis / legionella from hot water outlets, lift, portable appliances, electrical equipment and gas installations. All staff attended fire awareness training on 31.1.06. A monthly safety inspection is carried out in the home that covers risk assessments, environment, manual handling, COSHH, electrical safety, personal protective equipment (PPE), first aid equipment, housekeeping, training and records, accident reporting and investigation. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 25 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 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 4 X 3 X X 3 Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 26 Are there any outstanding requirements from the last inspection? NA 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. 1 Refer to Standard OP3 Good Practice Recommendations The manager should ensure that the homes expectations are made clear to social workers at the point of referral. In the meantime, in light of delays currently experienced and in the absence of a community care assessment, a preadmission form should be devised that covers the headings indicated under standard 3. This should be completed, dated and signed, to demonstrate due consideration of needs and the ability of service to meet them. Care plans should be detailed in respect of needs and actions to be taken to meet them. Subsequent monthly reviews should show progress or otherwise in meeting identified needs and include the views of relevant others The staff application form should be reviewed to include more space for information about qualifications and DS0000065869.V289035.R01.S.doc Version 5.1 Page 27 2 OP7 3 OP29 Abafields Residential Home experience, and to add a declaration of fitness to work. Abafields Residential Home DS0000065869.V289035.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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