CARE HOME ADULTS 18-65
Abandale Lodge 87 Station Road Leigh-On-Sea Essex SS9 1ST Lead Inspector
Nicola Dowling Announced 27 June 2005
th 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 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 Stationary 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. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Abandale Lodge Address 87 Station Road Leigh-On-Sea Essex SS9 1ST 01702 714128 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Jean Ellen Grange Mrs Jean Ellen Grange CRH Care Home 8 Category(ies) of LD Learning Disability (8) registration, with number MD Metal Disorder (8) of places Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Care to be provided for up to 8 people with learning disability. This needs to be added to the existing registration as some service users may also have a mild learning disability. 2. All service users admitted prime care need must be mental disorder. Date of last inspection 5th October 2005 Brief Description of the Service: Abandale Lodge is an established care home situated in a residential area of Leigh on Sea. The home has the appearance of a large detached family house and is located near to bus routes, pubs, shops, town centre and sea front. The home is registered to provide care for up to eight adults who have either mental health problems excluding learning disabilty/dementia or mild learning disorders. The home is very well maintained and comprises of a communal lounge, kitchen and dinning area. All residents have their own room. There is a smoking lodge that has been purpose built in the rear garden for the residents. The garden is well maintained. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and service users, observing the care given, and reading of documents. As there were no relatives or professional visitors at the home during the inspection their views have not contributed to this inspection report. Three resident surveys were received about the home and all described the home as good with caring staff. All the staff that work at the home are familiar with the residents and no agency workers are used. Through the day residents were observed to come and go from the home to do their own activities. The inspector would like to thank the staff and residents for their hospitality and contribution to the inspection. What the service does well:
The home provides a warm, comfortable and safe environment for the residents to live in. The residents are supported to maintain as much as their independence as possible. This means that they help to maintain their own personal care, their rooms, attend various activities by themselves outside of the home, manage their money and some manage their own medication. The residents said that they liked being able to do this. The home also supports residents in looking after their own pets. New residents are gradually introduced to the home. When living at the home they are shown round the local area by staff so that they know where facilities are, for example where the doctors surgery is or where the shops are. Residents spoken with liked the food at the home. The staff talk to all the residents at the beginning of the week about the weeks menu. If residents want different meals other than the one set out in the menu this is their opportunity to request a different meal. This system was working, as on the day of inspection there were three different sorts of meals being prepared. Another aspect that was liked by the residents was the time staff spent listening to them. One member of staff commented that the manager was happy for her to sit and talk with the residents and did not push her to continue with her work during these times. Both residents and staff found it easy to communicate with each other. The residents were on first name terms with all the staff and approached them whenever they wanted to. The staff were seen to be relaxed and happy in the company of the residents. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 6 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. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 2 The home manages the needs of the residents well EVIDENCE: There is a good knowledge base of mental health issues at this home and experienced staff undertake assessments. The home staff participate in care programme approach (cpa) meetings with the residents. This enables communication with other professionals outside of the home about the residents care needs. This information is recorded well and also details restrictions placed on residents. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 6 and 9 There is a good detailed monthly report for each resident that is supported by informative daily care notes. Care plans were good and up to date and incorporated highlighted risks. EVIDENCE: A risk profile is conducted for each resident and this links in with the care information held on file. Residents have a book that records their daily care notes. These notes contribute to a detailed monthly report. The residents spoken to confirmed that they knew of their care plans and file notes. Some residents have special restrictions and these were clearly recorded and staff were aware of them. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 15, 16, and 17 The food is good and activities are varied for each resident. The staff respect the residents right to privacy and where possible family input is welcome. EVIDENCE: The residents confirmed that the food is good and served in ample quantity. They are consulted on their choice of meals and this was confirmed by staff and residents. Three different types of meals were being served on the day of inspection and the weekly menu evidenced the residents different choices. Activities are tailored to the resident’s needs and wishes. Some go out to day centres, others use the Rethink facilities. Other residents were shopping and went to local clubs nearby. There are various things to do in the home and the home also arranges day trips out. Staff support residents to maintain family contact where possible. One resident said the staff were “very helpful” in this area Residents have locks on their room doors for their privacy and independence. The staff were observed to knock before entering when the resident was in. The rooms had resident’s personal things in them which includes their DVD collections and art work.
Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 19 and 20 Residents’ physical and mental health is looked after well. Medicines are properly kept in the home however record keeping of depot ampules received into and leaving the home are poor. EVIDENCE: The home uses the monitored dosage system to administer the residents’ medication. Two residents self medicate using this system. The medicine was stored and recorded correctly. However, ampules for depot injections are not recorded into the home or leaving the home. These ampules are dispensed from the pharmacy to the home. The home then gives the required amount to the resident who then takes it to the doctor’s surgery for administration. As the resident may require more than one ampule for the required dosage of the injection the home must keep records to track these drugs to ensure that there is no mishandling of them. The residents have regular care programme approach meetings that involve psychiatrists and community psychiatric nurses to monitor their mental health. The residents GP deals with physical health issues. Other areas of care can be undertaken in the home such as monitoring of blood sugars. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Adequate safeguards are in place for the protection of residents. Residents approach staff to express their views, and meetings are in place to ensure that their views are listened to and documented. EVIDENCE: The staff spoken to had received training in the protection of vulnerable adults. There have not been any adult protection incidents reported at this home. Residents spoken with said they were happy with the way staff treat them and had no complaints. Written complaint documentation is available in the home, however no complaints had been made to the manager via this method. There have not been any complaints made to the Commission for Social Care Inspection. Residents were clear about whom to go to if they have a problem. There are also residents meetings were they can express their views if they choose to attend. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 standard(s) 24 and 30 The accommodation is warm, comfortable and homely for the residents. It is clean and well maintained and suitable for the residents needs. EVIDENCE: There are five bedrooms upstairs and the manager has tried to maintain the upstairs rooms for the male residents. The bathroom upstairs has a small bath with an overhead shower in it that is nicely decorated. Female residents mainly occupy the downstairs rooms. There are separate male and female toilets, however, because the female bathroom has a larger bath in it, this is shared with the male residents. The residents spoken with were happy with their accommodation and are encouraged to keep their rooms to a reasonable standard. Rooms contained personal items and looked comfortable. The home was decorated to a good standard throughout. The laundry area is separate from the food area and was clean, tidy and well organised. There have not been any infection control problems at the home. Hot water temperatures have not been a highlighted risk area for the residents, however the home continue to monitor these temperatures. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 34 There is a risk to residents’ safety because of periods when staff numbers have been reduced and staff recruitment checks are not fully complete. EVIDENCE: The staff rota identifies who is on duty and who is on call. There were some gaps in the rota at the weekends where only one member of staff was on duty for periods in the afternoon or morning. On Sunday mornings the residents do not get up early so one member of staff has remained on shift with one on call. When staffing numbers are reduced at the home the Commission for Social Care Inspection must be informed. The home must make sure that the reduction in numbers does not affect any management of emergencies at the home. Also if other staff fill in gaps in the rota their name must be written on to it otherwise it looks like the shift numbers have been reduced. A Resident said that he liked the staff and found them helpful. He liked them as they had time to listen. Staff were observed to have a good rapour with the residents and were seen communicating well with them. Two recruitment files were checked and both had proper police checks, application forms and references. However there was no proof of identity or photographs in them. Although this family run home has a stable staffing
Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 15 structure it is required that recruitment checks are robust and must evidence that all staff checks have been completed for the safety of the residents. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home is well managed, however the quality assurance system is not completed. EVIDENCE: The home has developed questionnaires that are undertaken quarterly with the residents and also an admission questionnaire. One resident remembered doing these questionnaires, however as yet the results of these questionnaires have not been formulated into a report that demonstrates the residents’ satisfaction with the home. When complete the report should be made available to the residents and the Commission for Social Care Inspection. The safety checks for gas, fire and electricity are all up to date however the portable appliance testing is now due. Safe working practice risk assessments are undertaken and highlighted needs are recorded. Safety procedures are displayed and staff and residents were aware of the fire procedure and assembly points. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 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 x 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Abandale Lodge Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 18 no 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. Standard 20 Regulation 13(2) Requirement The registered person must ensure that all medicine is recorded entering and leaving the home The registered person must record on the duty rota the staff that actually worked a shift and ensure that staff numbers are appropriate to the needs of the residents. The registered person must ensure that staff files contain proof of identification and a recent photogragh. Timescale for action 08.08.05 2. 33 18(1)(a) Schedule 4 (7) 08.08.05 3. 34 19 Schedule2 08.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 42 42 Good Practice Recommendations Portable appliance testing needs renewing A report should be developed from the quality assurance questionnaires. Abandale Lodge I56 S15503 Abandale Lodge V226951 270605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-On-Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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