CARE HOMES FOR OLDER PEOPLE
Abberdale House 165-169 Hinckley Road Leicester Leicestershire LE3 0TF Lead Inspector
Kim Cowley Unannounced Inspection 13th October 2006 11:00 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 Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Abberdale House Address 165-169 Hinckley Road Leicester Leicestershire LE3 0TF 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) 0116 2915660 0116 2915660 None Shankar Leicester Ltd Marie French Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (24) Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30.11.05 Brief Description of the Service: Abberdale House accommodates 24 older people, some of whom have dementia or mental health needs. The home is on three floors and has a passenger lift. It is situated on the Hinckley Road about a mile from the centre of Leicester. The home has three lounges, a small smoking room, and a large dining room. At the rear of the home is a secluded garden with seating areas. Fees range from £320 to £370 per week. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted four hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to three residents living at the home by meeting or observing them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. The inspector also met with to further residents, the Responsible Individual, a senior carer, a carer, and the chef. What the service does well:
Abberdale House provides a homely and comfortable environment for older people, some of whom suffer from dementia. The atmosphere is friendly and the staff warm and caring. All residents interviewed said they were happy at Abberdale House and those unable to give their views appeared relaxed and content. The home specialises in the care of residents with mild dementia and mental health needs, and provides them with a secure environment. Staff are experienced in this area of care and the majority have received specialist training. In-house activities include bingo, board games, television, baking, and reminiscence sessions. A librarian brings books (including large print) and CDs to the home every few weeks. Visiting musicians provide entertainment every three months to residents. Communion is held in the home once a month. Residents can also attend local churches. The home has an enthusiastic and caring staff team, the majority of whom are experienced in caring for older people with dementia. During the inspection staff were observed interacting with residents in a warm and professional manner. All residents interviewed praised the staff and the following comments were made: ‘The staff are very good’, ‘We like to have a laugh with the staff’, and ‘The staff look after us very well.’
Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 6 The Manager and Owner talk to residents every day and to relatives when they visit. The Owner said, ‘First and foremost our residents are people and this is their home. We make sure every member of staff who works here understands that.’ All areas of the home inspected were clean, tidy and fresh. The range of lounges meant that residents can choose where they sit. Doors are alarmed to prevent residents from wandering and the garden is secure. 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. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. EVIDENCE: The home has a mixture of private and social services funded residents. All are fully assessed prior to admission. A senior member of staff visits them in their own homes or in hospital in order to do this. Staff also talk to relatives and health professionals to get their views on resident’s needs. If a prospective resident is diagnosed with dementia staff liaise with their consultant. These steps help to ensure the home is suitable each resident and that staff can care for them properly. Once admitted each resident has a four weeks trial period. Records showed that a resident who was recently admitted was properly assessed prior to admission, and that both the resident and their family had the opportunity to view the home before deciding whether it was suitable. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 9 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health and social care needs are met. EVIDENCE: Three case files were inspected in detail. All were comprehensive and contained clear instructions to staff on how to meet residents’ needs. Minutes of social services reviews showed that residents are satisfied with the care at Abberdale House. The home specialises in the care of residents with mild dementia and mental health needs, and provides them with a secure and homely environment. Staff are experienced in this area of care. The majority of the care staff have completed a 12-weeks ‘Dementia Awareness’ course via a local college. Some residents have consultants who advise staff of how best to meet their needs. Records showed that staff take a holistic approach to residents’ care and there is regular input from doctors, nurses, chiropodists, dentists, opticians, hearing services, and other medical personnel.
Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 10 Arrangements for health and personal care giving are individual to each resident. Staff use their assessments as a starting point, and then get to know the resident in person, gradually finding out their individual likes and dislikes. Each resident’s preferred term of address is established when they are admitted to the home and staff are made aware of what this is. Senior carers, who have been trained in-house by the home’s contract pharmacist, give out medication. There are written procedures for them to follow, and the majority have completed a 12-weeks ‘Safe Handling of Medication’ course. No residents self-medicate at present. Residents with a psychiatrist have their medication reviewed routinely every three months. Staff monitor other residents to see if their medication is effective and consult GPs if there are any concerns. Two residents are non-weight bearing. The home has two hoists (one electric and one manual) which staff have been trained to use. There is a passenger lift for residents who are unable to use the stairs to the first floor. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 11 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, 15 The quality outcome for this area is good. This judgement has been made using the available evidence including a visit to the service. Daily life and social activities enable residents to lead full lives. EVIDENCE: In-house activities include bingo, board games, television, baking, and reminiscence sessions. A librarian brings books (including large print) and CDs to the home every few weeks. Visiting musicians provide entertainment every three months to residents. Communion is held in the home once a month. Residents can also attend local churches. The home has a fully equipped hairdressing room and a senior member of staff who is also a hairdresser does the residents’ hair. The Owner said there is a small charge for this service. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 12 Visitors see residents in their rooms or in one of the lounges. Visitors are offered refreshments and invited to dine with residents if they wish (there is no charge for this) and attend all social events at the home. The home’s Terms and Conditions state that visitors are welcome at the home at any time. Residents are encouraged to bring personal possessions and small pieces of furniture to the home, and all bedrooms inspected were uniquely decorated for the occupant. Smoking is allowed in a designated lounge and in the garden. The home has three smokers who have all been ‘risk assessed’ and are supervised where necessary. The home has an experienced qualified chef who has a City and Guilds in Cooking for Hotels and Restaurants. The majority of dishes are homemade using fresh produce. Lunch served during the inspection consisted of minced beef pie or cheese and onion pasties, mashed potatoes, broccoli, carrots and peas. Dessert was baked rice pudding or peaches and cream’ Residents’ comments about the food included: ‘I’m full up after my dinner – it was lovely.’ ‘We have nice meals.’ ‘The rice pudding today was good.’ The Chef talks to residents every day about the menus and asks for their choices. Diabetics, vegetarians, and those who require a soft diet are catered for. The kitchen was well stocked, and tidy. Records showed that residents are given a wholesome and varied diet. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 13 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents feel able to talk to staff about any concerns they might have. EVIDENCE: The home has an internal complaints procedure, which includes information on how to contact the Commission for Social Care Inspection and the local Ombudsman. This is given to all residents and their representatives on admission and is displayed on the home’s notice board. The home has a policy on abuse, which explains the different forms abuse might take, and advises staff on how to respond to allegations of abuse. There is also a whistle blowing policy and an updated copy of ‘No Secrets’. Staff try to create a culture in the home where both staff and residents can raise any concerns they may have about any aspect of care. Protecting residents from abuse is stressed during staff induction, training, and supervision. There have been no complaints since the last inspection. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 14 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in an environment that is safe and well maintained. EVIDENCE: All areas of the home inspected were clean, tidy and fresh. The range of lounges meant that residents can choose where they sit. Doors are alarmed to prevent residents from wandering and the garden is secure. Overall, the environment is homely and comfortable for residents. Since the last inspection new guttering has been fitted to the exterior of the home and the roof has been repaired. There is a new sign in place advertising the home. Inside there are three new wide screen televisions, some redecoration has been carried out and some new carpets fitted. A part-time handyperson’s post has been created and filled.
Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 15 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, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Well-trained and professional staff meets residents’ needs. EVIDENCE: The home has an enthusiastic and caring staff team, the majority of whom are experienced in caring for older people with dementia. During the inspection staff were observed interacting with residents in a warm and professional manner. All residents interviewed praised the staff and the following comments were made: ‘The staff are very good’, ‘We like to have a laugh with the staff’, and ‘The staff look after us very well.’ The staff team consists of the Manager, the Owner, seniors (one on each shift), carers, the housekeeper, a cleaner/laundry assistant, and the handyperson. Staffing levels meet minimum standards. Staff turnover is low and appropriate recruitment procedures are in place for when new staff are needed. Staff files were inspected. These have been improved and all staff have the necessary documentation in place to work in a care home, including references and CRB checks. This will contribute to the safety of residents in the home. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 16 The staff are well trained. Ninety-five per cent of them have NVQ Level 2 or above. All have first aid certificates and in the last year staff have attended the following training courses: Dementia Awareness, Safe Handling of Medication, Infection Control, Health and Safety, Catheter Care, Diabetes, and Moving and Handling. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 17 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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is safe and well managed. EVIDENCE: The Manager and the Owner run the home as a team. Both work full-time and share an office where residents and relatives are welcome to call in at any time. The Manager is an experienced carer who has worked at Abberdale House for eight years. She has successfully completed her NVQ Level 4/Registered Managers Award. The Owner looks after the business side of the home. Either the Manager or the Owner is on call at all times. The home has a friendly atmosphere and staff encourage residents to make choices about their lives. The Manager and Owner talk to residents every day and to relatives when they visit. The Owner said ‘First and foremost our
Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 18 residents are people and this is their home. We make sure every member of staff who works here understands that.’ The home looks after small amounts of money for some residents who are not able to look after it themselves. Appropriate records are kept. Other residents have their money looked after by their relatives or solicitors. Social workers are involved if there are any concerns about how a residents’ money is being managed. Records showed that the health, welfare and safety of residents and staff is a priority in the home. Appropriate checks and servicing of equipment has been carried out, as has consultation with the Fire Department and the home’s Environmental Health Officer. Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 19 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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abberdale House DS0000053123.V315136.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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