CARE HOME ADULTS 18-65
Abberleigh Grove 6 Queens Road Weston Super Mare North Somerset BS23 2TA Lead Inspector
Catherine Hill Unannounced Inspection 13th March 2006 16:05 Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 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 Abberleigh Grove DS0000008128.V285960.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 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. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Abberleigh Grove Address 6 Queens Road Weston Super Mare North Somerset BS23 2TA 01934 625582 NONE 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) Dr Joseph Conlon Mrs Jacquetta Miner Mrs Jacquetta Miner Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. May accommodate up to 11 persons aged 18 years and over Age of persons who may be received in the home - 18 - 64 years and 65 years and over 7th November 2005 Date of last inspection Brief Description of the Service: Abberleigh Grove is a large Victorian house providing residential care for young men and women with learning disabilities. The home is set in a quiet residential area with a large garden. An on site craft workshop is provided for residents to encourage expression of creativity and practical tasks. Its sister home, Abberleigh House, is in the next road and residents from the two homes share many social events together and facilities. Most staff work in both homes as well as in the supported living service run by the homes’ owner. The home aims to support its residents to develop their independent living skills in a family environment with a view to moving on to more independent living if appropriate. Staff support residents to access community facilities and pursue their social, vocational and leisure interests. They also enable links with local health services. A range of other professional input is sought on each resident’s behalf and the team involves relatives appropriately to ensure that residents receive the services they need to enable them to enjoy the best possible quality of life. Respite care is offered, one client at a time. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted during the late afternoon and early evening of one day. It focused on talking with residents about their quality of life and observing interactions between staff and residents, but the inspector also sampled some of the care records and medications records. The inspector spoke with eight of the residents, mostly in depth and in the privacy of their own rooms. Each person was able to show the inspector examples of how fulfilling their life is, and many people described their daily routines and opportunities. Without exception, people described excellent relationships with staff, and felt that they are always treated with respect and kindness. Some people did not find it so easy to tell the inspector about their lives, but showed by their answers and their general demeanour that they feel happy and relaxed in the home. Staff supported some residents during these conversations by offering prompts and helping to explain what the person might mean. The inspector also spoke with one of the two staff on duty, met a visiting relative, and spoke with the person who was staying at the home for respite care. Nobody had any concerns or serious complaints, and people felt comfortable discussing any worries with the staff or owners. What the service does well: What has improved since the last inspection?
A homely remedies policy has been drawn up since the last inspection. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 6 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. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 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 Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed at this inspection. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 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): 6-10 Residents’ needs are well documented and they are supported to make their own decisions. Arrangements for promoting independence should be recorded in more detail. EVIDENCE: The staff team has been gradually expanding residents care plans, and there has been a noticeable improvement in the detail of these over the past year. However, many care plans could usefully be improved by including information on what each resident is being encouraged to do for themselves, and including detailed step-by-step plans for enabling residents to learn the tasks they want to that will increase their independence. Care plans are being formally reviewed every six months, but key workers also go through a comprehensive monthly checklist that covers personal care issues, health care, the persons environment, and any issues identified in the care plan. Some of these reviews contain some useful information but a lot of entries simply read All OK. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 10 The daily records that staff are keeping on residents are now much more detailed, informative and regular than before. They provide a greatly improved record of events, progress, and interventions. Some of the task lists on the office noticeboard reinforce the homes aim to promote residents independence, by detailing what tasks staff should ensure are done on their shift and reminding staff to do these with residents as far as practicable. It will help to further integrate this aim into practice if residents care plans give details of what each person can do. One person has recently moved into supported living from the homes independence flat. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-14, 16 Each person has plenty of opportunities to pursue their preferred lifestyle. EVIDENCE: Each person has their own full schedule of vocational, leisure and social activities. Most people attend day centres or college placements, and there are lots of group activities organised between the two homes. Some of the more able residents occasionally arrange their own activities. Holidays tend to be arranged in small groups. Residents go out for walks most evenings, to the local park or the local pub, and every Wednesday is Activity Night. The list of activities for the first few months of this year shows that people have had opportunities to join in cookery groups at home, play indoor skittles, have arts and crafts sessions, have a beauty night (including hair colouring, face masks, nail painting, foot massages, and intensive care conditioners) with the alternative of a recent DVD for those who werent interested, go tenpin bowling with a visit to a restaurant afterwards, go to discos and karaoke, and see the Chinese State Circus. People felt that there is plenty to do and that their lives are rewarding.
Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 12 Some residents have been undertaking Towards Independence training modules with their college. Residents are actively encouraged to maintain links with the other people who are significant to them. At present, people are being supported to buy cards and gifts for Mothers Day, and the residents files sampled included lists of the birthdays of those people they would like to send birthday cards to. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 13 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): 19, 20 Residents health care needs are generally well met but health action plans need to be developed to ensure that each person can access routine health checks. EVIDENCE: The care plans and associated records sampled showed that residents are supported to attend regular dental checks and opticians’ appointments, among other things, but there was no evidence available to show that the women had been offered smear tests, for example. Health Action Plans need to be developed, in line with the guidance of Valuing People. These need to show not only how each persons particular health needs are being met but also how they will be supported to access routine health check services. A homely remedies policy has been drawn up since the last inspection. A copy is kept in the main policy file, and the inspector suggested that another would be useful in the medications file, where other medications policies have already been filed. It was recommended at the last inspection that any handwritten entries on medication records should be countersigned by a second member of staff.
Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 14 Although all the handwritten entries on the medications records sampled had been signed by one member of staff, none had been countersigned. This recommendation was therefore repeated. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 15 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): 22 Peoples concerns are taken seriously and acted upon. EVIDENCE: The complaints procedure is very welcoming, and was updated in March last year to include the CSCIs new contact details. It includes clear instructions on how to phone CSCI. In practice, residents felt comfortable raising any worries or grumbles with the staff, and said that they feel people listen and try to put things right for them. Staff will also raise any concerns on residents behalf, and felt that the owners encourage this. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 16 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 Residents are provided with safe, comfortable surroundings. Outdoor space is attractive and easily accessible to residents. EVIDENCE: The home is decorated and furnished to a very high standard. The two spacious lounges are well equipped with TV and video, a pool table and a variety of board games. There is a crafts room in the garden. There is a large kitchen-diner with seating for all the residents and the staff on duty. There is a good variety of bathrooms, shower rooms and toilets around the home. Several of the residents showed the inspector their bedrooms, some of which have been redecorated in the past year. Each of these people was very happy with their room, and was proud to show the inspector evidence of their leisure and vocational achievements that staff have helped them to display. One person made a comment to the inspector that indicated she might like a lock on her bedroom door. The homes policy is not to routinely provide these but to fit a lock if individual residents want. Staff said that residents are asked about bedroom locks at each care plan review, but this was not recorded on
Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 17 any of the reviews seen. Staff undertook to discuss door locks with this resident again. Everywhere was well decorated, comfortably furnished, and clean. Some of the documents sampled showed that repairs to a residents chest of drawers were first reported in October last year and continued to be reported up till recently. The resident told the inspector that these were mended the week before this inspection. Staff explained that the handyman has been away quite a lot recently, so repair tasks have been prioritised. One of the strip lights in the corridor between the first floor landing and the second-floor staircase was not working. As the evening drew on, this created a well of darkness at the bottom of the stairs which could be hazardous, so it is recommended that the light is replaced. As these lights are in regular use, it may be worth replacing the strip lighting with more ordinary domestic lighting. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 18 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): EVIDENCE: These standards were not assessed at this inspection. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 19 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): EVIDENCE: These standards were not assessed at this inspection. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X X X X X Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 21 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. 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. 2. 3. 4. 5. 6. Refer to Standard YA9 YA19 YA20 YA24 YA34 YA35 Good Practice Recommendations Care plans should be expanded to give more detail on how individual residents independence is being promoted. Residents health action plans should be developed to help ensure that each person has regular access to routine health checks. Hand written entries on the medicine administration records should be signed and dated by 2 members of staff. The broken strip light in the corridor between the first and second floors should be replaced. To maintain proof of identity for all employees. The record of training to include the numerous one-to-one training sessions that the owner-manager provides. Abberleigh Grove DS0000008128.V285960.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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