Inspection on 29/08/07 for Abbeville Lodge

This inspection was carried out on 29th August 2007.

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

Abbeville Lodge 06/12/06

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Abbeville Lodge Acle New Road Great Yarmouth Norfolk NR30 1SE Lead Inspector Ann Catterick Unannounced Inspection 29th August 2007 09:15 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 Abbeville Lodge DS0000068044.V349702.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. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeville Lodge Address Acle New Road Great Yarmouth Norfolk NR30 1SE 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) 01493 857300 Abbeville RCH Limited Mrs Rita Rose Care Home 20 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (1), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (1), Old age, not falling within any other category (18), Physical disability (2) Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Eighteen (18) older people, not falling into any other category, may be accommodated. Two (2) services users who have a physical disability and are under the age of 65 years may be accommodated. One (1) male service user who has a mental disorder, excluding learning disability or dementia, who is over the age of 65 years may be accommodated. Three (3) service users who are under the age of 65 years and have a diagnosis of dementia may be accommodated. One (1) service user, named in the Commission’s records, who is over the age of 65 years and has a diagnosis of dementia may be accommodated. Maximum number not to exceed twenty (20). Date of last inspection 6th December 2006 Brief Description of the Service: Abbeville Lodge stands within the seaside town of Great Yarmouth. The service operates from an adapted building where all of the accommodation is on the ground floor. The home was previously known as Bridge House, but changed its name with a change of ownership in the summer of 2006. Fees for the service range between £271 to £350 a week. The home was originally established in 1993 and is a single storey building with all bedrooms off the main corridor. The home has extensive gardens that consist of one enclosed garden with a patio and seating area, and a further open lawned area. There is ample car parking at the front of the premises. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection and took place on the 29th of August and lasted for 7.5hrs. There was opportunity to speak with the manager, staff and residents as well as have a tour of the building and look at staff files, care plans and other documents and policies. Prior to the inspection we received an annual quality assurance assessment. This is a document that asks the manager to identify what the home does well, what has improved and what plans there are for the future. Eleven comment cards from relatives and eight from residents and generally all comments were positive and some have been included within this report. This is an improving home and the overall quality of the care received by residents is good. Comments from residents “Staff very good.” “Good attitude.” “When I press the buzzer they come quickly.” “Always see the matron if I have any concerns.” “Very happy here.” “Able to get to the pub.” “Staff good - treat me with respect.” “Need things easier to eat, like more stews.” Comments from staff “Very supportive management.” “Best thing is it’s homely.” “Treat people how I would treat my mother.” “Lots of improvements in the last 12 months.” “Opportunity for training.” Comments from relatives “They are all doing more than expected.” “They keep in touch by phone if there is a problem, no matter how small.” “The staff at Abbeville are very friendly and very good at what they do.” “Since matron came here there things have improved greatly in every way.” What the service does well: Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 6 The manager is committed to providing a good quality service to the residents who live in the home. Residents’ needs are assessed thoroughly prior to admission to ensure that those people admitted to the home would have their needs met. The home has a good relationship with the local health professionals. Staff are well supported and receive training to enable them to fulfil their role. The quality of food in the home is good. What has improved since the last inspection? What they could do better: There is still opportunity to improve the environment. The quality of baths is poor with one bath very worn and needing replacement. Some carpets are well worn and have an odour and need replacing. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 7 The home has no opportunity to take residents out as the company mini bus is usually kept in London. 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. The summary of this inspection report can be made available in other formats on request. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 8 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 Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living in the home can be sure that their needs will be assessed before admission and they will have the opportunity to visit the home and read information about the home. EVIDENCE: The assessments of three residents were seen. These included assessments made by the placing social worker as well as assessments completed by the manager of the home. Those residents living in the home on the day of the site visit were having their needs met. The manager informed me that since she has managed the home five residents have been reassessed and moved to a more appropriate placement to meet their differing needs. This is seen as good practice and evidence of clarity, the manager being clear on what type of differing needs can be met in the home. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 10 Two contracts were seen. One had neither the number of the room to be occupied nor the cost of the placement. Cost was seen on a social services file but should be included in the contract given to the resident. A recommendation has been made in this area. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs were identified in care plans and residents were having identified needs met. There is still opportunity for some improvement within plans of care for residents. Residents can be assured that staff caring for them are receiving the training they need to meet these needs in a way that promotes dignity and respect. EVIDENCE: The home has a system of having care plan information in two places. Care plan folders are kept in the medication room and not generally available and care plan diaries are kept in the staff area for staff to read and have regular access to. There is also a general resident file for other information not needing to be part of the care plan. The manager may want to devise a single system of care planning. The care plan diaries are bound and do not have a Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 12 page relating to social history, recent history or leisure pursuits interests and aspirations. The care plans that are locked in the medication cupboard have some of this information that could be transferred. A recommendation has been made in this area. Residents spoken to were very satisfied with the care provided and said that their care needs were being met. This was confirmed by observation made on the day of inspection. Staff were seen to work with residents in a way that promoted privacy and dignity. Since the new manager has been in post staff have received training in many aspects of care and the manager felt staff knowledge and skills had improved significantly. This was supported by observation made on the day of the site visit. The care, storage and administration of medication was inspected and in all but one area evidenced safe practice. All staff administering medication have the appropriate training. One resident self-administered their medication and selfmedication assessment had been completed and the resident had signed this. The resident had a lock facility in their room to store the medication safely. In the medication door six capsules were being stored without any way of knowing to whom they belonged. Although an explanation was given by the member of staff who had administered medication on the day of the site visit, this was seen as unsafe practice. A requirement has been made in this area. The manager and deputy manager of the home are completing a palliative care course and follow the good practice recommendation when caring for residents who are coming towards the end of their lives. This was seen as good practice. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the opportunity to become involved in different activities within the home. Further work can be done in this area to ensure residents specific needs and preferences are met. Residents are provided with good quality food. EVIDENCE: Since the last inspection the manager has planned more activities and outings for residents. The new provider has a mini bus but this is kept in Essex and therefore not available to the home. Residents have been taken shopping, to the promenade and for other trips in the local community. One member of staff has been allocated the task of developing activities and to try to find out what particular interests individual residents have. As mentioned earlier in the Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 14 report it would be useful to have preferences identified in care plans that are available to staff. Bingo, quizzes, keep fit activity takes place and residents have a baking day once a month. Some individual work has taken place and the staff are doing their best in this area. There has been improvement in this area. Some residents have been encouraged to develop their social network and a resident confirmed this saying they were now much more independent and could enjoy visiting the local public house. Visitors are always made welcome and evidence of this was seen on the day of the site visit. Bedrooms are all of a good size and residents are able to bring in some of their own possessions and furnishing. Residents are encouraged to manage their own finances for a long as possible. The cook says that since the new provider and manager have been in place the food within the home has improved considerably and the home now always has plenty of food stock in the home. Residents have a choice for both dinner and tea but some residents felt there was not always a choice at dinner time. This needs to be made clear to all residents. A recommendation has been made in this area. Staff have not received MUST training, (training specifically related to wellbeing and nutrition), and the manager has been advised to follow this up. A recommendation has been made in this area. Residents have a choice on where to eat their meals with some choosing to eat in their bedrooms, some eating in the lounge and others eating in the dining area. The dietary needs and preferences of a resident who has a different cultural background are catered for. Food is often sought from specialist shops that cater for these different cultural needs. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be given the information they would require if they needed to make a complaint and be assured that any complaint would be taken seriously. Staff have received training with regard safe guarding adults and this should mean that they work in a way that promotes safe practice and that they would be confident to report any poor practice seen. EVIDENCE: The provider has introduced an appropriate complaints process and this has been made available to service users through the service user guide and is also displayed in the home. There have been no complaints received since the last key inspection. Those residents spoken to said that the manager was always available and they would go to her if they had any concerns and they felt confident that these would be addressed. Staff have all attending training with regard vulnerable adults and all staff spoken to were aware of the whistle blowing policy and said that they would always report poor practice. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living in the home experience an environment that would benefit from improvement as some areas are shabby and some facilities and furnishing well worn. Improvements would make the environment a more comfortable and attractive place in which to live. EVIDENCE: The programme for maintenance was looked at and no significant improvements have been made in the past 9 months. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 17 At the time of the last key inspection it was believed that the home was to have a major extension and many improvements would be done at this time. The plans for this have been rejected by the local council and there is now no immediate plan for extension. The consequence of this is that those areas of the home that would have been improved with the extension need to be updated now to ensure good standards of accommodation in the home. The home has only one lounge area and as the home has residents of varying ages and needs the manager may want to consider other options to offer another communal space. A recommendation has been made in this area. Some bedroom carpets have been replaced but others are well worn and have a bad odour and need replacing. The manager said that carpets are washed on a regular basis but this is not having the desired affect. A requirement has been made in this area. Bedrooms are of a good size and residents are encouraged to make them very personable and homely. Some beds are old fashioned and have very old bedsides that are difficult to get protectors for. These old fashioned bed sides could also cause a risk of injury as they do not detach from the beds. A recommendation has been made in this area. The home has three bathrooms and all would benefit from being refurbished. The enamel has started to come off one bath. This bath is deemed to be aesthetically poor and could also have an impact on safety. A requirement has been made in this area. One resident is unable to have a bath due to personal needs but would be able to use a shower. Another resident always had a shower at home and would prefer this to be an option in Abbeville. No shower is available. A recommendation has been made in this area. Lighting in most bedrooms is strip lighting that is not very homely. recommendation has been made in this area. A The back garden has the potential to offer a delightful setting for residents, with a wooden patio type area that is covered and circular path with safe access and being enclosed. The home has no gardener and the handyperson only has limited time so this area is somewhat neglected. A recommendation has been made in this area. Some areas of the home were not free from offensive odours and this was due to those old carpets that smelt of stale urine. A requirement has been made in this area. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be provided support by staff who are well trained and supported within their role. There are enough care staff on duty at any one time to meet the needs to the residents living in the home. EVIDENCE: On the day of the site visit staff were present in such numbers and had the right knowledge and skills to meet the needs of residents. Eighteen residents live in the home and three care staff, the deputy and manager were on duty. Three staff were spoken to and felt that staff were always on duty in sufficient numbers and were always supported by the deputy manager and manager when they were on duty. The new manager has ensured that staff have received all appropriate training and training is continuing throughout the year. The manager felt that the training staff had received over the last 12 months had considerably improved their skill and broadened their knowledge. She commented that she was very proud of them. This training has included dementia care training, medication training, fire training, safe guarding adults training, palliative care and much more. Several staff have NVQ level 2 and other are completing this. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 19 The manager has only recruited two members of staff since she has been in post and the appropriate paperwork was completed including criminal checks and references. Induction takes place for new staff and some established staff have completed the induction training booklets to ensure they are up to date with modern practice. The home has only one domestic who works 20 hrs a week. This means that care staff need to complete all domestic tasks on three days a week. On the day of the site visit some areas of the home had an unpleasant odour and there was no domestic on duty to deal with this. A requirement has been made in this area. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 30, 31, 32, 33, 35, 36 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be living in a home that is well managed and staff supported to fulfil their role in full. Policies and procedures around health and safety are sound and the welfare and safety of residents is paramount. EVIDENCE: The manager has the competence and experience to manager the home well. Since being appointed there have been significant improvements within the home. All staff spoke positively about the manager saying that she was supportive and was improving the quality of service for residents. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 21 The home has a quality assurance system although this could be further developed. The proprietor now completes Regulation 26 visits. Some residents’ money is looked after by the home and some of this was audited and found to be in good order with safe systems of recording and storage. This area has improved since the last inspection. Staff are offered regular supervision and evidence of this was seen in staff files. The approach to health and safety is sound with records supporting this. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 2 2 2 x x 2 2 2 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 3 3 x 3 3 x 3 Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13.2 Requirement Timescale for action 01/09/07 2. OP26 16k 3. OP21 23(2)c The registered person must ensure that safe practice around the safekeeping of medication takes place at all times. This will promote the safety of residents. The registered person must 01/11/07 ensure that all areas of the home are kept clean and any old carpets that cannot be made odour free are replaced. This will ensure that residents are living in a clean and comfortable surroundings. The registered person must 01/01/08 ensure that the baths in the home are in a state of good repair and fit for purpose providing a safe facility for residents. 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 Good Practice Recommendations DS0000068044.V349702.R01.S.doc Version 5.2 Page 24 Abbeville Lodge 1. 2. 3. 4. 5. 6. 7. 8. 9 Standard OP2 OP15 OP15 OP15 OP20 OP21 OP25 OP20 OP23 That all contracts include the number of room to be occupied and the cost of the placement. It would be good practice to include a social history, recent social history and information regard leisure preferences and aspirations in the care plan diaries. It would be good practice to ensure that residents are always aware the second main choice of meal at dinnertime. It would be good practice for staff to have ‘malnutrition universal screening tool’ (MUST) training. It would be good practice to have more than one lounge area for residents. It would be good practice to have a shower for those residents who prefer a shower or cannot use a bath. It would be good practice to have domestic type lighting in the bedroom areas. It would be good practice to further maintain the garden to make this a more attractive a usable space for residents. It would be good practice to consider replacing some of the old fashioned beds. Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeville Lodge DS0000068044.V349702.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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