Inspection on 20/06/06 for Abbey Care Rest Home

This inspection was carried out on 20th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbey Care Rest Home 08/09/09

Abbey Care Rest Home 27/11/07

Abbey Care Rest Home 09/01/07

Abbey Care Rest Home 25/08/05

Abbey Care Rest Home 16/06/05

Abbey Care Rest Home 18/01/05

Abbey Care Rest Home 28/09/04

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

CARE HOMES FOR OLDER PEOPLE Abbey Care Rest Home 14 Hampton Road Blackpool Lancashire FY4 1JB Lead Inspector Mrs Jackie Riley Unannounced Inspection 20th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbey Care Rest Home DS0000060139.V292619.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. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey Care Rest Home Address 14 Hampton Road Blackpool Lancashire FY4 1JB 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) 01253 341458 abbey_care@yahoo.co.uk Mr Gulan Asger Abdullah Mukadam Dr Bilqis Mukadam Care Home 11 Category(ies) of Dementia (9), Mental disorder, excluding registration, with number learning disability or dementia (2) of places Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Two Mental Disorder excluding Learning Disability or Dementia (MD) are to be maintained until the two service users no longer reside at the care home. There is a requirement for a registered manager to be in post at all times, until such a time the registered provider has gained the knowledge, skills and qualification to undertake the management of the home on a day to day basis. 25th August 2005 Date of last inspection Brief Description of the Service: Abbeycare is a registered facility, providing care for nine adults who suffer dementia and two adults suffering from mental illness. The care home is situated in a residential area of Blackpool, close to amenities including shops and the transport network. The home is spacious, with service user rooms on the ground floor and first floor. There are two double bedrooms and seven single rooms. There are no en-suite facilities. There is a choice of two lounges with toilets in close proximity. Access to the home is facilitated by a ramp. There is no rear garden area however the front garden is accessible for service users and regularly used during the summer months. There is a written Statement of Purpose outlining the home purpose and function, however this has not been reviewed, and there is no other information in the Service User Guide, which would inform people who use the service of what is available to them. The most recent inspection report was not seen to be freely accessible to users of the service. At the time of the site visit (22.06.06) the information provided to the Commission showed that care home fees were £280-329 per week, any additional expenses including chiropody, newspapers and additional toiletries are met by the resident or third party. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first of two unannounced site visits, scheduled from April 2006 to March 2007. This unannounced site visit took place during a daytime period over 4 hours, and was undertaken by one inspector. The inspection included discussion with a number of residents, however there were constraints in communication due to the level of dementia and mental disorder affecting residents living in the home. The registered provider assisted with the site visit, there were no other staff on duty throughout the inspection process. There were no comments received by any user of the service prior to the inspection process. The site visit included observation of records, discussion with people living in the home and included a tour of the home. Since the previous inspection there have been no complaints investigated by the Commission for Social Care and Inspection (CSCI). What the service does well: What has improved since the last inspection? What they could do better: The homes environment requires attention in that external paintwork and repairs to woodwork need to be addressed. Curtains must be attached to pelmets in order to reinforce privacy at all times. Wires for extensions must be placed in a position, which does not cause a risk to people living in the home. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 6 There must be adequate heating on in the home at all times so that residents are comfortable. The home requires general decoration throughout to ensure residents are living in pleasant surroundings. There must be adequate staff on duty in numbers, which meet the needs of residents and can address domestic tasks, so that the home is clean and comfortable to live in. There must be suitable flooring in areas where there is incontinence so that there are no offensive odours and residents are not at risk from measures taken to address the issue. There remains a requirement to put in place suitable locking mechanisms on the bathroom door in order to ensure residents privacy. Assessment plans must be updated if residents return to the home, so that current needs are identified. Staff working in the home must have current Criminal Record Bureau (CRB) checks in place for the safety of people using the service. The registered provide must ensure the home is run in the best interests of residents living there for their safety and comfort. All staff should be updated on training in adult protection so that users of the service are protected. There must be evidence of appropriate activities available for residents living at the home. All staff working in the home must have training in adult protection for the safety and protection of users of the service. The registered manager is not undertaking management duties in the home other than at weekends, therefore leaving the home without leadership and guidance. 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. Abbey Care Rest Home DS0000060139.V292619.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 Abbey Care Rest Home DS0000060139.V292619.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&3 The quality judgment is adequate. This information was based upon evidence gathered including a visit to the service. Assessments are in place for people living at the care home, however they must be current in order to meet the needs of residents at the time of admission. EVIDENCE: There were three assessment plans viewed during the site visit. Assessment plans seen were included with the written care plans. They contained information relating to the needs of the resident, however in one case it was noted the resident’s professional assessment had not changed since a previous admission. This information must be updated so that the home knows what the current needs of the person are so that staff can provide the level of assessed care needed by that person, so that they are not disadvantaged in any way. Each resident has been provided with the homes terms and conditions, all the documents were agreed and signed. Abbey Care Rest Home DS0000060139.V292619.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 The quality judgement is adequate. This information is based upon evidence gathered including a visit to the service. The registered provider closely monitors the healthcare needs of residents, so that access to healthcare is good. The registered provider closely monitors the management of medication, so that it is safe. Privacy and Dignity could be compromised by lack of adequate locking mechanisms. EVIDENCE: There is evidence the home makes sure residents have access to healthcare professionals should it be required, with GP and other healthcare appointments being seen. There is evidence of mental health support for a number of residents living at the home, in that there is liaison with mental health workers, who support two residents living in the home. Care plans contain information based upon professional assessment, as well as the home meeting individual needs, based upon there own assessment. The registered provider takes medication management seriously. Records seen are current and up to date. There remains concern around issues of Privacy and dignity in that there is an unacceptable locking mechanism on the first floor bathroom door. This has been raised before and must be addressed, so that a safe and secure locking mechanism is in place, to ensure privacy at all times. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 10 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 is poor. This information is based upon evidence gathered including a visit to the service. There remains a requirement to make sure there is an appropriate activity programme for people who live at the home. Meals are balanced and take into account choice. There are good family links with some residents. Community services are accessed by a limited number of residents. EVIDENCE: There has been no development in how the home provides access to activities, which are based upon the needs of an older resident group who suffer from dementia and mental disorders; therefore they are seen to be disadvantaged. There was no record of any additional activity or therapeutic activity, which would provide some stimulation to people living in the home. One resident said, “I like to go out sometimes”, but other than that this resident chooses to sit alone in a room from day to day. Whilst this was confirmed to be personal choice there must be some evidence of how therapeutic techniques can assist people to develop their day-to-day lives and extend their choice of activities. Meals are prepared on the premises taking into account individual likes and dislikes whist making sure the food is balanced and nutritional. Residents spoken to said, “the curries are really good”. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 11 There is evidence relatives come to visit, one resident said “I like it when my family come to see me”. As there is only one member of staff on duty at any one time, there are constraints as to how an activity programme could be developed, therefore there needs to be consideration in how the home is being staff, so that there is allocated time for staff to be involved in activities designed to meet the needs of older people with dementia and mental disorder. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 12 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 The quality judgement is adequate. This information was based upon evidence gathered including a visit to the service. There is access to the homes complaint procedure and who to contact in the written literature. All staff must have knowledge and skills in areas of adult protection for the protection of residents living at the home. EVIDENCE: There is a complaints procedure in place. Residents and other users of the service can clearly see the homes procedure which is in plain English on the homes lounge wall as well as being included in the homes written literature. There was evidence the home has local procedures in place for adult protection. Through discussion with the registered provider and observation of training records it was confirmed training in this area has been undertaken, however no other staff working in the home have received accredited training in this area, and must do so for the protection of users of the service. There were no other staff available to speak to during the inspection process, therefore their understanding of the procedures could not be confirmed. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 13 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 The quality outcome is poor. This judgement has been made using available evidence including a visit to the service. The homes environment requires attention in order to make it a safe and comfortable place in which to live. EVIDENCE: The general environment of the home is poor in that there is requirement for general maintenance and decoration both internally and externally, so that the home is a pleasant place in which to live. There is a requirement to make sure all curtaining is attached to the pelmet, that the home is clean and hygienic. At the time of the inspection one first floor room had one curtain down due to replastering of the wall, however the net curtains were in need of cleaning. One ground floor room had a curtain hanging of the pelmet, it was explained the resident uses the curtain for support, and this was confirmed by the resident, however this is not an acceptable way of managing someone’s mobility and therefore appropriate aids and adaptations for movement and mobility must be considered. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 14 There are health and safety issues including the making safe of extension leads. At the time of the inspection it was noted a telephone extension lead was being used down a stairwell, whilst this did not pose a falling hazard, it was not acceptable and a more appropriate method of placing and securing wiring must be applied. It was noted a residents bedroom floor was being protected by covers for the management of incontinence. This practice is not appropriate. Suitable flooring must be in place for residents who have incidents of incontinence so that there are no offensive odours. There should be televisions in lounges, which are of a suitable size to make it comfortable to watch. At the time of inspection a portable television was in place, which was not conducive to being comfortable to watch for any length of time. The inspector was informed this was due to residents not being able to manage remote controls, however a simple explanation and assistance in this matter would resolve the problem. Heating control should be assessed when weather conditions deteriorate so that the home has a consistent temperature at all times. At the time of inspection the external temperature had dropped, no heating was on in the home and when a number of residents were asked about the temperature they agreed it was cold. The heating was put on during the inspection and the homes environment became much more comfortable, however this situation must be managed better. There must be evidence of domestic work being carried out regularly to make sure the home is clean and hygienic at all times. Windowsills were seen to be dirty and rooms cluttered, making it less than comfortable to live in. Abbey Care Rest Home DS0000060139.V292619.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 The quality outcome is poor. This judgement is based on evidence gathered including a visit to the service. Resident’s care could be compromised due to the level of staffing in the home. The lack of adeqate pre-employment checks potentilly puts residents at risk. EVIDENCE: There are now six residents accommodated in the home, with either a level of dementia or mental disorder. At the time of the site visit it was noted there is one carer on duty at any time of the night or day, with a volunteer working on an ad-hoc basis. Night time cover is provided by a staff member sleeping on the premises. There was evidence of volunteer work being undertaken by the providers family members who had not been subject to Criminal Record Bureau (CRB) checks and so their fitness to work with vulnerable people had not been assured. The registered provider is committed to provide a good level of care and observations made confirmed residents feel comfortable with the registered manager, who knows the individual needs of residents, however there is a requirement domestic tasks must be undertaken so that the homes environment is clean and comfortable to live in. It is clear the registered provider cannot undertake all tasks and therefore additional staff are essential for the well being of residents. There was evidence the night time carer has been employed with a transferred Criminal Record Bureau check from another care service. This is poor practice. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 16 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 The quality outcome is poor. This judgement is based upon information gathered as well as a visit to the service. The registered manager not managing the home on a regular basis, leaving it without leadership and guidance and must be improved for the benefit of people who live there. EVIDENCE: There is evidence the registered provider is committed to make sure residents living in the home are well cared for with their individual needs being met, however it was noted that due to a lack of resources, the home is not being managed well, in that the environment must be improved, staffing levels must be adequate to meet the needs of users of the service as well as providing domestic hours for the cleanliness of the home. In addition it is of serious concern the registered manager of the home is only working in the home at week-ends and not in full time capacity, leaving the home without leadership and guidance and potentially affecting the well being of residents. This Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 17 situation must be addressed so that there is evidence the home is being managed effectively for the benefit of residents living there. There must be evidence of a review system in place so the home can assess its performance against its stated aims and objectives. The home has records of health, safety and appliance checks so that the home is safe. There are two residents receiving personal allowances from the home, records seen demonstrate they are paid weekly and signed for by the person receiving the money. The home does not hold any monies or valuables on behalf of residents living there. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 18 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 3 Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 16(a) Requirement The home must ensure there is a social activity programme in place appropriate to meet the residents needs. (Extended from 01/09/05) The registered person must develop a maintenance plan for the renewal of the fabric and decoration of the premises, and must ensure the home is free from hazards and reasonably clean. (Extended 31/03/06) All toilet and bathroom facilities must have appropriate locking mechanisms for the privacy fo people using those facilities.(Extended from 31/10/06) All residents admitted to the care home must have a current assessment plan in place The home must be staffed in accordance with the needs of residents. There is a requirement to ensure all staff working in the home have current Criminal Record Checks in place, including volunteers. DS0000060139.V292619.R01.S.doc Timescale for action 30/09/06 2. OP20 23(20)(b) 30/09/06 3. OP10 4 (a) 31/07/06 4. 5. 6. OP3 OP27 OP29 14 18 19 31/07/06 31/07/06 31/07/06 Abbey Care Rest Home Version 5.2 Page 20 7. OP31 10 8. OP33 24 9 OP18 18 10 OP31 39 The registered provider must ensure the home is run in the best interests of residents living there. The home must have a system of review in order to measure its effectiveness against its stated aims and objectives. Staff working in the home must have received training in adult protection for the safety of users of the service. The home must inform CSCI of its reasons for the registered manager to be absent during the week period and for what appropriate management cover is being provided. 31/07/06 30/09/06 30/11/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP36 Good Practice Recommendations Staff should receive regular supervision with records made available for inspection. Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbey Care Rest Home DS0000060139.V292619.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!