CARE HOMES FOR OLDER PEOPLE
Abbey Care Rest Home 14 Hampton Road Blackpool Lancashire FY4 1JB Lead Inspector
Mrs Jackie Riley Unannounced Inspection 9th January 2007 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.V324106.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.V324106.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.V324106.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. 20th June 2006 Date of last inspection Brief Description of the Service: Abbeycare is a registered facility, providing residential care for up to ten adults who have dementia and one adult with 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 the services it will provide to residents. This information is made available to all prospective residents or their relatives/representatives to help them make an informed choice about going to live at the home. At the time of the inspection 18.01.07 the information provided to the Commission showed that care home fees were £280-£350 per week, any additional expenses including chiropody, newspapers and additional toiletries are met by the resident or third party. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This second unannounced site visit was undertaken to look at issues identified on the last key inspection. The site visit commenced at 9.30am and took place over 4 hours. The Inspector spoke to one staff member, four residents and the manager of the home. It should be noted three of the five residents living at the home have communication difficulties due to dementia, and physical constraints therefore their comments were limited, however the inspector made direct observations of the interaction between residents and staff throughout the inspection process. Comment cards had been received from three relatives and one resident prior to the site visit providing their views about the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the manager. What the service does well: What has improved since the last inspection?
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 6 The home has identified individual interests and activities in which residents might like to be involved in, and this is clearly recorded on their individual care plans. Some residents with dementia are given the space and time to move around the home and to help with small tasks. This was observed during the site visit and the interaction with residents and staff was seen to be positive and meaningful. The home has increased its staffing levels and this was seen to be positive for all residents, as there was additional time to spend with them on an individual basis. The management team say this has been beneficial for the service. The recruitment of staff has been improved in that records seen confirmed there have been suitable checks made including obtaining Criminal Record Bureau (CRB) disclosures , so that users of the service are safeguarded. A staff member said “I didn’t start until I had all the checks in place”. A staffing rota is now in place, so that it shows who is on duty at any one time. The manager spoken to said “as we are a small home there is little change but the rota does help us to identify when any changes have to be made, so that there are enough staff on duty at any time of the day or night”. The cleanliness of the environment has improved greatly throughout the home, so that residents are living in a clean and comfortable environment. A staff member was seen to be involved in the domestic improvement and this is carried out daily so that all areas of the home are well cared for. There was improvement seen in how resident’s rooms are maintained. What they could do better:
Both bathrooms in the home are showing signs of age and would benefit from refurbishment for the comfort of residents using the bathing facilities. The manager was advised of the requirement to make sure annual gas appliance servicing is taking place as records showed this was overdue. The inspector was informed this is in hand and contact had been made to the supply company to arrange this service, so that people are living in a safe environment. Staff employed at the home should continue working towards achieving nationally recognised care qualifications to ensure the residents are in the safe hands of well trained staff. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 7 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. Abbey Care Rest Home DS0000060139.V324106.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 Abbey Care Rest Home DS0000060139.V324106.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: There have been no new admissions to the home since the previous key inspection, however three records seen confirmed the home has improved its assessment information. Records seen showed they were fully completed, with evidence of social work assessments being in place for people living in the home. Staff could describe in detail individual care needs and how they are being met. New members of staff are being introduced to record keeping. Staff spoken to said “Its important we get to know all the information so that we can provide the right level of care”. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 10 Residents spoken to commented on how they are involved with the care they receive at the home, saying “we are asked about how we like to be cared for” and “do I feel well, if I’m not I’ll tell them and they’ll do something about it”. Staff responsible for the preparation of meals said they identify any special dietary requirements so that they can meet individual likes and dislikes and also any special medical reasons for dietary needs. A resident spoken to said, “its really good food here, they give you what you want”. The home does not provide intermediate care. Abbey Care Rest Home DS0000060139.V324106.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are met. Residents feel respected by the staff team and their right to privacy is upheld. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that needs to be taken by staff to ensure all aspects of health, personal and social care needs of the residents are met. Significant events had been recorded and daily entries made setting out the care given. Two residents spoken to confirmed they are involved in their care plans and the reviews, when staff speak to them about how they are cared for. The records of all five residents were looked at. They have been reviewed and clearly described individual healthcare needs so that they can be met by the home. Discussion with staff members confirmed they were fully aware of the
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 12 healthcare needs of residents and the importance of keeping records under review so that any changes can be identified and responded to. Entries made on care plans showed there is good communication between the home and healthcare professionals. The records of one resident showed a healthcare problem had been identified and appropriate action had been taken by the home to make sure the appropriate care and treatment was being received. Two residents spoken to said they liked living at the home and were well treated by staff members. One resident said, “ I’ve been here for a long time and they treat you well”. A relatives comment included “This is a small family run home and the staff are now our extended family. My relative cares about them and they care for them more than you can imagine and I can put into words”. Observations made demonstrated the staff team respect residents privacy and dignity in all aspects of their care. Some residents choose to stay on their own in lounge areas and their own rooms. One resident said, “I like my own space and that’s why I sit in here”. Another resident spoken to said the staff at the home were polite and kind. “They help everyone in here”. Medication practices observed were safe and good records had been maintained ensuring that service users receive their medication as prescribed. Abbey Care Rest Home DS0000060139.V324106.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are helped to exercise choice in their day-to-day lives and meals are wholesome and provide daily variation and interest for people living in the home. EVIDENCE: There has been improvement in how the home identifies residents individual likes and dislikes including their preference to social activities. Records seen showed all residents choices and preferences are clearly recorded, and the staff team are knowledgeable in what people like to do so that they can meet their individual needs. Staff spoken to said “it’s been useful to look at everybody individually, because they all like different things”. A resident spoken to was happy the home had recently helped them to a social function for a charity they had been involved with for a number of years. A family member commented, “ My relative does not want activities. If we ask for them they would provide them. She is happy doing day to day things”. This was evidenced through observation of residents helping staff with small tasks, which were seen to be stimulating to some of the residents living at the home.
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 14 Social activities are not structured but residents who were able to comment were satisfied that their leisure interests were being met. The home provides a varied and balanced diet for residents. The staff member responsible for the preparation of meals was able to confirm they had information about residents with special diets and personal preferences. Residents spoken to were happy with the choice of meals available. A comment received from a relative stated “ The meals are super. Before going into the home my mum would not eat properly, she now eats everything”. Abbey Care Rest Home DS0000060139.V324106.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a complaints procedure, which is made available to all residents on admission to the home. Two residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. One resident said, “if I’m not happy about something I tell them and its gets sorted out”. The relatives of four residents said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. At the time of this site visit one complaint had been recorded by the home. The Inspector was satisfied the complaint had been taken seriously and had been dealt with appropriately. The home has a procedure in place for dealing with allegations of abuse. The manager spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. There was evidence staff are going to receive further training in this area, when external training is available, however the home does have adequate local authority
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 16 procedures and guidance in place which is being used as a training tool, so that staff have the knowledge to make sure residents are safeguarded. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 17 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): 19,21,26 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The environment is clean, warm and comfortable for the comfort of residents living there. Bathrooms do not provide suitable equipment and good decoration to make bathing a pleasant experience for residents. EVIDENCE: The homes general environment has improved since the key inspection of June 2006. A tour of the home found it to safe and free from hazards. Individual residents rooms were found to be clean and tidy with one room having had flooring replaced by a more suitable material for the benefit of the resident. One resident spoken to said they were happy with their room and how they can use it. Another resident said, “I like to have my things where I want them and the staff know this”.
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 18 The manager stated the homes windows are to be replaced in the next few months so that it will be more energy efficient. The first floor bathroom is not generally used for bathing, as residents prefer to use the ground floor shower room, this was confirmed through discussion with one resident who said, “I like to have a shower it’s easier”. Both bathing facilities are basic, in need of refurbishment and do not provide additional mobility equipment, which may be necessary for residents who have limited mobility. The manager said it is the intention of the home to improve the bathing facilities in the business plan. Water temperatures were taken at both sources and were found to be safe, with the use of control valves. There are infection control policies and guidance for the control of infection ensuring the home is kept clean, pleasant and hygienic. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment of staff throughout the day is sufficient to meet the needs of residents. Staff have access to training so they are competent to do their jobs. EVIDENCE: The recruitment practices have improved so that people are safe. One staff member spoken to said they had to have the checks in place before they could work in the home. Staffing levels are based on the needs of residents living at the home. A number of residents spoken to said they think the staff team are good and “nothing is too much trouble”. A staffing rota is now in place and clearly shows who is on duty at any time, whilst also making it easier to manage any changes that may be necessary. Relatives surveys confirm they are happy with the staff team and commented positively on how the staff always act on what is requested of them, “not that we need to say anything”. When asked if the staff are available when needed a comment included “this is a small family run home and the staff are now our extended family”.
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 20 A new staff member was spoken to and commented positively on the support they receive to carry out their role. Training is seen as an essential process in making sure the staff team are equipped with the knowledge and ability to carry out their role. Records seen showed there is a plan of action for the training needs of the small staff team. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a way in which it benefits the people who live there and has systems in place for the protection of all users of the service. EVIDENCE: The home has reviewed all its operational systems and records to make sure it provides a good service for the benefit of people who live and work there. Residents and relatives were very complementary in their comments about the care which is provided, one comment included, “this home provides care that you would not receive anywhere else. They can’t do enough”. In order to measure the level of care the home provides the management team have introduced survey records for relatives and any user of the service who is able
Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 22 to make comment, so that changes can be made when necessary for the benefit of all users of the service. The manager provided evidence of the homes service history for all appliance certificates, which showed they are current except for the gas installation certificate. However, there was evidence this is currently being addressed by the manager and it was anticipated it will be completed within the next month. This is essential to make sure that the home is safe and people using the service are protected. The inspection of all records for residents showed they are complete, well written and up to date ensuring other members of staff are aware of residents needs at any time. One staff member had a good knowledge of residents living at the home and their individual needs, a comment included, “there are only a small number of residents and I know them all, they are so different it’s really nice to work with them”. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 23 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 X 3 X X N/A 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 2 3 X 2 X X X X 3 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 X 3 X 3 X X 2 Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP21 Regulation 23(2)(d) Requirement Both bathrooms must be maintained to a good standard for the comfort of residents using them. The servicing of gas appliances at the home must be carried out annually for the safety of users of the service. Timescale for action 31/07/07 2. OP38 23(2)(c) 09/02/07 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 OP30 Good Practice Recommendations There should be a continuing effort made to make sure all staff have access to training in order to carry out their roles competently. Abbey Care Rest Home DS0000060139.V324106.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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
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