Inspection on 16/07/08 for Abbey Court (West Kingsdown) Nursing Home Limited

This inspection was carried out on 16th July 2008.

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

Abbey Court (West Kingsdown)... 22/01/07

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Abbey Court (West Kingsdown) Nursing Home Limited School Lane West Kingsdown Kent TN15 6JB Lead Inspector Mrs Susan Hall Unannounced Inspection 16th July 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.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 Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey Court (West Kingsdown) Nursing Home Limited School Lane West Kingsdown Kent TN15 6JB Address 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) 01474 854136 01474 855223 Abbey Court (West Kingsdown) Nursing Home Limited Mrs Rohini Persand Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (5) of places Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd January 2007 Brief Description of the Service: Abbey Court Nursing Home is a large, detached building, set in its own grounds, and is situated just off the A20 in the village of West Kingsdown. The property comprises an original period house, and additional wings which were built over twenty years ago. It is managed and owned by Mrs. Persand, who is a trained nurse with experience of caring for older people. She is assisted by the matron, who oversees all clinical care. Accommodation is provided on two floors, and there are sixteen single and three shared bedrooms. Eight of the single rooms have en-suite facilities. All rooms can be easily accessed via two passenger lifts in different parts of the building. As this home includes nursing care, there is a registered nurse on duty throughout the twenty-four hour period. The home has communal areas on the ground floor, and pleasant gardens with lawns and flowerbeds. The current fees range from £565.00 to £725.00 per week, depending on the assessed needs of individual residents. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has been given a rating of good, 2 stars. This was a key inspection, which includes assessing all of the key standards. Many other national standards were also assessed at this visit, so as to provide a comprehensive view of the home. The inspection takes into account all information obtained since the last inspection, such as letters, phone calls, survey results, legally required notifications, and any complaints or concerns. Nine completed survey forms were returned to CSCI from residents and staff members, and these were generally very positive. Some residents had asked their relatives to help them to complete the forms. The surveys showed that residents feel comfortable and well cared for, with comments such as “this is a happy, well run home. The staff are very caring” (written by a resident); and “the care, support and administration are very good. The home is very caring” (written by a different resident). The visit was carried out by one inspector, and lasted for over seven hours. During the visit, we (i.e. CSCI) examined documentation such as care plans and maintenance records; viewed the building; observed staff interaction with residents; and talked with twelve residents, two visitors and five staff, as well as with the matron and manager. Feedback was given at the end of the day to the manager, the matron, and the administrator. The home provides a warm, friendly and caring environment. There were many comments made about how caring the staff are, and how committed they are to delivering good standards of care. The home has a complaints procedure clearly on display in the front entrance hall. There have been no formal complaints during the past year; and no referrals to the Social Services Safeguarding Adults team. What the service does well: Care staff carry a high degree of responsibility in caring for the residents, working under the supervision of the matron and trained nurses. They act as key workers for residents, and write the care plans as well as delivering the care. Residents and relatives (as appropriate) are involved in drawing up care plans. The staff act promptly in making referrals to other health professionals as necessary, to ensure that individual health needs are properly met. The care plans showed clear evidence of referrals to people such as GPs, dietician, Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 6 physiotherapist, consultant neurologist, community psychiatric nurse, chiropodist, optician and dentist. The residents are fortunate to have a GP who acts as the visiting medical officer, and who visits the home on a weekly basis, as well as in emergencies. Many comments were made about the high standards of the food. This was seen to be well prepared and presented. Residents said that there is always a choice, and there is always plenty of food. Snacks are provided at any time. The manager and matron work opposite weekends, meaning that there is always a senior nurse on duty in the day times. They both have a visible presence on the floor, and lead the way in carrying out nursing care. Residents said that they are easy to talk to, and that they will respond quickly if any concerns are raised. What has improved since the last inspection? What they could do better: The residents’ guide contains staff details referring to their training and CRB (Criminal Record Bureau) checks. This material is sensitive, and could be in breach of staff confidentiality data. The manager was already concerned about this, and stated that she would take this out of the guide, and précis the information so that it is more general. Care planning is generally good, but could be still further improved with some additional attention to details. This was discussed with the matron and manager. Areas which could be more clearly specified include risk assessments (including risks associated with using bed rails); highlighting allergies more Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 7 clearly; and ensuring that application of the Mental Capacity Act 2005 is clearly evidenced when specific decisions are being made (e.g. for end of life care). The clinical room had a small sign showing that oxygen is stored there, but it was a not a recognised approved notice. Proper hazard signs must be in place wherever oxygen is stored or in use. The manager said that this would be dealt with promptly, so this has been issued as a recommendation rather than a requirement. The matron was in the process of arranging for the correct method of disposal for unused controlled drugs, and this process must be clearly set up, so that all trained staff know the correct procedures. Application forms for the recruitment process did not include ensuring that applicants are asked to provide a full employment history; and staff photos were not on file (although each staff member has a photograph displayed in the lounge area). The application form was being altered during the visit, and the manager said that she would ensure that staff photos are added to each file. The fire log book shows that there are weekly fire tests, and yearly staff fire training. The manager stated that fire drills are carried out approximately every two months, but there was no evidence to show the dates for these or who had attended. 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 Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.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 Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.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): Standards 1-5. Standard 6 does not apply in this home. Quality in this outcome area is good. The residents’ guide provides sufficient information to enable people to make a choice about moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and the Service Users’ Guide had been altered since the last inspection, and put into one document as the “Residents’ Guide”. This contains all the required information from both documents. This was discussed with the matron and manager, as they said they may decide to alter this again into two separate documents. We (i.e. CSCI) stressed that this is entirely their decision, so long as they ensure that the documents continue to contain the required information specified in Regulations 4 and 5, and Schedule 1. Some of the staff data included is not necessary to put in the residents’ guide, and the manager said that this would be removed and stored separately, so that only authorised people will see it. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 10 The residents’ guide is prepared as a bound copy with a photo on the front, and is laid out in a style which is easy to read, and produced in large print. A copy is given to prospective residents or relatives. The home also has a colour brochure, which is available for all enquirers. Copies are kept in the front entrance hall, and include all salient points about the home. All residents have a pre-admission assessment and these are carried out by the matron or manager (who are both level 1 nurses). Sometimes they carry out assessments together. Three pre-admission assessments were viewed, and they contain sufficient information to establish that the home can meet the needs of the person concerned. They follow a system known as Roper’s “activities of daily living”, which incorporates information about all aspects of care such as personal hygiene needs, nutrition, communication, medication, mobility etc. Residents are admitted for a trial period of four weeks. A review is held after this time to ensure that the placement is suitable. The administrator stated that all residents are provided with a copy of the terms and conditions of residency, and with a contract. This applies to residents who are funded by Local Authority as well as privately funded residents. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.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): 7-11 Quality in this outcome area is good. Care plans demonstrate that residents’ individual care needs are met, and that advice is obtained from other health professionals as needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are kept in individual folders, and include an index for easy access of information. Residents (and relatives as appropriate) are included in the care planning, and with ongoing reviews. The manager ensures that confidentiality of information is maintained with suitable storage for documentation. We read three care plans, and these generally include comprehensive ongoing assessments and associated care plans. They incorporate all aspects of care such as management of personal hygiene needs, nutrition, moving and handling, pressure area care, medication, continence and pain relief. Each assessment and care plan is reviewed and updated on a monthly basis. Care Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 12 plans also include a “life history”, and the resident or relatives are asked to complete these in order for staff to have an understanding of the resident’s background and previous way of life. The care plans generally contain very good information. For example, personal hygiene plans include what times the resident prefers to get up and go to bed; if they can assist with their own hygiene needs; and arrangements for managing mouth care/denture care and foot care, hair washing etc. Wound care shows clear directions for the dressing to be applied, and there is a written record maintained each time the dressing is changed. However a few points were highlighted where care plans could be improved still further, and these were discussed with the manager and matron together at the end of the inspection. For example, moving and handling instructions state if a hoist is to be used, but do not always specify which hoist and sling should be used. Risk assessments are put together on one form, and these might be clearer if there is a separate form for each identified risk. Risks associated with using bed rails were not identified on forms used for consent for this equipment. There is a separate page for allergies, but these are not highlighted in red at the front of the care plans. Care plans show excellent evidence for input from other health professionals, such as GPs, physiotherapist, dietician, district nurses, occupational therapist, and consultant neurologist. End of life care is discussed with residents if they are willing to discuss this subject, and any specific wishes are recorded and adhered to as far as possible. Resuscitation forms show that a discussion is held with the resident or the next of kin about their wish to be/not be resuscitated in a time of emergency. The forms viewed were not clearly completed with the name and date of the person signing the form, and the names/dates/signatures of other people involved in the discussion (e.g. GP and nurse). And they did not clearly demonstrate that the Mental Capacity Act 2005 is fully applied when these decisions are made. There is a recommendation to show evidence for the decisions more clearly. Medication is stored in a small clinical room, with two medication trolleys. Medication administration is carried out via a monitored dosage system. Stock cupboards were generally clean and tidy, and there is good stock rotation. No out of date items were identified. Oxygen is stored in the clinical room, and two residents have oxygen in their rooms. The hazard signs were not approved notices, and the manager said she would obtain these. There were currently no homely remedies in stock, although the GP who acts as a visiting medical officer has signed a list for items which the home may use. All Medication Administration Records (MAR charts) were viewed and were generally well completed. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 13 Residents expressed confidence in the nursing and care staff with comments such as “you can’t fault the staff, they are excellent”; and “ the staff look after us very well”. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 14 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): 12-15 Quality in this outcome area is good. The home provides opportunities for joint activities, and enables residents to follow their preferred lifestyles. The food is of good quality and provides suitable nutritional value. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a weekly planner for activities, which is displayed in the lounge area. This includes one group activity on four days per week, such as cards and dominoes, ball games, bingo, armchair exercises and “singalongs”. An activities organiser carries out the joint activities. There are no prepared activities on the day when the hairdresser visits or at weekends. Residents were unaware of the activities programme, and said that they take “each day as it comes”. However, they seemed content with the level of activities. Residents who prefer to stay in their own rooms or are too unwell to leave their rooms, said that staff are very good at coming to chat with them. They also benefit from having two volunteer visitors, who visit each week, and spend time chatting with residents on a one to one basis. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 15 An entertainment afternoon is arranged once per month, and special days such as birthdays, Pancake Day, Christmas etc. are celebrated. A clothing company visits twice per year, enabling residents to buy their own clothes. Residents were seen to have newspapers/magazines/radios and TVs as wanted. Residents said that staff are very good about offering to take them out for walks or out in wheelchairs, or to sit in the gardens; and some are taken out by relatives. A church service is held in the home each month for the benefit of residents who wish to attend this, and the vicar visits residents on a one to one basis as requested. Other priests/ministers are requested to visit according to residents’ wishes; and arrangements will be made to take residents out to places of worship on an individual basis. Visitors are welcomed into the home at any time, and are usually offered a drink. There has been an increased involvement with family and friends over the past year, and they are invited to join in with other organised events such as a summer fete, bring and buy, and coffee mornings. The proceeds from these go into a residents’ fund, and will be used for future outings or to purchase new items for the residents. Residents spoke highly of the food in the home. The cook has worked there for many years, and is familiar with residents’ likes and dislikes. There is always a choice of meals, and residents said that they can ask for another alternative if they don’t feel like the choices on the menu. One resident said “The food is always well cooked and there’s plenty of it. I can have a snack any time, but the meals are so good, I don’t usually want anything extra”. The main meal is at lunchtimes, and there is a lighter choice of soup/sandwiches or a hot choice (e.g. something on toast) at tea times. Mid-morning drinks and biscuits and afternoon tea and home-made cakes are offered; and hot drinks are provided mid evening and late evening, as well as on request. The kitchen has sufficient equipment, and is generally well maintained. There had been a recent visit from an Environmental Health Officer (EHO), who identified that the flooring needed replacing, and this had already been ordered and arranged. The home was awarded the high rating of 4 stars by the EHO for the hygiene standard of the kitchen. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 16 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. Residents are able to voice any concerns, and are confident that appropriate action will be taken. There are good procedures in place for the prevention of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has had no formal complaints during the past year. Any concerns are recorded in a notebook, and the records demonstrate that suitable action is taken to address these. The complaints procedure is on display in the entrance hall, and there is a suggestions box as well. There were no forms available for using for the suggestions box, and this was being arranged during the day. The complaints procedure states that complainants will be sent a written response within one week. The only details provided were for the home and CSCI. It may be helpful for residents and visitors to be reminded that they can access Social Services as well, and the manager said that the details for the local office would be added in. The matron and manager work on alternate weekends, so there is always a senior nurse in the home on day duties. They both have a visible presence in the home, and meet relatives and visitors on a daily basis. This enables any Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 17 concerns to be voiced very quickly, and dealt with as soon as possible. The home produces a bi-monthly newsletter, and this includes a reminder of the complaints process, and encourages readers to speak with the matron or manager about any matters of concern. All staff receive training in the prevention of adult abuse. This training is commenced at induction, and there are training updates each year. Training records confirm good staff attendance levels. Staff are aware of the action to take if they have concerns. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 18 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): 19-22 & 24-26 Quality in this outcome area is good. The home provides a clean, homely and pleasant environment for residents. The manager is proactive in ensuring that it is kept well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large detached building, which comprises an original old building, and new wings added approximately 20-30 years ago. The premises are generally well maintained, and there is an ongoing programme of redecoration. Two maintenance men are employed. Many bedrooms and communal areas have been redecorated during the past year. The home has a welcoming front porch and entrance hall, and there is a relaxed and friendly atmosphere. Residents are able to choose the colour for their bedrooms when Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 19 they are redecorated, and are encouraged to bring in their own personal belongings. The home has a large lounge/diner, which is divided into separate areas, so that residents have a choice of where to sit. There is a small quiet area in one of the new wings, and this includes a payphone as well as providing a quiet place to sit. The home has attractive gardens, with lawns and flowerbeds. Most bedrooms are for single use, and most have small en-suite facilities. These are mostly too small for wheelchair or hoist access, but there are other toilets providing disabled access. Most residents prefer to use a commode at night times. The home has two sluices – one on each floor. The home has three mobile hoists; and other equipment such as handrails and pressure relieving mattresses are available. Nursing beds are provided. There are two passenger lifts. Shared rooms have sufficient curtaining to provide privacy. Discussions are held with residents prior to admission to check if they wish to share a room, or are happy to do so. The home has three bathroom facilities and a back wash sink for hairdressing. Two of the bathrooms are in good condition, and one has an integral bath hoist. The third bathroom is generally in poor condition, and the manager has already made arrangements to refurbish this room, and to have a new Parker bath fitted. The bath will have spa (Jacuzzi) features which can help residents to relax; and the type of bath will make it easier for residents to get in and out. There is no requirement made in regards to this bathroom as the work is already planned. Radiators have low surface temperatures, and hot water outlets are fitted with thermostats. The hot water temperatures are checked by one of the maintenance men each week. There is a nurse call system for each room, and these were seen to be accessible to the residents. The laundry is situated in the basement. This is accessed via a steep stairway, which has a door with a keypad lock at the top. The laundry room is small but well organised. There are two dedicated laundry staff. The laundry has two washing machines and two tumble dryers. Bed linen is ironed with a roller iron, and clothes are also ironed. Relatives are requested to ensure clothes are properly labelled before people are admitted. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 20 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): 27-30 Quality in this outcome area is good. Residents’ benefit from having a competent and caring staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s manager or matron are usually on duty during the day time. Both are trained nurses, and the matron provides the clinical oversight for residents’ care. The home always has at least one nurse on duty at all times. The matron usually carries out the busier morning shifts, and another nurse comes on duty at 3pm. This enables a good handover period of an hour or more. The nurses are assisted by 4 care staff in the mornings; 3 in the afternoons and evenings; and 1 at night. Care staff on late shifts commenced duties at 2 or 3 pm, so some are working till 9-10pm and are available to assist the night staff with helping residents to bed. Other staff include a daily cook/kitchen staff; 1-2 cleaning staff each day; a laundry assistant each day; and administrative and maintenance staff. Residents said that care staff answer bells reliably and promptly. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 21 Current numbers of care staff with NVQ 2 training or higher are below 50 , but the home is working towards this. Some care staff at the home are nurses in their own countries, but are working in Britain on student visas, and are studying for NVQ 2, 3 or 4. Recruitment procedures are generally well carried out, with POVA first checks and Criminal Record Bureau (CRB) checks prior to confirmation and commencement of employment. CRB checks are obtained for staff from abroad from their own countries. Application forms did not specify that a full employment history is to be declared, and the administrator was immediately working to amend this form. Staff photos were not on file, and the manager said she would organise this immediately also. These matters have not therefore been given as a requirement but as a recommendation, as CSCI are confident that the manager is already addressing these issues. Volunteers to the home are CRB checked. The staff induction programme training is thorough, and each item is discussed and signed for by the trainer and trainee. It includes all aspects of the running of the home such as understanding fire awareness; clinical waste management; cleaning; confidentiality; daily routines; use of lifting equipment, and emergency procedures. Care staff are given detailed training in regards to carrying out personal care, such as nail care, bedbathing, care of teeth etc. Policies and awareness about the recognition and prevention of adult abuse are discussed. Staff training programmes include opportunities for nursing and care staff to develop and maintain their skills and competencies; with courses such as wound care, nutrition training, and understanding the Mental Capacity Act 2005. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 22 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. The home is run by a knowledgeable and efficient manager, and matron, who work together to ensure the smooth running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager purchased the home in 2005. She is a trained nurse, and has experience of general nursing, and nursing people with dementia. The matron is the former owner and manager, and now carries out all of the clinical care oversight and supervision. Staff were seen to work well together, and to carry out their tasks with respect, and attention to privacy and dignity. The manager and matron both Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 23 work alongside other staff, leading the way. Staff meetings are held at regular intervals, and one to one formal staff supervision is carried out every six eight weeks. This ensures that staff are able to raise any concerns or share ideas. Residents are invited to express their views at residents and relatives meetings, which are held every two months. These are not always well attended, but residents and relatives have the opportunity to give feedback to the matron or manager every day, so do not always wish to attend a formal meeting. Feedback is also obtained from relatives/visitors who attend entertainment functions. Residents are provided with survey forms to give feedback about the food every few months, so that they can ask for new items to be added to the menu. The bi-monthly newsletter is another way of informing relatives and residents about what is going on in the home; and includes pieces of news such as birthdays, activities, and names and designation of new staff. The home does not oversee any residents’ personal finances. Payments for items such as hairdressing and chiropody are invoiced to the resident or their representative on a monthly basis. Advocacy can be arranged for any residents who do not have a next of kin or representative. Documentation is stored so as to protect confidentiality, and is generally in good order. The home has gained the Investors In People award. Staff have been trained in the importance of correct recording of information, and documentation. Health and safety is well managed, and all staff are trained in health and safety matters including fire awareness and COSHH. Servicing records were viewed for lift servicing; fire training; PAT testing; landlords’ gas certificate; hoist servicing; and nurse call system servicing. All of these were up to date. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 24 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 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 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 3 3 Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP7 Good Practice Recommendations To ensure that detailed staff information is not included in the statement of purpose, but is kept separately for authorised persons to view. To improve documentation in care plans in regards to: • recording risk assessments more clearly; • highlighting allergies; • forms regarding resuscitation to be more clearly completed, so that they show compliance with the Mental Capacity Act 2005. To ensure that correct procedures are put into place for disposing of unused controlled drugs. To ensure that approved hazard signs are displayed wherever oxygen is stored or in use. To ensure that application forms are amended, so that applicants are requested to provide a full employment history since the time of leaving full time education. To keep a photograph on file for each staff member. DS0000063775.V366995.R01.S.doc Version 5.2 Page 26 3 OP9 4 OP29 Abbey Court (West Kingsdown) Nursing Home Limited 5 OP38 To ensure that fire drills are properly recorded, showing the date of each fire drill, and the names of staff who are present. Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Abbey Court (West Kingsdown) Nursing Home Limited DS0000063775.V366995.R01.S.doc Version 5.2 Page 28 - 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. 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