Inspection on 31/01/06 for Abbey Grange Nursing & Residential Care Home

This inspection was carried out on 31st January 2006.

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 Grange Nursing &... 14/08/08

Abbey Grange Nursing &... 14/08/07

Abbey Grange Nursing &... 26/10/06

Abbey Grange Nursing &... 07/06/05

Abbey Grange Nursing &... 08/03/05

Abbey Grange Nursing &... 20/04/04

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Trevaylor Manor

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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 Grange Nursing & Residential Care Home 61 South Road Weston Super Mare North Somerset BS23 2LT Lead Inspector Alison Murray Announced Inspection 31st January 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 Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abbey Grange Nursing & Residential Care Home Address 61 South Road Weston Super Mare North Somerset BS23 2LT 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) 01934 623223 01934 414024 jean@manor-court Manor Court Care Homes Ltd Mrs Jean Taylor Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (3) of places Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. May accommodate up to 38 persons aged 65 years and over, requiring nursing care. May accommodate up to 7 persons aged 65 years and over, requiring personal care. Staffing Notice dated 21/12/2000 applies Manager must be RN on Parts 1 or 12 of the NMC Register May accommodate up to 2 persons in the Cedar Lodge Annex who are aged 18-64 years and have a Mental Disorder. May accommodate up to 3 persons between 18 - 64 years of age with physical disabilities, requiring nursing care. May accommodate one person aged 50 years and over. One named Service User, aged 44 on admission; this condition will cease when named service user leaves the home. 07/06/05 Date of last inspection Brief Description of the Service: Manor Court Care Homes Ltd owns Abbey Grange. Mr Jan Mohammed is the responsible individual for the company. Mrs Taylor is the registered manager of the home. Abbey Grange offers a total of 40 places. The main home provides predominantly nursing care for older people, although up to 8 service users who require personal care only may be accommodated. Cedar Lodge is a small self-contained unit, which provides personal care for 2 people, aged between 18 and 64 years, who have a mental disorder. In addition, the home offers day care to older people. The day care unit is housed within the main home, but has designated facilities and a separate staff team. Abbey Grange is a converted and extended older property on the hillside of Weston Super Mare. Many rooms enjoy panoramic views over the town, and there is an attractive garden to the front of the building. A passenger lift provides easy access to all areas of the home. Accommodation is provided in 27 single, and 6 double rooms. 8 of these have en suite facilities. The company is in the process of upgrading the accommodation. The communal areas of the home have recently been refurbished and redecorated to a high standard. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive announced inspection. During the 4 hours spent in the home, a small number of care and staff records were sampled. Time was spent in discussion with Mrs Taylor, the home manager, the trained nurses on duty, the domestic supervisor and the administrator. Other staff were not formally interviewed, but observed as they went about their work. Comment cards were received from 6 residents, and 9 regular visitors to the home. During the inspection, the inspector spoke with 9 residents. Many of the other residents were not able to express an opinion, so time was spent sitting and chatting with them. During this time, it was possible to observe their body language, and the way staff and residents responded to each other. What the service does well: What has improved since the last inspection? Mrs Taylor and Mr Janmohamed have continued with their programme of refurbishment and redecoration. Work has been completed to a high standard. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 6 Abbey Grange offers good all round accommodation. One visitor commented ‘the improvements made in the past years have been many, and sustained. The matron and her staff deserve praise. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 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 Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 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): 1, 2, 3, 4 and 5. Standard 6 does not apply. Prospective residents are given good information about the services offered at Abby Grange. Their needs are assessed before admission, and staff consult together to ensure that these needs can be met within the home. EVIDENCE: The statement of purpose has not been amended. It contains all the required information. Mrs Taylor is in the process of updating the service user guide. She plans to make the layout easier to follow, and include updated photographs of the home. The draft copy of this new guide was attractively presented, and provided good information about the range of services offered at Abbey Grange. During the inspection, two of the trained staff went to the local hospital to meet a prospective resident and assess her needs. When they returned, they gave Mrs Taylor detailed information about the lady and her needs. It was clear that they had carried out a comprehensive assessment, and consulted Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 9 with the ward staff about her health and personal care needs. Together, they made the decision that staff in the home could meet these needs. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 10 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 and 11 Residents feel that staff have the skills and competence to meet their health and personal care needs. The staff have forged good relationships with other health professionals to ensure that the residents have access to a good range of services. The standard of support given to terminally ill residents is commendable. EVIDENCE: The standard of care documentation was good. Care plans were written for each area of identified need. They provided staff with clear guidance to meet residents’ needs. Staff demonstrated a sound awareness of residents’ needs. They said that they received very good support from the Primary Care Trust Older Peoples’ team. A number of residents had been referred to the wound care specialist and mental health nurse. One person has been admitted for terminal care. The hospice staff visit regularly to offer support to the both the resident and staff. Records demonstrated that this resident had been actively involved in care decisions, and had negotiated with the GP and consultant what interventions would or would not be acceptable. This was well documented, so all staff were aware of the resident’s wishes. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 11 Residents said that they were confident in the staff’s ability to care for them. One person commented ‘they know what they are doing’. A total of 9 residents were consulted individually, and others observed in the communal areas of the home. All were neatly dressed, and attention had been paid to their hair and nail care. Some residents were being nursed in bed. They looked peaceful and comfortable. Care charts confirmed that staff were regularly changing their position, and offering drinks. There was a calm, relaxed atmosphere in the home. The residents said that the staff were ‘lovely’, with several naming specific favourites. One person said ‘from the minute I get up, to the moment I go back to bed, staff are wonderful to me’. They gave numerous examples of staff members going out of their way to be helpful. Regular visitors to the home echoed these comments. Medicine administration records, and drug storage facilities were well organised, and demonstrated good practice. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 12 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 and 15 The programme of planned and informal activities offered at Abbey Grange, meets the needs and expectations of the residents. They enjoy the meals provided. EVIDENCE: Residents said that they were able to choose how to spend their day. One person prefers to spend her time in her room. She said that staff always ‘pop in to make sure that I am alright’. Other residents said that they liked to sit with friends in the communal lounge, and ‘watch what is going on’. An activities organiser works in the home 5 days a week. Residents said that they enjoy the programme of formal and informal events she arranges. Photographs of recent social events were on display in the home. A monthly newsletter keeps residents and their visitors up to date with future plans, as well as providing articles of interest. All those consulted said that the standard of food provided at Abbey Grange is very good. Residents said that they particularly enjoy the cakes served with afternoon tea. Mrs Taylor said that she and the chefs had recently reviewed all the menus. Residents wanted some dishes removing, and gave suggestions for others to be included. The majority of the residents did not want curry on the Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 13 menu. Mrs Taylor said that this disappointed one of the residents. The chef now makes a ‘batch’ of curry, which he freezes in individual portions for this person. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 14 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 and 18 The complaint procedure in the home is satisfactory. Staff receive regular training in adult protection issues. EVIDENCE: There are comprehensive policies and procedures in place. Comments received from residents and relatives confirmed that they knew how to use these procedures if the need should arise. Several commented that they felt comfortable raising informal concerns with Mrs Taylor or her staff. They added that these had always been ‘Sorted out’ very promptly, and there had been no need to make a formal complaint. Mrs Taylor has received one complaint since the last inspection. The complaint record indicated that this was dealt with promptly, and to the satisfaction of the complainant. Staff said that they received regular adult protection updates. Notices displayed in the staff areas advertised forthcoming training. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 15 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 and 26 The standard of accommodation is good, providing residents with a pleasant and homely place to live. EVIDENCE: Since the last inspection the programme of refurbishment and redecoration has continued. Work has been completed to a high standard. Rooms at the front of the building have panoramic views over the town. A number of residents said that they enjoyed sitting, and looking out of their window. Others said that they were looking forward to the summer months, when they could sit out on the patio. All the residents consulted said that the standard of housekeeping was consistently good. The home was clean and tidy. No offensive odours were noted. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 16 A requirement made at the last inspection regarding window restrictors was met within the agreed timescale Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 17 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 and 30 Staffing levels meet the needs of the current residents. Staff are given very good opportunities to develop their skills and knowledge. Recruitment procedures are not sufficiently robust to ensure that suitable staff are appointed to work in the home. EVIDENCE: The majority of residents and relatives said that the staffing levels were appropriate. One visitor commented that staff could be ‘a bit thin at the weekends’. A review of the duty rota indicated that the home consistently meets the staffing notice set by the previous registration authority. Mrs Taylor said that the number of care staff on duty does not vary between days of the week, but at the weekend there are fewer domestic and admin staff on duty. She said that she keeps staffing levels under review. Mrs Taylor places a commendable emphasis on staff training and development. All staff have access to a good range of training opportunities both in the home, or outside. Records were reviewed for two staff members employed since the last inspection. In both cases, two written references had not been obtained, or a CRB disclosure requested before the person started work in the home. Neither Mrs Taylor, nor the administrator was aware that full recruitment checks need to be carried out for overseas staff, and had received conflicting advice from Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 18 the Home Office. This was discussed during the inspection, and new systems identified to ensure that appropriate checks are carried out before staff start work in the home. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 19 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, 32, 35, 37 and 38 The home is effectively and efficiently managed. Systems are in place to enable staff, residents and visitors to comment on the way the home is run. EVIDENCE: Staff and residents praised Mrs Taylor’s open management style. They said that they had regular meetings and were encouraged to voice their opinion about the running of the home. There was evidence of a strong sense of teamwork, and staff morale was high. The home holds money for a number of residents. Clear records are kept of transactions carried out on their behalf. Mrs Taylor and Mr Janmohamed, the responsible individual, carry out regular home audits and ‘satisfaction surveys’. Copies of these are sent to CSCI with his monthly report on the conduct of the home. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 20 Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 21 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X 3 3 Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 22 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 OP29 Regulation 19.-(1) Sched. 2 Requirement Two written references and a CRB disclosure or PoVA First check must be in place before staff start work in the home. Timescale for action 31/01/06 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 OP27 Good Practice Recommendations Mrs Taylor should keep staffing levels under review to ensure that they are appropriate to the needs of the residents. Abbey Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Grange Nursing & Residential Care Home DS0000020225.V271839.R01.S.doc Version 5.1 Page 24 - 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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