Inspection on 07/06/05 for Abbey Grange Nursing & Residential Care Home

This inspection was carried out on 7th June 2005.

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 &... 31/01/06

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

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

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The Vicarage

Fairfields Country Rest Home

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Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Abbey Grange Nursing and Residential Home 61 South Road Weston Super Mare North Somerset BS23 2LT Lead Inspector Alison Murray Unannounced 7 June 2005 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 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Abbey Grange Nursing and Residential Care Home 61 South Road Weston Super Mare, North Somerset, BS23 2LT Address Telephone number Fax number Email 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 Manor Court Care Homes Ltd Mrs Jean Taylor Care home with nursing 40 Category(ies) of Old age (40) registration, with number Physical disability (3) of places Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. May up to 38 persons aged 65 years and over, requiring nursing care. 2. May accommodate up to 7 persons aged 65 years and over, requiring personal care. 3. Staffing Notice dated 21/12/2000 applies. 4. Manager must be RN on Parts 1 or 12 of the NMC Register. 5. May accommodate up to 2 persons in the Cedar Lodge Annex who are aged 18 -64 years and have a mental disorder. 6. May accommodate up to 3 persons between 18 -64 years of age with Physical disabilities, requiring nursing care. Date of last inspection 8 March, 2005 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive unannounced inspection. Over 5 hours were spent in the home. During this time, 11 of the 30 residents were consulted individually. The inspector spent time chatting to others in the communal lounges and dining room. A total of 6 staff and one relative were interviewed informally. Time was spent reviewing care records and in discussion with Mrs Taylor. All areas of the home were inspected. What the service does well: What has improved since the last inspection? The standard of care documentation has improved since the last inspection. Resident’s needs are clearly identified and care plans regularly reviewed. Mrs Taylor and Mr Janmohamed have continued with their programme of refurbishment and redecoration. Work has been completed to a high standard. Abbey Grange offers good all round accommodation. Since the last inspection, Mr Janmohamed’s application to become responsible individual for the home has been approved by CSCI. It is clear that he and Mrs Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 6 Taylor are working well together. His monthly reports to CSCI show that he is actively involved in monitoring how the home meets the needs and expectations of the residents. 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed. EVIDENCE: Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 and 11 The standard of care documentation is good. Residents’ health and personal care needs are well met. There is a friendly atmosphere in the home, with a good rapport between residents and staff. 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. The wound care documentation has been reviewed since the last inspection. The new format was easy to read, and the guidance it offered based on current good practice. 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. Some of the current residents can display quite challenging behaviour. Staff consulted during the inspection showed a very good understanding of things that may provoke these behaviours, and how to avoid or manage outbursts. Residents said that they were confident in the staff’s ability to care for them. One person commented ‘they know what they are doing’. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 10 A total of 11 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. They gave numerous examples of staff members going out of their way to be helpful. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 11 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 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. Family and friends are made welcome. Residents enjoy the meals provided. EVIDENCE: This inspection started at 12md, just as lunch was being served. The two choices, chicken curry and a casserole both looked and smelt appetising. Staff offered discreet assistance where necessary. All the residents praised the standard of food in the home. One lady commented that the cook ‘always does a good curry’. Others said that they particularly enjoyed the homemade cake served with afternoon tea. Residents said that they were able to choose how to spend their day. One person prefers to spend his time in his room. He said that staff always made sure that his radio was tuned to his favourite channel, and his call bell was accessible. Other residents said that they liked to sit with friends in the communal lounge, and ‘watch what is going on’. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 12 Since the last inspection a new activities organiser has been appointed. Residents were enthusiastic about the newsletter she produces each month. This gives details of planned trips and activities. These activities include art and craft sessions as well as music and pet therapy. Residents said that their family and friends were able to visit anytime. A regular visitor commented that staff always made her feel welcome. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 and 17 The complaint procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: There are comprehensive policies and procedures in place. Residents and a visiting relative all 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. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24 and 25 The standard of accommodation is good, providing residents with a pleasant and homely place to live. EVIDENCE: There is an ongoing programme of redecoration and refurbishment. Since the last inspection, a number of unoccupied rooms have been redecorated. This work has been carried out 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 were keen to point out items of their own furniture, or pictures that they had brought into the home. 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 15 The inspection took place on a hot afternoon. Staff had opened two windows in first floor unoccupied rooms, to allow a cool breeze. The opening restrictors on these windows had been disconnected. The bedroom doors were wedged open. The open windows posed a potential risk to residents. This was brought to Mrs Taylor’s attention. She arranged for the maintenance person to fix the opening restrictors the following day. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 Staffing levels meet the needs of the current residents. Staff are actively encouraged to develop their skills and knowledge. They are enthusiastic about the range of learning opportunities offered. EVIDENCE: There were 30 residents in the home during the inspection. Conversations with staff and residents indicated that staffing levels were appropriate to the needs of residents. Staff said that they were kept busy, but still had time to chat with the residents. Call bells were answered promptly during the inspection. All the staff consulted said that they are actively encouraged to enrol on training courses. A high proportion of the care and domestic staff have achieved NVQ level 2. The Mayor is due to present staff with their awards at a prize giving reception in the home in the near future. Trained nurses said that they appreciated the training sessions provided by the local Primary Care Trust. The deputy manager is enrolled on the Registered Manager Award. Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 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. 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 x x 3 3 Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 25 Regulation 13.4 Requirement Opening restrictors on identified windows must be repaired. Timescale for action 08/06/05 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 Good Practice Recommendations Abbey Grange Nursing and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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 and Residential Home D53 -D02 S20225 Abbey Grange V222262 070605 Stage 4.doc Version 1.30 Page 21 - 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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