Inspection on 09/12/08 for Abbey Grange Residential Home

This inspection was carried out on 9th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbey Grange Residential Home 17/04/07

Abbey Grange Residential Home 25/04/06

Abbey Grange Residential Home 26/09/05

Abbey Grange Residential Home 21/06/05

Abbey Grange Residential Home 10/02/05

Abbey Grange Residential Home 01/06/04

Abbey Grange Residential Home 27/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Abbey Grange Residential Home Oaks Road Whitwick Coalville LE67 5UP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin Hefferman     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Abbey Grange Residential Home Oaks Road Whitwick Coalville LE67 5UP 01509600354 01509600137 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Woodley Holidays Limited care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: No additional conditions of registration apply. Date of last inspection Brief description of the care home Abbey Grange is registered to provide care for up to fourteen people with learning disabilities. The latter live in a large old country house, situated in grounds with gardens, trees and pleasing views of the countryside. They have access to a number of lounges and dining areas. Bedrooms are situated on the ground, first and second floors. There is a lift to facilitate access to the first floor. The rooms vary in character and size, and most overlook gardens and fields. People who live at Abbey Grange attend community day services, which are run by the registered provider in a nearby town. At the time of the inspection, fees ranged from approximately £600 to £1100 a week depending upon individual need. 14 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A visit to Abbey Grange took place on 9th December 2008, lasting approximately six and a half hours. The main method of inspection used on that day was case tracking which involved selecting two people who live at the home and tracking the care they receive through review of their records, discussion with them & staff and observation of care practices. We were not able to communicate with one of the people who were chosen for the purposes of case tracking. A thematic inspection took place on 24th April 2008. This was a short, focused inspection which looked at the homes arrangements for safeguarding people. This inspection took account of the findings from that visit and all information received since the date of the last key inspection, including the providers annual quality assurance Care Homes for Adults (18-65 years) Page 5 of 26 assessment. Comment cards were received from three people who use the service and two members of staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 7 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to the information they need to make an informed choice about whether to move to Abbey Grange. Evidence: A guide to Abbey Grange is displayed in the entrance hall. It is written in plain English and is illustrated with photographs and symbols. This helps to ensure that the information is accessible to as many people as possible. The outcome of Standard 2 (Needs Assessment) could not be fully assessed on this occasion. No one has moved to Abbey Grange since the date of the last inspection. The people who were chosen for the purposes of case tracking moved to the home during 1997 and 1998. Records indicate that their needs are kept under review. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make decisions about their lives with support if they need it. Staff members have access to the information they require to meet individual needs. Evidence: Individual plans were available for the people who were chosen for the purposes of case tracking. The plans that were inspected cover a range of issues including communication, family contact, mealtimes, health care, access to the kitchen, sexuality & relationships and religious & cultural needs. A summary of each persons care needs has also been produced, providing valuable background information. The deputy manager completes an evaluation of the care provided each month. Staff members indicated that they are always given up to date information about the needs of the people they support. Revised risk assessments have been completed on a range of issues and work has started to cross reference them to individual care plans. A number of risk assessments Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: in one of the files that were inspected had not been dated. A senior member of staff stated that these assessments had yet to be reviewed and reported that this issue would be addressed when they were. People are able to make decisions about their lives. One person chose, for example, not to attend day services on the day of our visit but later changed her mind. People are able to access communal areas and the grounds. A chain has been fitted in the kitchen to enable people to enter but to prevent them from putting themselves or others at risk. The people who completed comment cards indicated that they can do what they want during the day, in the evening and at the weekend. One person stated that they can do what they want at the weekend if we have enough staff on shift. A second person reported that sometimes I have to go out when I dont want to (see Staffing). Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Abbey Grange have access to a range of social activities and enjoy a lifestyle which appears to meet most of their expectations. Evidence: People who live at Abbey Grange attend Choices for Life, a day service which is run by the registered provider in a nearby town. One person stated that she is able to go swimming and horse riding whilst attending day services; a second reported that she likes to go to the library. One person does not attend Choices for Life. The acting manager stated that day services staff visit him twice a week to undertake activities and that he also accompanies home staff on trips out. Records indicate that over recent months people who live at Abbey Grange have attended a Halloween party, held at another home owned by the registered provider, Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: been on a boat trip and visited Matlock. One of the people who were chosen for the purposes of case tracking has indicated that she would like to attend church services. A staff member reported that she has been a couple of times but stated that it is difficult to arrange due to staffing levels at the weekend. A person who completed a comment card indicated that they can do what they want at the weekend if we have enough staff on shift (see Staffing). Records indicate that people are in regular contact with their families. People who live at Abbey Grange stated that they enjoy the food that is provided. Menu records indicate that they eat a varied diet. Peoples likes & dislikes are recorded in their individual plans. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Abbey Grange receive health and personal care which is based on their individual needs and preferences. Evidence: Individual plans detail the personal support each person requires and any preferences that have been identified in respect of that care. Staff members work with people to encourage a greater degree of independence where possible. Individual plans set out details of any health care needs that have been identified and of any action that is necessary as a result. Records indicate that people are in contact with a range of health care professionals. A body chart completed on 05/11/08 for one of the people who were chosen for the purposes of case tracking indicates that staff had identified a health related issue. The deputy manager stated that this issue had been resolved without the need for medical intervention. Staff had not however recorded the outcome in the persons notes. None of the people who live at Abbey Grange manage their medication. Records of the administration of medication met relevant requirements. Care plans have been Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: completed on the use of as required medication. Records are kept of their administration and the reasons for their use. Staff members have received training on the safe handling of medication. Since the date of the last inspection, the home has equipped a new medication room with a cabinet and fridge. No one was prescribed controlled drugs at the time of the visit. A recommendation has been made that the home obtain facilities for the storage of controlled drugs which comply with revised regulations. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Abbey Grange are protected by the homes arrangements for handling complaints and for dealing with allegations of abuse. Evidence: A copy of the complaints procedure is displayed in the entrance hall. It has been produced using symbols & photographs. The people who completed comment cards indicated that they know who to speak to if they are not happy and that they know how to make a complaint. Records indicate that two complaints have been received during the past twelve months. Appropriate action appears to have been taken in respect of both. A copy of the local multi-agency policies & procedures on the protection of vulnerable adults was available. The home also has its own policy & procedure on abuse. Staff members have received training on this issue. Staff who were present at the time of the visit were aware of the action they should take if they suspect someone is being abused. Financial records relating to the two people who were chosen for the purposes of case tracking were inspected. Each entry had been signed by two members of staff and a monthly balance check had been completed. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Abbey Grange benefit from an increasingly comfortable and homely environment. Evidence: Improvements continue to be made to the environment in which people live. Several areas of the home including one of the lounges have been redecorated since the date of the last inspection and new sofas have been purchased. People now have the choice of four communal areas. One person stated that she prefers to sit in a separate lounge because its quiet. Four bedrooms were inspected. All of them have been individually decorated and reflect the persons interests. Two of the three people who completed comment cards indicated that the home is always fresh and clean, with the third person ticking sometimes. The acting manager completes a building risk assessment each month and the outcome is used to develop an action plan. He stated that he was in the process of obtaining quotes for the refurbishment of ground floor toilets. Care Homes for Adults (18-65 years) Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Abbey Grange are protected by the homes arrangements for recruiting and training staff. Evidence: People who live at Abbey Grange appeared to enjoy a positive relationship with the staff who were on duty at the time of the visit. Several people confirmed that staff treat them well. The rota for the week in which the inspection took place indicated that there are a minimum of three members of care staff on duty throughout the day and two at night. One person who completed a comment card stated that they can do what they want at the weekend if we have enough staff on shift. A staff member reported that service users are unable to go out at weekends due to staff shortages. The deputy manager stated that additional staff are provided to enable people to attend specific events such as discos but acknowledged that a person identified at the time of the visit had not been to church. Records indicate that appropriate pre-employment checks have taken place. New members of staff complete induction training based on the standards set by Skills for Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: Care. Staff members indicated that they receive training which is relevant to their role, helps them understand & meet peoples individual needs and keeps them up to date with new ways of working. Records indicate that staff have received training on issues such as person centred planning, health action plans, a number of specific health care issues, medication, adult abuse & safe working practices. The acting manager stated that eight out of ten staff members have obtained National Vocational Qualification level 2 or above. The deputy manager has completed the Registered Managers Award; one of the seniors has obtained National Vocational Qualification level 4 and a second is in the process of completing level 3. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Action continues to be taken to ensure that Abbey Grange is run in the best interests of the people who live there. Evidence: The registered provider continues to employ a representative of a company who provide health care consultancy to manage the home. He is supported by a deputy manager and senior staff. The home has not had a registered manager since March 2005. The manager from another home owned by the registered provider completes the monthly reports required by Regulation 26. A quality assurance survey was conducted during April 2007. The acting manager stated that he intends to repeat the survey and to publish the results, possibly as a newsletter. Staff members have received training on issues such as moving & handling, fire safety and infection control. The acting manager stated that most members of staff had Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: completed first aid training recently (certificates were not available at the time of the visit) and reported that the rest would undertake the training during February 2009. Records indicate that fire tests and drills are completed at regular intervals. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 Staff members must record the outcome of any health care issues they identify. This ensures that appropriate action has been taken. 31/12/2008 2 33 18 Staffing levels at weekends must be reviewed to ensure that peoples individual needs are met. Increased staffing levels will enable people to undertake specific activities such as attending church. 31/01/2009 3 37 8 The registered provider must submit a plan for the registration of a manager. A manager must be registered with ourselves to enable checks to be undertaken to verify their fitness to manage. 31/01/2009 Care Homes for Adults (18-65 years) Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 The home should obtain a medication cabinet for the storage of Controlled Drugs which complies with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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