This inspection was carried out on 3rd 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.
CARE HOMES FOR OLDER PEOPLE
Abbey Lea Care Home York Road Barlby Selby North Yorkshire YO8 5JP Lead Inspector
Kate Shackleton Unannounced Inspection 3rd January 2006 10:00 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 Lea Care Home DS0000059063.V274236.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 Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Abbey Lea Care Home Address York Road Barlby Selby North Yorkshire YO8 5JP 01757 213811 01757 708523 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) Holistic Care Provision Limited Mrs Beverley Ann Emmett Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 23(OP) and up to 23 (DE (E)) up to a maximum of 23 service users. 23 Service Users to be accommodated on the understanding that communal space be increased sufficiently to satisfy National Minimum Standards for Care Homes for Older People - Standard 20, by 31st March 2006. Date of last inspection Brief Description of the Service: Abbey Lea care home is a two storey building set in its own grounds and is situated in the village of Barlby, which is close to the market town of Selby. It is on a main bus route to the city of York. The home is owned by Holistic Care Provision Ltd and provides long term care for up to 22 older people who may have dementia care needs. It also has one further place, which offers respite care. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours including one hour’s preparation time. The majority of the time was spent sitting talking with service users and watching staff delivering the care service. Discussions were held with some staff, one visitor and the registered manager. A sample of staff, service users and health and safety records were examined. Some parts of the premises were looked at. What the service does well: What has improved since the last inspection? 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 Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 6 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 Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 7 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): None of these standards were assessed at this inspection. EVIDENCE: Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 8 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): 9 The administration of medication is well managed promoting the health of service users and minimising the risk of error. EVIDENCE: The home operates a monitored dosage system All medication is securely stored and medication administration records are well maintained. The decision as to whether or not service users are capable of self-medication follows a risk assessment of the situation. Service users where possible and /or their relatives are involved in the discussions. Only designated care staff are allowed to give out medicines following medication training The community pharmacist who supplies the monitored dosage system visits to check that the system is operating properly and is available for advice. Arrangements have been made for the pharmacist to talk with staff about medication issues. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 9 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 and 13 Service users social, cultural, religious and recreational needs are met. Contact with family and friends is encouraged. EVIDENCE: Several service users spoken to say that they enjoyed the activities provided and that visitors can call at any reasonable time and are always made welcome. One visitor spoken to commended the staff for the care and attention they provide saying that ”You can walk in anytime and are always made welcome”. Files examined provided ample evidence that service users lifestyles involved them in a range of activities within and outside of the home including contact with family and friends and clergy. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 10 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 Service users concerns are taken seriously and acted upon. EVIDENCE: Everyone is given a copy of the complaints procedure in the information pack provided when the service user first comes to live at Abbey Lea. Conversations with service users showed that if they had any concerns, they would talk to the registered manager as they found her to be very helpful. The Quality Assurance scheme seeks views about the complaints procedure. The questionnaires sent out asks if people know how to complain. There have been no complaints recorded since the last inspection. The manager said that staff are asked to report any concerns/grumbles so that they can be dealt with quickly. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 11 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 Service users live in a clean comfortable home. EVIDENCE: A tour of the premises showed the home to be clean and well maintained. Decoration and furnishings are to a good standard. An extension to the dining room is being built in order to increase the communal space. There are plans to replace the hall, stairs and landing carpet once the building work is completed. Plans are also being discussed about ways of securing the front garden in order to make it safer for service users to use. Recent inspections by the Fire Authority and Environmental Health Agency have found the home to be satisfactory. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 12 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): 30 Staff are well trained and knowledgeable about service users. EVIDENCE: The staff training records examined showed that staff receive training in a range of topics that promotes best practice and provides staff with the information and skills to do a good job. Staff were observed providing a service in a kind and competent manner. Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 13 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): 33 and 38 Service users best interests are promoted and reflected in the service provided. EVIDENCE: A comprehensive Quality Assurance process is in place. Questionnaires are sent to service users/representatives and other people who have contact with the home. Following the audit, a report is sent to the Commission for Social Care Inspection. Records examined showed that there are systems in place to ensure the health and safety of service users and staff. Regular routine servicing of systems and appliances are carried out. Staff are provided with training on safe ways of working for example, moving and handling, first aid, infection control and food hygiene.
Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 14 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 15 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. 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. Refer to Standard Good Practice Recommendations Abbey Lea Care Home DS0000059063.V274236.R01.S.doc Version 5.1 Page 16 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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