Inspection on 08/05/06 for Abbey Lodge

This inspection was carried out on 8th May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbey Lodge 09/08/07

Abbey Lodge 27/02/06

Abbey Lodge 31/08/05

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Conquest House

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

CARE HOME ADULTS 18-65 Abbey Lodge 55 Harvey Road London Colney Herts AL2 1NA Lead Inspector Jeffrey Orange Key Unannounced Inspection 8th May 2006 08:00 Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 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 Lodge DS0000062483.V293841.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 Adults 18-65. 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 Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abbey Lodge Address 55 Harvey Road London Colney Herts AL2 1NA 01727 825899 01727 825899 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) Mrs Meetranee Chintaram Mr Krishna Iyapah Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4) Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Abbey Lodge is located in a semi-detached house in a residential area of London Colney, with access to both local shops and services and by public transport to St Albans city centre. There is car parking available to the front of the property with gardens, accessible to residents, at the rear. The home offers a service for four adults of any age experiencing mental health difficulties. Accommodation is on two floors - there is one bedroom with en-suite shower on the ground floor and three bedrooms on the first floor, one with an en-suite toilet and washbasin. Staff accommodation is also on the first floor. There is a lounge/dining area, kitchen and office on the ground floor. The laundry is in an outbuilding linked to the kitchen by a covered walkway, where service users may smoke if they wish. A service user guide is available to current or prospective service users, together with copies of the previous inspection reports. Weekly fees are £777.75 (Information current at 08.05.06) Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been complied following a visit to the service and draws of the experience of those living in Abbey Lodge, examination of some key records and discussions with the proprietor and manager of the service. This inspection builds on the experience of the previous inspections of August 2005 and February 2006 and took place over four and a half hours, commencing at 8 am, which provided a good opportunity to talk with service users before they left for day- time activities. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to be better supported by Adult Care Services and other health and social care agencies to enable him to ensure that care plans include the most up to date records under the Care Programme Approach process in each case. Further consideration should be given to how service users might become increasingly involved in the domestic routine of the home and their own care, including for example their medication, to help them to build the skills and confidence they need to progress to more independent living if that is possible and in line with their wishes. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 6 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 Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Because the assessment process is comprehensive and takes account of the individual needs and requirements of prospective service users, they can be confident that their care needs will be both identified and met appropriately. EVIDENCE: All four care plans seen demonstrated a very full assessment process, involving the service users themselves, their relatives and other health and social care professionals involved with them. The Statement of Purpose and Service Users Guide were revised in response to a requirement previously made and are now much improved. They should be kept under review and revised as and when appropriate to ensure they remain up to date. Staff records indicate that staff have the necessary skills to enable them to meet the needs of the service users and service users were positive about the standard of care they receive. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 67 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of care plans are generally good with evidence now included to reflect the home’s own process of review of care needs and how they are being met. They would be improved further if in each case they could include full details of any reviews carried out under the Care Programme Approach. Service users are encouraged to develop an independent lifestyle with any risks arising being identified and assessed, with appropriate action taken if indicated. EVIDENCE: Service users were spoken to and gave details of a variety of interests, activities and community involvement outside of the home. They were aware of their own Care Programme Approach and care plans provided adequate details of the home’s review process. It had apparently not always been possible for the home to obtain copies of Care Programme Approach meetings that had taken place. This is regrettable Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 10 as it makes it difficult for the home to keep the care plan documentation as full and comprehensive as it would otherwise be. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users participate in a range of activities within the local community and can take advantage through independent travel, both within and outside the UK, of opportunities to maintain and develop social and family contacts. Consideration should be given to further enabling and encouraging service users to take a more consistent and structured role in basic domestic tasks such as cooking and cleaning so as to build and develop or maintain independent living skills. EVIDENCE: Care plans seen and discussions with each of the three services users present during this inspection visit provide good evidence of significant opportunities for social, community (including voluntary work) and family involvement. This support is particularly important if any move to more independent living is to be realised. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive health and social care support from a range of agencies and services to enable their health and social care needs to be met. Medication practice appears basically sound. It is however not clear if the potential for moves to some degree of self-medication, within a risk assessment framework is always actively kept under review. EVIDENCE: Each care plan seen includes good evidence of the involvement with service users of community health and social care agencies. Discussions with service users and the manager and looking at care plans and risk assessments did not conclusively demonstrate that the potential for service users to have some increased role in their medication, even if full selfmedication may not currently be appropriate, was being actively considered and kept under review. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families and supporters can be confident that they will be protected from abuse and that their concerns will be dealt with. EVIDENCE: The home has a satisfactory complaints policy and procedure and services users spoken to demonstrate that they are very articulate and have ample opportunity outside of the home to raise any concerns they may have. A recent allegation of potential abuse was dealt with satisfactorily through the Hertfordshire Adult Care Services protection of vulnerable adults procedures and provided an opportunity for staff and management to gain or reinforce knowledge of issues around adult abuse and how they should be reported and recorded. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 28 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Abbey Lodge is comfortable, well furnished and decorated and offers a comfortable and essentially homely environment for those living there. EVIDENCE: Two service users agreed to speak to the inspector in their own rooms, which gave an opportunity to see how these were personalised and decorated. Service users were seen to be making use of the communal sitting and dining area. One recommendation is made which might be considered to enhance the homely, non-institutional appearance of the entrance hallway. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a small, appropriately qualified and wellestablished staff team, which provides a consistent and good standard of care. EVIDENCE: It is understood that there have been no new staff members recruited since the last inspection. One staff file was examined and found to be satisfactory, although staff supervision is not yet at the required frequency. All service users spoken to were positive about the staff team and the standard of care that they receive at Abbey Lodge. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and provides a stable, comfortable and essentially safe environment, in which its service users experience a good level of care. EVIDENCE: The manager is professionally well qualified including the Registered Manager’s Award. Service users have been consistently positive over recent inspections about the experience of living in Abbey Lodge. Records seen indicate that the health and safety of services users is promoted and protected by the home’s policies and procedures. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 18 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 YA20 Regulation 13(2) Requirement Timescale for action 08/05/06 2 YA36 18(2) The manager must demonstrate and record on a regular and ongoing basis that service users are encouraged and supported to achieve the maximum possible degree of self-medication possible within an appropriate risk assessment framework. The frequency of staff 31/10/06 supervision must be further improved to ensure that all staff are appropriately supervised. 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 YA6 Good Practice Recommendations The manager should make further efforts to obtain, where appropriate, and with service users agreement, full details of all Care Programme Approach reviews for each service user to include within their care plans. The manager should review current practice to ensure that all service users are encouraged and enabled to build independent living skills to the maximum possible extent DS0000062483.V293841.R01.S.doc Version 5.1 Page 19 2 YA16 Abbey Lodge 3 YA24 through active and structured involvement in domestic tasks such as cooking and cleaning etc. (It is however recognised that this takes place to some extent already) Consideration should be given to repositioning some of the various certificates, currently displayed in the hallway, (perhaps into the office area) as this gives a rather institutional feel to the area of the home first seen on entering. Abbey Lodge DS0000062483.V293841.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Lodge DS0000062483.V293841.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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