Inspection on 09/08/07 for Abbey Lodge

This inspection was carried out on 9th August 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbey Lodge 08/05/06

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 Julia Bradshaw Unannounced Inspection 9th August 2007 10:00 Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 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.V349216.R01.S.doc Version 5.2 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.V349216.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey Lodge Address 55 Harvey Road London Colney Herts AL2 1NA 01727 825899 01727 825899 meetranee@tiscali.co.uk 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.V349216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 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. 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. The home offers a service for four adults of any age with mental health needs. A service user guide is available to current or prospective service users, together with copies of the previous CSCI inspection reports. Weekly fees are £777.75 (Information current at (09/08/07) Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. Although only one service user was at home during this inspection the inspector was able to gain a comprehensive and detailed overview from speaking to this person who gave an in depth, honest and enlightening opinion on both the service provided and of how the home was run. The main focus of the inspection was on checking the progress made in complying with the statutory requirements made at the last inspection in February 2006. In depth discussions were held with both the proprietor and the manager of the home. Documentation examined included service users care plans, the service user’s guide, staff recruitment, supervision and training records and quality monitoring records. The service user who was at home gave the inspector an excellent tour of the premises, taking in some of the bedrooms, communal areas and the grounds of the home. The inspector would like to thank this service user for their trouble and for taking time out of their day to discuss; in detail, what it is like living at Abbey Lodge. The inspection indicated that the home was running very well, with a calm atmosphere and confident, well-trained and highly motivated staff was supporting service users. Only one requirement was made as a result of this inspection, which related to risk assessments. What the service does well: The manager and staff have managed to create an environment that is both supportive and respectful with regard to the current service users needs. The day-to-day routines of the home are presented in a way that gives people the flexilbity and autonomy that is on a par with any family/group living ethos. Various systems are in place to ensure that service users are fully consulted with decisions regarding the service and with the running of the home. All four service users are fully conversant and confident in raising their concerns or issues with the staff and with the manager. The standard of care planning is excellent and evidence seen on the day confirmed that all service users are fully involved in this process. A copy of each care plan is kept in the privacy of each service users bedroom bedroom. The proprietor and manager have created a very comfortable and welcoming home for its service users, with all areas decorated and maintained to a very high standard. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 6 The service users are provided with an individual daytime activity programme, which includes both 1:1 work with some service users whilst two people choose to attend the local daycentre in St Albans. During the inspection one service user returned home from a mornings swimming session with the manager. The home also provides regular day trips to the coast and places of local interest. All four-service users had the opportunity to have a two-week holiday in Mauritius in 2005 and are hoping to go again later this year. There are several systems in place in which to consult both service users, families and other relevant professionals and evidence was seen of a recent service user survey that had been conducted and action plan which has been drawn up from these outcomes. 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. The summary of this inspection report can be made available in other formats on request. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 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.V349216.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 –5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users individual aspirations and needs are assessed and reviewed, enabling the service users and the home to continuously review the individuals care package provided. A detailed statement of purpose and service users guide is in place in order for people to make an informed choice about where to live. EVIDENCE: Two files of service users who reside at Abbey Lodge were reviewed and evidence gained regarding the initial assessments that are carried out to access if the home can meet the needs of the service users. Detailed information is held regarding the service users history and current needs. Assessments of each service users needs and aspiration are made before the service user moves into the home. Competent people complete the assessments. The home also receives and seeks external specialist support to meet the individual service users needs. Care programme reviews occur to support the service users in achieving and reviewing individual needs, goals Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 9 and aspirations. The assessment process includes the gathering of information from other professionals. The admissions procedure includes trial visits for the service users to make an informed choice about where to live. A contract is then drawn between the service provider and the service user. The statement of purpose contains information for the service user to make an informed choice about where to live. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6 –10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are evident; with service users assessed needs and individual risks identified and clearly set out in plans that promote their health and welfare. Risk assessments require updating in order to ensure service users are safeguarded. EVIDENCE: The manager and staff should be congratulated on the standard of care planning within the home. Two service user plans were inspected and provided a detailed insight into the care, aspirations and needs of the service users. The care plans have been devised in a way that is easily understood and provided a true ‘working’ document. The inspector had the opportunity of discussing, in detail, with one service their current care plan and how consulted they felt in this process. The service user confirmed that they are fully involved in any changes to their care plan and had signed the current care plan in order to evidence that they are happy with this. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 11 There is a range of risk assessments in place. Although these risk assessments are both comprehensive and detailed the manager must ensure that when the date of review is not simply just crossed out and a new date inserted on every occasion as this does not alone, evidence that this risk assessment has been fully reviewed. There should be a new risk assessment drawn up periodically. Activities and outings enjoyed by the service users determined that service users are supported to take risks as part of an independent life style. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 –17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff provide excellent support so that service users can take part in the local community and leisure activities. Varied meals are provided which service users enjoy and which promote their well-being. EVIDENCE: Service users are provided an excellent range of opportunities for personal development. Two service users attend the local daycentre and one person is supported at home, through an individual programme, which is provided with staff support. Service users are encouraged to use the local community facilities. Service users have access to the homes on site transport as well as using local public transport independently. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 13 Staff support people in ensuring that meals are well balanced and that mealtimes are both flexible and relaxed. An excellent range of holidays is provided, which have included a trip to Mauritius in 2005. One service user was on holiday in France with his father at the time of the inspection. The home has a welcoming atmosphere and encourages service users families to visit whenever possible. The service user spoken to during the inspection confirmed that staff assist where necessary but also ensure people maintain their levels of independence with regard to daily living tasks and independent living skills. They were also very complementary about the daytime activities provided and especially the holiday to Mauritius, which was obviously thoroughly enjoyable and successful. They stated that “ the manager and proprietor introduced us to their families and we were made to feel very welcome. “We were also able to experience the local culture and try a variety of different foods.” “I felt very safe”. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 –20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in place ensure that service users are protected and have their needs met in a way they prefer. EVIDENCE: Care and support practices observed on the day of the inspection was both caring and sensitive. Care plans contain comprehensive information regarding residents health care needs. All staff members have medication training and have their competency authorised by a senior. There were no gaps found on the MAR sheets. There is a detailed medication policy in place, which is reviewed on an annual basis. There is currently no controlled medication held in the medication cupboards, however there is a robust procedure in place for the administration of these medications, if required. The home does not hold any homely remedies. The current arrangements for the dispensing of medication are straight from the prescribed bottles. Whilst the commission would prefer the dispensing of Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 15 medication to come from pre-ordered blister packs, it is acknowledged that the manager is in the process of negotiating with the local chemist to provide all medication in blister packs and therefore this is expected to be in operation before the next inspection takes place. There are no service users who are self medicating. However the manager carries out regular risk assessments in relation to this issue and will ensure that if appropriate, service users will be given the opportunity to maintain and manage their medication. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 16 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. 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. The complaints procedure is sufficient and adequate in order for the service users to feel that their individual views are listened too. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: There is a detailed complaints procedure in place. A record is maintained of any complaints made detailing actions and outcomes as necessary. No complaints have been received since the last inspection was carried out. All service users have been informed about the complaints procedure. This is on display within the home. A detailed procedure is in place to ensure that service users are protected from abuse and harm. Staff receive suitable and adequate safeguarding adults training. Staff employed are all subject to enhanced Criminal Records Bureau (CRB). The standard of training currently provided in relation to safeguarding adults is good. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 –30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The environment is maintained to an excellent standard throughout. The furnishings and fittings have been chosen to provide a very homely and comfortable place in which to live. EVIDENCE: The manager and proprietor have worked hard to create a very homely and comfortable environment in which service users can enjoy and relax in. The service users can enjoy a range of in-house entertainments, including a Television/DVD and video, which are located in the lounge. Also service users all have televisions in their bedrooms. The home has one bathroom/shower unit, a lounge and dining room. The kitchen is domestic in style and has all the necessary appliances. Staff maintain and record fridge and freezer temperatures. Hot water temperatures are maintained within safe limits. There is an adequately sized garden that Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 18 service user can enjoy in the warmer months. There is also an area for people who wish to smoke and an outhouse that provides a separate laundry facility. All areas of the home are maintained to a high standard. The standard of furnishings and fittings throughout are excellent and colours and fabrics’ chosen are complementary Clinical waste services are not required. All fire checks were up to date and recorded as follows – last fire drill 6/06/07.There was a current fire certificate dated the 28/11/06. The current fire certificate is dated the 15/8/06.The smoke detectors were checked on the 12/08/07.The last environmental health inspection was carried out in January 2007 and the legionalla check was carried out in June 2007. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 –36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and training of the permanent staff ensures that people are equipped with the necessary underpinning knowledge to provide the appropriate care and protection to service users. EVIDENCE: Staff are clear of their individual roles and responsibilities. There is a loyal core staff team that appear to have a good understanding of the current service users needs and abilities. The manager and proprietor were on duty at the time of the inspection. There are clearly defined job descriptions and person specifications in place. All staff have received a series of mandatory training course in order for them to meet the complex needs of the service users. Training in Safeguarding Adults is provided as part of a rolling mandatory training. The company has rigorous recruitment procedures that involve thorough vetting of applicants. Two staff Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 20 files examined contained photographs of the person, application forms, two positive references and CRB disclosures. All new staff receives structured induction and foundation training. The manager maintains detailed records in relation to training. Recent training includes, mental health training, health and safety (10/10/06) first aid (21/12/06), communication skills (7/12/06), diabetes training, food hygiene (30/05/07) and medication training (28/03/07). The manager ensures that all staff have mandatory training provided. Both the manager and Proprietor have NVQ level 4 in managment. One member of staff is commencing NVQ level 2 in September 2007.Three staff currently have NVQ level 2 and have now commenced level 3.The manager carries staff supervisions and staff meetings out on a regular basis and meets the required standard. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 & 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well managed home. Accurate health and safety records are maintained in order to safeguard service users, staff and visitors. EVIDENCE: The home is very well run, with service users benefiting from the support and guidance of the manager, proprietor and the committed and enthusiastic staff team. The manager has been in post since the home was registered and is experienced and qualified and provides strong leadership to the team. The home is operated in an inclusive manner that enables staff to contribute ideas Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 22 and the service users to have some control over their lives within a risk assessment framework. The home should be congratulated on implementing several systems of selfauditing/monitoring including their own service user, relative and professionals questionnaires. The manager and proprietor also carry out weekly and monthly checks on medication, environment and care planning to ensure that all systems are critically monitored and improved, where necessary. The manager has also been proactive in involving service users in some of the staff training courses, which have been relevant to both service users and staff. Adequate training is being provided to ensure staff have the necessary underpinning knowledge to carry out their role effectively. Supervision records are in place. Data Protection Act 1998 ensuring that service users rights and best interests are safe guarded by the homes polices and procedures. Records regarding staff were inspected and found to contain all the necessary information to meet this standard. Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 23 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 3 5 3 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 4 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 2 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 4 3 3 3 3 x Abbey Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 24 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 YA9 Regulation 13 (4) C Requirement To ensure that the relevant and current information is in place the current risk assessments must be updated and reviewed and new documentation completed where appropriate. Timescale for action 30/09/07 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 Lodge DS0000062483.V349216.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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.V349216.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!