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Inspection on 16/01/06 for Abbey Lodge Residential Care Home

Also see our care home review for Abbey Lodge Residential Care Home for more information

This inspection was carried out on 16th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents are treated with kindness and respect. Comments from residents on the day of inspection included: "the home is absolutely wonderful"; "I consider myself fortunate to be cared for here"; "staff are extraordinarily kind"; "staff always have a smile." Residents feel comfortable in expressing their views and where necessary complaining. They are regularly consulted on their views of the care they receive. One resident said, "they ask for my opinion." Another said, "they are good listeners." Residents are regularly offered opportunities to take part in a social or recreational activity. One resident said, "there is always something to keep your mind occupied." Care plans remain at a very high standard.

What has improved since the last inspection?

The manager and deputy manager are now trained First Aid trainers, and the manager is a trained Moving and Handling trainer. A comprehensive "in house" training package has been purchased, and plans are underway to commence this training with staff shortly. This will help staff in maintaining and learning new skills and develop their understanding which will benefit the residents. The results of residents` surveys on how they are experiencing life are now being more effectively fed back to both the residents and staff. A system for ensuring staff read and understand the home`s policies and procedures has been introduced. The manager is continuously reviewing and refining forms and paperwork so that the care can be provided more effectively to the residents. Complaints recordings have improved.

What the care home could do better:

Paper towels in wall-mounted dispensers must be provided in toilets and bathrooms. These are now in place in the kitchen. Staff would benefit from receiving training on adult abuse, basic food hygiene and infection control. As identified in a recent residents` survey, some residents would like to be more involved with their care plans.

CARE HOMES FOR OLDER PEOPLE Abbey Lodge Abbey Lodge Residential Home 91 Seabrook Road Hythe Kent CT21 5QP Lead Inspector Julian Graham Announced Inspection 16th January 2006 09:30 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 Lodge DS0000059725.V265060.R01.S.doc Version 5.0 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 Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbey Lodge Address Abbey Lodge Residential Home 91 Seabrook Road Hythe Kent CT21 5QP 01303 265175 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) Abbey Lodge (Residential Home) Ltd Mrs Elizabeth Caroline Bown Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with a diagnosis of DE(E) to be restricted to two (2) whose dates of birth are 24/12/1920 and 06/08/1913. 14th July 2005 Date of last inspection Brief Description of the Service: Abbey Lodge provides accommodation and personal care for up to 17 Older People. The premises is detached and has 16 single and 1 double bedroom which are occupied on a single basis. Fifteen of the bedrooms have ensuite facilities. Accommodation is on the ground, first and second floor. There is a shaft lift servicing all floors and also a stair lift. Three bathrooms are available for residents’ use, two of which are assisted. There are communal sitting areas on all three floors allowing residents a choice of where to sit. One of the proprietors (Mrs Elizabeth Bown) manages the home and has gained the Registered Manager’s Award. The home has achieved the Investors in People Award. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 09.30 and lasted around five hours. Most of the time was spent talking with the residents, including having lunch with them. The deputy manager, cook and cleaner were spoken with and two care staff were interviewed privately. Staff were observed directly and indirectly as they were going about their work with the residents. A visiting relative was spoken with. Time was spent with the manager looking at a small sample of the paperwork and the some parts of the premises were viewed. Prior to the inspection, the commission received a pre-inspection questionnaire and self-assessment form, which were completed in a thorough manner by the manager. In addition, seven feedback comment cards were received from residents, and ten from relatives. One relative took the trouble to write a letter outlining his views of the home to the inspector. All this feedback was extremely positive. Examples of some of the comments received from relatives include: “the staff are exceptional”; “couldn’t wish for a better place”; “a really well run, happy, family run home”; “she is very happy there, because she tells us often”; “the standard of care is superb”. What the service does well: What has improved since the last inspection? The manager and deputy manager are now trained First Aid trainers, and the manager is a trained Moving and Handling trainer. A comprehensive “in house” training package has been purchased, and plans are underway to commence this training with staff shortly. This will help staff Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 6 in maintaining and learning new skills and develop their understanding which will benefit the residents. The results of residents’ surveys on how they are experiencing life are now being more effectively fed back to both the residents and staff. A system for ensuring staff read and understand the home’s policies and procedures has been introduced. The manager is continuously reviewing and refining forms and paperwork so that the care can be provided more effectively to the residents. Complaints recordings have improved. 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 Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 The care planning system remains at a high standard. Residents’ health is promoted. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Previous inspections revealed that an excellent care planning system is in place, with regular and effective monitoring and review. A small sample was briefly viewed on this occasion, confirming these high standards. A recent residents’ feedback survey showed that all residents are aware of their care plans, but that some want more involvement. The home has noted this, and steps are being taken to respond effectively to these requests. Residents said that their health care needs are being met, with staff arranging for them to see their GP or other health care specialists, like optician, when they need to. Staff who were interviewed were clear as to their role of promoting residents’ dignity and privacy, with one giving a good example of how she would assist a resident in having a bath, demonstrating sound understanding of good care practice. Residents said that staff always knock and wait for an answer before entering their rooms, and this was seen on the day. All the residents were looking very nicely presented. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 10 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): 12,13,14,15 Opportunities for residents to have an interesting day are regularly given. Contact with relatives and friends is encouraged. Routines are flexible and residents are able to take part in the life of the home where they wish. The meals in the home are good offering both choice and variety. EVIDENCE: A variety of activities are available to residents to enable them to have an interesting day. These include ball and board games, skittles, sing-alongs and so on. One of the proprietors takes residents into town for a coffee or a walk along the beach each week. Comments in a recent residents’ survey and meeting has led to the home giving the residents a day’s notice before an outing, demonstrating that the home is listening to what the residents are saying and taking appropriate action. Residents said that visitors are always made welcome when they come, and are always given a cup of tea or coffee. A visiting relative on the day confirmed this, and spoke very well of the home. One resident is continuing to help out with some household tasks like laying the table, and chooses to clean her room herself. Routines remain very flexible with residents saying they can please themselves when they get up and go to bed. Staff were very clear that residents are helped to exercise choice and control over their lives. Menus were viewed, and these were seen to have been reviewed recently. Results of the recent residents’ feedback survey regarding meals provided were positive, with all residents saying they are very satisfied Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 11 with the food. Comments from residents on the day of inspection confirmed this. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 12 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): 16,18 Residents know their complaints will be listened to, taken seriously and acted upon. Residents are being protected from abuse. EVIDENCE: All the residents spoken with, were adamant that should they have anything to complain about, they would be listened to and their concerns taken very seriously. The home is now making complaints records individually and separately to preserve confidentiality, as required from the last inspection. Complaints records seen showed that the home responds quickly to complaints and takes appropriate action. Both staff who were interviewed knew what action to take in the event of any allegation or suspicion of abuse, and confirmed that the abuse procedure was covered in their induction training, including watching a video on abuse. Staff would however benefit from further training on abuse and this is a requirement of this report. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 13 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): 19,20,21,24,26 The standard of the environment is good, providing residents with a comfortable and homely place to live. Good standards of cleanliness are being maintained. EVIDENCE: A tour of the communal areas of the home revealed good decorative standards, and a sample of bedrooms seen were very comfortable and attractive, with good evidence of residents being able to personalise their rooms and bring in small items of their own furniture and other possessions. Matters requiring attention from the last inspection have been addressed. Toilets and bathrooms were clean and hygienic. To minimise the risk of cross infection, however, these rooms must be provided with paper towels in wall mounted dispensers, and pedal bins. The home was at a comfortable temperature, clean and free from offensive odours. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 14 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): 27,28,30 Staffing levels are sufficient to meet residents’ needs. Staff morale is good resulting in a motivated team that works positively with the residents to improve their quality of life. Arrangements for training the staff are generally good, although training in some areas is required. EVIDENCE: All residents spoken with said that the home is meeting their needs, and that staff are always there for them, and respond promptly to any calls for assistance. Staff said that they are not rushed in their work and have plenty of time to fulfil their duties effectively. This would indicate that staffing levels are satisfactory. The pre-inspection questionnaire shows that the home is moving towards the standard of fifty percent trained staff. The manager said that four staff have a NVQ, with four more in the process of obtaining this qualification. Staff said that they have had training recently on dementia, medication and moving and handling. The training matrix shows some gaps in training for staff in safe working practices, such as infection control and basic food hygiene. Requirements have been made in this report to address this. However, the home has recently purchased an in-house training package covering a wide range of areas, including food hygiene and infection control, which the manager is now in the process of implementing. This training will be undertaken “in house”, with staff needing to complete question and answer papers, which will be marked externally. The manager is also a trainer in moving and handling and First Aid. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 15 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): 31,32,33,36,37,38 Residents are benefiting from a well run home. The systems for resident consultation are good. Records are well maintained. EVIDENCE: The manager is qualified and experienced and is continually updating her knowledge. She is also continually looking at ways the care and service could improve, with regular and effective consultation with staff and residents, in which comments and suggestions are welcomed. Quality assurance systems are in place with residents’ surveys and meetings, and maintenance schedules. A feedback questionnaire for relatives is being developed. There is an open and friendly atmosphere in the home, and both residents and staff said that the manager is very approachable. Staff said they enjoy working in the home and feel supported in their work. Formal one to one supervision is provided for staff on a regular basis, which staff said they find helpful. The domestic staff said that it is good to receive positive feedback about her work from the manager. Some records were viewed on this occasion, including care plans, complaints Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 16 and accident records, and these were well maintained. The pre-inspection questionnaire showed that equipment and appliances are being serviced appropriately. Environmental risk assessments are in place and are being reviewed. Whilst no obvious health and safety hazards were seen, the radiator in one of the bathrooms was not protected and was hot to the touch. The manager said that this room is only used by one or two residents who are supervised at all times; and therefore the radiator is not amounting to a significant risk. It is recommended that this is reflected in the risk assessment, and regularly reviewed. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x x 3 x 2 STAFFING Standard No Score 27 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 x x 3 3 2 Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? no 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 OP26 Regulation 13 Requirement Paper towels in wall mounted dispensers and pedal bins to be provided in bathrooms and toilets. Staff to receive training in infection control, basic food hygiene and adult abuse. Timescale for action 16/02/06 2 OP30 19 16/05/06 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 OP38 Good Practice Recommendations The risk assessment in respect of the radiator in the bathroom containing the hipbath to be updated and regularly reviewed. Abbey Lodge DS0000059725.V265060.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000059725.V265060.R01.S.doc Version 5.0 Page 20 - 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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