Inspection on 05/06/07 for Abbey The

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Abbey The 13/02/06

Abbey The 03/11/04

Abbey The 12/05/04

Similar services:

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Braeburn House - North Yorkshire County Council

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

CARE HOMES FOR OLDER PEOPLE Abbey The Town Street Old Malton Malton North Yorkshire YO17 7HB Lead Inspector Pauline O`Rourke Key Unannounced Inspection 5th June 2007 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 DS0000007737.V333224.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 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. DS0000007737.V333224.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey The Address Town Street Old Malton Malton North Yorkshire YO17 7HB 01653 692256 F/P01653 692256 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) Mr Walter Bishop Mrs Josephine Anne Bishop Mrs Ann Race Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places DS0000007737.V333224.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 Brief Description of the Service: The Abbey is registered to provide accommodation and personal care for a maximum of twenty-four older people. Ann Race is the Registered Manager and Mr and Mrs Bishop are the owners. The Abbey is a large detached Grade II listed property set in extensive grounds. The original building dates from the 12th Century. The care home is located in the old town area of Malton and is conveniently situated for all of the main community facilities including the public transport network. There are gardens to the front and back of the property that have seating for use by the people who live there. There are 16 single and 4 double bedrooms. It is the policy of the home that bedrooms will only be shared with the full agreement of the person involved and/or their representatives. There are stairs and a passenger lift to both floors. All of the bedrooms, have en suite facilities consisting of a bath, toilet and wash-hand basin. There is a main lounge, dining room and several small lounges or quiet areas for use by the people on the ground floor. Information about the service is available on request from the home and it can be provided in a variety of formats. On the 12th June 2007 the cost to the residents was between £325 and £450 per week. DS0000007737.V333224.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on a pre inspection questionnaire. Comment cards returned from five people who live at the Abbey, four relatives, four GP’s, one health care professional and one care manager. and one healthcare professiona.l A visit to the home carried out by one inspector that lasted five hours. During the visit to the home five residents, three staff and three visitors were spoken with. Care records relating to three people, three staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at The Abbey for the people living there. The manager, Mrs Ann Race and the proprietors Mr and Mrs Bishop were available to assist throughout the visit and for feedback at the close. What the service does well: The service provided at The Abbey continues to provide a high level of service. People living there can choose how they want to live their lives and can contribute to the lives of others. The service is well integrated in to the community. People who live at The Abbey appreciate the help and support they receive from the staff. People said: “This home is in my village and always had a good relationship, so I came in and feel safe and very happy. It is a very caring home with loving staff”. My daughters checked other homes and felt that the Abbey was the best based on the staff relationships with residents. A visiting professional commented: Carers have added to the quality of life and in some cases helped reduce isolation for individuals, so much so that confidence has been repaired and independence re-established. There is a full programme of activities and people enjoy the variety available. All the people spoken with enjoy the food provided: DS0000007737.V333224.R01.S.doc Version 5.2 Page 6 “The queen could eat here” “We have some very good cooks and the meals are lovely”. The home is clean and tidy and people can move freely around the building. The home is well maintained and all equipment is serviced at regular intervals. 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. DS0000007737.V333224.R01.S.doc Version 5.2 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 DS0000007737.V333224.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply. People who use the service experience excellent quality outcomes in this area. People who decide to use this service can be assured their individual needs will be assessed and recorded prior to entering the home so their needs will be met and will be given information so they can make an informed choice about going to live there. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Information about The Abbey is in the Service User Guide and this is given to people interested in coming to live at The Abbey. Three case files were seen they all contained assessment information from which a care plan was developed. The manager always carries out her own assessment even if other care professionals are involved. These assessments cover all aspects of the person’s health, care and social life. Staff spoken with said that they always DS0000007737.V333224.R01.S.doc Version 5.2 Page 9 had enough information about someone new to provide them with appropriate assistance. The also said that the first care plan was a starting point and for the first few weeks they continually assessed people so that at their initial review the information they had was enough to inform decisions about whether the person was stopping on a permanent basis. One relative spoken was impressed that there was a care plan in place on the day the person she cared for was admitted for a short stay. DS0000007737.V333224.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience excellent quality outcomes in this area. People who live at The Abbey have their personal and health care needs met by staff that work in way that promotes dignity, respect and independence. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A plan of care was in place for each of the people living at The Abbey. Three plans seen showed that they were pertinent to the individual concerned. The health care needs and the involvement of health professionals was recorded. This included medical, dental and optical appointments. Records were maintained on each person on a daily basis detailing their changing needs and the care provided. DS0000007737.V333224.R01.S.doc Version 5.2 Page 11 The risks associated with caring for individuals were also recorded, such as risk of falling or development of pressure sores. Some people need assistance to bath, and the need for use of hoisting equipment was also recorded. Whilst one person had specialised bed the bed rails were not in place because it had been recognised that the person may attempt to climb over them and be at risk of a potential serious injury. People praised the care staff and the care they received. One said, ‘We have good care here’. Feedback received from relatives said ‘Service meets the needs of my relative’ and ‘the staff are wonderful they have been caring for my friend and she is very comfortable here’ One health care professional commented ‘Staff respond to individuals as individuals. Carers have added to the quality of life and in some cases helped reduce isolation for individuals, so much so that confidence has been repaired and independence re-established’ A GP also said ‘Excellent caring environment. There is always someone senior to discuss service users with and staff have a clear understanding of peoples needs’. The administration and storage of the medication was seen to be satisfactory. One person looks after his or her own medicines and there was a risk assessment in place for this. The home uses a monitored dosage system for the medication and the records seen were accurate and up to date including information about medication taken occasionally. The controlled drugs were stored separately and the record showed that two members of staff administer this medication. All staff that administer medication have been on a distancelearning course in the safe handling of medicines. During the visit interactions were observed between people in the home, visitors and staff and dignity and respect were shown to everyone. People spoken with said that staff provided care in a way that was sensitive to their need for privacy and dignity. DS0000007737.V333224.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. People enjoy the fulfilling lifestyle that they experience at The Abbey, and a varied and well balanced diet. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: During the visit people were seen coming and going at will. People said ‘you can do as you like here’ and ‘staff let you get on with what you want to do you don’t have to join in with anything you don’t want to’ The activities organiser had displayed activities available for the coming month. Events such as musical memories, bingo, a reading group, entertainers and trips out to Ryedale Folk Museum and Castle Howard. People spoken with said that they ‘enjoy the activities’. Staff also said that they had time to spend with people on a one-to-one basis or as a group. DS0000007737.V333224.R01.S.doc Version 5.2 Page 13 Visitors spoken with said ‘we are always made welcome and offered a cup of tea when we arrive’ and ‘the staff are wonderful they keep us informed about the condition of my relative’ There is a visitors’ policy and this allows for people to say if they don’t want to see anyone. During the visit visitors came and went as they wanted, they knew the names of the staff, other people in the home and all said hello to the manager. There is a four-week menu in place and this is devised by the cook in consultation with people who live in the home. They use fresh local products and on the day of the visit the meal prepared was home made. People who live at The Abbey said that all the meals were home cooked. It was well presented and people were offered appropriate sauces and condiments. The home caters for three vegetarian and one diabetic diet. People said ‘We have some very good cooks and the meals are lovely’ ‘We receive good support and the food is usually good’ and ‘the food is good enough for the queen to eat here’. People who required help with their meal were assisted in a way that preserved their dignity. DS0000007737.V333224.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience excellent quality outcomes in this area. People are safe and they and their relatives can be confident they will be listened to. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There have been no complaints since the last visit. People are given information about how to complain when they move in to The Abbey; it is in the Service User Guide. People spoken to all said they would take any concerns to the manager. One relative said ‘in the beginning we were told by Anne that she operates an open door policy so if we had any concerns then we could tell her at any time.’ People are reminded of the complaints policy during staff meetings, and with people in a one-to-one basis. All staff have had training in the safeguarding of vulnerable adults. This is cascaded to them from the manager who has developed a programme designed to train staffing in the protection of vulnerable adults. The training meets the requirements of the ‘No secrets’ document that is produced by the Department of Health and follows procedures laid out in the North Yorkshire County Council multi agency policy. Staffs understanding of the training is checked by a written questionnaire. Staff were clear about reporting procedures. DS0000007737.V333224.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience excellent quality outcomes in this area. People live in a well maintained and clean house that is homely in style We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is well maintained and presented it is decorated in a homely style. . All areas of the home were clean and odour free. A relative said ‘Very good homely house, which is helped by good management’ and ‘it also functions like one large family home-not an institution’. People who live at The Abbey were spoken with and they said ‘they enjoyed going out in to the garden when it was warm’. There are several quiet areas they can sit if the do not want to be in the main lounge. DS0000007737.V333224.R01.S.doc Version 5.2 Page 16 The pre-inspection questionnaire informed this inspection that the equipment is well maintained and serviced within the recommended guidelines. There is an infection control policy in place and staff were aware of it. The cleaning routines in the house are implemented fully and this is reflected in the high standards throughout the house. The laundry is appropriate for the needs of the people living at The Abbey. DS0000007737.V333224.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. People who use the service experience excellent quality outcomes in this area. People who live at The Abbey are supported by well trained staff whose suitability to work with vulnerable people has been properly checked. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a rigorous recruitment process and the three staff records confirmed this. They contained training information, an application form, a Criminal Records Bureau disclosure and/or a POVAFIRST check, two references and a contract of employment. One of these was a recently employed member of staff and during the visit she brought a signed contract in. All staff have an interview before commencing their employment. The pre inspection questionnaire identified 73 of the staff group as having a National Vocational Qualifications level 2 in care. Several have gone on and completed their level 3 as well. Staff are employed in sufficient numbers to provide the level of support that people need, through the day and through the night. Staff training is feely available and two staff spoken with said ‘ you can have as much training as you want’ and Ann is really keen on training’. Some of the topics covered DS0000007737.V333224.R01.S.doc Version 5.2 Page 18 include, dementia awareness, elder abuse, first aid, infection control, back awareness, fire safety, medication, health and nutrition, non-direct care and mental health issues. Feedback received from people who live at The Abbey said: • My daughters checked other homes and felt that The Abbey was the best based on the staff relationships with residents. • A very caring home with loving staff. • My relative has only been at The Abbey for 6 months. The staff, soon made him feel at home which made things easier for both of us. Feedback received from a visiting professional stated: • Carers have added to the quality of life and in some cases helped reduce isolation for individuals, so much so that confidence has been repaired and independence re-established. DS0000007737.V333224.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience excellent quality outcomes in this area. The home is managed in an inclusive way that allows the people who live there to express their views. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager operates an open door policy and people who live work and visit the home were seen freely entering the office to speak to her. Evidence was seen during the visit that she keeps her training up to date. Visitors spoken with during the visit said: DS0000007737.V333224.R01.S.doc Version 5.2 Page 20 • • Anne is very friendly and is always pleased to see u.s We can go to Anne anytime if we have any concerns. People who live in the home said: • • The manager is always pleased to see us Anne is like a member of the family. Staff spoken with said that the manager was always approachable and provided them with good support. The manager is supported by Mr and Mrs Bishop the proprietors. There is a quality assurance system in place and this is reviewed annually. This covers monthly administration tasks, collecting the view of people who live in the home, and staff, regular maintenance of the building and general issues. There are staff meetings and peoples opinions are sought, although they are not recorded, abut what is happening in the home. A quarterly newsletter is produced to inform people in the home, staff relatives and visiting professionals about what is happening in the home. People who live in the home manage their own finances and lockable facilities are provided for them to store their money and valuables safely. If someone wants the manager to hold his or her personal monies records are in place to ensure that it can be audited at anytime to ensure it is accurate. All health and safety documents are up to date and in place. Staff training is up to date in fire training, first aid, manual handling, and infection control and food hygiene. All accidents and incidents are properly recorded and when necessary they are reported to the Commission of Social Care Inspection. DS0000007737.V333224.R01.S.doc Version 5.2 Page 21 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 DS0000007737.V333224.R01.S.doc Version 5.2 Page 22 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. 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 DS0000007737.V333224.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000007737.V333224.R01.S.doc Version 5.2 Page 24 - 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!