Inspection on 09/05/06 for Abbeycrest Nursing Home

This inspection was carried out on 9th 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 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

Abbeycrest Nursing Home 28/06/07

Abbeycrest Nursing Home 11/10/05

Abbeycrest Nursing Home 19/07/05

Abbeycrest Nursing Home 15/11/04

Abbeycrest Nursing Home 18/05/04

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

CARE HOMES FOR OLDER PEOPLE Abbeycrest Nursing Home Essex Way Sonning Common Reading Berkshire RG4 9RG Lead Inspector Philippa MacMahon Unannounced Inspection 9th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abbeycrest Nursing Home Address Essex Way Sonning Common Reading Berkshire RG4 9RG 0118 9724414 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) Abbeycrest (Reading) Limited Mrs Lesley Jacqueline Wright Care Home 24 Category(ies) of Learning disability (2), Old age, not falling registration, with number within any other category (24) of places Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. On admission persons should be aged 60 years and over. The total number of persons accommodated must not exceed 24 The above LD category relates to two named individuals and CSCI will need to review any changes to the above 11th October 2005 Date of last inspection Brief Description of the Service: Abbeycrest is situated at the edge of Sonning Common village, near Reading. It provides accommodation and care for a maximum of 24 older people who require general nursing care. The building was originally a school and was converted for use as a residential care home in the 1980s. It is within reach of a local bus service, village shops, a library and the doctors’ surgery. Residents’ accommodation is provided in 14 single and 5 shared (double) rooms. All rooms are equipped with a washbasin. There are 3 bathrooms one on the ground floor and 2 on the first floor - and 3 separate lavatories. A small passenger lift and stairs serve the first floor. A dining room and sitting room on the ground floor and a combined sitting and dining area on the first floor provide the communal rooms. There is a very small room used as a laundry on the first floor and a kitchen on the ground floor. The home is set in a large plot of ground laid to grass, with a large mature tree, and overlooks a stretch of common land and public right of way across the fields at the rear. A paved patio area with garden seating is accessed from a fire exit door. There is a gravelled parking area for cars at the front of the home. The fee range for this service is currently £518 - £720 per week. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10am and was in the service for 6.hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector was offered a warm welcome by the staff and all cooperation was given. A sample of care plans was examined and this was followed through by meeting the residents to see if the plan matched the care delivered. Time was spent meeting with the registered manager, residents , and staff. The medication system was examined, and a tour of the building was undertaken. Lunch was taken with the residents in the dining room. Staff files, and other records required by regulation were examined. The facilities and the layout of the home do not meet many of the current National Minimum Standards for Care Homes for Older People. The proprietor has acknowledged this and has submitted numerous plans to South Oxfordshire District Council to build a new care home on the site of the present home. The first application was made in 1988 and each scheme and/or amendment has been rejected to date. The most recent amended application had been withdrawn on the advice of the Planning Officer and a new submission has been made in November 2005. The home was first registered as a care home in 1988 and, though it met the registration criteria at that time, much of the building is not suitable for more heavily dependent residents. The outcome of previous inspections by the Commission demonstrates that there are aspects of the home’s environment that must be improved or new provision made. The proprietor is in the process of selling the home to a new provider and it is anticipated that this will take place in August 2006. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The disposal of unwanted medication needs to be reviewed with the contractor. When residents take responsibility for their own medication a risk assessment needs to be undertaken and continuous monitoring put in place. An interim plan for the continued redecoration and refurbishment of the residents’ rooms needs to be drawn up even though there are plans to rebuild the home. It could be some time before any new build is completed and the present standard of décor is poor. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 7 The ongoing programme to provide opportunity for the residents to be involved in social and recreational pastimes needs to be progressed further to include more than one day a week. 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. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 8 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 Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 9 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): 1,3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All relevant information is given to prospective residents and every resident has a full assessment of their care needs prior to being admitted to the home. EVIDENCE: A copy of the most recent Service Users Guide and Statement of Purpose were given to the inspector by the registered manager who confirmed that these are made readily available to all the present and prospective residents. The registered manager carries out pre-admission assessment of care needs, and from this a decision is made as to whether the home is able to meet the individual person’s care needs. The inspector examined a sample of assessments and found them to be comprehensive and clearly reflecting the person’s care needs. Intermediate care is not provided at this home. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good system of care planning in place ensuring that the residents’ care needs are met. Overall the medication system is in good order; however a review of the disposal of unwanted medicines needs to be undertaken, and risk assessments put in place for people taking responsibility for their own medication. Staff have a clear understanding of the issues of privacy and dignity. EVIDENCE: The inspector examined a sample of care plans and followed this through by meeting the individual resident to see if the care delivered matched the care plan. On each occasion there was a clear “picture” of the person, their care needs and how these are being met. Residents spoken to said that they were well cared for and that they felt they were in good hands. One resident said, “I am very pleased with the care here and I am being encouraged to maintain my independence.” The sample of care plans had been regularly reviewed. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 11 The medication system was examined and found to be in good order. One of the residents has taken responsibility for giving their own medication and no risk assessment had been carried out. It is a good practice recommendation that a risk assessment should always be carried out with any resident who wishes to take responsibility for their own medication. The registered manager told the inspector that the disposal of unwanted medication is through a contractor, but any controlled drugs are returned to the local chemist. The registered manager was advised that this is no longer permissible and recommended that the contractor should be approached to ascertain if they are able to provide this service and if not pursue other contractors. The inspector observed staff assisting residents in a courteous and respectful manner, and noted that they always knocked on doors before entering a resident’s room, the toilets or bathroom. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The provision of activities is very limited. Meals and mealtimes are good and much appreciated by the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. EVIDENCE: One of the care assistants has a dual role of activities co-ordinator, and has a limited number of hours on one day a week to provide an opportunity for the residents to take part in planned activities. The registered manager explained to the inspector that it is planned to increase this amount of time but due to the proposed change of ownership in the near future this has been placed on hold. The inspector observed the staff sitting talking to residents on a one to one basis and engaged in meaningful conversation. Residents spoken to said how Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 13 much they enjoyed the day when activities are provided and really looked forward to this. Visitors are always made to feel very welcome and the inspector observed that one of the residents had a visitor at the time of this inspection and they were able to sit outside and enjoy the extensive views across the fields. A prospective resident’s family visited the home during this inspection, and were made to feel very welcome by the registered manager. Following this visit the family phoned back to say how much they liked the home and please could their relative come to live there. The residents’ rooms were all personalised with their own possessions that they had brought with them to the home. The local church provides a service of “songs of praise” once a month in the home, and a copy of the parish magazine is provided. The Catholic priest also attends the home on a regular basis. The inspector joined the residents for lunch in the dining room. The layout of the tables in this room is not very attractive, and for those people needing to be in their wheelchairs, it does not allow them to sit close to the table. It is recommended that the registered manager should look into other ways of positioning the tables in the dining room to enable those residents who need to remain in their wheelchairs to sit up to the table in comfort. Residents spoken to enjoyed all their meals and said that the cook was very good. The staff assisted residents who required help with their meal in a kindly, unhurried, appropriate manner. The inspector spoke to the kitchen staff, and examined the menus, and these showed that there was always a choice of meals available, and that a balanced diet is provided. Snacks and drinks are always readily available should the resident request it. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good complaints system in place. The staff are all aware of issues of the protection of vulnerable adults. EVIDENCE: The inspector observed that the complaints procedure is available on the notice board in the entrance hall and in the Service Users Guide. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The registered manager told the inspector that all staff receive training in the protection of vulnerable adults as part of their induction and ongoing training. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25,26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of the home’s furnishings, fittings and décor is poor and considering this, it is commendable that the standard of cleanliness throughout the home is good. There is no planned maintenance and redecoration programme in place. EVIDENCE: The inspector toured the building and observed that all areas are looking in need of redecoration or refurbishment. However, one of the double bedrooms was in the process of being decorated and a new carpet fitted whilst the resident is in hospital. As it is anticipated that the home is to come under new ownership in the near future and that there are plans to build a new home in the grounds, it is understandable that no further investment has been made. However, it is recommended that the registered manager should have a planned redecoration programme, as it could be some time before a new home Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 16 is ready for occupation and the residents deserve to have a pleasant environment to live in. All areas were found to be clean and orderly. A random selection of hot water outlet temperatures were recorded and two of these were in excess of 52ºC. This in the inspector’s view could pose a risk of residents being scalded. It is a requirement that a means of controlling the hot water temperature at close to 43ºC must be made, and that the registered manager reviews the method of recording all hot water temperatures on a weekly basis. The laundry was found to be clean and orderly and the staff are to be congratulated on working in the confines of such a small space and making the best use of the available space. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately staffed at all times, and the recruitment procedure for all staff is now robust to ensure the protection of the residents. The registered manager is committed to the training and development of all staff, and a good programme is being developed. EVIDENCE: The staff rosters examined showed that sufficient number and skill mix of staff were on duty at all times, to meet the care needs of the residents. A sample of staff files was examined and found to be complete and all the necessary checks were in place. Discussion with the registered manager and the training and development coordinator showed a real commitment to all staff having access to appropriate training and development. Four more care assistants have been registered on the NVQ level 2 in care programme. Once these are complete the National Minimum Standard of 50 of care staff being trained will have been met. Trained nurses have access to training in order to maintain their registration with the Nursing and Midwifery Council. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 18 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): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there is good teamwork with the registered nurses, care, housekeeping and kitchen staff. The inspector is unable to make a judgement with regard to the financial and accounting procedures, as these were not examined at the time of this inspection. EVIDENCE: The home is well managed by the registered manager who is a registered nurse and has completed the NVQ 4, Registered Manager’s Award. The inspector observed a staff handover meeting and was impressed by the excellent communication between the registered manager and her staff, all of Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 19 whom showed a good working knowledge of the residents’ daily and ongoing care. The registered manager does not have a deputy and no allocated supernumerary hours to carry out administrative tasks. This coupled with the uncertainties of the future under new ownership has put a lot of strain on all of the staff working in the home. There is no formal quality assurance system in place at the present time. However the registered manager does have an “open door” style of management and makes herself accessible both to the residents and their families. Satisfaction surveys have been carried out in the past and the registered manager is planning to develop a quality system in line with the National Minimum Standards in the future. There has been good consultation with the residents, families and staff about the new ownership and redevelopment of the home; this is commendable as they work through the change process. The proprietor’s daughter works part-time to maintain the accounts and financial records for the business, and deals with invoicing and staff salaries. She was not available at the time of this inspection. Records and receipts are kept of sundry expenses on behalf of the residents and the registered manager showed the inspector how this was now being managed, as previously there had been an issue of lack of clarity, and ability to trace the expenditure. A system of formal supervision is in place for all staff and this is recorded and kept on staff files. Records required by regulation were examined and found to be up to date and complete. As the home does not have a sluice disinfector machine for the effective cleaning and disinfection of commode inserts, advice has been sought from the community infection control nurse as to the most appropriate method to use. All staff have been instructed as to how to clean the inserts and urinals so as to protect the residents from any cross infection. Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 20 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 21 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 OP25 Regulation 13(4)(a) Requirement It is a requirement that a means of controlling the hot water temperature at close to 43ºC must be made, and that the registered manager reviews the method of recording all hot water temperatures on a weekly basis. Timescale for action 09/06/06 Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 22 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 OP9 Good Practice Recommendations It is a good practice recommendation that a risk assessment should always be carried out with any resident who wishes to take responsibility for their own medication. • It is further recommended that the contractor who deals with the disposal of unwanted medication should be approached to ascertain if they are able to dispose of controlled drugs and if not other contractors should be approached. It is recommended that the registered manager should look into other ways of positioning the tables in the dining room to enable those residents who need to remain in their wheelchairs to sit up to the table in comfort. It is recommended that the registered manager should have a planned redecoration programme for the home. • 2. OP15 3. OP19 Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU 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 Abbeycrest Nursing Home DS0000027139.V292967.R01.S.doc Version 5.1 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!