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Inspection on 08/01/09 for Abbeydale Nursing Home

Also see our care home review for Abbeydale Nursing Home for more information

This inspection was carried out on 8th January 2009.

CSCI found this care home to be providing an Adequate service.

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.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeydale Nursing Home 88 Handsworth Wood Road Handsworth Wood Birmingham West Midlands B20 2PL     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisa Evitts     Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Abbeydale Nursing Home 88 Handsworth Wood Road Handsworth Wood Birmingham West Midlands B20 2PL 01215545024 08707059966 Abbeydale@abbeydale.plus.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Jagruti Patel care home 35 Number of places (if applicable): Under 65 Over 65 35 35 dementia old age, not falling within any other category Additional conditions: 0 0 The maximum number of service users to be accommodated is 35. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 35 Old Age not falling within any other category (OP) 35 There shall be no further admissions of service users to Abbeydale Nursing Home without the prior written agreement of the Commission for social Care Inspection. Date of last inspection Brief description of the care home Abbeydale Nursing Home is a period house that has been adapted and extended with a two-storey extension to create a home offering nursing care for up to 35 older people who may also have dementia care needs. The home is situated in a residential area of Birmingham. The railway station is nearby and the home is on a bus route. There is one main lounge on the ground floor plus two further small lounges and a dining room. Care Homes for Older People Page 4 of 26 Brief description of the care home There are sixteen single bedrooms plus eight double bedrooms and seven have ensuite facilities. However, all en-suite facilities are not suitable for people with mobility problems. There are assisted bathing facilities on each floor, but space is limited and they are not all suitable to meet the needs of the people living in the home. A passenger lift gives access to all floors. To the side of the main building there is a laundry where laundering of all linen and clothing is undertaken. The kitchen is situated on the ground floor and there is also a large garden situated to the rear of the home. The area at the front of the home is made over largely for car parking, which is limited and contains well established herbaceous and shrub borders. At present there are no people living at the home and Birmingham City Council have terminated their contract with the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. At the time of the key visit in February 2008 only four people remained in the home. Some improvements were noted however We, the commission believed that the low numbers of people living in the home, high staff ratio and the input from the Primary Care Trust were the reason for the improvements in outcomes for the people living at the home. Following concerns raised about the home, Birmingham City Council had ceased contracting with the home and people were in the process of moving to Care Homes for Older People Page 6 of 26 alternative accommodation. Since the last key visit to the home a random inspection was undertaken in May 2008, to monitor the homes progress. At this visit there was no one living at the home and no nursing or care staff were working there. We were able to gain access to the building and a tour of the premises was completed which identified a number of concerns about the fitness of the building and requirements were made to make improvements. Due to the seriousness of the concerns we imposed a condition on the registration of the home, which means that they cannot admit anyone into the home without our prior written agreement and means that we would need to be satisfied that the building was fit for purpose. One inspector visited the home to undertake an inspection, as the service remains registered. We were unable to gain access to the building and it was clear that no one was living or working there. Therefore this report is a summary of information from the time of the last key inspection. We were unable to review the outstanding requirements and recommendations, which were made at previous inspections of the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. At the previous key inspection the collection of information about peoples needs before they moved into the home was adequate and enabled staff to determine if they could meet their needs when they moved in. Evidence: Birmingham City Council had ceased contracting with the home and therefore there have been no new admissions into the home for some time. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. At the previous key inspection, the home had not been able to consistently deliver a service that met the personal and health care needs of the people living there without the support of nurses from the Primary care Trust. Evidence: At the time of the last key inspection nurses from the Primary Care Trust were visiting the home to monitor the conditions of the people living there and to provide support and advice to staff. People were in the process of moving out of the home and there were only four people living there. Care Homes for Older People Page 11 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. At the previous key inspection it could not be evidenced that the social care needs of the people living in the home were being met. Food records did not evidence that the cultural needs of the people living in the home were being met. Evidence: At the last key inspection as there were only four people living in the home, they were getting a considerable amount of one to one staff time. Two people spoken to were content and satisfied with the service they were receiving but were aware that they would be moving home. Care plans for spiritual/social and cultural needs did not inform staff how they should assist people to meet these needs. There was evidence that people had visitors to enable them to maintain relationships that were important to them. There did not appear to be any rigid rules or routines in the home and the people that were able to move around the home on their own were seen to do so without any restrictions put on them. They were able to make some choices in their daily lives, for Care Homes for Older People Page 12 of 26 Evidence: example, when to get up and go to bed and what to do with their time. If they wanted to spend time in their rooms this was not an issue. Care Homes for Older People Page 13 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit. As there was no one living at the home there are no concerns about peoples safety. At the previous key inspection it could not be evidenced that the people living in the home were safeguarded from harm. Evidence: At the last visit to the home there had been a history of complaints and concerns being raised about the home and some of these had led to safeguarding procedures which had involved the police. However no further action was taken as a result of the investigations. Concerns were raised about the managers approach and attitude, the quality of the food, lack of bathing facilities and working arrangements of staff in the home. Staff were found to be working excessive hours and requirements were made to address the excessive hours which put the people living in the home and staff at risk. None of the concerns detailed above were included in the complaints log. Only one complaint was detailed which had been raised by a member of staff in relation to not having adequate supplies of incontinence aids and soap available and which of the people they were to get up in the morning. The manager had investigated this and parts of the investigation were documented. Care Homes for Older People Page 14 of 26 Evidence: The proprietor had co operated with vulnerable adults investigations and staff had received training in adult protection issues to help resolve the issues being raised. We have not received any further complaints about the home. Care Homes for Older People Page 15 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. We were not able to gain access to the building. At the previous inspection there had been some improvements in the environment and decoration. Further improvements are required to ensure that the building is fit for purpose and would meet the needs of the people who may live there. Evidence: A random inspection was undertaken in May 2008 and a tour of the home was completed. The heating was on to ensure an adequate temperature was maintained. Lounges were generally unchanged from previously, the flooring in the dining room was wet and it appeared there might be a leak from the skylight. There were a number of things found that needed to be improved such as electrical wires dangling from the ceiling in one room, wet and stained flooring, ripped carpets, damaged walls and equipment. Some toilets were out of order or damaged, bath panels were cracked. One toilet seat had been replaced but it did not fit properly and could cause an injury. There was no cold water from some taps in hand basins and a number of toilets had little or no water in the bowls. A sluice area had not had the upgrade completed; the passenger lift and pay phone were out of order. There was a mound of rubbish in the garden. Hoisting equipment was available but there was no indication whether this had been serviced to ensure they were safe to use. Care Homes for Older People Page 16 of 26 Evidence: Following this visit we imposed a condition on the registration of the home, which means that they cannot admit anyone into the home without our prior written agreement and means that we would need to be satisfied that the building was fit for purpose and would meet peoples needs. On the day of this visit we were unable to gain access to the home and there was a notice on the main door stating that it was out of order. A notice requested post to be put through the porch door, which was locked, and the home was in darkness. Care Homes for Older People Page 17 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. At the previous key visit appropriate staffing levels were being maintained to meet the needs of the people living in the home. Staff files indicated staff had undertaken a variety of training to enable them to care for the people living in the home appropriately. Evidence: At the last visit to the home no new staff had been employed and the numbers of staff had reduced as the people living in the home had moved to other facilities. Staffing levels were found to be appropriate with two staff being on duty throughout the day and night one of these being a qualified nurse. Ancillary staff were also still available in the home. Staff did not appear to be working excessive hours. Care Homes for Older People Page 18 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It was not possible to review this outcome group at this visit, as there was no one living or working at the home. At the previous inspection the home was not run in a way that ensured the best interests of the people living in the home were maintained. Evidence: The home has a long history of a poor response to the requirements made by us. They had not been able to consistently deliver a service that met the needs of the people living in the home and maintain their health and well being. A decision was made by Birmingham City Council to cease contracting with the home, which meant that they would not pay for anyone to live there. Care Homes for Older People Page 19 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 2 2 A contract of residence must 08/01/2009 be provided to all the people living in the home and their representatives. This will ensure the people living in the home are provided with all the information about the terms and conditions of their stay in the home. Timescale of 30/4/07. 2 4 12(1) 18(1) All staff must receive training 08/01/2009 in caring for people with dementia commensurate with their position in the home. This will ensure staff have the appropriate skills and knowledge to care for the people living in the home. Timescale of 30/10/05. 3 7 12(1) All care plans must: Detail the individual needs of the people living in the home and how they are to be met by staff. Be updated following reassessment, evaluation or change in the conditions of the people living in the home to ensure 08/01/2009 Care Homes for Older People Page 20 of 26 up to date information is available to everyone. Previous time scale of 30/12/07. 4 8 13(4) The management plans that 08/01/2009 are in place for any identified risks must be comprehensive and be updated as changes occur. This will ensure the people living in the home are not exposed to any unnecessary risks. Timescale of 27/05/08. 5 8 18(1) Staff must be provided with training in respect of handling aggression. This will ensure the people living in the home and the staff are safe. 08/01/2009 6 10 16(2)(a)(i) The telephone must be in working order to enable anyone admitted to the home to make calls. 08/01/2009 7 15 12(4)(b) There must be evidence on 08/01/2009 site that the dietary needs in relation to the culture of the people living have been met. This will ensure that the people living in the home are receiving the appropriate foods. 8 16 22 The record of complaints must clearly indicate the nature of all complaints, the 08/01/2009 Care Homes for Older People Page 21 of 26 investigation, the outcome and resolution. Previous time scale of 20/12/07. This will ensure all complaints raised are recorded and have been managed appropriately and people are confident their views are listened to. 9 20 23(2)(g) Plans with timescales for 08/01/2009 extension to the communal space should be forwarded to the Commission. This will ensure there is adequate communal space for the use of the people living in the home. Timescale May 2004. 10 20 23(2)(b) Make repairs to all areas where water leaks were identified e.g. dining room, bathroom, bedroom to ensure the premises are fit for purpose. Ensure all bathrooms and toilets are in full working order so that they can be used by anyone admitted to the home. The passenger lift must be fully operational at all times for anyone admitted to the home to use. 08/01/2009 11 21 23(j) 08/01/2009 12 22 23(2)(b)(n) 08/01/2009 13 22 22 Ensure all manual handling 08/01/2009 equipment is fit for use and there is evidence of servicing to reduce the risk of infection Page 22 of 26 Care Homes for Older People control or accidents. 14 24 13(4)23(2) Ensure the carpets in the home are not damaged in order to reduce the risk of accidents. 08/01/2009 15 24 23(j) Ensure a hot and cold water 08/01/2009 supply from all water outlets at all times for anyone admitted to the home. 16 24 13(4)23(2)(b) The electrical wiring in the 08/01/2009 home must be made safe. An audit of all areas must be undertaken to ensure electrical wiring is safe and evidence provided to demonstrate this. 19 A record of up to date PIN 08/01/2009 numbers must be kept in the home for all nurses. Evidence of staff eligibility to work must be available for inspection. This will ensure the people living in the home are safeguarded. 17 29 18 38 13(4) Evidence must be forwarded 17(2)23(4)(c) to the CSCI that: (iv) The emergency call bell system. Time scale of 04/12/07. The gas equipment. The electrical wiring. Have been serviced/checked at the required intervals. 08/01/2009 Care Homes for Older People Page 23 of 26 This will ensure the safety of the staff and the people living in the home. Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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!