Inspection on 09/12/08 for Abbeydale Residential Care Home

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeydale Residential Care Home 179 Bolton Road Elton Bury Lancashire BL8 2NR     The quality rating for this care home is:   two star good 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: Grace Tarney     Date: 0 9 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 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 27 Information about the care home Name of care home: Address: Abbeydale Residential Care Home 179 Bolton Road Elton Bury Lancashire BL8 2NR 01617615613 01617615612 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karen Lesley Barlow Type of registration: Number of places registered: Prime Healthcare (Bury) Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 32 Date of last inspection Brief description of the care home Abbeydale is a converted house situated on a main bus route not far from Bury Town Centre. It is close by to local shops and other amenities and not too far from other public transport and the motorway network. Car parking is provided at the front of the home and there are safe garden areas at the back of the home. The home is registered to provide personal care services for up to 32 elderly residents. There are lounges and dining rooms on the ground floor. Bedrooms, bathrooms and toilets are situated on the ground and first floor. The fees range from £378.89 to £420 per week. The charges Care Homes for Older People Page 4 of 27 Over 65 32 0 Brief description of the care home depend on whether the fees are paid for privately or by the local authority and whether the rooms are single, shared or have an ensuite toilet. Additional charges are made for private chiropody, hairdressing and individual newspapers. This information was received on the 7th January 2009. A copy of the last inspection report is displayed in the reception area. Care Homes for Older People Page 5 of 27 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: two star good 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: This inspection visit to the home by 1 Inspector lasted 8 hours. The management and staff did not know that we (the commission) were going to visit. Several weeks before the visit to the home we asked the manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we do. Also several weeks before the inspection visit we sent out questionnaires to the residents and relatives asking them what they thought of the care and quality of the service provided. 3 resident and 3 relative questionnaires were returned. Some of their responses are detailed in different sections of this report. Care Homes for Older People Page 6 of 27 During our visit to the home we looked at care and medicine records to make sure that the staff knew how to look after the residents and that their health and care needs were being met. We also looked around most of the building to check if it was clean, warm and well decorated. We also looked at what the residents were having for their meals, to make sure that there was a choice of meals and that they were varied, good and wholesome. We also checked how many staff were provided on each shift to make sure the residents needs were being met. We then looked to see if management recruited and trained the staff properly and safely. This is so the staff can do their jobs properly and the residents are protected from being cared for by unsuitable people. In order to get further information about the home we also spent time talking to 2 residents, 1 visitor, 2 care staff, the manager and the owners. 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 27 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 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff feel they can meet their needs. Evidence: Before any person was admitted to the home we saw that a senior member of staff from the home undertook an assessment of their needs. An assessment looks at what help and support a person who may be admitted to the home needs to help them make the most of their daily life. We looked at two assessments that had been undertaken. They were detailed and showed clearly what the people were able to do for themselves and what they needed help with. Based on this information it was decided that the staff at the home could meet their needs and therefore their admission to the home was possible. Care Homes for Older People Page 10 of 27 Care Homes for Older People Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans show what care needs the residents have and care practices ensure that their needs are met in a caring and dignified way. Evidence: Individual care plans were in place for each resident. The care plans of two of the residents were looked at. One had enough information in it to show how this persons care needs were to be met, however the other one was not as detailed as it should have been. Some important information that would help in showing how to care for the resident was missing. This resident had however, only been in the home for a very short time and the information had been written but not transferred into the care records used by the majority of the staff. We discussed this with the Manager and she told us that she would make sure that it was transferred into the daily care plan without delay. We also saw that some of the residents care notes either did not have the residents name on or were not dated by the person writing them. The Manager told us that these things would be discussed with the staff concerned. It is important to write the date of any care note entry so that staff have a clear record of a residents Care Homes for Older People Page 12 of 27 Evidence: condition at any one time. The care plans were checked regularly by the staff so that any change in the residents condition could be identified and action taken if necessary. The AQAA document sent to us stated that every six months, or more often if required, the staff review the care plan with the resident and where possible their family. This gives them the opportunity to be kept up to date and to be involved in agreeing and developing their care plan. The staff looked at whether or not there was any risk in relation to the residents developing pressure sores. Staff did identify that one of the residents was at risk of developing pressure sores and although she was being cared for safely and with the involvement of the district nurses, there was no written care plan in place to show how to prevent any further problems. The staff also looked at whether there was any risk of the resident falling and also if a resident was at risk due to problems with their food and fluid intake. Staff also looked at and wrote down how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. We saw that residents were weighed regularly and their weight was recorded in their care notes. We noted however that how often a resident was to be weighed was not written into their care plan. We were told that residents were routinely weighed monthly unless there were concerns and then if there were concerns about weight loss they would be weighed more often. We advised the manager to write down in the care plan how often a resident was to be weighed. This should ensure that all persons involved in the care and monitoring of the residents welfare are aware, at all times, of the frequency of weighing. We saw that staff wrote in the care plans when the residents had received visits from health care professionals, such as dentists, opticians, district nurses and chiropodists. We looked at the system for managing the medicines. Overall a safe system was in place. Staff who have received medicine training are the only people allowed to have responsibility for managing the medicines. There is a locked medicine room and a locked medicine trolley that is secured to the wall when not in use. Medicines and Controlled drugs were stored securely. The following things however needed putting right: A care assistant was made aware that a resident needed some pain relieving medicine. Instead of checking the medicine prescribed against the prescription sheet she took the medicines out of the residents medicine box and gave them to her. Although the care assistant knew the resident very well and knew what medication she had been taking, it is not safe practice to do that. It is important to always check against the prescription to ensure that there has been no change in the prescription and that the correct dose has been given. Staff had changed the prescriptions for pain killers for 3 of the residents from doses to be given at set times to as and when required. Staff told us that this was because Care Homes for Older People Page 13 of 27 Evidence: the residents did not need them as often as they had been prescribed. Whilst this shows that staff are aware of the residents individual needs it is not acceptable practice. Staff must not change what a doctor has prescribed. They must refer back to the GP for them to change the prescription if necessary. Care Homes for Older People Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported and encouraged by staff to make choices about what they do, so that they can find enjoyment and satisfaction in their daily life and with the activities available to them. The residents are given a choice of well-balanced and nutritional meals. Evidence: The residents that we spoke to told us that they can, more or less, do as they please and that they are not made to do anything that they do not want to. Their routines of daily living and what they liked to do were written down in their care plans. The care staff provide activities during the morning and afternoon and several of the residents go to a drop in at the church nearby on one afternoon a week. Whilst we were at the home some of the residents went off to a Christmas party held at this church. A list of what entertainment is being provided is displayed in the entrance hall. We were told that two or three times a month a singer is brought into the home for their entertainment. The care plans showed what religion a person was and if they practiced their faith. We were told that the majority of the residents had either a Church of England or Care Homes for Older People Page 15 of 27 Evidence: Roman Catholic religious faith but all faiths are welcome at the home. We were also told that the Catholic Priest or one of his Ministers brings Holy Communion every Sunday and the Church of England Minister visits monthly. We were told that the hairdresser visits the home every week and a resident confirmed that this was so. We saw visitors coming and going throughout the day and they seemed to know the staff very well. Some sat with their relatives in the lounge and one relative was taking her mother out to do some shopping and then for lunch. This relative told us that the staff always make her very welcome. We did not eat with the residents but saw what they were having for lunch. The meal served looked appetising, nutritious and there was plenty of it. We looked at the menus and saw that the residents have a choice of meal at breakfast, lunch and the evening meal. We saw hot and cold drinks being served throughout the day and we were told that milky drinks and light snacks are served at supper time. A relative told us that the home offers a varied menu and that the meals looked good. Care Homes for Older People Page 16 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have a good knowledge and understanding of what abuse is and know what to do if it happens. This helps reduce the possible risk of harm to the residents. Evidence: There is a notice displayed on the wall in the entrance hall that explains how any complaints will be handled. It did not however, tell people how quickly their complaint would be acknowledged by letter and did not give a time frame for when any investigation findings would be sent to them. We were shown a log book that the manager had put together to record any complaint made. No complaints have been made to us or to the management since the new owners took over the running of the home. We spoke to some of the staff and asked them to tell us what they would do if they felt that a resident had been mistreated in anyway. They were very aware of what to do and how to report it. They told us that they had been trained so that they could, as far as possible, protect the residents from harm. We saw evidence of this training in their training files. Care Homes for Older People Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in clean, safe, comfortable and suitably adapted surroundings. Evidence: There are two lounges, a conservatory and two dining areas on the ground floor. They are very pleasant rooms, nicely decorated, warm and comfortably furnished. The corridors throughout the home are wide and well lit. Bedrooms, bathrooms and toilets are situated on the ground and first floor. The toilets are easy to get to, as they are close by to bedrooms, lounges and dining rooms. The bathrooms and toilets have a lock on the door to ensure privacy and have suitable aids on them so that the residents can use them safely. Some of the bathrooms and toilets had a white call bell cord attached. We felt that, for some people with impaired vision, this could make it difficult for them to see it. We discussed this with management who agreed to change the cord to a more visible colour. We looked at most of the bedrooms. They were clean, warm and well furnished. Each bedroom had a safety overriding door lock and some had a lockable space to store anything that is of value or importance to the resident. We saw that a few of the radiators throughout the home were not guarded and that there were no thermostatic control valves on the baths and showers. This posed a risk of accidental burning and scalding to the residents. We discussed this with the new owners who agreed to have the radiators guarded and control valves fitted Care Homes for Older People Page 18 of 27 Evidence: straightaway. We have since been informed that guards and control valves are now in place. This ensures the safety of the residents. The home was clean and there were no unpleasant smells. Disposable hand washing equipment was in place in bedrooms, bathrooms and toilets and disposable gloves and aprons were provided for the staff to wear. Providing all this equipment helps to reduce the spread of infection and therefore helps to protect the residents health and wellbeing. Care Homes for Older People Page 19 of 27 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. The residents are cared for by staff that are properly trained and safely recruited. This helps to ensure that they are kept as safe as possible. Evidence: A check of the duty rotas showed that for the number and dependency of the residents in the home there was enough staff on duty. We asked the staff if they felt that they had enough staff to meet the needs of the residents and they said that they did. Relatives and residents told us that the staff looked after them well and that they were very supportive, polite and approachable. The information that we looked at in the training files showed that 61 of the staff had obtained their NVQ (National Vocational Qualification) level 2 or level 3 in care. Other staff were working towards these qualifications. This is good progress. The recruitment files of 2 staff members were checked. All were in order and these staff had been properly and safely employed. This helps protect residents from being cared for by unsuitable people. The information received from the AQAA form showed that management provide a staff induction programme for all newly employed staff. We looked at some of the Care Homes for Older People Page 20 of 27 Evidence: training files and saw evidence of this. We also saw evidence of further training that had been undertaken. The staff had undertaken training in moving and handling and the protection of vulnerable adults. Also training in basic food hygiene, first aid, health and safety, fire safety, and other relevant topics had been undertaken or had been arranged. The staff spoken to told us that they had plenty of training to enable them to do their job. Care Homes for Older People Page 21 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed and is run in the best interests of the people who live and work there. Evidence: The Registered Manager has a lot of experience in caring for the elderly. She has been the manager of the home for over two years. Before that she was the Deputy Manager. She has a management qualification and keeps herself up to date with regular training. Staff that we spoke to told us that she was very approachable. A relative told us that she has nothing but praise for her. She felt that she had so much common sense. Infromation from the AQAA document sent to us and documents looked at in the home showed that management do a regular check of lots of things in the home. They check to make sure that there are no hazards around the building and also check the records about care, medicines, accidents and complaints. They also regularly send out surveys Care Homes for Older People Page 22 of 27 Evidence: to residents, relatives and other visitors asking for their views on the services provided at the home. The home also has the Investors in People Award. The way that the residents money is handled was good. We were told that they mainly handle money brought in for the residents expenses. We saw that receipts were kept for any money that was spent on behalf of the residents. We were told that they do not routinely give receipts out to people who bring money in for their relatives. We advised them to do this so that there is clear evidence of money received. Information received from the AQAA form sent to us and from random checking of servicing records showed that the equipment within the home is properly maintained and regularly serviced. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 24 of 27 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 1 7 15 When a resident is assessed 19/01/2009 as being at risk of developing pressure sores, a care plan for prevention of pressure sores must be put in place. To prevent any deterioration and protect the health and wellbeing of the resident. 2 9 13 Staff must ensure that they check against the prescription before giving the resident their medicine. To ensure that the correct amount of prescribed medicine has been given. 19/01/2009 3 9 13 Staff must not change what a doctor has prescribed. They must refer to the prescribing doctor. To ensure that the residents medication needs are being met safely. 19/01/2009 Care Homes for Older People Page 25 of 27 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 1 16 So that people can feel confident that their concerns are being addressed, the complaints procedure should have clear time scales for acknowledging a complaint and for responding to the investigation findings. So that the residents can have somewhere to privately store belongings that are valuable or important to them, they should be provided with a lockable space. 2 24 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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. 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