Inspection on 05/11/09 for Abbeydale Residential Home

This inspection was carried out on 5th November 2009.

CQC 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

Abbeydale Residential Home 08/02/10

Abbeydale Residential Home 04/11/08

Abbeydale Residential Home 13/11/07

Abbeydale Residential Home 05/12/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/02/2010.

Key inspection report Care homes for older people Name: Address: Abbeydale Residential Home 281 Gloucester Road Cheltenham Glos GL51 7AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Adam Parker     Date: 0 9 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Abbeydale Residential Home 281 Gloucester Road Cheltenham Glos GL51 7AD 01242525107 01242522671 abbeydalerh@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Charlton Care Ltd care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of sevice users who can be accommodated is 13. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - (Code OP) Date of last inspection Brief description of the care home Abbeydale is an adapted older property situated in the residential area of St Marks, within easy reach of local shops and the railway station. The Home is also on a bus route to Cheltenham town centre. Charlton Care Ltd purchased the home in 2006. Single accommodation for thirteen older people, who require personal care, is provided on two floors. All the bedrooms are pleasantly decorated comfortably furnished and have en-suite facilities. Communal facilities are provided on the ground floor and consist of a comfortable lounge and a large conservatory, which is used as a dining room. The attractive well maintained garden has easy access and may be enjoyed by the service users during the summer months. A copy of the most recent inspection Care Homes for Older People Page 4 of 26 Over 65 13 0 1 0 1 1 2 0 0 8 Brief description of the care home report is contained in an information folder located in the main hall of the home. Current fees range from 500 pounds to 750 pounds. Prices for hairdressing, chiropody and any personal items are available on request. 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: 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: The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The visit to the service included a tour of the premises, examination of documentation and medication systems and discussions with residents, staff and management. The inspector was joined on the first day of the inspection visit by an expert by experience. A person who, because of their experience visits a service with an inspector to help them get a picture of what it is like to live in or use the service. As well as the registered manager the inspector spoke to one resident and two members of staff. The expert spoke to a number of residents. The expert commented I found Abbeydale to be a home that provides good care and staff are attentive to the personal care needs of the residents. All residents felt they were treated well. Care Homes for Older People Page 6 of 26 Care Homes for Older People Page 7 of 26 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes assessment procedure generally ensures that all prospective residents receive a full assessment of their needs before they are admitted to the home so that they can receive the care that they require. Evidence: Following a requirement made at the previous inspection, residents had been given statements of terms and conditions relating to any fees payable and any additional costs. The assessment documentation for three residents who had recently moved into the home was looked at. One of the residents was privately funded and the home had obtained information from the hospital and had carried out its own assessment before the resident moved into the home. The second resident was being funded by the local authority and as well as carrying out its own assessment the home had received the Care Homes for Older People Page 10 of 26 Evidence: care plan from the local authority although this was dated the same day as the resident moved into the home. For the third resident the home had received a copy of the local authorities care plan although this contained little information and was incomplete in one part. For all residents a letter had been written stating that the home could meet their needs. The home does not provide intermediate care and so Standard 6 does not apply Care Homes for Older People Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents had detailed care plans, although attention must be given to developing care plans in a timely manner for short stay residents so that staff have clear instructions on how to meet their needs. Good medication systems and liaison with health care professionals ensure that residents health care needs are met. Evidence: The home had introduced a computerised care plan system. Care plans looked at for residents as part of the case tracking exercise were detailed and as well as describing the assistance that a resident needed also described what they could do for themselves. However one resident who had been admitted for a short stay did not have a written care plan prepared to guide staff in meeting their needs. This was discussed with the registered manager during the inspection visit. Risk assessments had been completed for pressure area care as well as a number of other care related areas. Residents had also received visits and input from General Practitioners,(GP) other health care professionals as well as chiropodists and an optician. Following the previous inspection staff had received training in Stoma care Care Homes for Older People Page 12 of 26 Evidence: which was relevant to a residents care needs. In addition input had also been provided by a specialist nurse. Medication, storage administration and recording arrangements were looked at. Storage was secure and appropriate arrangements were in place for controlled drugs. Temperatures for medication stored in the medication cupboard were not being monitored although there was monitoring for medication stored in the refrigerator. Examination of the Medication Administration Charts showed that where hand written directions had been made the majority of these had two staff signatures indicating that entries had been checked. Examination of the Medication Administration records showed that there were no gaps in recording the administration or omission of any medication and this was the same when the records were looked at for September 2009. A medication audit was in place that checked stock levels following administration. there were no residents self medicating at the time of the inspection visit. Records showed that residents had been receiving input from GPs for medication reviews. A protocol for dealing with any errors with controlled drugs was put in place in place by the second day of the inspection visit. The Manager confirmed that staff are instructed to knock on doors before entering residents rooms and to introduce themselves. Care Homes for Older People Page 13 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. Although a programme of social activities is in place in the home, these are limited and there is little contact with the local community so that residents do not enjoy the levels of social interaction that they wish. Evidence: It was reported that social activities in the home were discussed with residents and there was a plan to introduce music and movement as a new activity. A session about wartime memories had been provided by two outside organisers although this had apparently not been enjoyed by some of the residents. The expert who accompanied the inspector noted When asked about the activities on offer to them, most of the residents I asked knew the planned activities and had a copy of the timetable in their rooms. She observed that Every week provides the same activities, Monday Trip out, Tuesday music man. Wednesday hairdresser, Thursday music man, Friday bingo/quiz, Saturday sing-along and Sunday Church service. Some residents although pleased with these activities thought that more could be offered. The expert also commented that I felt that resident consultation in this area would be helpful in meeting social need. One resident stated that he would like to go out more even if it was to the local shop. Another resident said she did not leave her room because there was nothing to do. When checking the reports compiled by the Care Homes for Older People Page 14 of 26 Evidence: registered provider under the Care Homes Regulations 2001, one quoted a resident as saying they would like more social activities. One resident received visits from representatives of a local church. In addition a service is held in the home on a weekly basis by an ex employee who is a member of a methodist church. The entrance hall of the home contained photographs of activities that residents had taken part in. In addition there were also some staff training certificates on display. The Expert commented A notice board for residents and visitors could provide space for notices, organised activities and menu plans. Consideration should be given as to how information is displayed in the entrance hall. The home has a policy of open visiting. The home had little contact with the local community or any any local community groups and improving this in line with residents wished should be considered. The home has information about advocacy services available and one resident spoke about the visits he had been receiving from an advocate. Individual rooms showed various degrees of personalisation where residents had brought in their own possessions. The Expert commented I observed that rooms held personal belongings and treasured photographs which I feel add to a sense of belonging. Meals in the home consisted of a cooked lunch and in the evening a cooked snack or sandwiches and soup. Breakfast was cereals and toast. It was reported that there had been no requests for cooked breakfasts. There were no special diets being catered for at the time of the inspection visit. The homes AQAA document stated that Special diets are catered for where necessary. After speaking to residents the Expert commented The food was described as OK by all I asked. The cook informed me that she plans the weekly meals on a Monday. No choice is given regarding the main meal at lunch, the two course meal is written up daily on a board in the dining area. Some residents choose to eat in their rooms and all meals are served for everyone at the same time. During lunch I observed a resident telling a member of staff that she did not like her meal, she was not offered an alternative and her meal was left untouched. This was later discussed with the manager who stated that the resident is always offered an alternative and that the situation had arisen through the residents usual response to the situation. The residents weight was being monitored. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available if any resident or their representative should wish to make a complaint and the homes policies and the training given to staff should ensure that residents are protected from abuse. Evidence: The home had a complaints procedure and this was on display in the entrance hall. In the previous twelve months the home had received two complaints, the responses to these complaints had been fully documented and were held in a file in the home. One care plan for a resident described how they were not fully aware of the complaints procedure and the actions that should be taken regarding this. The management of the home had received training in the Mental Capacity Act 2005 and information about the Deprivation of Liberty Safeguards was displayed in the office. The homes adult protection policy was looked at. This instructed staff to inform the duty social worker and the Commission in the event of any abuse to a resident. The policy would benefit from the updated contact details for the Commission as well as the direct contact details for the local authority adult protection unit. The home also had a whistle blowing policy and one member of staff spoken to was aware of this. All staff apart from recently recruited staff had received training in protecting vulnerable Care Homes for Older People Page 16 of 26 Evidence: adults. The training matrix showed where new members of staff were due to have this training. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the benefit of living in a well-maintained and clean, environment with personalised individual rooms. Evidence: A tour of the premises was undertaken. All areas of the home inspected were found to be clean, well maintained and decorated. There were two communal lounges and a dining area at the front of the home. The entrance hall contained information about the home and photographs of activities that residents had taken part in. The rear garden with seating and tables was accessible through two separate doors which led onto ramps. Residents rooms were comfortable and contained various degrees of personalisation. There was an odour problem in one room and the registered manager described the actions that had been taken to try to resolve this. The laundry had washable floor and wall surfaces and arrangements for hand washing. In order to keep keep cord light pulls in toilets in a hygienic state, beads had been threaded onto the cords so that they could be cleaned with a disinfecting spray. Staff were observed to be following infection control procedures. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are deployed and training is undertaken in a number of areas to meet residents needs with improved recruitment checks in place. However induction training must be provided to staff in line with national standards so that residents are supported by competent staff. Evidence: Typical staffing arrangements in the home in the home consist of the manager, the deputy manager with two carers in the morning. In the afternoon there are two care staff. At night there is one waking and one sleeping member of staff. Other staff consisted of a cleaner and a cook. The home had five out of seven permanent care staff with an NVQ at level 2 or above. Records for three recently recruited members of staff were looked at. Two had been recruited with all the correct documentation and information obtained prior to employment in the home. A third member of staff had not provided reasons for leaving past employment where they were involved in caring for people. It was noted that since the employment of this member of staff the homes application form had been improved to specifically request information about why an applicant had left past employment. Checks should be made that this information is always obtained where a Care Homes for Older People Page 19 of 26 Evidence: person has worked in a position that involved caring for vulnerable people or children. However there was still no evidence that new staff had received induction training in line with the nationally specified Common Induction Standards. New staff are given an induction into the working of the home. One resident commented that Staff work Hard and the Expert noted that One lady stated that staff were always helpful and kind; another said some are better than others but all gentle and caring. Care Homes for Older People Page 20 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 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 generally well managed with a variety of quality assurance audits in operation and safety checks to ensure that the home is run in the best interests of residents. Evidence: The registered manager has been registered since 2004 and has achieved the registered managers award and NVQ level four he had recently undertaken the same training as the rest of the staff team. A number of weekly and monthly audits were in place including environmental audits as part of the quality assurance in the home. Quality questionnaires had also been used and responses from these formed part of the homes improvement plan. A copy of the improvement plan was looked at and was divided into the seven outcome areas of the National Minimum Standards for Care Homes for Older People. Group and individual residents meetings had also provided an opportunity for any issues to be raised. Visits had been made and reports compiled by the registered provider as Care Homes for Older People Page 21 of 26 Evidence: required under the Care Homes Regulations 2001. On examination these reports were good and were being used as a way of checking the homes ongoing improvement plan. Reports also showed where residents and staff had been consulted about their views on the service provided in the home. The homes AQAA document stated that The Regulation 26 visits have been improved in depth and breadth. The home does not hold any money on behalf of residents although locked drawers are available in individual rooms if these are needed. Staff had received training in infection control, fire safety, first aid and manual handling and food hygiene. Heating and electrical systems and appliances had been serviced and maintained as well as hoists and the lift. The storage of cleaning materials was checked and apart from one bottle labelled odour neutraliser with a handwritten label, all containers displayed their correct original labels. Hot water temperatures were being checked and recorded on a monthly basis. Work had also been carried out to reduce the risk of Legionella in the home with an annual test from a specialist consultant. The home did not have a security risk assessment, this was discussed with the registered manager and is recommended following recent criminal activity in the area affecting care homes. A window restrictor in place on the landing of the first floor was reported to be subject to a monthly check. However there was no restrictor on the window to room nine. This must be risk assessed to check if there is any risk to the resident occupying the room. The home has a fire risk assessment and a regular fire safety audit is in place. Care Homes for Older People Page 22 of 26 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 23 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 1 7 15 Any resident who moves into 29/01/2010 the home for short stay or respite care must have a written care plan prepared by the home without delay. This is so that staff have information on how to meet the residents needs. 2 30 18 Induction training must be 26/02/2010 provided for new staff in line with the Common Induction Standards. This is so that residents can be looked after by competent staff. 3 38 13 A risk assessment must be 31/12/2009 carried out in relation to the lack of a window restrictor in room nine. This is to check that there is no risk to the resident occupying the room. Care Homes for Older People Page 24 of 26 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 3 The home should always check that they have enough information from any local authority funding a prospective residents care before they move into the home. Monitor and record the temperature in the medication storage cupboard to check that all residents medication is being stored at the correct temperature. Review the positioning and content of information in communal areas of the home to provide suitable information for residents and their representatives. A wider range of activities should be provided for residents both inside and outside of the home. Consideration should be given to involving local community groups in the home taking into account residents, preferences. Update the adult protection policy to include the new contact details for the Commission as well as the contact details for the local authority adult protection unit. Where an applicant has indicated that they have worked in a position that involved caring for vulnerable people or children a check should be made that they have given a reason for leaving this employment. Check that all cleaning materials are stored in their original or in correctly labelled containers. A risk assessment should be completed regarding the security of the premises. 2 9 3 12 4 5 12 13 6 18 7 29 8 9 38 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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