Inspection on 07/11/06 for Abbeyfield Edward Moore House

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbeyfield Edward Moore House 06/11/07

Abbeyfield Edward Moore House 27/02/06

Abbeyfield Edward Moore House 20/10/05

Abbeyfield Edward Moore House 10/01/05

Abbeyfield Edward Moore House 16/06/04

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield Edward Moore House Trinity Road Gravesend Kent DA12 1LX Lead Inspector Alison Spreadbridge Key Unannounced Inspection 14:00 7th November 2006 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Edward Moore House Address Trinity Road Gravesend Kent DA12 1LX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01474 321360 01474 533712 felicity.somerville@abbeyfield.medway.or The Abbeyfield Kent Society Post Vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Dementia category to reside in Rumcroft Unit only Care of 5 older persons with a diagnosis of dementia is restricted to 5 service users whose date of births are: 31/08/07 07/03/36 27/04/09 01/06/21 03/02/21 27th February 2006 Date of last inspection Brief Description of the Service: Edward Moore Residential Home is a large, detached premises designed specifically for the care of older people. Shops and other amenities are about ten minutes walk away from the home and the nearest bus stop is five minutes walk. The home has good parking facilities and is set in well laid out and accessible gardens that are well maintained. All bedrooms are equipped with call bells, telephone points, wash hand basins and television aerial points. A shaft lift connects the ground and first floor. The home has a dedicated dementia care assessment unit. The current fees are £353.00 - £510.00 per week. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit took place on the 7th November at 2pm and was carried out by Alison Spreadbridge Regulation Inpsector. The inspection was carried out with the assistance of senior staff on duty as the manager was away at a conference. During the inspection, service users, relatives and staff were spoken with. Documentation and records were read, and a tour of the building was made. The last inspection report was seen pinned on the notice board in the home. Staff stated that inspection reports can be requested from the home if needed. What the service does well: What has improved since the last inspection? What they could do better: The home has not responded to the requirements made at the last inspection. There is a very strong odour of urine throughout the home which the cleaners are unable to eradicate, despite cleaning carpets on a regular basis. The Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 6 furniture in some of the bedrooms and lounges are in need of replacement. Redecoration and refurbishment is required. A number of carpets are presenting service users with trip hazards. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with sufficient information to make a decision about moving into the home. EVIDENCE: The statement of purpose and service users guide have been updated to show the change in the home’s manager and the provider’s change of company name. At the time of the inspection there were twenty-eight people living in the home. Each service user has a written contract, which includes the Abbeyfield Society’s terms and conditions, which outline the service users rights and responsibilities. A number of files were inspected and found to contain the information required under the standards. The service users spoken with said that either they or their relatives came to visit the home before they moved in. The policies and procedures for admission advise that service users spend some time visiting the home, seeing Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 9 the room available and staying for lunch or tea to meet some of the people living in the home before making a decision to move in. If service users choose to move into the home they do so on a 28-day trail basis. At the end of this time a review is held and if the service user is happy and their assessed needs are being met then the arrangement becomes permanent. The home does not offer intermediate care. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. While the home has a comprehensive assessment process the daily records do not fully reflect the care provided. EVIDENCE: Some of the service users care plans were looked at during the inspection. They contained the basic information required with some personal history included. The home has a comprehensive assessment process. The daily records are being maintained but contain mostly records of food and drink taken during the day. They do not cross-reference to other parts of the care plan and risk assessments. Professional visits and changes to the care plan cannot be identified in the daily records. This was discussed with the senior staff on duty. The medication is stored securely. The area was clean and tidy. The trolley contained only the medication in use. The staff member responsible said she likes to ensure the medication is not overstocked. All medication seen was in date and correctly stored. The medication is ordered as required by one of the Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 11 senior staff. The home is in contact with eight doctors surgeries. The pharmacist arranges for the collection of prescriptions and delivery of the medication. The medication is stored in blister packs. Medication is checked into and out of the home by a member of the senior staff team. The Medication Record Sheets seen were completed correctly. The home has a good working relationship with the local district nurse who calls into the home when needed. The dentist and opticians call into the home annually or on request and service users are able to access chiropody services on a regular basis. The service users spoken with said that staff treat them well and speak to them respectfully. The service users spoken with said they were happy with the care they are receiving. Staff were seen to knock on service users’ doors before entering. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a choice of activities and entertainment throughout the year. EVIDENCE: The home does not have a full time activities co-ordinator but some of the staff have taken on that role and offer a programme of activities throughout the week. The programme was seen on the notice board. Service users and their families are encouraged to come to various events during the year. The senior carers said they are planning a Christmas party to which service users and families are invited. Staff said the families are very supportive of not only the activities but also the fund raising which takes place. All of the home’s televisions have been replaced with the money raised over the last year. The staff are able to offer various activities which include bingo, quizzes, reading the newspapers with service users, arts and crafts activities and flower arranging. The staffing levels should reflect the work staff are doing in maintaining the daily activities for service users. A full time co-ordinator would Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 13 be of benefit to both staff and service users especially if the home chooses to review its categories in the future. Families spoken with said they are always made welcome when they come to visit and they said they enjoy the parties and activities especially at Christmas time. The service users spoken with said they enjoyed the food and that they were offered a choice of two meals at lunch times. The menus were seen and found to be quite varied. However there were a number of repetitions over the four weeks. Alternatives to the menu were available and the snacks menu was seen pinned up in the two dining rooms. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,28 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that their concerns will be listened to and acted upon. EVIDENCE: The complaints procedure is included in the information provided to prospective service users. Service users spoken with were confident that they could talk with staff about their concerns and they would be listened to and action taken. The home has a copy of the local authority’s adult protection policy. Staff spoken with were aware of their responsibility in reporting issues around service users’ safety. The senior staff said they had received training in adult protection. All staff are CRB checked as part of their recruitment procedure prior to beginning work in the home. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a warm and friendly atmosphere. However, they would benefit from a redecoration and refurbishment programme. EVIDENCE: The service users live in a warm and friendly home with a dedicated staff team. Service users spoken with said they liked living in the home. One service user wanted to show me their room. They said they were very comfortable and had been able to personalise it with some furniture from home. They said staff helped them with their dusting and tidying up and that their bedroom was hoovered regularly. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 16 There are a large number of notices to staff around the home which are sited inappropriately and should be reviewed. Some of the notices refer to service users’ belongings or aspects of personal care which had been placed on the outside of service users’ wardrobe doors. This practice does not safeguard service users’ dignity and privacy and should cease. The home is moving towards becoming a ‘smoke free’ home. Arrangements have been made for two of the service users who do smoke to have suitable smoker detectors in their rooms, or they can choose to smoke outside in good weather. If this decision is made then the home they will need to amend the service user’s guide to reflect the new policy. The dementia unit is accessed by keypad to ensure the service users are safe. The quiet room in the dementia unit was unsafe as the chairs and television were blocking people’s entry. There was a smell of urine throughout the home on both floor. The cleaning staff said they have been washing carpets on a regular basis but to no effect. Areas in the house were untidy giving an uncared for appearance. Things had been left around which staff could have easily tidied away. Storage had been left under the stairs which forms part of the fire escape route. Mattresses have been left in the garden with other items of household furniture waiting for disposal. These are in full view of the service users and as well as being unpleasant to look at pose a health and safety risk and must be removed. A number of areas in the home need redecorating and furniture replaced to ensure service users continue to have a comfortable home to live in. The television picture in both lounges was very poor, service users said this had only occurred recently and that some times it was difficult to watch. It was interesting to note that service users were choosing to sit in the dining rooms on both floors in preference to the lounges. On speaking with service users they said they were nice bright rooms and staff were always willing to make them a cup of tea. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are being cared for by competent and well trained staff. EVIDENCE: There were five staff on duty at the time of the inspection this included a senior member of staff and four carers, two on each floor. The staff said that they usually have five on duty throughout the day with three awake staff at night. The staff are well trained with 86 of the staff achieving NVQ passes at level 2 and 3. The staff rotas were seen and a number of shifts were being covered by the home’s flexi staff due to staff sickness. The staff were seen to be very welcoming to families and friends visiting. All staff are receiving training in dementia care as well as first aid, health and safety, food hygiene and the administration of medication. The staff said they are well supported by the local doctors and district nurses. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 -38 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management in the home would benefit from sound quality assurance procedures and the assistance of an administrator. EVIDENCE: There have been a number of changes to the management in the home since the last inspection. The new manager was away on a conference at the time of the inspection. The manager has now been in post for several months and prior to that was a registered manager in another of the Abbeyfield homes. The home’s deputy manager has also left and moved to another Abbeyfield home. There is a very strong senior team in the home who help to supervise and support the care staff. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 19 The Inspector had some concerns around the number of notices addressed to staff around the home including inappropriately placed notices on the office door, in corridors, on cupboards, in service users rooms and in other areas in the home. This practice should be reviewed. Supervision is beginning to take place on a more regular and formalised basis; the individuals concerned showed copies of some of the supervision notes to the inspector. Annual appraisals are also being put into place. All of the staff have or will receive training in dementia care, as well as completing their NVQ training at level two and three. A number of safety hazards were seen during the inspection, these included, a chipped toilet seat, storage under stairs, which form part of the fire escape route, damaged furniture, which should be replaced. The home must ensure that furniture used by service users are comfortable, safe and fit for purpose. The manager must ensure that regular monitoring of the home and quality assurance is taking place. The staff on duty said that the homes maintenance man had recently retired and they were sharing a maintenance man with another home. Edward Moore is in needs of its own full time maintenance man to help maintain the homes decorating and refurbishment requirements. The maintenance person was also responsible for testing the fire alarms. Staff stated that this will now be undertaken by the home’s senior staff. This is not currently being undertaken on a regular basis. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 3 3 2 2 Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16 Requirement The provider must ensure that sufficient staff are available to ensure daily activities do take place The provider must ensure that the home is safe and well maintained. The home must provide private accommodation for each service user, which is furnished and equipped to assure comfort and privacy, and meets the assessed needs of the service user. Action plan to be provided for the outstanding works with timescales to complete within the next 9 months This was identified at the last inspection and a timescale of 30/04/06 was made. 4. OP26, 32,33,38 12,13,23 The premises must be kept clean, hygienic and free from offensive odours throughout and systems must be put in place to control the spread of infection, in accordance with relevant DS0000023928.V300609.R01.S.doc Timescale for action 31/03/07 2. 3. OP19,33,38 12 OP24,33 12,13,16, 23 31/03/07 31/03/07 31/03/07 Abbeyfield Edward Moore House Version 5.2 Page 22 legislation and published professional guidance. This was identified in the last report and given a timescale of 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7, 37 Good Practice Recommendations All staff should understand and detail all the care provided through the day for individual service users including the time of provision and not the time the report was written. Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeyfield Edward Moore House DS0000023928.V300609.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!