Inspection on 21/11/05 for Abbeyfield Greensted

This inspection was carried out on 21st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Greensted 17/10/08

Abbeyfield Greensted 18/10/06

Abbeyfield Greensted 20/06/05

Abbeyfield Greensted 11/11/04

Abbeyfield Greensted 01/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield Greensted 16 The Orpines Wateringbury Maidstone Kent ME18 5BP Lead Inspector Sally Hall Announced Inspection 21st November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 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 Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbeyfield Greensted Address 16 The Orpines Wateringbury Maidstone Kent ME18 5BP 01622 813106 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) The Abbeyfield Medway Valley Society Mrs Lorraine Edith Cousins Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Rooms 37, 38 and 39 are not suitable for wheelchair users. Date of last inspection 20th June 2005 Brief Description of the Service: Greensted is situated in a quiet residential area within walking distance of a local shop and approximately 15 minutes drive to the town of Maidstone. The home has a large dining room and several sitting rooms. One area of the home on the upper floor has been turned into a relaxation area complete with an automated massage chair and a music centre. The home has a well-maintained library with some large print books. There is also access to talking books and tapes. The gardens are attractive and well maintained with seating areas. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection took place on 21st November 2005 between 9:50am and 3.15pm. The Inspector agreed and explained the inspection process with the Registered Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures and reviewing care plans and records kept within the home. The inspector also read and fed back the outcome of surveys sent out by the Commission for Social Care Inspection prior to the inspection. These findings are also included as comment in this report. A tour of parts the premises was undertaken. The focus of the inspection was to assess Greensted in accordance with the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: Staff are doing a lot of very good work with the service users. However, they need to document more of this. They also need to ensure that they record follow up information when service users are receiving treatment. Staff training needs must be prioritised and courses arranged to ensure all staff do Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 6 the required training. Particularly regarding health and safety topics and adult protection. Staff would benefit from regular supervision. 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 Greensted DS0000023944.V253554.R01.S.doc Version 5.0 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 Greensted DS0000023944.V253554.R01.S.doc Version 5.0 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): 3,4,5, Service users needs are fully assessed to ensure that the home can meet their needs. Service users are given opportunities to both view and sample the care offered before committing themselves to permanent care. EVIDENCE: Pre-assessment documents were seen on the files sampled. All prospective service users are visited prior to admission and the manager, or her senior team undertake an assessment of their needs. The assessment record is based on the staff recording the relevant code numbers. This does mean however, that you need to have sight of the codebook to understand the assessment. Information taken about the service user and their medical history is recorded and used to ascertain if the home will be able to meet their needs. Staff explained that if the referral came via the local authority then they would receive an assessment and care plan from the placing care manager. The manager stated that all staff receive the required training. A training matrix seen showed that staff are being trained to look after the needs of the service users they currently care for. This training is ongoing and many staff have yet to complete all the courses. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 9 The home cares for older people who are frail and can also offer care to older people who have a diagnosis of Parkinson’s disease. It is very pro-active in ensuring all staff have received relevant training in Parkinson’s care, as well as encouraging and supporting staff through NVQ’s in care. All prospective service users and their families are invited to visit the home prior to admission. At this time they are shown the room that is available and the facilities the home has to offer. If the service user chooses to move into the home this will be on a 28-day trial basis. At the end of this time a review is held to ascertain if the home is meeting the service user’s needs and that the service user is happy. If the trial period has been successful the stay then becomes permanent. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Service users’ personal, social and health care needs are met according to their needs and wishes. Service users receive a high standard of personal care, are treated with respect and their privacy is respected at all times. EVIDENCE: The home has a very comprehensive assessment process and the care plans seen were also very detailed. From observation and comments from service users during the day, it was evident that staff work hard to fulfil the service users needs. Although, daily records did not cross reference well with the care plans and it became evident that staff are not fully recording the care and social interaction they have with service users. The detail in the reports also varied between staff. Gaps between entries were also discussed with the manager. The daily records did not record the times that events and care provision took place. The daily records did not contain follow up information when treatment had been started, as to how the treatment was working etc. The treatment itself was not recorded sufficiently to know if staff had been Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 11 providing it as requested by the district nurse. No new care plan had been written when a gentleman had had a catheter fitted. Service users are able to keep their own doctor when possible. Due to the position of the home there are only two surgeries that serve this home. New service users can choose between them. District nurses visit as required. Evidence was seen that the chiropodist, optician and dentist all visit those service users who cannot visit them. The assessment process of the home identifies whether service users need these services. A team leader explained that only staff trained to do so carry out the administration of medication. The medication storage room was inspected. It was tidy, well ordered and clean. Medication was stored correctly. A check of the medication records indicated that there were some discrepancies between the tablets signed for and those taken. The manager is to investigate, staff are recording the medication left in stock at the end of each month on the new sheet, which means a full audit can be undertaken. The Medication Record Sheet was not fully completed with personal details of the service users. Sheets did show that medication is checked when it arrives at the home. During the tour of the building staff were heard addressing service users by their name and were sensitive about any personal issues being discussed. The service users said “the staff treat us with utmost dignity”, “you’re never made to feel anything is too much trouble”. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 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, 14, 15 Service users benefit from a range of activities and entertainment. Family and friends are encouraged to visit and the home has a friendly and welcoming atmosphere. Service users benefit from a varied and nutritious menu. EVIDENCE: The home has an activity programme. On the day of inspection a large number of service users were seen enjoying a game of bingo. Activities are organised by a senior carer and facilitated by staff and volunteers. Activities on offer included gardening, bingo, quizzes, craft making and music/sing-along. Service users are able to choose which activities they wish to participate in and the home has organised outings, seasonal activities and outside entertainment. Service users spoken to said there were things they can join in with through the week. They also talked about the massage chair that they can use upstairs. This facility has been provided with Parkinson sufferers in mind, but all service users are welcome to use it. The home operates an open visiting policy and service users can meet with their relatives in private in the library, if it is not in use, or their bedroom. A number of friends and family were observed visiting relatives at various times during the day. One family spoken with said that they are always made to feel Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 13 welcome and enjoy visiting the home. They were very positive about the way the home provides for their relative. It was evident from discussion with several service users that the routines of the home are sufficiently flexible to allow for individual preferences in respect of personal care. Throughout the day service users were seen being encouraged by staff to make choices about various aspects of their lives. Service users spoken to said they felt able to choose how they spent their day and the staff help them to do this. Service users have a choice of meals through the day and lighter options are also available. It was noted that the amount the service users eat during the day is noted in the daily record. Staff also keep a record of what choices the service users make. The choices available on the day of inspection were appetising, and several service users said they enjoy the meals, and “ there’s always plenty of it” and there was always plenty of variety and choice. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a complaint procedure but complainants do not know the timescales for action to be taken. The home has an adult protection policy for the protection of its service users, but it does not reflect recent changes to legislation and local protocols. EVIDENCE: The complaints procedure was seen and discussed with the manager It needs to be reviewed to include timescales. Staff said that all complaints were taken seriously and used to improve the service they offered. The home did not have a copy of the local authority adult protection protocols issued earlier this year. It was recommended that the manager obtain a copy of these. There is a whistle blowing policy for staff. However this needs to be reviewed to reflect the recent changes in the local protocol and legislation regarding POVA etc. Not all staff have undertaken adult protection training. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 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): These standards were not fully inspected during this visit, but the comments below reflect the progress being made of areas highlighted in the previous inspection. EVIDENCE: The manager confirmed that funding has now been agreed to refurbish the dining area. The manager is waiting for the flooring to be replaced and the ceiling to be sorted before the rest of the room can be decorated. It is looking very shabby now, as are some of the sitting room chairs around the home. The manager confirmed that some new chairs have been purchased and a delivery of more is due soon when the old ones will be disposed of. The manager hopes that the old bathroom and shower room with also be upgraded and redecorated in the near future. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 16 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): 28,29 The home protects it service users with a robust recruitment procedure. The staff are having training to ensure that they have the skills and knowledge to care for the service users at the home. However the home needs to ensure that all staff are trained in the required subjects. EVIDENCE: The staff files sampled contained the required documentation. This included application forms, references and CRB checks etc. The home has provided a number of staff with training which gives them the skills and knowledge for caring for people who suffer from Parkinson’s disease. A staff member who had undertaken this training said they found it very useful and it gave them a better understanding of the service users’ care needs. The manager said that this training is ongoing and more courses will be organised. A training matrix seen showed that most staff have an up to date moving and handling certificate. However, not all staff have completed other required training. This was discussed with the manager and she has been asked to prioritise the required training particularly regarding health and safety issues and adult protection. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 17 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, 32, 36, 38 The manager has the skills and knowledge to manage the home effectively. Thereby meeting the needs of both the service users and the staff and creating a warm and inclusive atmosphere within the home. The home strives to ensure that the health, safety and welfare of the service users is promoted and protected. However, not all staff have received the appropriate training. Service users would benefit from staff who receive regular formal supervision. EVIDENCE: Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 18 The manager has completed an NVQ level 3 in care and is about to complete her Registered Managers Award. The manager said that she hopes to start her NVQ level 4 in care soon. The home had a warm and friendly atmosphere. Good interaction was observed between the service users, staff and the manager. Service users spoken to said that they felt comfortable asking staff for help and expressing concern if they were not happy. Visitors said that any comments they had made had always been responded to and they were happy to talk to any of the staff. The supervision notes seen for formal supervision showed that this is not happening at least six times per year. The manager explained that the team leaders do the supervision of the care staff and that she tries to monitor this. Staff meetings are held regularly and are recorded. The night care staff, domestic staff and kitchen staff also have their own regular meetings. The fire test record book evidenced that tests were being carried out in the home. The compliance certificates for gas, LOLER for the lift and electrical installation were confirmed by the manager to be in date. The home has a COSHH file, which the manager confirmed contained a sheet for all the chemicals used in the home. The training matrix seen showed which staff had undertaken the required courses, such as manual handing, infection control, fire training health and safety etc. Not all staff have completed all the courses required. The manager explained that a number of the courses have already been organised and booked. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 19 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 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 2 X 2 Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 15 schedule 3 Requirement A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered, staff recording the daily out comes so that it cross references with the plan, and no gaps are felt between entries that show the time the care etc. took place. At least six monthly the service users assessment should be redone to ensure the subsequent care plan covers the service users changing needs. The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, the Medication Record Sheet is fully completed with the service users information and that medication is audited to ensure it is being administered correctly. The registered person ensures that service users are safeguarded from physical, DS0000023944.V253554.R01.S.doc Timescale for action 31/12/05 2 OP9 12,13,14 31/12/05 3 OP18 12,13,17 01/05/06 Abbeyfield Greensted Version 5.0 Page 21 4 OP38OP30 5 OP36 financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies, and ensure all staff receive the required training. 12,18 The registered person ensures 01/06/06 12, 13, 23 that there is a staff training and development programme ensures staff fulfil the aims of the home and meet the changing needs of service users and includes the required training to meet health and safety, i.e. infection control, basic food hygiene, health and safety, fire training etc. 18,19 The registered person ensures 31/12/05 that supervision arrangements are put into practice. 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 2 Refer to Standard OP18 OP8 Good Practice Recommendations Ensure that the home has a copy of the local authority adult protection protocols and reviews there own policies. The home ensures that treatment advised is documented and followed up via the daily reporting notes. Abbeyfield Greensted DS0000023944.V253554.R01.S.doc Version 5.0 Page 22 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. 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