Inspection on 13/01/06 for Abbeyfield Lear House

This inspection was carried out on 13th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Lear House 23/04/07

Abbeyfield Lear House 14/09/05

Abbeyfield Lear House 04/11/04

Abbeyfield Lear House 03/06/04

Abbeyfield Lear House 07/02/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abbeyfield Lear House Darmonds Green West Kirby Wirral CH48 5DT Lead Inspector Inger Moynihan Unannounced Inspection 13th January 2006 09:00 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 Lear House DS0000018850.V276885.R01.S.doc Version 5.1 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 Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abbeyfield Lear House Address Darmonds Green West Kirby Wirral CH48 5DT 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) 0151 625 1883 Abbeyfield Hoylake and West Kirby Limited Mrs Lesley Joyce Saunders Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: Lear House was first registered in 1984. The home is owned and managed by The Abbeyfield Society and provides accommodation for 24 service users in a large detached house in its own grounds. The home is close to local facilities including shops, leisure centre, library, churches, and public transport including bus and train services.The home provides single accommodation with en-suite facilities consisting of a toilet and washbasin. There is one lounge/dining room and two further lounges one on the ground floor and another on the first floor. A seating area is also provided in the former entrance hall. The home is furnished and decorated to a high standard throughout. There is a passenger lift which accesses the bedrooms on the first floor. There are four bedrooms which are accessed by four stairs. All corridors have handrails.There is a level access to the front and rear gardens. All the grounds are well maintained with mature trees, shrubs and flowerbeds. The garden room opens directly on to the garden where there is an ornamental fishpond, benches and other garden furniture. There is parking space for twenty cars within the grounds of the home. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4.5 hours and was the statutory second unannounced inspection for 2005/2006. A partial tour of the premises took place and staff and service users records were inspected. Three staff and five service users were spoken to during the inspection. One district nurse and three relatives were also spoken to with regard to the care provided. What the service does well: Service users’ care needs are assessed before they move into the home to ensure the registered manager and staff team can provide the required care. Systems are in place to ensure service users care needs are fully met. Service users health care needs are fully met and laid out in a documented plan of care. Systems are in place for the safe handling, storage and administration of service users medication. Service users confirmed they are always treated with respect and their right to privacy is upheld. The routines within the home are flexible which gives service users the opportunity to exercise a choice in how they spend their day. A range of social activities are provided and contribute to creating an interesting environment for the service users to live. Service users can exercise choice and control over their lives. A varied and nutritious diet is provided to ensure service users interest and good health. The home has a comprehensive complaint procedure to ensure service users views are listened to and acted upon. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 6 Systems are in place to ensure service users are safeguarded from abuse and harm. The standard of the decor at Lear House remains very high and provides a comfortable and pleasant environment for service users to live. The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. The home is managed by Mrs Lesley Saunders who is of good character and manages the home for service users best interest. Effective quality assurance systems are in place to ensure the high standards of care provided at Lear House are maintained. Staff have no input into the management of service users money. The health, safety and welfare of the service users is well promoted throughout the home. The relatives of several service users were spoken to during the inspection. They all spoke highly of the registered manager and staff team and said they were happy with this standard of care their relatives received. They had no complaints to make. What has improved since the last inspection? What they could do better: Although service users’ care needs are assessed before they move into the home, risk assessments are not routinely carried out. To ensure service users safety, the registered person is required to address this issue. Improvements need to be made to the record keeping in relation to the delivery and return of medication to be supplying pharmacist. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 7 Service users and relatives made comments with regard to the time service users rise in the morning and this being too early. In the light of these comments some changes need to be made to this aspect of care provision and a more flexible routine needs to be introduced. 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 Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 8 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 Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 9 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 and 4 Although service users’ care needs are assessed before they moved into the home, risk assessments are not routinely carried out. Systems are in place to ensure service users care needs are fully met which ensures their safety and welfare. EVIDENCE: An assessment of service users individual care needs is carried out prior to any service user being admitted into the home. This ensures the registered manager and staff team are able to meet the service users’ specific care requirements. Documentation examined indicated risk assessments are not routinely carried out. In order to ensure all aspects of service users care needs are addressed, risk assessments must be routinely incorporated into the assessment process. All of the service users spoken to during the inspection confirmed their needs were met in every way. They said the staff were fully up to date on all of their particular needs and requirements and they felt well cared for. One service user stated the staff are very kind and helpful. A number of service users Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 10 explained how the staff met their particular care requirements and confirmed they were always up to date with their changing needs. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 11 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, 8, 9 and 10 Service users health care needs are compiled into a documented plan of care. This is in line with good practice and ensure staff are clear on how to deliver the required care. Systems are in place for the safe handling, storage and administration of service users medication. Some improvements do need to be made to the record keeping in relation to the delivery and return of medication to the supplying pharmacist Service users confirmed they are always treated with respect and their right to privacy is upheld. EVIDENCE: A documented plan of the support provided to each service user is in place. The purpose of this care plan is to give staff guidance around the details of the required care and how the care should be provided. Service users physical and mental health care needs are met through the support of a range of healthcare professionals, staff being provided with appropriate training and the support of the care staff. Service users confirmed Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 12 they had access to the health care professionals they required and all spoke highly of the registered manager and staff team. One Service user commented, I couldnt be living in a better place, the staff are very discreet particularly when carrying out personal care. Another service user commented the staff are always very polite and pleasant. A district nurse visiting the home at the time of the inspection commented Lear House is wonderful. The staff are spot on with the care and I feel there is good continuity in the staff team. Any instructions I give to staff are always carried out correctly and I have never observed any signs of neglect or abuse. A daily record of service users welfare is kept to help staff monitor their general welfare. This is further supported by a handover period which is when the staff come together to discuss the service users welfare from the previous 24 hours. The inspector observed a handover take place during the inspection and noticed this was an effective way of ensuring good commoditisation amongst the staff team. The staff contributed their observations of the service user group and the registered manager gave advice and guidance on how the care is to be provided. Good facilities and systems are in place for the storage, recording and administration of medication which ensures service users medical needs are met. All staff who administer medication have been provided with appropriate training in this aspect of care provision. A discussion took place with the registered manager around the record keeping for the admission and return of service users medication to the supplying pharmacist. The registered manager agreed some changes needed to be made to these records to ensure they could be audited more easily. One service user takes responsibility for their own medication which promotes and maintains their independence. A risk assessment had been carried out to ensure this service user was safe to take on this responsibility. Service users spoken to confirmed they always received their medication as prescribed by their GP. The registered manager must ensure all handwritten entries on the medication administration record sheets are signed by two members of staff. The relatives of a number of service users were spoken to during this inspection. They all spoke well of the service provided as at Lear House and praised the registered manager and staff team for the standards of care their relatives received. They confirmed they were always kept informed of any changes that took place and how the staff reacted promptly to any health care issues. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 13 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 and 15 The routines within the home are flexible which gives service users the opportunity to exercise a choice in how they spend their day. A range of social activities are provided and contribute to creating an interesting environment for the service users to live. Service users exercise choice and control over their lives. A varied and nutritious diet is provided to ensure service users interest and good health. EVIDENCE: The service user spoken to during the inspection confirmed the routines in the home are flexible and they can go about their day as they wish. During discussion the service users confirmed their friends and relatives could visit the home at any time. This was observed by the inspector during the inspection. A programme of activities is in place each week which service users are free to participate in if they wish. The registered manager has established contacts with social groups within the local area which enables service users to maintain contact with the local community if they wish. A number of service users confirmed they attend these groups. Some service users stated they did not Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 14 wish to become involved in these activities and were happy the staff respected their decision. One service user commented I am aware the social activities take place and I know I can join in if wish. However, I am happy with my own routines and like to keep myself to myself. A number of service users confirmed they had their own routines with regard to social activities and were free to go about their day as they wished. This is a positive aspect of the home and ensure service users can exercise choice and maintain independence. The registered manager stated that mealtimes are flexible and service users dietary requirements are met. A varied and balanced diet is provided to ensure service users interest and good health. Service users confirmed they always have a choice of meal and plenty to eat and drink. Through discussion with service users and their relatives the inspector was informed that service users had been informed by the staff that they had to rise early in the morning in order to be downstairs for breakfast by 8.15am. This issue was discussed with the registered manager who explained that although service users are encouraged to get up in the morning in time for breakfast, they were free to raise later if they so wished and a more flexible routine could be accommodated. The start of the day is when older people need more time to get up and prepare themselves for the day. In the light of this the registered manager agreed to ensure all service users were informed that they did not need to rush in the morning for breakfast and that if they wished to have a more flexible routine this could be accommodated. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 15 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 and 18 The home has a complaint procedure to ensure service users views are listened to and acted upon. Systems are in place to ensure service users are safeguarded from abuse and harm. EVIDENCE: Neither the CSCI but Lear House have received any complaints about the standard of care provided. The complaint procedure is clearly displayed and staff spoken to were aware of the action they should take in the event of them receiving complaint. The service users spoken to during the inspection stated they were happy with the standard of care they received and had no complaints to make. One service user commented the staff are always pleasant and polite, I have no complaints to make about the care I receive. The relatives of a number of service users were spoken to during the inspection. They confirmed they were completely satisfied with the standard of care provided for their relatives and had no complaints to make. One relative stated the home is absolutely superb another relative commented I like the staff and the manager and feel my relative is well looked after. Documentation is in place on the protection of vulnerable adults from abuse along with a copy of the Wirral Adult Protection Procedures. All staff have completed training in this area of care although a new training video has been purchased to ensure all staff are up to date on current good practice. This is in line with good practice and ensures service users safety and protection. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 16 Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 17 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 and 26 The standard of the decor at Lear House remains very high and provides a comfortable and pleasant environment for service users to live. EVIDENCE: The standard of the décor throughout the home remains very high and a planned programme of maintenance is in place. There are landscaped mature gardens surrounding the home. Handrails and sloped paths are provided to assist service users with their mobility and to ensure their safety. For security purposes, a CCTV camera has been installed at the front entrance along with secure gates. There are sufficient toilet and bathing facilities for the number of service users living at the home and all rooms have en-suite facilities. The home has two small lounges and a lounge/dining room. The dining room can accommodate all the service users in one sitting, although this area is rather cramped at lunchtime. The home has a no smoking policy in all Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 18 communal areas. It is clear the staff are continuing to work very hard to ensure a high standard of cleanliness is maintained throughout the home. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 19 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 and 29 The required staffing levels and skill mix of staff are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. EVIDENCE: The staff rota indicated staff are evenly deployed across the week and that the required staffing levels, as agreed by the Registering Authority are provided. The staff spoken to stated there were sufficient staff employed in the home to enable them to carry out their work properly and staff vacancies such as holidays and sickness were always covered. The staff spoken to confirmed they had completed a range of training relating to the care of older people and confirmed they were always encouraged to become involved in any training relevant to the care of older people. Through discussion the registered manager outlined the plans she had for future training of the staff team. This is a positive aspect of the home and ensures the service users are being cared for in accordance with their particular needs and in line with current good practice. This also demonstrates the registered manager is considering the future development of the staff team and the service. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 20 The staff have a positive attitude towards their work with one member of staff stating I enjoy my work and feel we all work well as a team. This is a positive aspect of the home and contributes to maintaining a positive working environment where high standards of care are set and maintained. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 21 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, 33, 35 38 The home is managed by Mrs Lesley Saunders who is of good character and manages the home for service users best interest. Effective quality assurance systems are in place to ensure the high standards of care provided at Lear House are maintained. Staff have no input into the management of service users money. The health, safety and welfare of the service users is well promoted throughout the home. EVIDENCE: The registered manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. Through discussion she demonstrated her commitment to Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 22 supporting the staff within their role and demonstrated an open and positive style of management. Discussion with service users confirmed that Lear House is run for service users best interest. The service users spoke well of the registered manager and stated she was always available for support and advice when necessary. A district nurse visiting the home at the time of the inspection spoke highly of the registered manager. Her comments included Lesley is brilliant. She has a good understanding of the service users needs and reacts quickly to any issues or concerns. I feel very confident in the care provided at Lear House. Staff have no input into the management of service users money. Effective quality assurance systems are in place to ensure high standards of care are maintained. The registered person reports to the CSCI each month on the standard of care provided (this is in line with the Care Homes Regulations 2001) and the society and house chairperson visit the home to speak to the service users and staff about the standard of care provided. Questionnaires are given to service users, their relatives and relevant health care professionals in order to obtain their views on the standard of care provided. Records demonstrated and staff confirmed they have undertaken fire safety training in accordance with the fire departments recommendations. Documentation indicated that all equipment used in the home is regularly serviced and staff have completed training in this aspect of care. Fire safety checks were up to date. All of this is in line with good practice and ensures staff and service users safety. Through discussion the registered manager demonstrated she kept up to date with changes to practice within the area of health and safety. To support the registered manager in this aspect of care provision, the registered person is advised to keep up to date with all of the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 23 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 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x x x x 4 Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? no 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 OP3 Regulation 13 &14 Requirement Timescale for action 30/03/06 2 OP10 13 3 OP10 13 4 OP14 12 The registered person is required to ensure risk assessments are routinely carried out during the assessment process. The registered person is required 01/03/06 to ensure the records in place for the delivery and return of medication to the supplying pharmacist are streamlined so they can be audited more easily. The registered person is required 13/01/06 to ensure all handwritten entries on the medication administration record sheets are signed by two members of staff. The registered person is required 13/01/06 to ensure service users are able to exercise choice and control over their lives. In this instance that service users are informed they do not need to rise in the morning unnecessarily early. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 25 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 38 Good Practice Recommendations It is recommended that the registered person keeps up to date with all of the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. Abbeyfield Lear House DS0000018850.V276885.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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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