CARE HOMES FOR OLDER PEOPLE
Abbeyfield Residential Care Home Castle Farm Road Newcastle upon Tyne NE3 1RF
Lead Inspector Janine Smith Unannounced 20 April 2005 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 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 Residential Care Home Version 1.10 Page 3 SERVICE INFORMATION
Name of service Abbeyfield Residential Care Home Address Castle Farm Road Newcastle upon Tyne NE3 1RF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 284 1344 0191 284 1331 N/A Abbeyfield Newcastle upon Tyne Society Mrs Irene Aspinall CRH 24 Category(ies) of OP Old age - 24 registration, with number of places Abbeyfield Residential Care Home Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 22/9/05 Brief Description of the Service: Abbeyfield Residential Care Home Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 5 ¾ hours and was an unannounced visit. A partial tour of the premises took place and a sample of care records were inspected as well as other records. Three of the staff on duty and nine of the twenty-four residents were spoken to. What the service does well: What has improved since the last inspection?
There are large gardens surrounding the home, which are very well maintained with good seating areas and lots to interest residents. The gardener is
Abbeyfield Residential Care Home Version 1.10 Page 6 currently constructing a new Japanese themed garden and a new sitting area and residents were enthusiastic about the work in progress. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbeyfield Residential Care Home Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Abbeyfield Residential Care Home Version 1.10 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 standard(s) 1, 3, 4 and 5. The process followed in the home ensures that potential residents are provided with details of the services the home provides enabling them to make an informed decision about admission to the home. EVIDENCE: Inspection of the records for the three most recent admissions showed that a full assessment had been carried out prior to their admission, including making contact with their GP to obtain information about any health care needs. Residents had visited the home prior to making a decision to move in and had received written information about the home. Two had based their decision to move in on their previous knowledge of the home, as they knew people who already lived here. Three of the residents spoken to, said that their health and social care needs were met by the staff team. One of the staff members on duty was spoken to and was fully informed about the care needs each person had. Abbeyfield Residential Care Home Version 1.10 Page 9 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 standard(s) 7, 8 and 10. There are generally good arrangements in place to ensure that residents’ health care needs are met, however, there is no monitoring system to ensure that all residents are offered the opportunity to see a dentist at appropriate intervals. EVIDENCE: Three care plans were inspected and found to be thorough and based on a clear assessment of the individual residents’ needs. Residents confirmed that they saw doctors when they needed to and had used their own choice of dentists, opticians and chiropodists. However, in one case, it could not be established from the written record that they had been offered the opportunity to see a dentist in the preceding two years. A monitoring system should be put in place to address this. Where particular health concerns arose, there was evidence that doctors and/or community nurses were contacted for advice and treatment. All of those residents spoken to, said that they were treated well by the staff, although one commented that some staff were better than others as some can get frustrated. It was apparent that attention was paid to residents’ dignity
Abbeyfield Residential Care Home Version 1.10 Page 10 and a resident confirmed this. However, it was observed that not all of the staff remembered to knock on bedroom doors or wait for permission to enter before going in and a resident said some staff forgot to do this. Staff should be reminded of the importance of respecting privacy. The medication system was not examined on this occasion but it was confirmed that a requirement made at the last inspection had been acted upon. Abbeyfield Residential Care Home Version 1.10 Page 11 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 standard(s) 12, 13, 14 and 15. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Visitors are made very welcome which enables residents to entertain their friends in their ‘home’. Residents are enabled to look after their own finances and medication giving them choice and control over their lives. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it was and that they welcomed the daily choices offered. There is a good programme of activities in place including crafts, fitness video, visiting choirs, scrabble and dominoes. Communion services also take place regularly. One resident particularly enjoyed participating in the fitness video exercises. A resident confirmed that there were monthly meetings during which residents’ opinions were sought about the food and social activities. Residents are encouraged to maintain control over their finances and medication, following any risks being assessed, if they wish to do this. Abbeyfield Residential Care Home Version 1.10 Page 12 Residents confirmed that there were no restrictions on visitors and one was particularly pleased that their friend could have a meal with her in the home for a reasonable charge. This is good practice. Abbeyfield Residential Care Home Version 1.10 Page 13 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 standard(s) 16, 17 and 18 Staff had good knowledge and understanding of Adult Protection issues which protects service users from abuse. There is an effective complaints procedure which means service users are listened to and acted upon. EVIDENCE: The home has a detailed complaints procedure and there was evidence that any complaints are listened to and investigated and a written record kept. At this visit the complaint record held in the home shows three complaints since the previous inspection visit, which had been satisfactorily addressed. A procedure for responding to allegations of abuse has been drawn up previously. A carer spoken to during the inspection was aware of the policy and adult protection issues. The Deputy Manager confirmed that action is taken to ensure residents’ names are placed on the Electoral Roll and one service user confirmed that she normally obtains a postal vote. Abbeyfield Residential Care Home Version 1.10 Page 14 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 standard(s) 19, 20, 21, 23, 24, 25 and 26 As on previous inspection visits, the home was found to be very well maintained with good quality furnishings and décor which creates a pleasant, homely and safe environment for those living there and visiting. There was a strong smell of urine in one particular place in the home, which needs to be addressed for the comfort of residents. EVIDENCE: A tour of the premises was undertaken and a small number of bedrooms viewed. The home is well maintained and décor and furniture is of good quality. Hot water temperatures were tested and found to be appropriate but a thermometer was not available in one bathroom. This needs to be put in place to remind staff to always test the water prior to using, even though thermostatic controls are fitted. The home was warm and radiators are guarded for the safety of residents. The home was generally clean, apart from a strong smell of urine in one part of the home. Abbeyfield Residential Care Home Version 1.10 Page 15 Bedrooms are comfortable and pleasant to sit in with low level windows providing excellent views of the beautifully maintained gardens. There is plenty to look at in the gardens, including bird tables, etc., and a range of outdoor sitting areas. The gardener is currently building a new sitting area and Japanese style garden. Although it was fairly early in the year, the garden was full of colour, shapes and textures. Abbeyfield Residential Care Home Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27. The number of staff and type of staff on duty throughout the day and night is sufficient to meet the needs of residents. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. There is little staff turnover and some staff have worked in the home for many years which provides consistency of care to the residents living in the home. EVIDENCE: Examination of staff rotas and discussion with members of the staff team provided evidence that there are adequate care staff, including senior carers, on duty as follows:8am-2.30pm 4 2.30pm-9.30pm 3 9.30pm-8am 2 waking The Manager’s hours are not included in the above or staff employed for duties such as food preparation, laundry and cleaning. Staff stated that they enjoyed working in the home and had done so for many years. Residents spoken to said that the staff at the home were kind and caring. Several residents also commented on how well the staff had handled a situation over the previous weekend when an electricity power cut lasting 24 hours had affected the supply of hot water, heating and equipment for food preparation. Whilst this had caused significant disruption, the staff on duty
Abbeyfield Residential Care Home Version 1.10 Page 17 had worked quickly and efficiently to ensure that alternative foodstuffs were obtained and that residents were kept warm and comfortable and reassured. The Manager was on holiday so access to staff records could not be gained. Evidence to show that the requirement from the last inspection has been acted upon will be followed up at the next inspection. Abbeyfield Residential Care Home Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The home has been successfully managed by the Registered Manager, Mrs Aspinall, for a number of years. EVIDENCE: The Registered Manager, Mrs Irene Aspinall, was on holiday when this inspected was carried out. She has worked in the home for several years during which time she has managed it very successfully. She plans to retire at the end of May this year and a new manager has been appointed to take over from her. An application for registration will be required in respect of the new manager. Standard 38 was not looked at in any detail on this occasion. However, a requirement was issued to ensure a thermometer is available in every bathroom to remind staff to test hot water for the safety and wellbeing of residents.
Abbeyfield Residential Care Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Abbeyfield Residential Care Home Version 1.10 Page 20 No 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 8 Regulation 12(1)(a) Requirement Ensure service users are provided with access to a dentist in accordance with the NHS National Service Framework. Staff must knock doors and await permission to enter. Address unpleasant smell of urine in one area of the home. Provide a thermometer for testing hot water temperatures in each bathroom. Timescale for action 30 June 2005. 31 May 2005 31 May 2005 31/5/05 2. 3. 4. 10 38 38 12(4)(a) 13(4) 13(4) 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 Good Practice Recommendations Abbeyfield Residential Care Home Version 1.10 Page 21 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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