Inspection on 06/02/07 for Abbeyfield Residential Care Home

This inspection was carried out on 6th February 2007.

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 Residential Care Home 03/02/09

Abbeyfield Residential Care Home 28/09/05

Abbeyfield Residential Care Home 20/04/05

Abbeyfield Residential Care Home 22/09/04

Abbeyfield Residential Care Home 06/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield Residential Care Home Castle Farm Road Newcastle Upon Tyne Tyne & Wear NE3 1RF Lead Inspector Janine Smith Unannounced Inspection 10:30 6 February 2007 th 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 Residential Care Home DS0000000430.V322912.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 Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Residential Care Home Address Castle Farm Road Newcastle Upon Tyne Tyne & Wear NE3 1RF 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) 0191 2841344 0191 2841331 Abbeyfield Newcastle upon Tyne Society Mrs Christine Major Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: Abbeyfield Castle Farm provides a home for twenty-four older people who require residential care. Nursing care cannot be provided. The weekly fees are £402. The building is single storey providing ground floor accommodation throughout and is set in a residential area close to Jesmond Dene and the Freeman Hospital. There are public transport links close by. There are a variety of aids and adaptations around the building to allow residents to move about more independently. All of the bedrooms are single and have an ensuite toilet. There are three communal bathrooms, which also have toilet facilities and a shower. The home is set within very attractive large grounds filled with mature plants, which are well maintained. The home is run by the Abbeyfield Society, which is a voluntary organisation. Information about the service, including inspection reports, is readily available. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took 12 hours and was carried out over two days, starting on the 6th February 2007. The home had not been given advance warning. There were 24 service users at the time of the visit. A tour of the premises was made and some of the bedrooms were seen. The systems for the storage, handling and administration of medication were looked at, as well as the system for handling service users’ money. A sample of records about service users and staff were also looked at. Six of the people staying in the home were spoken to. Discussions took place with the Manager and five staff. Three visitors were also spoken to. A discussion also took place with the Chairperson of the Abbeyfield Management Committee. Before this inspection took place, questionnaires were sent to a range of professional visitors to the home and made available for service users and their relatives. Eight replies were received from service users, three from relatives and five from GP practices who have patients living in the home. The results of these surveys have been included in this report where relevant. What the service does well: The manager and staff closely monitor service users’ wellbeing and ensure that their health care needs are met. General Practitioners, who completed surveys, said that they were satisfied with the overall care provided to service users and one said, ‘This is an excellent home’. Service users are very happy living here. One said, ‘I love it here. It’s a perfect place’. Another said, ‘I had to go into hospital and when I came back, this felt like home’. Service users’ privacy and dignity is respected. The manager finds out whether any service users have cultural or spiritual needs and ensures that these are met. The food provided is of very good quality, well cooked and presented. Service users have plenty of choice and their personal requests are acted upon. The following comments were made. ‘I went to see the chef and told him my talbe would like more soup and we got it’. ‘The food is excellent and there is plenty of choice. I ask for small helpings and get them. The chef is wonderful’. Very positive opinions were received about the way the staff do their jobs. One service user said, ‘The helpers are very kind and caring. They never complain or show that a task may be unpleasant. They work as a team.’ Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 6 Another said that the staff were very good, kind and caring and treated her well. A relative said that the staff were ‘very caring and it wasn’t just a job’ for them’. The home is very well managed. The service users are encouraged and supported to give their opinions and influence the way in which the service is provided. What has improved since the last inspection? What they could do better: Before offering a place in the home, the Manager must ensure that full information is obtained about any mental health conditions a potential service user may have. This helps ensure that the home will be able to fully meet their needs. The care staff regularly assess service users to identify if they are at risk of falls, malnutrition and pressure sores. Where a risk had been identified, a care plan had been put into place except in one case of the sample looked at. Individual risk assessments have not been carried out where service user may wander at night or be at risk due to aspects of their behaviour. This should be done so that all staff are clear how they should provide support and care and ensure the safety of all. Medication is generally stored and handled safely, however there were a couple of issues, relating to pharmacy instructions and in-house recording, which need to be dealt with for the protection of service users. Service users are encouraged to look after their own medication, which is good practice, but the risk assessment process for this needs to be tightened up, which will help protect them. The Manager and staff have good knowledge of adult protection issues, which helps protect service users from abuse. However, the procedure for responding to suspicions of abuse need review, to ensure that it provides appropriate guidance to staff and complies with the Department of Health guidance. Staff should be given training about the factors with lead to challenging behaviour from service users, so that they fully understand why service users may be physically or verbally aggressive and learn appropriate ways to support and protect service users and staff in such situations. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 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 Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A service user’s guide is readily available, which helps inform people about the services provided by the home. A contract is agreed with new service users, which means that they can be clear about the services the home will provide and the fees charged for this. Generally, the Manager finds out what needs people have before they are admitted to the home, but the process needs review to ensure that full information is obtained about any mental health needs a potential service user may have. This ensures that the staff will be able to provide the care that they need. Prospective service users and their relatives have an opportunity to visit the home without any obligation. This means they can find out if it will be suitable for them. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home has a Service Users Guide, which has recently been reviewed. This is not currently available in any other formats. All eight service users who completed a survey, said that they had a written contract with the home. A relative confirmed that she and her mother had been offered a tour of the home before deciding that it was the right place for her. She had also been given a copy of the Service User’s Guide and full information about charges. They were very happy with the care provided by the home. During the inspection, it was noted that two people arrived who were interested in the home. They were offered a tour and a copy of the brochure. A service user who had recently come to live in the home said that they chose this one after looking around this and some others. Another service user said the same. The records of three service users who moved into the home in the past year were looked at. Assessments had been carried out to find out what help they needed and information had been obtained from GPs about their health. In one case, relevant information from the GP was only received after admission had taken place, when it would have been more useful before. Discussions with the Manager and staff showed that the care needs of all three service users could be met by the home. Care plans had been put into place for all three service users using the information obtained through the assessment process. There was evidence that the Manager found out whether new service users had any cultural or spiritual needs and made arrangements for these to be met. Two service users confirmed that their cultural requirements were met. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements in place to ensure that service users’ physical care needs are regularly assessed, which helps staff to know what support service users need. But it would be helpful to also carry out risk assessments where service users may wander or present difficult behaviours, which could put themselves or others at risk. This process will then help ensure that a fuller plan of care can be drawn up, so that the staff know how best to support and safeguard them. The Manager and staff closely monitor service users’ wellbeing and ensure that their health care needs are met. Professional advice is sought promptly when necessary. Medication is generally stored and handled safely, however there were a couple of issues, relating to pharmacy instructions and in-house recording, which need addressing for the protection of service users. Service users are encouraged to look after their own medication, which is good practice, but the risk Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 12 assessment process for this needs to be tightened up, which will help protect them. Service users’ privacy and dignity is respected by the management and staff team. EVIDENCE: Four care records were looked at. Care staff assess and review service user’s care needs at regular intervals and update and review their plan of care with the service user. The care plans generally described their needs fully, although one would have benefited from further guidance to staff about how to respond appropriately to specific behaviours presented by a service user. The Manager and a senior member of staff spoken to were well informed about service users’ care needs. Each service user had been assessed regularly to identify any risks of malnutrition, falls and pressure sores. There was evidence that care plans had been put into place where appropriate, except for one person where a written care plan had not been put into place for the prevention of pressure sores although they had been identified as being at risk. Service users were being weighed regularly and records kept of this. Individual risk assessments have not been carried out where service users may wander at night or be at risk due to specific behaviours. After talking with service users, the manager and staff, as well as looking at records, it was confirmed that service users’ physical and mental health is closely monitored. All eight service users who completed a survey, confirmed that they received the medical support they needed. Six said they ‘always’ received the care and support they needed and two said they ‘usually’ did. They see GPs and other health care professionals when they needed. They also saw dentists, opticians and chiropodists at regular intervals. There was evidence that the staff quickly sought professional advice when service users’ health changed or they had concerns about them. Records were kept of the outcome of medical consultations or examinations, but one person’s was difficult to follow as the entries had not been recorded in datal order. Reviews are regularly held and care managers involved when necessary. Five surveys were received from GPs who have patients living in the home. All five agreed that the home communicated clearly and worked in partnership with them. Four said that there was always a senior member of staff to confer with, but one said this was not always the case. All were satisfied with the overall care provided to service users by the home and one added, ‘This is an excellent home’. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 13 One of the service users said, ‘I love it here. It’s a ‘perfect’ place’. Another also said, ‘this is an absolutely perfect place. I had to go into hospital and when I came back, this felt like ‘home’. Another said she liked the home very much and the ‘staff are very kind and caring, which is what you want’. Another said that staff helped her keep busy, which stopped her worrying about things. Regular opportunities are provided to service users to join in exercises. One service user said she enjoyed the ‘chairobics’ as ‘its fun’. A random sample of medication records and the system for the storage, handling and administration of medication was looked at. This was found to be appropriate, other than there was a difference in the dosage instructions for a service user’s eye drops on the bottle and that recorded on the medication administration record. A gap was seen on a medication administration record where it had not been recorded if a medication had been given or not. Service users are encouraged and supported to look after their own medication if they are able and wish to do this. A written risk assessment about this was seen, which would benefit from further detail about the actual risks assessed. For example, it stated that the service user was not at risk from ‘overdosing’ but it was not clear if this was an assessment of their cognitive abilities or potential for accidental or deliberate self-harm. Secure storage facilities are provided in service user’s bedrooms. The Manager said that all staff handling medication had received accredited training and evidence of this was seen on a sample of staff records looked at and confirmed by a member of staff. Service users were well groomed and attention was paid to their personal care. The laundry assistant confirmed that each service user has an allocated day when their laundry is washed separately from other service users. This ensures that nothing is misplaced, which is good practice. All service users have a single bedroom with an en-suite toilet. A service user said that the staff always respected her privacy and dignity. Three relatives, who completed a survey, confirmed that they could see their relative in private when they visited. All five GPs who completed a survey said that they could see their patients in private when they visited the home. Staff were seen to knock service users’ bedroom doors. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home seeks service users’ opinions about the activities provided and provides an adequate range of social activities both inside and outside the home. Service users are supported and encouraged to keep in contact with their relatives and friends. Service users’ rights to exercise choice and control over their lives are respected by the Manager and staff of the home. An excellent range of well-cooked food is available and enjoyed by service users. EVIDENCE: A range of social activities are provided both inside and outside the home. Each service user is given a large print poster each month to tell them about the activities planned. The record of activities over a 7 day period showed Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 15 that service users had been offered chairobics twice, games and cards, music in the conservatory and a crafts session. One service user said she enjoyed giving a reading at a regular Songs of Praise event held in the home. She had enjoyed an outing to Corbridge and said that her suggestion for an outing to the coast had been acted upon. Another service user confirmed that they received the monthly poster but felt that there weren’t many activities they wanted to participate in. The home has large, well landscaped and attractive grounds, which a service user said he enjoyed. Three service users, who completed a survey, said that there were ‘always’ activities that they could take part in and five said there ‘usually’ were. Service users are asked about their spiritual observance wishes and support will be provided with this where required. Service users can see their visitors in their bedrooms or there are several quiet communal areas in the home. Three relatives confirmed in a survey that they were welcomed in the home at any time and could see their relative in private. Service users spoken to during the inspection confirmed that their relatives could visit at any time. A visitor said they always received ‘ a lovely warm welcome’. A relative, who lives some distance away, had been allowed to use their relative’s bedroom whilst they were in hospital so they she could remain close by to provide support. Most service users handle their own finances and do not require any support from staff to do this. Information about local advocacy services is displayed in the home. A sample of bedrooms were seen, which were personalised with service user’s personal belongings. The Manager confirmed that the Abbeyfield Society has a policy about data protection and access to records. The menu provides choices at each mealtime, including breakfast and supper. Six of the service users who completed a survey said they ‘always’ liked the food, two said they ‘usually’ and one also said they would like more vegetables. Service users spoken to during the inspection gave the following opinions. ‘The food is excellent and you get a choice’, ‘I went to see (the chef) and told him my table would like more soup and we got it’, ‘the food is excellent and there is plenty of choice. I ask for small helpings and get them. The chef is wonderful’. A service user confirmed that her specific cultural requirements Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 16 were respected. sherry. A service user said that birthdays were celebrated with a The lunchtime meal provided on the first day of the inspection was mushroom soup, followed by a choice between salmon with a chilli dressing, with rice and green beans or beef casserole with potatoes and green beans. This was followed by bread and butter pudding or ice cream. The salmon was tried and found to be very tasty and well cooked. Service users took a great deal of interest in their food and evidently enjoyed it. The lunch time meal was unhurried with service users being given time to eat and enjoy conversation with their companions. Aids were provided to service users where appropriate to help maintain their independence. The chef was well informed about the nutritional and cultural needs of service users. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective complaints procedure, which means that service users are listened to and their concerns are acted upon. The Manager and staff have good knowledge of adult protection issues, which helps protect service users from abuse. However, the procedure for responding to suspicions of abuse need review, to ensure that it provides appropriate guidance to staff and complies with the Department of Health guidance. Staff should be given training about the factors which lead to challenging behaviour by service users, so that they fully understand why service users may be physically or verbally aggressive and learn appropriate ways to support and protect service users and staff in these situations. EVIDENCE: Each service user is given a copy of the Home’s complaint procedure, which is contained within the Service User’s Guide. Copies are also displayed around the home. One complaint had been received that an item had been broken. replaced to the satisfaction of the complainant. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc This was Page 18 Version 5.2 Seven service users who completed a survey said they ‘always’ knew who to speak to if they were not happy, one said they ‘usually’ did. A service user spoken to during the inspection said they would tell the Manager if they had any concerns and added ‘she would do anything for you’. Another said, ‘if anything wasn’t right, I would tell my son and the senior carers’. Another said she would tell the Manager who would ‘sort it out’. She added she had done this once and it was. A senior member of staff spoken to was aware of the importance of reporting any concerns about abuse and confirmed she had received training. However, she was unsure of the action she would be required to take if a concern was brought to her attention whilst deputising for the Manager in her absence. The Manager reviewed the Home’s written procedure for responding to suspicion or evidence of abuse and felt that this needed clarification to ensure that it fully complied with Department of Health guidance and gave appropriate advice to staff. Protection of Vulnerable Adults (POVA) training has been organised for March 2007, for those staff who have not had this yet. Day to day entries in one person’s care records indicated that some staff had described her in an inappropriate way and that they may require further training to increase their understanding about the reasons service users may present challenging behaviours. Management had rightly sought professional advice and support about the difficulties experienced by the service user. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. The home is kept very clean, which helps to protect service users. EVIDENCE: The home was purpose built for the care of older people and ground floor accommodation is provided throughout. A tour of the premises was undertaken and a small number of bedrooms viewed. Each service user has a single bedroom with an en-suite toilet. Each Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 20 bedroom has a large window, at a height, which enables service users to see the grounds when seated. The home also an adequate number of bathrooms equipped with suitable baths for people with disabilities to get in and out of safely. The home is well maintained and décor and furniture is of good quality. There is an annual development plan identifying areas and items for refurbishment and timescales for when this will be done. There are large grounds, which are well landscaped and provide space and areas of interest for service users. The home was very clean and no unpleasant smells were noted. All eight service users who completed a survey, said that the home was always fresh and clean. Protective clothing is placed close to hand throughout the home for staff to use. The home has a contract for the removal of clinical waste. There is a well equipped laundry and as stated earlier, service users’ laundry is washed separately. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and type of staff on duty throughout the day and night is sufficient to meet the needs of service users. They are kind and caring and work hard to meet service users’ needs. Robust vetting procedures are carried out before staff are employed, which helps to protect service users. The home has exceeded the minimum standard for the number of care staff achieving an NVQ in care. This training helps staff to understand and meet the needs of older people who require care and support. New staff are given thorough induction training, which helps them to provide the care that service users need. EVIDENCE: Very positive opinions were received about the way staff carry out their jobs. A service user spoken to during the inspection said that ‘The helpers are very kind and caring, they never complain or show that a task may be unpleasant. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 22 They work as a team.’ Another said that the staff were very good, kind and caring and treated her very well. A relative said that the staff ‘were very caring and it wasn’t ‘just a job’ for them’. A relative who completed a survey said, ‘The staff are always helpful and cheerful even in the most difficult circumstances.’ Seven of the eight service users completing a survey said that the staff were ‘always’ available when they needed them, and one said that they ‘usually’ were. Examination of the rota and discussion with the staff and Manager showed that the numbers of care staff are as follows:8 am to 2.30 pm 4 2.30 pm to 9 pm 3 9 pm to 8 am 2 waking The above includes a senior member of staff and is enough to meet the needs of service users. The Manager’s hours are not included in the above nor staff employed for other tasks, such as food preparation, cleaning or laundry. The Manager stated that there had been very little staff turnover in the care staff team since March 2004. Twelve (80 ) of the care staff team have a National Vocational Qualification in care at Level 2 or above. A sample of staff records were looked at and it could be seen that they had had a range of other relevant training, such as ‘management of diabetes’, ‘depression and the elderly’, ‘understanding people with dementia’. A training course about promoting Equality & Diversity has been booked for March 2007. The records of three recently recruited staff were looked at. Two written references and a Criminal Records Bureau disclosure had been obtained for all three before they were employed. The Society has also obtained the services of an Occupational Health Nurse to assess the fitness of staff for their roles. A new carer had just started work in the home and there was written evidence confirming that she was to receive induction training to TOPSS standards from a training agency. She was also receiving induction training within the home covering important aspects of her role. The Manager stated that any new carers spend a full week receiving training before they go onto the staff rota. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is appropriately qualified and experienced and provides clear leadership, which ensures that the home is well run in the interests of service users. The Abbeyfield Society and the Manager work hard to ensure that service users are encouraged and supported to give their views and opinions and influence the way in which the service is provided. The system for handling service users’ money is thorough, which helps protect service users and staff. The health, safety and welfare of service users and staff is promoted and safeguarded. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 24 EVIDENCE: Mrs Chris Major, the registered manager, has many years of experience and has achieved an NVQ 4 in management and care. She has also recently attended update training in employing people, managing disputes & grievances and managing absence. The home has a quality assurance programme in place, which includes seeking the views of service users to provide feedback on the quality of care provided. The results of these surveys are posted on the notice-board and service users are given information about them. A service user confirmed that residents meetings are held and that she had attended and had been able to give her opinion about the services provided in the home. Service users gave examples of how the service had listened to their wishes and acted upon them. These are referred to earlier in this report. Members of the Abbeyfield Society Management Committee meet service users regularly to obtain their opinions. The system for the handling and storing of money held on behalf of a small number of service users was looked at. This was found to be appropriate. A range of health and safety training had been provided to members of the care staff team since the last inspection. This included health & safety, fire safety, medication, moving and handling, food hygiene and first aid. Evidence of this was seen on a sample of staff records and confirmed by staff. The records showed that training of this type is updated regularly. Further training has been booked about control of infection. Evidence of regular maintenance and servicing of essential equipment used in the home was seen. Fire safety checks are carried out and a record kept. Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 25 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 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 26 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 14(1)(a) Requirement Ensure that full information is obtained about potential service user’s mental health conditions before a place is offered in the care home. Ensure that a plan of care is put into place for the prevention of pressure sores, where the assessment has identified that they are at risk. Ensure that care plans give guidance to staff as to how to support service users who present challenging behaviours. Medications must be checked more carefully when they are supplied to the home to ensure that the dosage instructions are recorded accurately on the container and the medication administration record. The responsible carer must record on the medication administration record whether each medication was given or not. Ensure that the risk assessment process carried out when service Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 27 Timescale for action 31/05/07 2 OP7 15 31/05/07 3 OP9 13(2) 31/03/07 4 OP18 13(6) 5 OP18 18(1)(a) users wish to self-administer medication, includes consideration of their cognitive abilities and potential for actual or deliberate self-harm. The risk assessment must be fully documented. Review the procedure for responding to suspicions or allegations of abuse to ensure that it complies with the Department of Health guidance No Secrets and local authority reporting requirements. Provide/arrange staff training, as necessary, in understanding and responding to challenging behaviours and in the conditions that may affect older persons as they age. 31/05/07 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abbeyfield Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Care Home DS0000000430.V322912.R01.S.doc Version 5.2 Page 29 - 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!