Inspection on 03/01/06 for Abbeyfield Rogers House

This inspection was carried out on 3rd January 2006.

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

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

Other inspections for this house

Abbeyfield Rogers House 25/07/07

Abbeyfield Rogers House 23/08/06

Abbeyfield Rogers House 06/06/05

Abbeyfield Rogers House 13/12/04

Abbeyfield Rogers House 29/07/04

Abbeyfield Rogers House 29/03/04

Similar services:

Ridgemount

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield Rogers House Drewery Drive Rainham Gillingham Kent ME8 0NX Lead Inspector Sally Hall Announced Inspection 3rd January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbeyfield Rogers House Address Drewery Drive Rainham Gillingham Kent ME8 0NX 01634 366211 01634 261374 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Abbeyfield Medway Valley Society Mrs Tonia Jeanette Waghorn Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of one service user who is under 65 is restricted to one person whose date of birth is 21/11/40 6th June 2005 Date of last inspection Brief Description of the Service: Rogers House is a modern purpose built home for the care of the elderly located in a residential area within easy walking distance of local shops. The home is currently registered for the care of 41 older people. Accommodation is in 37 single and two shared bedrooms, all of which have en-suite facilities or a dedicated toilet close to the room. All bedrooms are fitted with a call bell system and a telephone and TV point. There 5 day rooms and a large conservatory opposite the main entrance. The home has 5 assisted bathrooms, assisted toilets and has an 8 person lift providing access to all 3 floors. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced unspection at Rodgers House took place on 3rd January 2006 at 9:35am. The inspector agreed and explained the inspection process with the support manager and acting manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures and reviewing care plans and records kept within the home. A tour of premises was also undertaken and a number of service users and staff were spoken with. The focus of the inspection was to assess Rodgers House in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? What they could do better: The recording of medication must be improved to make audits easier. Care staff are working hard at the home to ensure that the service users needs are met, however this is not apparent when reading the daily notes, which lack detail. Due to a change in senior carers the care staff supervision has fallen behind the required six times per year. It is important that this is rectified in the coming year. A system is required to ensure that all maintenance certificates are in place and kept current. Both the periodic and PAT testing certificates were out of date. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 6 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 Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-6 Service users are provided with the information they require to make a decision before moving into the home. However, this needs to be made available in other formats to suit all service users’ needs and must contain all the relevant information. Service users are provided with a contract/terms and conditions. However copies of these could not be found on all files. EVIDENCE: The home provides a combined Service Users Guide and Statement of Purpose. All the required information should be included in the document and it should be available in formats to suit the needs of the service users. The service users’ contract documentation seen contained the required information. However it was not possible to find the terms and condition for the service users funded by the local authority. The acting manager explained that all prospective service users are either visited prior to admission or an assessment of their needs is undertaken when Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 9 they visit the home for the day. During this time service users have their daily living and care needs assessed. Part of the assessment process is based on staff recording the relevant code numbers under various headings. This does mean however, that you need to have sight of the codebook to fully understand the assessment. The home has been working towards ensuring that at least half the staff have attained an NVQ level two or above in care. Evidence was seen that other required training is being facilitated on a regular basis also. The acting manager confirmed that all necessary certificated training has been undertaken and certificates are current for all staff. All prospective service users and their families are invited to visit the home prior to admission. They are shown the room that is available and the facilities the home has to offer. If the service user chooses to move into the home this will be on a 28-day trial basis. At the end of this time a review is held to ascertain if the home is meeting the service user’s needs and that the service user is happy. If the trial period has been successful the stay then becomes permanent. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 11 The home has a comprehensive assessment and care planning system to ensure service users’ needs are identified and met. However, the daily records need to reflect fully the care provided. The service users can be confident that their health and wellbeing needs will be met. The medication administration and recording in the home needs to be more robust to ensure service users are not at risk. EVIDENCE: The home has a very comprehensive assessment process and the care plans seen reflected this. However, it was found that the plans had been added to and contained changes in need that were not reflected in the assessment. As the plans had been added to rather than being rewritten, it became difficult to ascertain the current needs of the service user. The assessments are reviewed three monthly, but are not rewritten, good practice would be to redo these six monthly, renewing the care plan at the same time. Of course this would need to be done sooner if the service user experienced major changes in care needs. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 11 The daily records did not cross reference well with the care plans and it became evident that staff are not fully recording the care and social interaction they have with service users. The detail in the reports also varied between staff. For example it was evident that staff are not recording the personal care they provide to all service users in the evening. The daily records did not record the times that events and care provision took place. Service users are able to keep their own doctor when possible. District nurses visit as required. Evidence was seen that the chiropodist, optician and dentist all visit those service users who cannot visit them. The assessment process of the home identifies the need of the service users regarding these services. The administration of medication was observed and a member of staff who is trained to do so administered this in the correct manner. The medication storage room was not inspected during this inspection. The acting manager explained that medication is stored in locked cupboards within a dedicated room, which also has the correct storage for controlled medication. The check of the medication records indicated that there was some discrepancy between the tablets signed for and those taken. The manager is to investigate, but a full audit was not possible as a record is not made of the medication carried forward each month. The Medication Record Sheets did not indicate if the service users have any allergies and the acting manager was asked to ensure this is completed. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Service users benefit from a range of activities arranged by the staff at the home. Residents maintain their independence and exercise their right to choice and control and are encouraged to maintain contact with their family and friends. The dietary needs of residents are well catered for in pleasing surroundings at convenient times. EVIDENCE: The activity programme was seen on the notice board. The service users confirmed that activities are arranged in the home and they can choose whether to take part. The home also has entertainers coming into the home, which the service users spoken to said they enjoyed. One service user spoken to explained that she likes to spend a lot of time in her room. She said this is not a problem, the staff respect her choice to do this, but they always keep her informed of what is going on. On the day of the inspection a number of service users were seen joining the visitors in the day centre room for bingo. Some service users and families canvassed did express that they felt that not enough activities take place. The home does not have a dedicated activity person and given that the home also takes in day service users this does stretch the home’s staff. The acting manager was asked to discuss this with the quality manager. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 13 Outings are not going well. The manager said that she has tried to encourage service users to go out but although they get plenty of interest when talking to service users once arranged many refuse to go. The home has access to transport. Some service users went to the theatre recently to see a pantomime. Families and friend s are encouraged to visit and are able to make refreshments. The home offers choices to the service users throughout the day and this was observed during the inspection process. There was little evidence of choice documented in the daily report and this needs to be expanded upon. Service users spoken to said that they are always asked what they want to do, i.e. time for getting up/going to bed etc. The mid-day meal was well cooked and very tasty. The food was arranged in an appetising way and the service users were given a choice of meal. Some staff note in the daily report if the service users enjoyed their meal and record the amount that was eaten. Service users spoken with all said they enjoy the meals at the home, which are usually home cooked and there is plenty of it. The menu showed balanced meals with plenty of variety. The manager explained that this is one of the topics of the regular service users meetings; they encourage service users to have an input to the menu. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has an adult protection policy for the protection of its service users, but it does not reflect recent changes to legislation and local protocols. EVIDENCE: The home did not have a copy of the local authority adult protection protocols issued earlier this year. It was recommended that the manager obtain a copy of this. There is a whistle blowing policy for staff. However this needs to be reviewed to reflect the recent changes in the local protocol and legislation regarding POVA etc. The acting manager confirmed all staff have undertaken adult protection training. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home offers clean and pleasant surroundings in which to live. EVIDENCE: A tour of part of the premises was undertaken. Most of the above standards were evidenced and met at the last inspection. The home was clean, and well maintained. It provides a choice of communal space and private space for service users. There is a laundry where all washing for the home is done. The laundry was seen and although small, was organised, clean and tidy. The red sack system is used to ensure staff handle foul linen as little as possible. It was evident when talking to the laundry person on duty that they take a pride in their work and it showed. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 30 Service users’ care, social and emotional needs are promoted by the employment of caring and suitably trained staff. EVIDENCE: When the current staff have received their certificates half the home’s staff will have achieved NVQ level 2 or above in care. The acting manager explained that a further 12 staff are due to undertake this training in 2006, the first of these starting in January. A staff member spoken with said they are looking forward to starting the course. Another, who has now attained the award, said it gave them a better understanding of how to meet the service users needs. The acting manager explained the induction that all new staff receive to ensure that they know the lay out the buildings, fire procedures, home’s policies etc. A training diary is kept which showed the courses booked for the year. All staff have to sign up to these courses and are given a choice of dates. The acting manager said that this ensures that all training remains current. The training listed was discussed as some courses were awareness only and it is now required that training courses are competency based. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36, 38 Although the registered manager is no longer at the home the service users are benefiting from an experienced acting manager. The quality of care offered is compromised because care staff are not in receipt of regular supervision. Service users cannot be confident that the home’s record keeping systems for personal money safeguards them. The home strives to ensure that the health, safety and welfare of the service users is promoted and protected. However, not all maintenance certificates were in date. EVIDENCE: The manager is acting at this time, and was the home’s assistant manager. She has a large number of years experience in residential care of the elderly and has achieved NVQ level 3 in care. She is due to start her level 4 award soon. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 18 Service users spoken with said all the staff, including the management, are very approachable. It was apparent that there is a very open atmosphere in the home. The home keeps a small amount of personal money for service users who can’t or don’t wish to manage their own day-to-day finances. The records were checked against the monies held. Two accounts were found to be correct. However one was not, due partly to incorrect addition etc. The acting manager agreed to audit all service users’ finances as a matter of priority. There was evidence that there has been some staff supervision. However the acting manager has not been able to keep up with the two monthly timescales due to recent changes in the senior care team. The acting manager is taking steps to ensure that all staff receive regular supervision in the coming year. Regular staff meetings are held, which are recorded. Residents said that they are invited to meetings and are kept well informed of what is happening in the home. Various measures have been taken to promote safe working practices in the home. This includes for example training staff in moving and handling, first aid, health/safety, infection control and regular checks and monitoring of systems in the home. Staff training is now being arranged, systems are in place to ensure that all training certificates remain in date and that all staff have covered all the required training. The home now has a COSHH file available for staff to use in an emergency. The fire log is being completed and most staff have now had fire training. The maintenance certificates such as gas, electric and LOLER were confirmed as being in place and current in the pre-inspection questionnaire completed by the acting manager. It was however noted that the electrical certificates were out of date. The acting manager has been asked to ensure that the home arranges the required tests and evidence of this is sent to the Commission for Social Care Inspection by the 31st January 2006. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 3 2 X 2 Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13,17, sched3(3) (i) Requirement The registered person must ensure that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling, administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. All staff at the home must receive regular formal supervision; the care staff need to have this supervision at least six times a year. Starting from March 2006 and ongoing The registered manager must ensure so far as is reasonably practicable the health, safety and welfare of service users and staff. Maintenance certificates must be kept up to date. Copies of the electrical certificates are required to be sent to Commission for Social Care Inspection by Timescale for action 31/01/06 2 OP36 18(2) 31/03/06 3 OP38 23,13,16, sched 4 31/01/06 Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP1 OP2 OP35 OP7 OP18 Good Practice Recommendations The Service Users Guide and Statement of Purpose although one document, should be reviewed to ensure it contains all the required information. Each service user should be provided with a statement of terms and conditions at the point of moving into the home (the contract if purchasing their care privately was seen). There should be a system of monitoring to identify any accounting errors in the recording of personal monies. There should be more detail recorded in the daily notes to give a true picture of what care the staff are providing and how independence is being encouraged etc. A copy of the local authority adult protection protocols should be obtained to ensure the home’s policy and procedure meets current legislation. Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeyfield Rogers House DS0000028736.V264179.R01.S.doc Version 5.0 Page 23 - 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!