CARE HOMES FOR OLDER PEOPLE
Abbeyfield St. Georges House Park Terrace Westcliff-on-Sea Essex SS0 7PH Lead Inspector
Ray Burwood Unannounced Friday 19 August 2005
th 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 St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Abbeyfield St. Georges House Address Park Terrace Westcliff-on-Sea Essex SS0 7PH 01702 331512 01702 345893 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) The Abbeyfield Southend Society Limited Mrs Patricia Anne Linsell CRH Care Home 26 Category(ies) of OP Old Age (26) registration, with number of places Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: NONE Date of last inspection 25th March 2005 Brief Description of the Service: Abbeyfield St Georges care home provides care for twenty-six older people who do not fall within any other registration category. The home is decorated, furnished and maintained to a good standard. All personal accommodation is offered on a single occupancy basis. Twenty-four bedrooms have en-suite facilities. Each room has access to telephone and television points. The gardens are well maintained and attractive and there is parking available. The home is situated in close proximity to Southend-on-Sea town centre, local community amenities and facilities. There is close access to local buses and the mainline train station to London. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was undertaken on the 19th August 2005 with the assistance of the Senior in charge, Sue Blackman, residents and members of the care staff team. The home’s Manager Pat Linsell was unavailable due to her being on annual leave. A general feedback on the outcome of the inspection was given to the Manager on her return. This unannounced inspection was carried out between the hours of 10.00am and 4.00pm. There was a homely atmosphere and residents were found to be relaxing in various parts of the home. Residents spoken with praised the way in which the home was run and the high standard of care they received. Visitors to the home also confirmed how they were kept informed about their relatives, and made welcome on their visits. A tour of the premises was undertaken and records relating to the care of residents inspected. Staff spoken with included two Senior staff and a member of the care staff team. A total of 14 standards were inspected with all being met, there were no requirements or recommendations necessary and none had been carried forward from the home’s previous inspection. What the service does well:
Abbeyfield St Georges provides a welcoming and homely environment, is decorated and furnished to a high standard and is clean, bright and airy. Personal healthcare needs are well supported by a dedicated staff team, who are appropriately trained and have in most cases, many years of experience, Relatives strongly commended the staff on their caring, but also, the good communication about their relatives care. Residents who were kind enough to contribute towards the inspection visit were complimentary about the high standard of the home and the mix of staff. One lady commented on the ability of staff to have a laugh and a joke, another on how they were well supported if required or able to remain as independent when ever possible. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: 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 St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 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 St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 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) 3, and 4. The admission process is well managed and residents, or their representatives, are given clear information regarding the service. EVIDENCE: Residents’ files sampled and inspected, contained the home’s assessment documentation in relation to individuals referred through care management arrangements and those individuals who are self funding. Residents and relatives spoken with detailed their involvement in visiting the home prior to making a decision to move in. Residents who were ill at the time of being admitted confirmed that their representatives were involved in the admission process and were given clear information in relation to the home’s capacity to meet their assessed needs. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 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 and 8. Residents’ health and personal care needs were well met by the home, with staff having a good understanding of the care planning process. EVIDENCE: The files of three residents were sampled and inspected and found to contain the required information generated from the assessment process to enable staff to carry out their care duties. Care plans are comprehensive and include residents’ personal details, risk assessment’s, ongoing needs assessments, records and prescribed medication/changes etc. Residents spoken with explained that they were involved in drawing up the care plan and contribute to any agreed changes if they are required. At the time of the inspection one resident, who had recently moved into the home, was having a review by a visiting social worker. A senior member of staff and a relative were also present at the review. Care staff spoken with confirmed their knowledge and responsibilities regarding care planning and their involvement in monthly and annual reviewing of care plans, together with updating records in relation to accidents and falls. Care staff discussed the increasing amount of paperwork, particularly
Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 10 around healthcare needs and the visits by professionals. Advice was given in terms of maintaining records by recording visits and outcomes in one record book for all visits. This was also suggested to the home’s manager. Records of healthcare input into the home were detailed with records kept of visits by professionals. Residents being treated by the district nurse explained the improvement to their different conditions and the expectation in relation to being more mobile on completion of their treatment. Overall, residents were satisfied with the access to healthcare services and how staff supported their assessed needs. Two residents are currently in the process of having assessments undertaken at the Leigh Clinic in respect of their mental health. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 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 and 13. Residents are able to experience a stimulating and varied life in the home if they so wish. Friends and relatives are encouraged to visit the home and are provided with a private space if required. EVIDENCE: From discussions with residents and staff, it was evidenced that social and leisure activities were taking place. Daily activities are planned by one of the home’s Senior’s and includes games, quizzes and bingo. A religious service is held in the home with those residents able, attending their own church weekly. Residents who were asked if they were happy with the daily routines of the home, replied that they were firmly in touch with what was going on and felt these coincided with their individual lifestyles. During the inspection, visitors to the home were spoken with in a private area. They explained that they were always made welcome and didn’t feel rushed into leaving. During the inspection there was numerous visitors to the home by friends and relatives. Residents confirmed that they are able to maintain relationships with friends they knew before living in the home. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 12 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 and 18. Arrangements for dealing with complaints, together with appropriate policies and staff training, help ensure the protection of residents. EVIDENCE: Residents spoken with knew who to talk to if they had any concerns or wished to make a complaint. Copies of the home’s complaints policy and procedures were available to residents, relatives and staff. Records of complaints were inspected and found to be correct with satisfactory outcomes recorded. There had been no complaints received by the Commission for Social Care Inspection (CSCI), since the last inspection. Staff that were spoken with evidenced a good understanding of how to protect and prevent abuse within the home, and had received training in this area. A copy of the Southend-on-Sea’s policy on the Protection of Vulnerable Adults was made available. Further information about the Essex Vulnerable Adults Protection Committee, and how to access copies, was left with the home’s staff. There are no current Adult Protection alerts relating to this home. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 13 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 and 26. The home provides a well-maintained environment that is accessible to residents, homely, and meets individual needs. Changes already in place, and further planned changes to the premises, will further help enhance the protection and safety of residents living in the home. EVIDENCE: From observations made during the tour of the premises, the home continues to be presented to an excellent standard of cleanliness and hygiene. All rooms viewed were well maintained and decorated to a high standard. Residents spoken with were happy with the way in which their bedrooms were kept clean by carers and auxiliary staff. One of the home’s vacant bedrooms has been highlighted for refurbishment and will include en-suite facilities when completed. Also, the hairdressing facilities have moved upstairs and the medical room is in the process of being moved from the old staff room upstairs to a new room on the ground floor.
Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 14 The home’s garden areas are regularly maintained and offer residents a quiet and relaxing area in which to sit during the better weather. Since the home’s last inspection, work had been completed in relation to the new laundry room. This has now moved from the original area and provides more room to enable residents to have individual shelving and storage space. Washing machines have a specified programme to meet disinfection standards and has also been fitted with an additional MRSA disinfection system to help ensure that cross infection is further minimised. The home is the first to use this additional infection control system in the area. The home provides sluicing facilities on the ground and first floor Sufficient adequately equipped bathrooms and toilets were available to residents, these were found to be clean and free from offensive odours. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 15 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 and 28. Staff working at the home, are well-trained, and employed in sufficient numbers to meet the assessed needs of residents. EVIDENCE: From the evidence obtained during discussions with staff and residents, together with sight of the staff rotas, it was noted that staffing levels are maintained by a stable staff team. Staffing numbers and skill mix of staff are appropriate to the needs of residents and the layout of the premises. Staff discussed their training undertaken in relation to the specialist service this home provides. These included dementia awareness, managing challenging behaviour, abuse in care, and health and safety related training courses. The home continues to support staff through their National Vocational Qualification (NVQ) Levels 2 and 3. The home’s manager and a senior carer are NVQ assessors (D33-32). Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 16 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 and 36. These standards were not fully assessed at this inspection. EVIDENCE: Due to the home’s manager being on annual leave, it was not possible to fully inspect the key standards relating to the management and administration of the home. However, from the information shared by residents and staff, the home is run by a manager who is fit to be in charge, is approachable, and will respond to any concerns raised by residents, staff, visitors and relatives. These standards will be further inspected at the next inspection of the home. Staff spoken with confirmed that regular formal supervisions were taking place and that they are signing a record of completion. Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 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 x 3 3 x x x x 3 x x Abbeyfield St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 18 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 Regulation Requirement Timescale for action 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 St. Georges House I56 I06 S15412 Abbeyfield St.George V241425 190805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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