Inspection on 16/10/07 for Abbeyfield Woodgate

This inspection was carried out on 16th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbeyfield Woodgate 06/10/08

Abbeyfield Woodgate 30/10/06

Abbeyfield Woodgate 30/11/05

Abbeyfield Woodgate 11/07/05

Abbeyfield Woodgate 16/12/04

Abbeyfield Woodgate 21/07/04

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield Woodgate Woodgate Tudeley Lane Tonbridge Kent TN11 0QJ Lead Inspector Ruth Burnham Key Unannounced Inspection 16th October 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Woodgate DS0000023772.V346942.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 Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Woodgate Address Woodgate Tudeley Lane Tonbridge Kent TN11 0QJ 01732 350952 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) viv.littlechild@abbeyfieldkent.org The Abbeyfield Kent Society Mrs Vivien Littlechild Care Home 48 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) 2. Dementia (DE) The Maximum number of service users to be accommodated is 48. Date of last inspection 30th October 2006 Brief Description of the Service: Abbeyfield Woodgate provides 24-hour care and support to older who are experiencing dementia. The home is located in a quiet residential area of Tonbridge and is close to local amenities and public transport. Service users’ bedrooms are single and 4 of these have en-suite facilities. There are bathrooms and toilets located at various points throughout the home. There are several lounges and a large dining room. The home has a summerhouse and large gardens. The current fees are £470.00 - £612.00 per week. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit was made to the home on the 16th October 2007 at 09:00 by one inspector who was in the home until 3.30 p.m. The assistant manager, a number of staff, one visitor and some of the people who live in the home were spoken with. Some documentation was seen and a tour of the home made. An observation tool was used as part of the inspection. The residents spoken with said the staff are always friendly and kind. Relatives said they were made welcome when they came to visit. Surveys were sent out to relatives, residents and health care professionals before the inspection. The majority of comments made were positive however there were some critical comments received. These were mainly about poor communication between the home and relatives. Health and social care professionals were mainly very positive in their responses. The home is has undergone a major refurbishment programme. The Abbeyfield Kent Society has changed the home’s category to mainly dementia care. People who were observed during the visit were interacting well with staff and a number of them were enjoying activities. There have been no complaints received about the home in the last year. The home will provide past inspection reports on request. What the service does well: People who were spoken to during the visit felt their needs were being met by the home. They said the staff are friendly and kind. They said they are spoken to respectfully and they are happy to speak to staff about any concerns they might have and know the staff will try to help. The refurbishment programme is nearly complete providing a pleasant and homely environment for the people who live there. The home is being managed and run by a committed staff and management team. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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 Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1–6 Quality in this outcome area is good. People are provided with good information about the home to help them to make a decision about moving in. There are good assessment procedures to ensure that people’s needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are provided with good information about the home in the statement of purpose and service users’ guide. This information is included in the welcome pack given to each person on arrival. The information helps people who are thinking about moving into the home and their relatives to decide if it will be suitable for them. Each Person is provided with a contract and a statement of terms and conditions to ensure their rights are protected. The manager or one of the senior carers assesses people before they move into the home. They visit them at the hospital or the person’s home after Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 9 which they are invited to come to the home for the day and an overnight stay if they wish to before deciding to move into the home. The home does not provide intermediate care. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 11 Quality in this outcome area is adequate. People who live in the home are cared for by friendly and considerate staff who respect their privacy and dignity. Care plans don’t always contain sufficient information to help staff provide person centred care for people who are experiencing dementia. Risk management processes need some improvement to ensure that people are protected form harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home may not have their emotional and social needs met. Four peoples’ care plans and risk assessments were inspected during the visit. These were incomplete, there was very little guidance for staff about how to support people with dementia and ensure their individual emotional needs are met. Peoples’ individual files contained numerous forms which staff are expected to complete, in all of this paperwork the information which staff need to help them to understand each persons social histories, individual needs, preferences, interests and aspirations is in danger of being lost or is not recorded at all. With so much paperwork to do staff struggle to find the time to record the most important person centred information such as biographies Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 11 and changes in people’s emotional and mental wellbeing so that people with dementia can be supported with understanding and sensitivity. Responses received from relatives before the visit included: ‘sometimes poor communication means that some staff don’t know about problems such as poor hearing.’ ‘Sometimes aren’t aware of a problem because information hasn’t been passed on.’ This also has an impact on risk management processes. Some risk assessment forms had not been completed at all, others lacked sufficient detail to provide guidance to staff to adequately protect people from harm. For example there are lengthy documents for staff to complete when people fall. These were not always fully completed with clear information about the action staff need to take to minimise the risk of the person falling again. Two relatives who responded to the survey said they had not been informed when their relative had had a fall. Responses received from health care professionals before the visit were positive. There are good lines of communication between the home and health services to ensure that people who live in the home have their health needs met. Interaction between staff and residents observed during the visit was warm, friendly and supportive. The service users spoken with said they felt they were treated with respect for their privacy and dignity. Responses to surveys from relatives, social and health care professionals included: ‘ Staff always find time to chat to residents and reassure them if they appear worried or confused.’ ‘staff are always friendly.’ ‘staff are kind and considerate and do their best to ensure each resident is safe and well cared for.’ People are protected from harm through good policies and procedures for the safe handling of medication. The medication storage and administration was seen during the visit, Medication Record Sheets were completed and recorded correctly. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 Quality in this outcome area is good. People who live in the home enjoy a relaxed lifestyle in which their individual choices and preferences are respected. People enjoy good home cooked food in a pleasant and homely atmosphere. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home enjoy a relaxed lifestyle. Routines are flexible and relevant and individual choices and preferences are respected. People can choose when to get up or go to bed, where to eat their meals and how to spend their day. Those who wish to attend church are able to do so and arrangements are made for religious observance in the home for those who wish to take part. People are encouraged to take part in a range of activities. A new activity coordinator has been recruited who is getting to know people. The manager said that biographies are being developed to help match activities to peoples’ individual interests and abilities. Some people occasionally go to the day centre on the site and join in with some of their activities. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 13 Visitors are always made welcome when they visit and there is a choice of communal areas where people can have a private chat. The manager plans to designate a separate room for private visits with tea and coffee making facilities. Mealtimes are relaxed. Some people prefer to eat in their rooms. Others like to eat in the main dining room or one of the smaller dining rooms. Everyone spoken to during the visit said the food was very good and there is always a choice. People have access to a bar and are able to request a drink if they want one, one person was enjoying a glass of wine with their meal. Some discussion took place about the importance of always offering choice to people with dementia in a way they can understand, even when staff believe they know what they like. The manager plans to make mealtimes even more flexible with a café style approach. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People who live in the home are listened to and are free to offer comment or complaint. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who were spoken to during the visit knew who to talk to if they were unhappy or worried about anything. There is a clear complaints procedure included in the welcome pack for each person. Complaints are recorded, investigated and action is taken wherever necessary to resolve issues as they arise. The commission has not received any complaints in the last year about the service. People who live in the home are protected from abuse through good policies and procedures. Staff are trained in how to recognise various kinds of abuse and how to protect vulnerable people. There are sound recruitment procedures including checks with the criminal records bureau before staff are appointed. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 Quality in this outcome area is adequate. People who live in the home benefit from the pleasant homely environment. Further improvements are planned to bring all areas of the home up to a reasonable standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the pleasant homely environment. A lot of work has been done since the last inspection and many areas have been updated and refurbished. Further improvements are planned. The carpet in the ground floor corridor is badly stained and is due to be replaced in the near future. There is a choice of communal areas including dining rooms, lounges and an activities room. People are able to personalise their own rooms and can choose the décor. They are encouraged to bring in small items of furniture to make their rooms as homely as possible. There are sufficient adapted bathrooms and toilets around the home some of which have been refurbished in the last year. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 16 The home has a full time handyman who is responsible for ensuring small repairs are done quickly. The laundry person ensures that peoples’ clothes are labelled to avoid confusion. The laundry is well equipped with plenty of space. People are protected from risk of infection through good working practices when handling soiled articles of clothing and bedding. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 17 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 – 30 Quality in this outcome area is good. People are supported by a caring and committed staff team who understand their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the support of a caring and committed staff team. The home operates a 4 week rota for all staff including support staff. There are waking staff on duty at night supported by a senior carer and manager on call as well. The majority of staff have a national vocational qualification, others are working towards this. People are protected through good recruitment policies and procedures. All staff are checked through the crininal records bureau before appointment. Two references are taken up, the manager was advised that these should be obtained before new staff begin to work on shift. All staff have formal induction training and a 6 month probationary period. They are given the General Social Care Council code of practice. All volunteers have the same checks as employed staff. People can be confident that staff are well trained. All staff have regular appraisal and supervision which includes looking at their training and development needs and ensuring they have completed their statuatory training. People can be confident that staff will understand their specialist Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 18 needs, training is accessed through the Primary Care Trust, the Alzheimers Society and the local college. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. The home is run in the best interests of residents. Some improvement is needed in care records to promote a more person centred approach to care. The health and safety of people who live in the home is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People can be confident that the management are committed to promoting their best interests. The new manager is currently undertaking the Level 4 National Vocational Qualification in Care. People benefit from the manager’s open door policy, the office is near the main entrance and residents and visitors know they can pop in for a chat. People can be confident that the management are constantly seeking to improve their quality of life through the home’s quality assurance systems. The manager holds regular meetings with residents and relatives and has started a Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 20 support group for relatives of people with dementia. All aspects of the home are monitored monthly using forms created by the organisation. These highlight any areas that need attention. The manager has a yearly action plan to focus on areas for development. Quality assurance surveys are conducted yearly, which include different people who use the service such as residents, their relatives/carers/friends and health and social care professionals. Feed back from the surveys is posted on the residents’ notice board and the visitors’ notice board. People have benefited from the improvements in the home in the last year as refurbishment has been carried out and more staff have been trained in caring for people with dementia. Discussion took place following the visit about the need to improve record keeping by reducing unnecessary paperwork and focussing on a more person centred approach to care planning for people who are experiencing dementia. The requirement to improve care plans has not been met from the last 2 inspections. The manager said that work is already underway to develop individual biographical information. People who live and work in the home are protected through good policies and procedures and through safe working practices. Their health and safety is promoted by staff who are trained in moving and handling, basic food hygiene, first aid, fire safety and infection control. Regular safety checks are carried out on equipment and installations. Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 21 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 3 3 Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 (2) Requirement The registered person shall keep the service users plan under review and, where appropriate, revise the service users plan. In that, service users plans must be reviewed and updated as their needs change. This was a requirement in the last 2 reports with a time scale of 02/01/06 and 2/1/07 2 OP7 13(4) The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. In that individual risk assessments should be completed and cover all aspects of people’s lives. The registered person, having regard to the numbers and needs of the service users, ensure that all parts of the care home are kept clean and reasonably decorated. In that, the carpets in the Abbeyfield Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 23 Timescale for action 31/12/07 31/12/07 3. OP19 23(2d) 31/12/07 ground floor corridor need replacing. 4 OP33 24 Quality assurance systems should ensure that care planning and risk management processes are monitored and reviewed so that information is person centred, complete and up to date. 31/12/07 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 Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Woodgate DS0000023772.V346942.R01.S.doc Version 5.2 Page 25 - 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. 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