Inspection on 30/11/05 for Abbeyfield Woodgate

This inspection was carried out on 30th November 2005.

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 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 16/10/07

Abbeyfield Woodgate 30/10/06

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 Jo Griffiths Unannounced Inspection 30th November 2005 11:30 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.V251766.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 Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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) The Abbeyfield Medway Valley Society Mrs Vivien Littlechild Care Home 47 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (35) of places Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care of one Service User with Physical Disability is restricted to one person whose date of birth is 22/08/1953 Care of two Service Users with Dementia is restricted to two persons whose date of births are 12/06/18 and 05/03/27 11th July 2005 Date of last inspection Brief Description of the Service: Abbeyfield Woodgate provides 24-hour care and support to older people. There is also an additional wing that can provide residence to 12 older people with 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 ensuite 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. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place between 11.30 and 15.15 on 30th November 2005. The Manager gave a tour of the building and feedback on the progress made since the last inspection. Some staff, service users and relatives were spoken with and a number of records were inspected. What the service does well: What has improved since the last inspection? What they could do better: All service users care plans need to be kept up to date and any amendments need to be dated to ensure staff are providing the correct support. Information recorded in the daily records must be followed up to ensure health issues are resolved. Service users should be consulted on their wishes in the event of dying to ensure that staff know that they can meet these needs and respect their wishes. As planned, the menu should be reviewed and it is recommended that a person with nutritional knowledge be involved in this. Records of the actual meals eaten by service users must be kept to monitor nutritional well being. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 6 The carpet in the dining room of the dementia wing needs to be kept clean, however it is recommended that it would be better to replace this with easy clean flooring. The Manager must ensure that the home is free from unpleasant odour. The floor of sluice room must be repaired to avoid cross infection risks and all environmental risk assessments require review. There is some risk to service users in the dementia unit of injury as they are able to access the kettle and toaster without staff support. A risk assessment should be completed and staffing levels considered as part of this review. 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 Woodgate DS0000023772.V251766.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 Woodgate DS0000023772.V251766.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, 3, 4 Service users are given the information they need to make a decision about moving to the home. They have a full assessment to ensure their needs can be met by the home. Service users needs assessed needs are being met. EVIDENCE: Service users and their relatives are provided with clear information about the home before they move in. The Statement of purpose and Service User Guide are provided at the point of referral. Service users have a full assessment of their needs before they move in to ensure the home can meet these needs. Their assessments are kept under review and service users said they feel that their needs are well met. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 the following standard(s): 7, 10, 11 Some service users have an up to date care plan ensuring their daily needs are met. Service users feel they are treated with respect. Service users’ wishes for the end of life have not been identified. EVIDENCE: Service users have a care plan to meet their needs. The care plans are well presented and provide care staff with the information they need to support the person. Some of the care plans have been reviewed regularly and it is recommended that amendments to the care plan be dated so that staff can identify the latest guidance. One service user has become unwell and the care plan for this person was inspected. This had not been reviewed and updated to reflect the change in the person’s needs. Whilst some of the daily reports for service users are detailed it was not always possible to track health concerns. The daily reports do not always correspond with the record of visits by the GP or show the follow up action taken. Service users said they felt staff treated them with respect and this was seen in practice. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 10 Service users’ wishes in the event of death had not been discussed with them and recorded in the care plans viewed. This should be addressed in a sensitive manner to ensure that the home knows how to support the person in the way they would wish. This will ensure their wishes can be honoured and respected. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 the following standard(s): 12, 15 Service users receive a balanced diet and enjoy the meals. They have the opportunity to take part in a range of activities in the home. EVIDENCE: An activity planner for the month is displayed in each of the downstairs lounges informing service users of the options available each day. The Manager said that service users views on the activities are taken into account when planning the monthly programme and that it will always include a monthly outside entertainer. In the dementia wing of the building activities are agreed upon each day and clear records kept stating who participated and the success of the activity. This is very helpful when reviewing the quality of what is offered. However, care staff have not always filled in the records. Service users said they liked the meals and the menu for the day was displayed on a board in the dining room and hallway. The cook said that the menu is currently under review and it is recommended that advice be sought from a person with nutritional training to help with this. The cook keeps records of the menu provided each day, but was advised that the record should show what actual meals the service users are eating to monitor that they are receiving a healthy, balanced diet. Fresh fruit, drinks and snacks are available all day. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: None of these standards were inspected on this occasion. Standard 16 was assessed as met and standard 18 as commendable at the last inspection. (11/07/05) Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Service users live in a comfortable and safe home. There are some communal areas that require redecoration, but generally the home is well maintained. Service users have access to bathroom facilities that meet their needs and plenty of communal space. Some issues of cleanliness of carpets need to be resolved. Service users bedrooms meet their needs and these are fully furnished and personalised. EVIDENCE: Since the last inspection some hallways in the home have been redecorated including areas where wheelchairs have damaged the doorframes and 2 toilets have been redecorated. The Manager has developed a plan for the redecoration of the remaining communal areas within the next 18 months. Radiators in all bedrooms have been replaced with low surface temperature ones and it is planned that the hallway ones will be replaced. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 14 The home has sufficient bathroom and toilet facilities to meet the needs of service users and there are several lounges and a large dining room for use by service users on the ground floor. In the upstairs dementia wing there are 2 small lounges and a dining room. The carpet in the dining room of this wing was very stained and dirty despite its weekly clean. The Manager was advised to consider an alternative that will be easier to keep clean. Some areas of the dementia wing had an unpleasant odour from the bedroom carpets. The staff stated that these are cleaned daily, but other options must be considered to ensure service users do not have to live in a home that smells unpleasant. The home has a lift and rails around the home to support people with mobility difficulties. The bathrooms have been adapted and there are call points in each room of the home for service users to summon assistance as needed. At times the call bells went off and staff were seen to respond to these within a couple of minutes. The laundry facilities in the home meet the needs of the service users and the home has a separate sluice room. However, it was noted that the flooring in the sluice room was cracked and this could present a risk of infection in the care home. Service users bedrooms are decorated to a high standard and fully furnished, although the Manager said that most service users like to bring their own furniture. Each person had personalised their room and some had TV, telephone and small fridges. The home was warm and homely and service users said they were very comfortable. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 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): 27, 28, 30 Service users are supported by sufficient numbers of staff in the main area of the home. There were not sufficient staff on duty to support the service users in the dementia wing. Staff are highly trained, qualified and competent in their role. EVIDENCE: There were sufficient staff to meet the needs of the service users in most areas of the home. There was some concern about the level of support available in the dementia wing as service users can access the kitchen when staff are supporting other people in the wing. Staff were observed in their duties and demonstrated an understanding of service users needs. Service users said they liked the staff and felt well supported. Staff training records showed that staff have attended a number of training courses relevant to their job and that training is given high priority by the Manager. Approx 60 of staff have achieved their NVQ award and more are working toward this. Staff spoken with demonstrated a commitment to their job and to developing further. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 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 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, 35, 38 Service users live in a home that is run by a competent Manager. They are protected by safe procedures for holding their money. Overall, service users health and welfare are protected. There are some risks to the service users in the dementia wing. EVIDENCE: The Manager is working to complete the Registered Managers award and will begin the NVQ4 in care in January 2006. The home is well run and staff and service users feel confident in the competence of the Manager. Some service users deposit small amounts of money with the home for safekeeping. Records are kept of all money held and any transactions made on behalf of a service user. All money held by the home is stored securely. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 17 In the dementia wing there were some occasions where staff were supporting other service users and some service users were left in the dining room unattended. This was of concern as the kitchen is open and people with dementia could access the kettle and toaster without staff support. The manager was advised to risk assess the situation and reduce the risk of injury. Risk assessments had been completed for all other areas of the home. These were detailed but had not been reviewed since February 2004. The Manager is present in the home most days and walks around the building several times a day to identify any health and safety issues. Accidents have been reported and action taken to reduce the risk of a recurrence. Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 18 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 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 3 3 4 2 2 STAFFING Standard No Score 27 2 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 2 Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 19 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 (2bc) 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. 2 OP15 17 schedule 4 The registered person shall maintain in care homes the records specified in schedule 4 In that, a record of all meals provided to service users in sufficient detail to allow a person inspecting the record to determine whether the diet is nutritionally balanced. 3 OP26 23(2d) 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 carpet in the Dementia unit must be kept Abbeyfield Woodgate DS0000023772.V251766.R01.S.doc Version 5.0 Page 20 Timescale for action 02/01/06 02/01/06 02/01/06 clean. 4 OP26 16(2k) The registered person shall, 02/01/06 having regard to the number and needs of service users, keep the care home free from offensive odours. The registered person shall make 02/02/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In that, the sluice room floor must be repaired to ensure it is impermeable. 6 OP38OP27 12(1a) The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users. In that, the risks to service users in the dementia unit with regard to accessing the kitchen when staff support is not available must be assessed and minimised. 02/01/06 5 OP26 13(3) 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 Refer to Standard OP7 OP11 Good Practice Recommendations It is recommended that amendments to the care plan are dated. Daily entries in the care plan regarding health needs must be followed up. It is recommended that service users are consulted on DS0000023772.V251766.R01.S.doc Version 5.0 Page 21 Abbeyfield Woodgate 3 4 5 6 7 OP15 OP19 OP25 OP26 OP38 their wishes in the event of dying and these wishes should be recorded. It is recommended that a person with knowledge of nutrition review the menu. It is recommended that the remaining communal areas be decorated as planned. It is recommended that the hallway radiators be replaced or covered as planned. It is strongly recommended that the carpet in the dining room of the dementia unit be replaced with easy clean flooring. It is recommended that the environmental risk assessments be reviewed. Abbeyfield Woodgate DS0000023772.V251766.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 Woodgate DS0000023772.V251766.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. 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