Inspection on 30/10/06 for Abbeyfield Woodgate

This inspection was carried out on 30th October 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 Woodgate 06/10/08

Abbeyfield Woodgate 16/10/07

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 Alison Spreadbridge Key Unannounced Inspection 30th October 2006 11:00 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.V313541.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.V313541.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) The Abbeyfield Kent 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.V313541.R01.S.doc Version 5.2 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 30th November 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 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 £360.00 - £580.00 per week. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home on the 30th October 2006 by Alison Spreadbridge, Regulation Inspector. The manager, staff, service users and some relatives were spoken with during the visit. A tour of the building was undertaken and some documentation seen. The home is undergoing a large refurbishment programme and consultation period, as it is the intention of the Abbeyfield Kent Society to change the home’s category to all dementia care by the end of 2007. The home’s manager has now been in post for a year, and is well qualified for the position. The service users are cared for by a very dedicated and well trained staff team with 74 of the staff achieving NVQ level 2. To help prepare them for the change of category specific staff training is being put into place to ensure the home continues to meet the assessed needs of all of the service users. Following consultation some of the service users who are in the category of frail elderly, are being offered places in other Abbeyfield homes. Past inspection reports are available from the home and the last report was seen pinned up on the notice board in the corridor by the entrance to the home. What the service does well: The majority of service users spoken with said they 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 progressing and the current phase of work is due to be completed by the end of December. The home is being managed and run by a committed staff team. Abbeyfield Woodgate DS0000023772.V313541.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.V313541.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.V313541.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. This judgement has been made using available evidence including a visit to this service. The prospective service users are provided with the information they need to make an informed choice about moving into the home. EVIDENCE: The home’s statement of purpose and service users’ guide have been updated to take account of the promotion of the new manager. Each service user is provided with a contract and their terms and conditions so as to ensure their rights are protected. The manager said that she or one of the senior carers assesses service users before they move into the home. They go to the hospital or the service user’s Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 9 home after 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 relatives spoken with said they are always made welcome and have been since they first came to view the home with their relative. The home does not provide intermediate care. Abbeyfield Woodgate DS0000023772.V313541.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 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans must reflect the changing needs of service users and changes to the care plans clearly identified to ensure staff are aware of the changes. EVIDENCE: Service users’ care plans and risk assessments were inspected during the visit. Some were found to be in need of updating. One care plan said that the service user’s nutritional status should be reassessed after one month and the assessment date was written for three months. The manager needs to ensure that the care plans and risk assessments reflect the changing needs of service users and that reviews are undertaken. Not all of the care plans seen had service users’ requirements for their end days. During the inspection the District nurse came to see some of the service users. She visit the home twice a week and undertakes some service users’ assessments as their needs change. The district nurse said they are developing a new assessment tool which should be of benefit to the home. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 11 She said that the home and the surgery have a good working relationship. This was agreed by the manager and staff. They said they felt able to ask for any advice and the nurse were also prepared to offer some training to staff as appropriate. The district nurse has their own documentation and the care provided does not always get entered into the service users care plans. This was identified at the last inspection and has still not been addressed. The service users spoken with said they felt they were treated with respect and they were called by their chosen name. The Abbeyfield Kent Society is looking into providing a document which will take account of service users’ spiritual needs and includes last day requests. The medication storage and procedure for their administration was seen during the visit, Medication Record Sheets were completed and recorded correctly. Abbeyfield Woodgate DS0000023772.V313541.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 adequate. This judgement has been made using available evidence including a visit to this service. Service users would benefit from a wider choice of activities to enhance their daily living. EVIDENCE: The home does not have a wide choice of activities to enhance the lives of service users. Some of the service users said they occasionally go to the day centre on the site and join in with some of their activities. Some items on the activities programme could actually be described as personal care and not activities. Two of the ladies in one of the lounges said that the seating arrangements make it impossible for them to see the television. The service users spoken with said their families are always made welcome when they visit. Service users in the main have families and friends visiting on a regular basis. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 13 While service users said the meals were hot they found them somewhat repetitious. They would like more choice especially at the main lunchtime meal. The manager said the menus were going to be reviewed, as they were about to introduce the winter menus. Service users said they would like more things to do during the day as the activities programme was not always consistent. However, at the time of the visit the dining room was decorated for their Halloween party. They said they have quite a few parties and one of the service users had just celebrated her 100th birthday. Staff said they would soon be preparing for the home’s Christmas party. The service users have access to a bar and are able to request a drink if they want one. The manager is the licensee. Abbeyfield Woodgate DS0000023772.V313541.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. This judgement has been made using available evidence including a visit to this service. The service users’ rights are protected by the home’s policies and procedures. EVIDENCE: The manager said that staff record complaints in the complaints book, which is then left for her to respond to. There had been three recent complaints which the manager had responded to within five days. The manager said that the complaints procedure is included in the home’s welcome pack. The manager said that complaints are always responded to in writing. The complaints procedure was seen and it included the address of the Commission for Social Care and Inspection should complainants not feel their complaint had been addressed satisfactorily. Some of the service users spoken with are not happy about the proposed changes to the home despite the consultation that has taken place. A number of service users are preparing to move to other homes. Abbeyfield Woodgate DS0000023772.V313541.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. This judgement has been made using available evidence including a visit to this service. The service users have access to a number of communal areas. The home is in need of a refurbishment programme as it is showing signs of wear and tear. EVIDENCE: Key pads have been fitted to the areas where the building work is being carried out . The actual environment is quite poor at the moment. The house needs to undergo a programme of refurbishment throughout. One of the lounges was out of use as part of the ceiling and wall plaster had fallen down due to a leak in the roof. The water has penetrated in a number of areas in the room and although the leak has been repaired the room smelt of damp and needs to be fully repaired and redecorated before service users can begin to use it again. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 16 The new dementia unit is under construction and it was noted that the dining area and two lounges are quite small to allow people to wander around. The use of areas needs to be carefully thought through. It is hoped this part of the refurbishment will be completed by Christmas. The home has a full time handyman who is responsible for ensuring small repairs are done quickly. The lights in one of the corridors needed replacing as it was quite dark and was a health and safety risk. Bedrooms are being redecorated as they become vacant. The manager said that whenever possible they ask the new service user what colour they would like it to be. Service users are encouraged to bring in small items of furniture to make their rooms as homely as possible. The service users are encouraged to personalise their own rooms, some of the rooms seen are somewhat overcrowded and should be risk assessed for the health and safety of the service user living in the room. Items stored on top of wardrobes should be removed. It was noted during the inspection that some books had been stored on top of a cupboard in the entrance area which could be hazardous if service users tried to reach for books on the top of the unit. There are sufficient toilets and bathrooms throughout the building, however there is only one toilet close to the dining room and this area became quite congested prior to lunch. The carpets throughout the house feel sticky when walked on and are threadbare in places and are in need of replacement. There are a number of areas in the home where there is a very strong smell of urine despite special air cleansing machines are in use and carpet cleaning is being carried out. Fire drills and regular testing of fire equipment is taking place. Abbeyfield Woodgate DS0000023772.V313541.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 excellent. This judgement has been made using available evidence including a visit to this service. Service users are benefiting from the support of a well trained staff team. EVIDENCE: 74 of the staff team now have their NVQ at second level. The manager said she is fully committed to ensuring staff receive the training they need to meet the assessed needs of service users. The staff spoken with are very committed to the work they do. At the time of the inspection there were seven care staff on duty supported by the maintenance man, laundry and kitchen staff. There were sufficient staff on duty to meet the assessed needs of the service users. The home will need to review the staffing numbers once the new wing is completed. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from having the support of a committed manager and staff team. EVIDENCE: The manager has been in post for a year. Prior to that she was the home’s deputy manger so she knows the service users and staff well. She is committed to creating a home of excellence and is ensuring staff receive the training they need to meet the changing needs of service users and the home’s move to dementia care. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 19 The service users and staff are protected by the home’s policies and procedures. While the service users and staff are naturally unsettled during this period of refurbishment and change, effort is being made to ensure the service users and their relatives are kept informed by the home’s manager and senior management team as the change to a full dementia home continues. Service users who do not wish to remain in the home are being assisted to find a more suitable placement. It is envisaged that the changes will be completed by the end of September 2007. Staff are receiving supervision on a more regular basis. Supervision is now cascaded to senior car staff who oversee the carers. Annual appraisals are being introduced. The health and safety of service users is being promoted and the manage said that the assistance they receive from the district nurses has been invaluable. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 20 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 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 2 Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 21 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 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. This was a requirement in the last report with a time scale of 02/01/06 The registered person must ensure that service users assessed needs are met 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. This was a requirement in the last report with a time scale of 02/01/06 Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 22 Timescale for action 02/01/07 2. 3. OP8 OP15 12 17 schedule 4 02/01/07 02/01/07 4. 5. OP25 23 23(2d) OP26 The registered provider must ensure that the rooms used by service users a safe 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 most of the home need to be replaced . 02/01/07 02/04/07 5. OP26 16(2k) The registered person shall, 02/01/07 having regard to the number and needs of service users, keep the care home free from offensive odours. 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. 1. 2. 3. Refer to Standard OP11 OP12 OP15 OP19 OP38 Good Practice Recommendations It is recommended that service users’ care plans include their wishes for their end days. It is recommended that a wider programme of activities is provided and service users would benefit from the presence of a full time activities co-ordinator. It is recommended that a person with knowledge of nutrition reviews the menu. It is recommended that the remaining communal areas be decorated as planned. It is recommended that the environmental risk assessments be reviewed. Abbeyfield Woodgate DS0000023772.V313541.R01.S.doc Version 5.2 Page 23 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.V313541.R01.S.doc Version 5.2 Page 24 - 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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