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Inspection on 04/03/09 for Abbeygate Retirement Home

Also see our care home review for Abbeygate Retirement Home for more information

This inspection was carried out on 4th March 2009.

CSCI found this care home to be providing an Excellent service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeygate Retirement Home High Street Moulton Spalding Lincs PE12 6QB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tobias Payne     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Abbeygate Retirement Home High Street Moulton Spalding Lincs PE12 6QB 01406373343 F/P01406373343 bgate3@totaldsl.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Abbeygate Rest Homes Limited care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Abbeygate Care Home is a modern purpose built single storey building. The home provides personal care for 27 older persons aged 65 years and over. The home is located in the village of Moulton, which is 6 miles from the town of Spalding and 4 miles from the town of Holbeach. It is in the centre of the village with the home sharing the grounds with the tallest windmill in England. Accommodation comprises 25 single bedrooms and one double bedroom, all but one single bedroom having an en-suite. There is car parking at the side of the home and garden areas with seating overlooking open countryside. The home is one of two care homes owned by Broadgate Builders. The general manager is actively involved in the running of the home. The fees at the inspection on the 4/3/2009 ranged from £430 to £575 per week. Care Homes for Older People Page 4 of 27 Brief description of the care home Extras are for hairdressing which range from £9.75 to £28, chiropody £10, toiletries, personal newspapers and magazines. Information about the home including the statement of purpose, service users guide and a copy of the last inspection report can be obtained from the manager. This can also at request be made available in Braile and talking tape. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was unannounced and started at 8 am. It was undertaken using a review of all the information available to us about the Abbeygate Care Home. It took place over 5 hours. We spoke with 13 people living in the home, one visitor, 3 staff and the registered manager. The main method of inspection was called case tracking. This involved selecting 2 people and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. We also examined the annual quality assurance assessment (AQAA) that was sent to us by the manager before this key inspection. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. It was very clear, accurate and Care Homes for Older People Page 6 of 27 detailed. Before making our visit we asked the people who live there to send us comments about the support they receive. We received comment cards from 7 of the people living in the home. All comments in the main were positive. We also received positive comments from 3 staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home receive clear information to suit their needs to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home they receive a comprehensive assessment to ensure that their needs can be met. Evidence: The home had a statement of purpose and service users guide. These were both very clear in large print with the aims and objectives for the home, examples of activities and the complaints procedure. They were available at the entrance to the home on a table with a new brochure and other useful information. There was a detailed admission procedure, which described the needs of the people coming into the home. The manager told us that where a person chose to move into the home she would assess them involving them in obtaining information about their Care Homes for Older People Page 11 of 27 Evidence: needs. Following this a letter would then be sent to confirm that the home was able to meet their needs. Each person had terms and conditions of being admitted to the home. This was clearly outlined in the statement of purpose and service users guide. The home did not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear, detailed and person centred care planning system in this home. This and the homes internal audit system ensures that the health and welfare needs of people living in the home are fully met. People are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Medication is safely given by care staff who know what they are doing and are safe in their practise. Evidence: Each person had a detailed care plan outlining their care and support. The care plan had been produced wherever possible with the involvement of the person, their family/advocate and other relevant people. We looked at records for 2 people. Each person had a separate file with an admission checklist, admission information, moving and handling assessment, risk assessment, family and social background, consent to bed rails, care plans, progress reports, weight, nutrition, dietary, oral health and other assessments as required to meet the needs of the person. The care plans were hand written with a description of their needs, assessment of needs and care instruction. Care plans were very detailed, personal, sensitive and very precise with very detailed Care Homes for Older People Page 13 of 27 Evidence: instructions. We saw a care plan which told us about the needs of one person who expressed a wish to remain independent and self medicate. We saw an instruction which requested staff to put medication on a spoon for her to access. The carer is to hold liquid whilst she sips. Time is required to allow her to take the medication correctly. We saw specific care plans about night care including the time the person liked to get up and whether the person liked a cup of tea in the morning. Personal care was again very detailed with the emphasis on remaining independent. We could see evidence of choice and personalisation. The manager was also introducing mental capacity assessments in line with recent laws. We saw that care plans were reviewed 6 weeks after admission and thereafter 6 months or when required. Records were signed and dated. Where required, people living in the home were referred to GPs, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist and Chiropodist. Care assistants administered medication. There was a policy and procedure for medication. The manager assessed each person before they were considered safe to administer medication. Records we saw were clear, and well maintained. The manager told us that she was to introduce a monthly audit of medication in the very near future. The manager told us that they encouraged people to be independent and that there were 4 people who had been assessed to be safe to take their own medication. There was a separate record and the signature of the person and their witness. All rooms had a lockable item of furniture where medications could be kept. People we spoke with were very satisfied with the way staff cared for them and had confidence in the staff. People told us I like to get up early and the staff help me to do this and I find staff very friendly and always there to help with a smile. We saw throughout our inspection staff seeing to the people in a warm, friendly manner, knocking on doors before entering their bedrooms and asking whether they needed any help. We also noted there was a lot of laughter between staff and the people living in the home. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are very varied, well managed, creative and provide stimulation and interest for the people living in the home. Visitors are made to feel welcome and supported. People enjoy varied and nutritious meals. Evidence: When admitted to the home details were obtained of each persons interests. In addition the manager had introduced service user life history information which was very detailed covering family and friends, pets, hobbies, likes, dislikes and feelings. The person was asked to complete this or by the family were asked to this on behalf of the person living in the home. There was a written monthly programme of activities, which was displayed on the notice boards and a copy was given to each person. On the afternoon of our inspection there was to be a performance by 2 musicians. Other social activities for the month included a passive exercises class, hairdressing, games afternoons, Bingo, country and western singers, Holbeach Police Officers with their dogs, a tea party birthday celebration for one the of the people living in the home, holy communion and a coffee afternoon. In addition information was on the notice board at the entrance giving Care Homes for Older People Page 15 of 27 Evidence: details of a spring sing a long, details of the library service, and the summer Newsletter. The manager told us she wanted to further improve this by providing beauty therapy sessions for the people living in the home. The manager had established very close links with the local community and the home was an integral part of the village. We spoke with one visitor who told us they could visit whenever they wished, always received a warm and friendly welcome and was satisfied with the care and approach of staff. The people living in the home were offered 3 main meals a day, plus snacks. Menus were on a four week rota and the people were involved in meal planning. Fresh fruit, vegetables and meat were bought from local suppliers. South Holland District Council awarded the home an excellent award in December 2008 following an inspection, in recognition of the catering service provided. The report stated good standard of cleanliness and structure observed. Catering staff were aware of the dietary needs of the people living in the home and provided soft and other dietary options. We saw breakfast and lunch being served during our inspection visit. Meals were served in the dining room or in bedrooms on a tray. We saw staff taking their time serving and assisting those people who needed assistance in a dignified and sensitive manner. All the people we spoke with were very complimentary about the food. The menu for the week was displayed on the wall outside the dining room and had been recently reviewed. Comments we received included, the food is excellent, I have had a very enjoyable and well cooked lunch and the food is always of a good standard and the cakes are excellent. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. The people are protected from abuse by correct and safe recruitment procedures. Evidence: Each person received a copy of the complaints procedure in the service users guide. The information was also on the notice board and in the statement of purpose. We noted that the procedure on the notice board did not refer to our Cambridge Regional office address. The manager agreed to amend and update this information as soon as possible. No complaints had been received by the home or the Commission since the last inspection. We and the home had received no safe guarding issues. None of the people living in the home or staff had any complaints about the home and felt they could discuss any concerns with staff or the management. Staff also knew what to do if they received a complaint from a person living in the home. All staff were correctly recruited including a check by the Criminal Records Bureau (CRB). During their induction each member of staff received information about abuse. Care Homes for Older People Page 17 of 27 Evidence: We asked 2 staff what abuse was and all knew their role and what to do if abuse was suspected. Staff also received regular refresher training to ensure their knowledge was up to date. The manager also had an up to date copy of Lincolnshire County Councils adult protection policy. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean, comfortable, safe, well decorated and well maintained accommodation. Evidence: Redecoration had been carried out since the last inspection. The manager told us that it is their policy that when ever there is a vacant room before a new person is admitted to the home the bedroom is repainted and where possible the person coming into the room is asked about the colour they would like the room to be painted. There was a maintenance and redecoration programme and the manager told us she had planned for the the lounge to be redecorated and new carpets throughout the home during 2009. During our visit we walked around the home and found all the areas of the home were clean, tidy, well maintained. People told us, I have my own bed which I like, my room is very comfortable and my clothes are well looked after and presented well. We noted their were clear signs indicating peoples bedrooms and facilities in the home in order to help people find their way around the home. There were seating areas where people could choose to sit away from the lounge. The housekeeping staff monitor how clean the home is and are responsible for Care Homes for Older People Page 19 of 27 Evidence: ensuring that hot water temperatures are safe. The home has under floor heating, which is supplemented by heating in the ceiling. This further reduces the possibility of any person being scalded by being in contact with a hot surface. We saw the housekeeping staff and laundry person working in the home showing pride in what they did. The people living in the home also spoke of how they liked their bedrooms. They were encouraged to bring into the home small items of furniture, television, pictures and personal items. There was a detailed infection control policy and gloves and aprons were provided for staff. People we spoke with told us how clean and well maintained the home was. The home had one open sluice and sluice cycle on both of the commercial washing machines. There is also one commercial tumble dryer. Considerable effort had been made to improve the extensive gardens which surround the home. The manager told us that by July 2009 they will have renovated the sensory garden to make it more accessible as well as provided a wild life area and improved the walkways and seating areas to give views over the surrounding countryside. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well-trained, supported staff team available who have the skills to meet the varying needs of the people living in the home. A wide range of inhouse training and National Vocational Qualification training is provided. Separate staff are provided for care, housekeeping, catering and laundry Evidence: People we spoke with felt the home was adequately staffed with people who were experienced and competent to care for older people. People we spoke with did not express any worries about the level or availability of staff. During our inspection visit we saw staff attended to the needs of the people promptly and in a calm and friendly manner. People told us ,if I need help the staff come to me as soon as they can, I always find them to be polite and respectful and I am satisfied with their approach and I cannot fault anything. The manager told us they monitored the dependency and varying needs of the people. We examined the files for 2 members of staff. Records were clear, detailed and showed that staff were safely recruited in accordance with the regulations. This Care Homes for Older People Page 21 of 27 Evidence: included a check by the Criminal Records Bureau (CRB). Each person received an induction programme then a more comprehensive nationally recognised induction. There continued to be a wide range of training provided. This included formal training in care to National Vocational Qualification standards (99 of the staff had achieved NVQ level 2) and one person had achieved NVQ level 3. in addition, 2 of the catering staff had started NVQ in food hygiene. Training over the last year had included, moving and handling, fire prevention (with separate evacuation training for night staff), dementia awareness, foundation in medication, abuse prevention, first aid and health and safety. Staff told us they received regular supervision and an annual appraisal. We spoke with 3 members of staff who told us the service delivers a good quality of care to every single service user who uses it and we take care of the needs of the service users i.e. personal needs e.g. hygiene, laundry, nutrition and house keeping. In addition, we have a good team. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and staff benefit from the positive leadership of the management team. Management record systems show that peoples health, welfare, safety and choices are promoted. The management ensures that the people living in the home have the opportunity to voice their views and opinions. The management uses feedback from questionnaires from a number of sources and quality assurance systems to make improvements. Evidence: The manager has a management and care qualification. She also has extensive experience in caring for children and elderly people. She is also an assessor. The general manager for the company visited the home daily and was therefore actively involved in the management of the home. The day to day responsibility lay with the manager. There were detailed policies and procedure which were up to date and enabled staff to deliver care and support the people in the home. The company had a policy on equality and diversity. Care Homes for Older People Page 23 of 27 Evidence: We saw staff attend to the people in a confident, knowledgeable, and sensitive manner. There was a relaxed atmosphere. People told us, I am very happy here, It is very comfortable, I like being here, I receive an excellent service, the staff are fantastic and I am very satisfied and I have enjoyed my stay here and the facilities in the home. Comment cards we received stated, I am happy and well cared for. One visitor told us we have been very satisfied with the care and approach of the staff. They have been very kind and supportive. Staff told us I receive regular support and supervision. The manager told us that this had been introduced since the last inspection and staff receive this 6 times a year and housekeepers 2 or 3 times a year. Peoples families with the written agreement of the person living in the home look after their money. Where small amounts of money are managed by the home again, written agreements are obtained and signatures obtained from the person. Records kept were well maintained and regularly audited by the general manager. There were quality assurance procedures. These included 18 completed surveys (as a result of 26 being sent out) from the people living in the home in October 2008 which resulted in positive responses. The manager carried out internal audits of medication, dependency and care plans. She also made regular unannounced spot checks of the home at night to see if peoples needs were being met and staff were working correctly. Again, very clear records were being kept. The home had comprehensive health and safety policies, which also included detailed and up to date risk assessments including a fire risk assessment. There were regular tests of the fire system as well as regular fire drills and monthly monitoring of hot water temperatures. There were also infection control policies. We found records throughout our visit were available, well maintained and up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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