Inspection on 20/06/07 for Abbeyrose House

This inspection was carried out on 20th June 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 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

Abbeyrose House 07/12/05

Abbeyrose House 02/08/05

Abbeyrose House 14/12/04

Abbeyrose House 17/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Abbeyrose House 1 St Michaels Road Maidstone Kent ME16 8BS Lead Inspector Wendy Mills Key Unannounced Inspection 20th June 2007 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 Abbeyrose House DS0000023884.V336706.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. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyrose House Address 1 St Michaels Road Maidstone Kent ME16 8BS 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) 01622 762369 abbeyrosehouse@ramaul.co.uk Ramaul Limited Mrs Heather Fé Maulayah Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. To provide a home for two service users with dementia whose dates of birth are: 4 March 1921 and 22 April 1922. Care to be provided to 2 service users with a diagnosis of dementia whose dates of birth are: 10 February 1919 and 26 August 1922 Care to be provided to one service user whose date of birth is 5 July 1943 To provide care for up to 10 older persons with the category of dementia. 7th December 2005 Date of last inspection Brief Description of the Service: Abbeyrose House, is a residential home providing care and support for up to twenty-three older people. It was formerly the Vicarage of St Michaels Church. It is situated in a quiet residential road in the county town of Maidstone. The home has spacious communal space with two larger sitting rooms, a dining room and small quiet room. There is a large secluded and mature garden to the rear of the property and a decked area to the side where residents can sit. The home currently provides fifteen single and four double bedrooms but planning permission has just been received to allow for the provision of three further bedrooms. This will mean that three of the current double rooms will then be for single occupancy only. Currently only one room is being used as a double room. The home is welcoming and well presented. There is parking to the front of the home and time limited on street parking outside. There easy access to bus services, and the local town and railway stations are approximately half a mile away. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key visit formed part of the inspection process of the Commission for Social Care Inspection (CSCI). Information received since the last inspection from a variety of sources, such as relatives, health and social care professionals and the home itself, was also taken into consideration whilst compiling this report. During the course of this visit, documentation, including care plans and staff files, was examined. Several residents were spoken to, two members of staff were interviewed in private and three were spoken to during the tour of the home. In depth discussion was held with the registered manager and the registered provider. Further comments were received by telephone from visiting health care professionals. A tour of the home was made and both direct and indirect observation were used throughout the time spent in the home. The residents, their supporters, the staff, the registered manager and the registered provider are all thanked for the welcome they gave and for their help during this visit. What the service does well: The home provides very good individualised care in a relaxed, friendly and homely atmosphere. Abbeyrose is a comparatively small, family run home and the owners are very actively involved in the day-to-day running of the home. They know all the residents very well. Residents and staff said it is like being, “part of their family”. The care plans are very good. They identified individual needs and the way in which they should be met. They are written in a way that makes it easy for staff to follow. The staff are kind and caring and residents said that they are always helpful and cheerful. The home promotes the health and well-being of the residents and maintains very good relationships with local health and social care professionals. Abbeyrose House DS0000023884.V336706.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. Abbeyrose House DS0000023884.V336706.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 Abbeyrose House DS0000023884.V336706.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&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: The home has a statement of purpose and service user guide. Both documents are up-to-date and provide good information. Care plans show that comprehensive pre-admission assessments are made before a place is offered at the home. There is provision for prospective residents to have a trial stay although few residents took up this option. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is proactive in the way it promotes the health and well-being of the residents. EVIDENCE: Care plans are well-maintained and comprehensive. Likes and dislikes are documented, specific care needs are noted and past histories are in place. Records show that all appropriate healthcare appointments are made and kept. The home ensures that, where necessary, a member of the care staff, or the manager herself, accompanies a resident to a hospital appointment. Visiting health and social care professionals speak highly of the home and the way in which they communicate with them and meet the care needs of the residents. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 10 The home manages and administers medicines in line with the guidance given by the Royal Pharmaceutical Society of Great Britain. The Boots monitored dose system (MDS) is used and good relationships are maintained with the pharmacist. Only staff trained in the administration of medicines are allowed to give medication to the residents. Storage of medicines is safe and secure. The registered manager takes responsibility for ordering medicines and ensuring unused medicines are returned to the pharmacy. Records are well maintained. Nutrition in the home is well managed. There is a varied and healthy menu. Nutritional assessments are carried out and residents are weighed regularly If a resident becomes terminally ill the home meets their needs for as long as possible, with the support of the appropriate health care professionals such as the GP and district nurse. Whenever possible they try to allow residents to die with dignity in a place where they are well known to staff, rather than to be transferred to hospital where they may not know anyone. Relatives of terminally ill residents can stay overnight in the quiet room where there is a sofa bed. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are encouraged and supported to participate in the day-to-day life of the home. This means that their lives can remain purposeful and interesting EVIDENCE: The care plans record the interests, likes and dislikes of the residents. Risk assessments are in place where needed. The residents have a lot of different needs and wishes. Some prefer to stay in their own rooms and listen to music or watch TV. Other residents like to join in games. Staff said that the home has a number of board games such as ludo and scrabble. They said that they have the time to spend with the residents and often find that the residents “Just like to chat”. They said that Bingo is very popular with a few residents but that they were less enthusiastic about music and movement. Some residents like to go out. There is good local community support with a mental health trust centre and café, and three churches and their various activities, all within easy walking distance. Some residents like to sit outside where there is a decked area. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 12 Nutritional services in the home are good. Fresh fruit and vegetables are purchased from local farms shops and fresh meat is purchased from a family butcher close by. On the day of this visit there was plenty of good quality fresh produce in the home. The cook said that there is always a plentiful supply of food in the home. Residents said that they enjoy their meals and always have plenty to eat. There is a seasonal menu and choice is offered at every meal. On one day a week, the cook prepares whatever each resident chooses. Birthdays are all noted and celebrated with the meal of that resident’s choosing, a present and a cake. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 13 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 home listens to the views of the residents and their supporters and acts upon them. Staff are clear about the need to protect residents from all form of abuse. EVIDENCE: There are sound policies and procedures in place, both for the handling of complaints and the protection of vulnerable adults (POVA). Staff interviewed showed a good understanding of the need to speak up on behalf of the residents if necessary and of the forms that abuse can take. Induction includes training in POVA. The registered manager is a “trained trainer” for POVA and ensures that staff are aware of their roles and responsibilities to report if they have any concerns. On occasions the registered provider and the registered manager work on shift alongside staff. They provide cover on early, late and night shifts. This gives them an opportunity to observe the way staff work with individual residents. There have been no formal complaints since the last inspection. The registered manager and provider speak to each resident on a regular basis to see how they are getting on. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 14 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, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe, clean and comfortable. This gives the residents a pleasant and homely place in which to live. EVIDENCE: The home has a friendly and relaxed atmosphere. Residents have been able to personalise their rooms. A tour of the home was made. All areas were very clean and uncluttered. The cleaner said that she has enough time in which to keep the home clean. No offensive odours were noted during this visit. The owners have an improvement plan for the home. Planning permission has recently been granted for the conversion of a disused flat on the ground floor into a new lounge and bedroom; and the conversion the old lounge into two further bedrooms. The owners stated that they do not want to increase the Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 15 numbers of residents in the home but do want to provide more single accommodation. They have been successful in obtaining a “Dignity in Care” grant for this work. They are currently in the process of obtaining estimates from local builders. Outside there is a large and pleasant garden with a decking area where residents can sit. The owners said that they have plans to improve the garden area in the future. No health and safety hazards were noted during a tour of the home. The owners are frequently on site and make regular health and safety checks. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 16 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff recruitment, staffing levels, staff training and staff morale are all good. This means that an enthusiastic and competent staff cares for the residents. EVIDENCE: There is a stable staff team. Many of the staff have worked at the home for a number of years. Both the registered provider and manager work occasional shifts alongside the care staff. They do not employ agency staff, preferring either to cover any shortfall due to leave or sickness by offering permanent staff extra hours, or working the shift themselves. They both said that they felt this is a very good way of getting to know the staff, the way they work and to identify any training needs. There is a minimum of three care staff covering the early and late shifts and two wake night staff. In addition there is a cook and a cleaner. There are enough staff to allow care staff to accompany residents to hospital appointments if necessary. The residents said that the staff are, “lovely”. One said, “They are very kind, I don’t have to wait if I need anything”. Residents spoke of the staff being like family”. Staff made similar remarks. One said, “It’s lovely here, very friendly and good team work. We care for the residents just like older members of our Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 17 own families”. All said that the home has a good atmosphere and that they like working with the residents. They said that they are well supported by the owners. The registered manager is an RGN and has also attended a number of course, including “Train the Trainer “for moving and handling and POVA”. She takes responsibility for much of the staff training in the home. This has the advantage that she can give one-to-one tuition and monitor progress following training. However, it does mean that staff do not always get the chance to meet up with other care staff in a formal educational environment where they can exchange ideas. It is recommended that consideration be given to supporting staff to attend external courses occasionally. Examination of staff files confirmed that there is a rigorous recruitment process that includes seeking two references; making telephone checks and obtaining POVA and Criminal Records Bureau (CRB) checks; and a structured and indepth interview, prior to offering employment at the home. Abbeyrose House DS0000023884.V336706.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, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the residents. EVIDENCE: The owners are both Registered General Nurses (RGNs). They have been running the home for seven years and have gained considerable management experience during this time. Conversation with them showed that they have a clear vision for the home and are up to date with best practice in care. Documentation in the home is well organised and securely stored. Much information about the running of the home, for example, the menus and staff rosters, has been computerised. All documentation requested during the Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 19 course of this visit was immediately available. Additional documentation was also offered as further evidence of standards having been met. Staff files contain regular supervision records and staff confirmed that they receive formal supervision. Abbeyrose House DS0000023884.V336706.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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 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 3 X 3 X X 3 Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP30 Good Practice Recommendations It is recommended that the home consider sponsoring staff on some external training courses. This will broaden their experience and allow for exchange of ideas with staff from other homes. Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 22 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 Abbeyrose House DS0000023884.V336706.R01.S.doc Version 5.2 Page 23 - 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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