Inspection on 07/12/05 for Abbeyrose House

This inspection was carried out on 7th December 2005.

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 20/06/07

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 Maria Tucker Announced Inspection 7th December 2005 09:30 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.V262272.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. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 Ms Heather Fe Maulayah Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To provide a home for two service users with dementia whose dates of birth are: 4 March 1921 and 22 April 1922. 2nd August 2005 Date of last inspection Brief Description of the Service: Abbeyrose House was formerly the Vicarage of St Michaels Church, is now a residential home for people over the age of 65 years, in the town of Maidstone. The home has a large secluded and mature garden to the rear of the property. The home provides a sitting and dining area on the ground floor, with a library / quiet room which is located on the first floor. The private bedrooms are located on the first and second floors of the home but are accessible via a lift, as well as stairs. The home currently provides 15 single and 4 double bedrooms for private accommodation. The home was established in 1989, it has been under the current ownership since February 2000. Two of the responsible individuals bought out the company in 2004. The home is welcoming and well presented. The home is well located for easy access to bus services only 100 yards away and local railway approximately ½ mile away. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 09.15 until 12.50 the inspection was conducted by the lead inspector Mrs M Tucker. Time was spent meeting the owners, who are the manager and responsible individual and going through various records and documentation. About forty minutes was spent meeting service users collectively. Three relatives were spoken with. Two staff were interviewed. A partial tour of the premises was made which included service users rooms and communal areas. Due to the nature of some of the service users it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about the quality of life and choices were taken from direct conversation with service users and observation followed by discussions with staff and evidencing records held in the home. The pre inspection documentation was received by the CSCI. 13 comment cards were received, comments included: • “Care of my elderly …at Abbeyrose House is second to none” • “My ……is very happy at Abbeyrose and frequently tells us so. We are very satisfied with care and attention”. • “The home is always clean and in good condition, with the staff of a very high standard. They welcome all of my family with a cup of tea or refreshment and a update of my ….. health” It is recommended that this report be read in conjunction with the unannounced inspection conducted on 2nd August, as some standards that were met during that inspection have not been inspected on this occasion. What the service does well: Abbeyrose House is a small family run business that provides a homely environment and welcoming atmosphere. The owners work as part of the staff team and provide some hands on care to service users. The level of care and attention provided to service users who are frail or unwell has given rise to a good quality of life and health promotion. The home has a regular staff team and a good clear management structure in place. The staff are well motivated, dedicated and work closely together as a team. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 6 The owners are committed to providing a high quality service, which is service user led and focused. Since taking over the home there has been many improvements made to the environment and the systems put in place such as service users questionnaires and meetings. Relatives are encouraged to visit and made welcome. Relatives and appropriate others are kept up to date with any changes in a service users condition. Referrals to and advice from health professionals and specialist services are appropriately made and changes in conditions identified and promptly acted upon. 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. Abbeyrose House DS0000023884.V262272.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 Abbeyrose House DS0000023884.V262272.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): 2, 3, 4, 5. Service users can feel confident that they will only be admitted following a full assessment of their needs and that the home are able to meet these. EVIDENCE: Most of the service users are admitted from hospital to the home, as they are no longer able to manage independently. Families and friends usually visit the home on their behalf and support them in making the decision to stay. Emergency admissions are rare although the home have just admitted someone on this basis. Case tracking and document reading evidenced good practice in this area. Service users are not sent confirmation in writing that following their assessment the home can meet their need. Copies of joint health and social care assessments were seen to be in service users files and formed part of the overall care plan. The manager expressed that it was difficult to fully assess service users who are in hospital prior to being admitted. It is the homes preference to see perspective service users in their own home. The manager and other senior staff conduct the pre admittance assessments. Further information is obtained in the first couple of weeks of being admitted. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 9 The manager consults the CSCI to discuss pending referrals for service users who may need specific support or those service users whose needs have changed and the home are committed to continuing to provide a service for. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 standard 9 was fully met during the last inspection. Service users can expect a high quality service, which promotes their health, welfare and dignity. EVIDENCE: Service users who are frail or unwell are well supported by the home and medical professional advice and support actively sought. Staff were seen to frequently visit a service user who was unwell and remained in their room, staff encouraged them to drink and made sure they were comfortable. Staff spoken with expressed their hopes that the service users health would improve stating that they “hope does well, is a sweet …”. Relatives spoken with described how their relative since being in the home had made vast improvements with their health and general well being. They were happy with the service provided. Service users spoken with about their care plans gave mixed reactions. One spoke of how they had just had a review and had discussed their needs. Others could not remember having a care plan although they were sure they would have one. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 11 The key workers had completed the care plans that were inspected, as staff are encouraged to take an active role in the plans and administration of care delivered. It was recommended that the care plans be reviewed so that the formats are more detailed, easier to use and perhaps the Person Centred Planning model adopted. A service user spoke of how they were visited weekly by a District Nurse and was seen in the comfort of their own room. Throughout this and during the last inspection staff were seen and heard to be respectful towards service users, treating them with dignity and respect, which was reciprocated. Service users spoken with confirmed that they were treated well. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 standard 15 was fully met during the last inspection. Service users are consulted as to their preferences. They are encouraged to choose from planned activities or to relax. Visitors are encouraged and made welcome. EVIDENCE: Service users spoken with had mixed responses when discussing the leisure and recreation provided by the home. Some felt that they did not wish to do much as they preferred to watch television or occupy themselves, others felt they enjoyed the outside singing entertainers and would like these to visit more often. Activities on offer are advertised on the notice board and provided by care staff usually in the afternoon. Art and crafts materials and objects made were evident. The home has rented DVD’s of old time movies for the service users to enjoy. Again mixed reactions were given some expressed their enjoyment stating “Alright, we had Frankie Howard the other day” while another did not like the DVD of Frankie Howard. A comment received by a relative in the comment card that “My isn’t a very social person yet staff never stop trying to help mix with other people for his own better quality of life”. There are two lounges a quieter smaller lounge for reading and relaxing and a larger lounge for activities and watching the television. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 13 During the inspection visitors were meeting their relative in the upstairs visitors room. They were greeted and made welcome and discussions were held as to the welfare of the service user. A comment made by a relative that the service user whom they were visiting had been telling them how good the food was. Service users meetings are held although the last minuets of one held had not yet been typed up. Service users confirmed that they had, had discussions where they talked about various things. One service user described their day, detailing when their preferred time for a bath and going to bed was and that this was accommodated. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Service users can feel confident that the home are proactive in ensuring their safety and identifying and acting upon anything that may potentially be a complaint. EVIDENCE: The accidents recorded were mainly minor in nature and had been managed appropriately. When it has been considered that a check out at the hospital accident and emergency the appropriate action had been taken. The home always makes a thorough analysis of any situation and if in any doubt they err on the side of caution. The comment cards received indicated that service users and relatives were aware of how to make complaints and that if they had any they would do so. Service users spoken with could not think of what they would change if they could or had any issues that they wanted to raise or complain about. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 standards 22, 24, 25, 26 were met during the last inspection. Service users live in a comfortable homely environment. EVIDENCE: Ongoing improvements continue to be made at the home to improve the quality and standard of life for the service users and the working conditions of the staff. Service users spoken with on the improvements commented the “decking it’s alright” another spoke of how they had spent a lot of time sitting in the decking area outside in the summer”. The providers have begun to decorate the dinning area. There are plans to refurbish and decorate the kitchen in line with recommendations made by the environmental health officer. The individual service users rooms that were inspected were homely, individualised and had plenty of personal effects in them. Some service users had bought in things from home to furnish their room. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 16 The home is very clean and tidy and very well maintained. The storage areas have been cleared. The outside areas have items that are waiting to be removed or taken to the tip following the tidying up and refurbishments. The laundry room floor has been made impermeable. Their have been arm rest/rails filled to the walls of the toilet so that the over the toilet unfixed frame could be removed. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29, 30 standard 27 was met during the last inspection. Service users have a small-dedicated staff team providing their services. EVIDENCE: The home has a stable staff team, most of who have worked at the home for some time. The owners/manager work as part of the team providing management and direct care. The home has a minimum of 3 care staff covering the am and pm shifts. There is 2 waking night staff. There is a daily cook and a cleaner for 21 hours a week. To provide support at times when the manager is not on duty and on call system has been developed where senior staff and the manger are available. Service users spoke highly of the staff, as did the relatives. The home does not have a ratio of 50 of trained members of care staff to NVQ level 2 or equivalent. Currently training on dementia care is done via the manger it has been discussed and the home has made contact and is awaiting a meeting with a dementia care consultant to discuss training and other areas of good practice for dementia care. The staff files inspected contained all items required and evidenced that thorough stringent recruitment procedures are followed. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 36, 38 standards 31, 31, 35, 37 were met during the last inspection. Service users benefit from a well run and managed home that is in their best interest. EVIDENCE: The owners are both qualified nurses who have gained considerable experience in jointly running the care home. During the inspection process discussions were held in relation to the overall running of the home with documents that have been introduced and amended and systems that have been put into place for effective monitoring and seeking service users views. Regular regulation 26 visits are now conducted and reports received by the CSCI. Staff files contained regular supervision records. These were not inspected. Staff confirmed that they received formal supervision. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 19 The pre inspection questionnaire list regular routine maintenance and related checks that have been conducted to ensure the home is safe. A spot check was made during the inspection. A private company has been out to check the water supply. The fire extinguisher in the kitchen has been replaced and following the environmental health officer’s visit the owners have instructed for the work recommended to be carried out. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 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 X 2 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X 3 X 3 X X X STAFFING Standard No Score 27 X 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X 3 Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 21 NO 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 OP2 Regulation 14 (1) (d) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. Timescale for action 07/12/05 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 OP28.1 Good Practice Recommendations It is recommended that the care plans be reviewed so that the formats are more detailed, easier to use and perhaps the Person Centred Planning model adopted. It is recommended that the home continue to work towards a minimum ratio of 50 trained members of care staff to NVQ level 2 or equivalent. DS0000023884.V262272.R01.S.doc Version 5.0 Page 22 Abbeyrose House 3 OP30.1 It is recommended that specialist formal training on dementia care be provided. Abbeyrose House DS0000023884.V262272.R01.S.doc Version 5.0 Page 23 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. 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