Inspection on 18/01/06 for Abbeywell Court Mental Nursing Home

This inspection was carried out on 18th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbeywell Court Mental Nursing... 16/07/07

Abbeywell Court Mental Nursing... 08/11/06

Abbeywell Court Mental Nursing... 25/08/05

Abbeywell Court Mental Nursing... 02/02/05

Abbeywell Court Mental Nursing... 02/11/04

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

CARE HOMES FOR OLDER PEOPLE Abbeywell Court Mental Nursing Home Dragon Square Chesterton Newcastle Staffordshire ST5 7HL Lead Inspector Mrs Yvonne Allen Announced Inspection 18th January 2006 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 Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Abbeywell Court Mental Nursing Home Address Dragon Square Chesterton Newcastle Staffordshire ST5 7HL 01782 561769 01782 563102 abbeywellcourt@aol.com 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) Abbeywell Care Limited Mr Paul Hudson Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30) Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3 DE Minimum age 50 years 3 MD Minimum age 50 years Date of last inspection Brief Description of the Service: Abbeywell Court provides nursing care for up to thirty older people with dementia care needs and mental health problems. The home is a two-storey purpose built building situated within Chesterton village, Newcastle-underLyme. The home has twenty eight pleasantly furnished and decorated bedrooms between the two floors consisting of twenty six single and two shared rooms. All of the bedrooms have en-suite facilities consisting of a toilet and washbasin. There is a lounge, dining room, small kitchenette and appropriately adapted toilet and bathing facilities to each floor. The central kitchen and laundry is situated on the ground floor. A passenger lift provides access between floors. Externally there is a car park and enclosed gardens. Local shops and facilities are close by and the home is within walking distance of bus routes. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over 5 hours by one inspector. Preparation and fieldwork had been carried out prior to the inspection. The manager of the home had completed the Pre-inspection questionnaire and comment cards had been collated from residents and relatives. Comments from these cards have been included in this report. A tour of the home was undertaken during which all of the communal areas and a selection of bedrooms were inspected. Discussions were held with staff, residents, a visitor and the manager of the home. Relevant records were examined in order to assist with the triangulation of evidence. At the end of the inspection verbal feedback was given to the registered manager. What the service does well: This was a very positive inspection with all standards except one being fully met and one exceeded. An area of excellence was in meeting the health care and psychological healthcare needs of individuals accommodated in the home. The involvement of relevant professionals and the approach to specific care needs was very good. Comments received from relatives included – “The care and understanding of her problems and dementia were outstanding. We couldn’t have wished for a better home.” It was also noted that there was a committed and caring staff team at the home. The staff were observed to interact very well with residents and comments received included – “ the care and dedication of the staff mixed with an essential sense of humour has been top class; helping me to accept the situation.” Other comments included – “All the staff, not just the carers, interact with the residents” and “staff took time to care for the family and their coping needs.” Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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 Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Residents, families and placing officers are able to make an informed decision on whether the home is suited to meeting the needs of the prospective resident. EVIDENCE: The Statement of Purpose was in place at the home. There had been no changes to this over the last 12 months. This document was accessible to prospective families and visiting professionals including placement officers. A copy of the Service User Guide was seen displayed in the bedrooms inspected. This document had been updated for 2005/2006. All residents are issued with a Statement of Terms and Conditions when moving into the home. The first 6 weeks following admission are regarded as a trial period at the end of which residents are assessed and a decision is made as to permanent residency. This also allows the resident and their family to decide on whether the home is suitable for them and can meet their needs. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 9 The manager commented that residents, families and representatives are very welcome to come and view the home prior to admission and meet the staff and other residents. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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): 7,8,9 and 11 The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: A random selection of care plans was examined. The plans were found be comprehensive and included an initial assessment of needs, individual risk assessments, short and long term care plans, and had been evaluated on a monthly basis. There was evidence of consultation with the representatives of individuals and relevant signatures. The plans were more consistent than at the last inspection, although there were still a few gaps in some in relation to monthly evaluations and it was noted that two plans which contained a resuscitation agreement, signed by the family and GP, did not have the corresponding care plan for this, whereas other plans were seen to have this in place. The manager stated that he was reviewing the care plan system used in the home and would be introducing the “building on strengths” model. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 11 This was aimed at meeting the specific needs of individual residents and focussed on individual abilities. The individual health, including psychological health care needs of residents had been assessed and monitored on a regular basis. There was evidence of involvement of other healthcare professionals and where necessary specialist treatment and advice. The meeting of healthcare needs for residents accommodated in this home was found to be excellent. One of the nurses was observed administering the morning medication in the lounge. Whilst the nurse ensured that individual residents took their medication, a care assistant stood by the medication trolley ensuring that this was not tampered with. Medication Administration Record charts were examined and had been completed as required. There was a policy in place for death and care of the dying and most of the individual care plans seen contained a plan for “last wishes”. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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): 14 and 15 Individual residents are helped to exercise choice and control over their lives in the home. Dietary needs are well catered for with a balanced and varied selection of food available that meets the residents’ tastes and choices. EVIDENCE: Evidence contained in individual care plans identified how residents are helped to exercise choice and control over their life in the home. Although it may not always be possible to gain information directly from individual residents in relation to their wishes and preferences, this had usually been obtained from their representatives. Throughout the tour of the home there were examples of individual choices being upheld – one resident was lying on her bed, as this was what she preferred to do, one gentleman was sitting having a cigarette in the front entrance being supervised by a staff member, other residents preferred to wander around their unit, with staff supervising. Activities were being organised by the activity co-ordinator for residents. Examples of preferences were also seen in relation to meals and mealtimes. The cook was aware of likes and dislikes and there were special diets catered for – a list was seen in the dining room. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 13 Some individuals would not sit for long periods to eat a meal and so staff were happy to accommodate the resident and let them come and go as they wished. The weight and nutrition of residents was regularly assessed and monitored with a care plan in place for this where required. Some of the residents were prescribed nutritional supplements. Staff were observed helping residents to eat their meals in a discreet and dignified manner. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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 and 17 Residents and their representatives can be assured that any concerns they have will be taken seriously and acted upon. The legal rights of individuals accommodated in the home are upheld. EVIDENCE: There was a clear and accessible complaint procedure displayed in the home. This was also contained in the Service User Guide in bedrooms. The CSCI had not received any complaints in relation to this home since the last inspection. The manager keeps a log of concerns and complaints and acts on them, recording any action taken as a result. There had been two complaints received by the manager, which had both been partially substantiated since the last inspection. The manager ensures that the legal rights of individuals are upheld. Two of the residents have advocates acting for them. The residents have families or social services acting on their behalf. Social services act as appointee for 6 of the residents in the home. 21 of the residents are subject to Power of Attorney. The electoral role is completed every year for the home and updated as required. Residents who have the capacity and desire to vote at election times are helped to do so by the staff at the home. This is usually achieved through postal votes. The manager commented that there is one gentleman who likes to go to the local polling station. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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, 20, 22, and 26 The standard of the environment within this home is good providing residents with an attractive and homely place to live, which has been adapted to suit their needs. EVIDENCE: A tour of the home was undertaken where all communal areas and a selection of bedrooms were inspected. Since the last inspection there had been redecoration to both of the lounges, the ground floor corridor, the foyer, stairs and landing and several bedrooms. It was noted that, in bedroom 20, the headboard was in need of replacement and the second floor lounge/dining room carpet was badly stained and in need of replacement. The manager explained that this was in hand and that new flooring, the same as in the ground floor dining room, would be provided. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 16 Bedrooms had been personalised and adapted to meet individual needs and bed auditing and replacement was on going. Bathrooms and toilets had been adapted and a new seat to the bath hoist in bathroom 1 on the ground floor had been provided since the last inspection. It was noted that one of the domestic assistants had left her cleaning trolley outside a bedroom in the corridor whilst she was in the bedroom cleaning. It was pointed out that this was bad practice in relation to health and safety as there were residents who were wandering around and that the products on the trolley would be classed as falling under COSHH requirements. The home was clean and hygienic throughout. There was an odour of stale smoke in the entrance foyer due to a resident smoking here. This was discussed with the manager – the resident refused to go to the smoking room provided and became very anxious if he could not go for a cigarette when he wanted one, so the manager had compromised and a staff member would take him to smoke at the entrance to the home. The manager was proposing to install an extractor fan in this area to help alleviate the smell of stale smoke. This would not be a problem during the summer months as the resident would be able to sit outside on the garden chairs. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 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): 27, 28 and 30 Staff are provided in adequate numbers and have the necessary skills and expertise to care for the residents accommodated in the home. EVIDENCE: At the time of the inspection there were 29 residents accommodated in the home, with one of these being on respite care. All residents were in receipt of nursing care. There had been no changes to the staffing or management structure within the home since the last inspection. On the first floor there were 15 residents accommodated. The deputy manager was in charge on this floor together with 2 care assistants and on the ground floor there was a first level nurse with 3 care assistants. The third care assistant floated between the two floors as needed. The manager was supernumery and the administrator and maintenance person were on duty. There was a dedicated activity co-ordinator working part time and there were two domestic staff on duty plus the laundry person. There was a cook and kitchen assistant on duty. The home took student nurses from time to time and the manager stated that they had been asked to increase by 1 to accommodate up to 3 students. There were none on duty at the time of this inspection. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 18 The manager stated that the only staffing vacancy was for the kitchen and there were a few telephone enquiries taken in relation to this vacancy noted during the inspection. There was a staff training and development programme in place at the home, which was geared around meeting the needs of the residents. NVQ training was on going with 11 of the care staff already trained to NVQ level 2 and above – this amounted to 45 of all care staff employed. Staff had also received training in – mental health in practice, diabetes care update, dementia care, wound management and infection control. Future planned training included palliative care for health care assistants, aromatherapy, breakaway training and diabetes management. Mandatory training was on going and records of this were seen. Staff spoken to stated that they felt very supported with their training needs. The inspector spoke with a trained nurse who had recently completed a degree in gerontology. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 and 38 Residents and staff benefit from the open, inclusive and effective management of the home. EVIDENCE: Quality assurance is on going at the home and the inspector was shown evidence of audits having been undertaken over recent months. These included relative surveys, care plan audits, infection control audits, fire safety and medication audits, audits of policies and procedures and monthly accident audits. The registered manager is also a director of the home and discussions revealed that the home was financially viable at the time of the inspection and for the foreseeable future. The administration of residents’ pocket monies was examined and found to be in order. It is recommended that two signatures be obtained when receiving monies into and out of individual accounts. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 20 Records of formal staff supervision were examined and care staff were receiving this 6 times per year for full time staff and pro rata for part time staff. Nurses received clinical supervision at group meetings. Mandatory staff training updates were on going. These included moving and handling, first aid, basic food hygiene, fire safety and fire drills. All had been recorded. Records relating to the maintenance of the home were examined. These included the testing and servicing of equipment used. There was evidence of the regular testing of the fire alarm system including emergency lighting. Hot water temperatures of baths and showers had been tested and recorded. PAT testing had been carried out and recorded. There was a current certificate in place for legionella testing. Accidents had been recorded and reported as required. Data sheets relating to COSHH products were not displayed in the laundry area and were locked in the cleaners’ cupboard. It is recommended that these are more readily available as they contain specific first aid advice. Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 21 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 x 3 3 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 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 3 3 x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 x 2 Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 13 (4) Requirement That COSHH products are kept locked away when not in use or unsupervised. PREVIOUS REQUIREMENT Timescale for action 18/01/06 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 3 4 Refer to Standard 19 19 38 7 Good Practice Recommendations That the flooring is replaced in the lounge/dining room on the second floor That the headboard is replaced in room 20 That data information sheets are available in relation to COSHH products in the laundry area That all care plans contain a “last wishes” care plan and are updated monthly Abbeywell Court Mental Nursing Home DS0000026932.V272012.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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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