Inspection on 08/11/06 for Abbeywell Court Mental Nursing Home

This inspection was carried out on 8th November 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 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

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

Abbeywell Court Mental Nursing... 18/01/06

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 Key Unannounced Inspection 8 November 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.V316689.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. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 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.V316689.R01.S.doc Version 5.2 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. The fees charged by the home range from £432.00 to £570.00. Extra charges are made for hairdressing, newspapers, toiletries and clothes. This information was provided by the manager on the Pre Inspection Questionnaire received on 26/10/06. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection visit was carried out by one inspector and took 4.5 hours to complete. The key standards were assessed and a brief verbal feedback was given to the Deputy Manager at the end of the visit. The Registered Manager – who was on annual leave at the time, received verbal feedback from the inspector via the telephone on 14/11/06. This home continues to offer high standards of care for individuals with enduring mental health needs (elderly). All the key standards were fully met and there was only one requirement made and 2 recommendations. The inspector was made to feel welcome by all the staff and the residents. The following methods were used to gather information and evidence in order to assess the standards – Direct observation Tour of the home Examination of documentation Discussions with staff, residents and two visitors The CSCI received a completed Pre-Inspection Questionnaire from the Manager of the home, 4 comment cards from relatives, 1 from the GP and 1 from a Placement Officer. No comment cards were received from residents. The Manager had documented that not many residents were able to neither understand nor complete these cards due to their limited mental abilities. Some comments were received from two residents at the time of the visit and have been included in the report. A remark on a comment card read – “I have been very happy with my mum’s care in fact to the point that when mum was very ill the staff came to see her even on their days off. This speaks for itself.” Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 6 Another read – “The home maintains a high standard of care and caring. I attended the funeral of a long term resident who had no relatives last week and I counted at least 20 staff present – some in tears. It gives me confidence about the care my mother receives.” It is of major concern that, although the CSCI have recently received a letter from the new providers (Minster Care), providing information of the change of Provider, they have not yet applied for Registration. This must be done, without further delay and has been made a requirement of this report. What the service does well: What has improved since the last inspection? The requirement to ensure that COSHH equipment is stored away appropriately has been addressed. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 7 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. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 8 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.V316689.R01.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents undergo a full assessment of needs prior to being offered a placement at the home. The home does not accept residents under the “Intermediate Care” category EVIDENCE: Examination of a selection of care plans for individuals who had been admitted over the past few months identified that pre-admission assessments take place before a resident is admitted to the home. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 10 The manager or another trained nurse usually carries this out at the resident’s own home, or wherever the resident is accommodated. Assessments were found to be thorough and comprehensive. Funding bodies, where applicable, also carry out assessments and these were also contained in care plans. This home does not accept residents under the category – “Intermediate care.” Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and welfare of residents accommodated in the home is promoted and protected and care is delivered with dignity and respect. EVIDENCE: Examination of care plans identified that all the required information was contained. The ones examined were clear and easy to follow. Risk assessments had been developed, including those specific to the needs of the individual. The plans focussed on meeting these needs and observation carried out at the time of the visit confirmed that care was delivered according to the plans. Health care needs had been assessed on an individual basis. These assessments focussed on psychological needs as much as general health needs. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 12 There was evidence of visits by healthcare professionals including General Practitioners, Psycho Geriatricians, Opticians and Chiropodists. Attendance at outpatient’s clinics was supported and facilitated by the staff at the home and evidence was seen of this. Good records were seen of the regular monitoring of the individual health and well-being of residents. Reviews were held but there was little evidence of the involvement of representatives in these and this could be improved. Of the five care plans examined, two had little or no information contained in the Social History section and this could be improved. It was identified that the model of care planning adopted by the home was in the process of change. The plans were moving to a more centred person approach, which would emphasise strengths and abilities of individuals. These would also help to promote autonomy for residents. Some of the documentation was already contained in the care plans. Relevant staff had received training in this area. A comment from a relative read – “One or two points need more attention – hand washing of residents, cleaning food residue from chair arms after meals and not talking over residents who do understand.” At the time of the visit staff were observed delivering care in a respectful and dignified manner and were attentive to the needs of the residents. The nurse in charge on the first floor unit was observed administering medication to the residents. She was accompanied by a student nurse, who was on placement at the home. The procedure used was in accordance with requirements policies and procedures. There were no residents accommodated in the home at the time of the visit who were able to self medicate due to their limited cognitive abilities. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff at the home help to promote autonomy and choice for individuals in all aspects of their daily life. EVIDENCE: At the time of the visit the therapeutic activity co-ordinator was helping out as care assistant on the floor due to staff sickness for the morning shift. Discussions with her identified that she had recently gained the NVQ level 3 “Therapeutic Activities for Older People” award run by the local college. The activities programme was interesting and varied and adapted to suit individual needs and abilities. Records were seen contained in care plans of individual participation. There was also evidence of trips out to local places of interest including photographs displayed of the day out. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 14 Links with the local Churches were maintained with services held in the home on a regular basis. The local Clergy from different denominations also visit individuals in the home. It was pleasing to observe care staff making arrangements for individual residents to maintain autonomy and choices in respect of some aspects of their daily life. One care assistant was seen liaising with the cook and passing on a list of food preferences for a resident who had recently been admitted to the home. She had obtained this information from a relative visiting the home. The care assistant then spoke of the importance of promoting choice for the residents. Other lists of individual food preferences were seen displayed on the kitchen wall. There was also written evidence of the promotion of autonomy contained within care plans. The lunchtime meal served was found to be wholesome and appetising. There was a choice available. Those individuals requiring help to eat their meal were assisted by staff members. One elderly lady was seen being assisted to eat her salmon sandwiches which she was obviously enjoying. The care assistant helping her commented that she preferred these to the main meal. The cook had worked very well on the morning of the visit as, due to staff sickness, was on her own in the kitchen. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 15 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives can be assured that any concerns they have will be listened to and taken seriously and that the procedures adopted by the home help protect residents from harm. EVIDENCE: There was a clear and accessible complaints procedure displayed in the entrance to the home and contained within the Service User Guide. The CSCI had not received any complaints directly since the last inspection. A comment contained on a relatives/visitors comment card read – “when I complained it was very minor and my complaint was dealt with straight away.” Staff are carefully selected to work at the home through the home’s recruitment procedure. This includes obtaining two written references and CRB police checks on individuals before being offered employment. Discussions with staff identified that they receive instruction on the protection of Vulnerable Adults including the local policies and procedures. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and comfortable environment, which has been adapted to meet their needs. EVIDENCE: A tour of the home was undertaken during which all of the communal rooms and a selection of bedrooms was examined. The home was found to be clean and well presented. Bedrooms had been adapted to suit individual needs and most were personalised with items brought in from home. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 17 In bedroom 4 it was identified that there were nails protruding from the wall where pictures had hung. These posed a health and safety hazard and must be removed. The temperature of the hot water at the bath tap outlet located next to bedroom 16 was registering too low at 37 degrees centigrade and this will need to be raised to 42 degrees centigrade. The housekeeper was working in the laundry area due to staff sickness at the time of the visit. She explained the arrangements for domestic cover and the cleaning schedule. The environment had been adapted to help meet the needs of the residents who live there. There were pictorial signs on doors informing residents of what the room was for and to help with orientation. Some of the residents were observed using the smoking lounge under supervision. This is located at the entrance to the second floor unit. The programme of redecoration and refurbishment is on going at the home and several of the bedrooms had been redecorated since the last inspection. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a skilled and competent staff team. EVIDENCE: A the time of the inspection visit there were 28 residents accommodated at the home, all of whom were in receipt of nursing care. There were two qualified nurses on duty, one of whom was the Deputy Manager of the home. The nurses were supported by care staff on each floor and two student nurses were also on placements at the home. At the time of arrival at the home the administrator and Deputy Manager were in the process of ringing up staff to sees if they could cover shifts where other staff had telephoned in to report off sick. They appeared to cope with the situation well at the time and ensured that there was sufficient cover for the home. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 19 Staff training is on going at the home and the staff spoken to stated that they felt well supported with their training needs. The training undertaken in the last 12 months included – Dementia Care (Building on Strengths), Palliative Care for Health Care Assistants, Aromatherapy, Break Away Techniques, Diabetes management, Pressure Relief, Abuse Awareness and Nurse Verification of Death. Future planned staff training includes – Mental Health in practice, Palliative Care for HCA’S, Blood Glucose Monitoring, Abuse Awareness and Breakaway Techniques. The home had achieved the standard for 50 of care staff to be trained to NVQ level 2 and above in care. Two staff files were examined relating to staff who had been recruited since the last inspection. All the required information relating to the recruitment procedure had been obtained including references and CRB police checks. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 20 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, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager was on annual leave at the time of the inspection visit. He has been the manager of the home for a number of years and is very skilled and competent to run the home. Comments received from staff members indicated that they felt very supported by the manager and that he was accessible and approachable. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 21 The home is run transparently and staff members are welcome to air their views about the running of the home during staff meetings and one-to-one meetings. Staff receive supervision and trained nurses receive clinical supervision. These records were seen. Representatives of residents are welcome to discuss the care of their loved ones at any time and two visitors commented that they had been made to feel very welcome at the home even though they were not the next of kin. The records relating to the maintenance of two of the residents’ personal pocket monies was examined. These were found to be in order at the time. Health and Safety was promoted at the home and records were examined in relation to this. Mandatory staff training had taken place and was on going. This included Moving and Handling, Fire Safety and First Aid. Records relating to the maintenance of the environment and testing of equipment were just starting to fall behind – these included the testing of emergency lights and ambient air temperatures. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 22 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 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 x x 3 3 x 3 Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP1 Regulation 7 (1-5) Requirement The new providers must make application for Registration with the CSCI and the Statement of Purpose must be amended accordingly. The nails protruding from the wall in bedroom 4 must be removed. Timescale for action 08/12/06 2 OP38 13(4) 20/11/06 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 Refer to Standard OP38 OP7 OP7 Good Practice Recommendations The records relating to the testing of emergency lighting and ambient air temperatures should be addressed in order to prevent them falling behind. Staff should be mindful to complete the social history sections in care plans. Care plan reviews should involve the participation of the resident or his representative. Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Abbeywell Court Mental Nursing Home DS0000026932.V316689.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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