Inspection on 16/05/06 for Abbingdon House

This inspection was carried out on 16th May 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

Abbingdon House 28/08/08

Abbingdon House 04/07/07

Abbingdon House 17/11/05

Abbingdon House 05/07/05

Abbingdon House 22/11/04

Abbingdon House 11/05/04

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Creative Support

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

CARE HOMES FOR OLDER PEOPLE Abbingdon House Abbingdon House 43 Thornton Road Bebington Wirral CH63 5PR Lead Inspector Les Hill Key Unannounced Inspection 16th May 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 Abbingdon House DS0000018851.V288719.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. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbingdon House Address Abbingdon House 43 Thornton Road Bebington Wirral CH63 5PR 0151 608 6722 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) Fairway Care Homes Limited Barbara Rankin Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (12) Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2005 Brief Description of the Service: Abbingdon House is a residential home providing care and support to 14 people over the age of 65 years who have a mental disorder. The home is located in the Bebington area of Wirral and is close to local shops, post office and pubs and is a short bus ride from Birkenhead town. Outside space for residents consists of a garden to the front of the home and a patio area to the rear. Most of the rear garden is used to provide off-road parking. Accommodation is provided on two floors with access to the first floor through stairs or a passenger lift. Most of the accommodation is provided in double bedrooms. Downstairs there is a large lounge/dining area and a separate small smoking room. Toilets and bathrooms are provided on both the ground and first floors. Fees charged are usually at the basic rate set by the DWP (Currently £361) but costs may be added for any additional levels of support required. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Abbingdon House was undertaken on Tuesday 16th May 2006 over a period of 2.5 hours. It involved the examination of records, a tour of the building, meeting with staff on duty and discussion with four of the residents. The home was providing support to 14 residents at the time of the inspection and so there were no vacancies. The inspection was undertaken as part of the Commission’s new programme of inspections. Abbingdon House will have this one “key” inspection and a further random inspection in the next twelve months. All of the inspections will be unannounced. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made in this report to establish the frequency of care plan reviews; to carry out some deep cleaning of carpets; cover drainage holes on a bath seat or have it replaced; provide liquid soap in WC’s and to ensure the regular one-to-one supervision of care staff. Recommendations have been made to ensure the kitchen area is protected through limiting the access of residents and staff; that staffing levels are Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 6 continually monitored and improved when necessary and that staff meetings are held. 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. Abbingdon House DS0000018851.V288719.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 Abbingdon House DS0000018851.V288719.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6. Prospective service users have the information they need to make a choice about the home. Pre-admission assessments provide good levels of information on which decisions about the appropriateness of the home can be gained. EVIDENCE: The home’s statement of purpose has been further amended and now contains all of the information required in Schedule 1 of the National Minimum Standards, Care Homes for Older People. The inspector examined the care files for three residents. Each of them contained a signed contract from the placing authority. The home has its own contracts/terms and conditions of residence that are use to support privately funded care. Good assessment documentation was in place. Resident’s current and past medical, social and mental health history was included and the information enabled staff to form an opinion about whether the home would be able to meet the identified areas of need. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 9 The home has been providing care and support to older people with mental health needs for over ten years and has the support of psychiatrists, community psychiatric nurses (CPN’s) and specialist social workers. The homeowner and the manager are clear about the admission criteria and do not accept any resident whose main needs are around dementia or a diagnoses of Alzheimer’s. The home prefers to admit residents after a process of introduction but will accept new residents outside of those arrangements if it is deemed to be in their best interests. Abbingdon House is not contracted to provide Intermediate Care. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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, 10 and 11. Care planning arrangements and the recordings of reviews confirm the tasks that staff are expected to undertake for individual residents. Appropriate health care arrangements, including psychiatric and psychological support is provided in conjunction with local services. EVIDENCE: Care plans were evidenced on the three resident’s care files seen during the inspection. They identified the main areas of need that were to be supported by staff and the ways in which support should be provided. The plans have been improved through a process of continued development and it will be important for the work to be maintained. Risk assessments were also in place and these too showed evidence of improvement. The notes confirming that a review of the care plan had taken place were recorded more appropriately. However, some had been reviewed bi-monthly and others less frequently. The frequency of reviews should be established and maintained. The Commission would advise the manager that reviews of care plans should be undertaken not less than bi-monthly. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 11 Newly admitted residents who are unable to maintain support from their own GP are registered with a local practice that is supportive to the home. The manager told the inspector that residents’ benefit from good GP, district nurse, CPN and psychiatric support. A local dentist provides domiciliary and surgery support and the manager recently changed the visiting optician service to ensure more regular support. Residents can purchase support from a visiting chiropodist. Continence products are provided following assessment. None of the current residents are able to self-medicate. An examination of the systems used to manage medicines in the home confirmed that they were safe. A homely remedy list has been approved by the GP for each of the residents and is maintained on their file. However, apart from simple cough linctus, the home does not use non-prescribed medicines. Residents who spoke with the inspector said they were happy in the home. Policies and procedures support the principles of privacy and dignity. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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 and 15. Some activities are being provided in the home. Meals are varied and well prepared and are appreciated by the residents. EVIDENCE: Most of the residents need to be supervised if they leave the home. A programme of activities has been drawn up and is displayed on a notice board next to the dining room. However, the manager told the inspector that it is often difficult to motivate and maintain the attention of the residents and so the programme is not always followed. The inspector was told that an activities organiser is employed to work at the home for two hours each morning, Monday to Friday, but on the day of this inspection she wasn’t on site. At other times, staff will attempt to encourage social interaction amongst the resident group. Three residents attend a local day centre and were waiting for the transport when the inspector met with them. They were well dressed and were looking forward to their time at the centre. Another resident has weekly funding for 20 hours individual support. The manager told the inspector that additional staffing is arranged when trips out from the home are organised or residents are to be accompanied to hospital appointments. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 13 Residents meetings are held bi-monthly. The last one was in February 2006 and another is due. Minutes are kept and from the records it was evident that matters of interest to the residents are included on the agenda and the meetings are kept short to maintain their attention. The manager told the inspector that visitors are welcomed at any time. A whiteboard by the dining room usually informs residents of the day’s menu, though it wasn’t displayed during this inspection. Residents who do not wish to take the main meal on offer are asked to let the staff know so that an alternative meal can be prepared. Special diets are catered for and two of the current residents have identified a preference for vegetarian meals. Residents who spoke about the meals were complimentary about the food served in the home. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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 and 18. Appropriate polices and procedures are in place to deal with complaints and to manage any adult protection concerns. EVIDENCE: The home has a complaints procedure in place that is available through the statement of purpose and the service users guide. No complaints have been made to the home and one complaint made directly to CSCI was passed to the homeowner for investigation. Residents are included on the Electoral Register and those who wished to vote in local and national elections would be supported to do so. The home has a copy of Wirral’s adult protection procedures and has a “whistle blowing” policy in place for staff. Only one member of staff has not yet attended a POVA training event but a future date for their attendance had been confirmed. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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, 21, 22, 23, 24, 25 and 26 With the exception of some small matters, the home was being well maintained. EVIDENCE: Abbingdon House is situated in a quiet residential area of Bebington, Wirral. Outside space is limited because of off-road parking to the rear of the home but a small, enclosed patio area is provided and residents are able to sit outside in the warmer summer months. Communal areas of the home are well decorated and furnished in a domestic style. Carpets are fitted throughout the home, except for bathrooms and WC’s where appropriate vinyl flooring has been laid. A carpet in one of the bedrooms seen by the inspector was badly marked and in need of deep cleaning. Most of the bedrooms are shared. Curtain and movable screens are provided to maintain privacy for washing and dressing and the rooms are large enough to accommodate two beds with plenty of personal space. Prospective residents Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 16 and their families are advised, when seeking a vacancy, if the available place is in a shared room. Ramps and handrails are provided throughout the home and there are assisted bathing facilities on both the ground and first floors. However the seat fitted to the bath hoist on the ground floor had a honeycomb of water drainage holes that have been the subject of a health and safety notice. The manager must arrange either for grommets to be fitted to block up the holes or for a new chair to be provided. No liquid soap was available in each of the WC wash hand-basins. Risk assessments have been completed to determine whether individual residents are able to manage a key to their room. Those who can manage to use a key and choose to lock their room are provided with one. The home’s kitchens have recently been inspected by Environmental Health Officers and the manager, together with the cook were in the process of completing a diary and questionnaire for them, about the use of the kitchen. Cooks maintain a clean and tidy kitchen environment but the room is small and is used by all staff to access a staff toilet. This is not ideal and Environmental Health Officers have been advised of the arrangements. The inspector discussed with the manager and the cook the need to ensure the kitchen environment is protected as much as possible from the risk of any bacterial contamination by care staff and residents who may need to pass through. There have been no changes to the construction or layout of the home. On the day of this inspection the home was clean and well cared for. Some odours from incontinence were confined to particular rooms and were being managed. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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, 29 and 30 Staffing is being maintained at previously agreed levels. EVIDENCE: Staffing is being maintained to previously agreed levels. The rota allows for two staff to be on duty during the waking day and for one wakeful and one sleeping member of staff to be available in the home at night. An activities organiser and cooks/domestics are available for additional support during the day if required. At the time of this inspection most residents are self-caring and require support and supervision to ensure they are safe. However, the home is now operating at full occupancy and in order to ensure there is time for personal care, supervision, activity/occupation, taking residents out, completing care plans and reviews and other administrative tasks (required of the manager) staffing levels should be kept under constant risk assessment and review. The inspector was told that additional staff are brought in to cover hospital appointments or trips out. Four of the home’s care staff have an award at NVQ level 2 or above and a further four staff are working to achieve the same award. Agency staff are not used at Abbingdon House. Two staff files were examined and found to contain all of the documentation required in National Minimum Standards. There was also evidence to confirm that staff had undergone a process of formal induction training. Copies of training certificates gained were also kept on the files. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 18 The manager told the inspector that additional training is being provided to support staff in dealing with the mental health needs of residents. A psychologist working with one of the residents in the home is advising staff on appropriate methods of support. The homeowner, who has a background in mental health work, provides some training and visiting mental health care professional will also support staff with specific advice and guidance. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 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, 37 and 38 Residents are supported by polices and procedures that recognise their needs and seek to provide protection. EVIDENCE: The Commission has registered the home’s manager. Abbingdon House provides care and support to 14 older people who have additional mental health needs and at the time of this inspection it was operating at full capacity. Current practice in the home requires the manager to work alongside staff in providing direct care and support and her working hours are included in the staff rota. The Commission would expect that time is set aside for the manager to maintain all of the records required to be kept in the home, to ensure care plans are being prepared in line with need and are being reviewed and given to time to support all other staff through one-to-one supervision. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 20 Evidence was available on some of the care files to confirm that the homeowner undertakes regular satisfaction surveys with those residents who are able to participate. The manager told the inspector that new residents are given a questionnaire when they have been in the home for several months and that information from the completed forms is used to review care practices in the home. Staff meetings have not been held for several months. The Commission accepts that it is sometimes difficult to ensure all staff can/will attend meetings but would encourage regular discussion with the staff group in order to ensure consistency of care practice and the sharing of information. During the course of this inspection an additional member of staff had taken a resident for a hospital appointment. When she returned the two members of staff on duty carried on with their day-to-day work without having to refer to the manager for direction or advice. The homeowner is appointee for only one of the residents and during the previous CSCI inspection he told the inspector that all monies are passed over to the resident when they are received. The home holds some small amounts of money for residents to purchase everyday items such as cigarettes, toiletries or hairdressing. The inspector examined the records of deposits and expenditure that were being kept appropriately. Annual staff appraisals are being undertaken and the notes are maintained on individual staff files. However, although some formal staff supervision has taken place the manager indicated to the inspector that they were not being held bi-monthly. It is important to ensure that staff development is supported through formal supervision and that staff are encouraged to raise any matters themselves. There have been improvements to the standards of record keeping the home particularly around care planning and these should be maintained. The home’s electrical installation safety certificate was seen and is current. The gas safety certificate was due to expire in the week following this inspection and should be renewed. Confirmation of checks on the safety of the lift was also seen. The records of fire safety identified that fire alarms are tested weekly and that drills are held from time to time. The temperature of hot water delivered to resident’s rooms is also tested and recorded, on a monthly basis. The temperatures of fridges and freezers are taken daily and the cook told the inspector that although the Environmental Health Officers had said temperature probes need no longer be used during cooking, she intended to carry on with this practice to ensure food provided in the home is being cooked safely. Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 21 Abbingdon House DS0000018851.V288719.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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 3 18 3 2 3 3 3 3 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 2 3 3 3 2 3 3 Abbingdon House DS0000018851.V288719.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. 2. Standard OP7 OP19 Regulation 15(2)(b) 16(2) Requirement Timescale for action 31/08/06 3. OP36 18(2) The registered manager must ensure that resident’s care plans are kept under regular review. The registered manager must 30/06/06 ensure that The environment is maintained to a good standard. This refers to: 1. The deep cleaning of carpets. 2. The safety of the bath seat. 3. The provision of liquid soap in WC’s around the home. The registered manager must 31/08/06 ensure that staff are appropriately supervised. 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 OP19 Good Practice Recommendations The registered manager should restrict the use of the kitchen area by non-cooking staff to ensure that it is DS0000018851.V288719.R01.S.doc Version 5.2 Page 24 Abbingdon House 2. OP27 OP32 OP36 protected from the risk of bacterial contamination. The manager should routinely monitor the needs of the resident group to ensure staffing levels remain appropriate. The manager should ensure that staff are provided with one-to-one professional supervision not less that six times each year. The manager should ensure that staff meetings are used to ensure consistency of care practice within the home. 3. 4. OP36 Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Abbingdon House DS0000018851.V288719.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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