Inspection on 17/11/05 for Abbingdon House

This inspection was carried out on 17th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbingdon House 28/08/08

Abbingdon House 04/07/07

Abbingdon House 16/05/06

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 Announced Inspection 17th November 2005 09:00 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.V257049.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. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 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) Mersey Link Limited, Trading as Fairway Care 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.V257049.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 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 provided through stairs and 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. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Abingdon House took place on Thursday 17th November 2005 over a period of 4.5 hours. It involved the examination of records, a tour of the building and meeting with five of the residents. The home was accommodating 10 residents at the time of this inspection. The inspection was undertaken as part of the Commission’s requirement to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? An activities organiser is in post for 20 hours each week. More detailed records are being kept of staff and resident’s meetings. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 6 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. Abbingdon House DS0000018851.V257049.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 Abbingdon House DS0000018851.V257049.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): 1, 2, 3, 4, 5 and 6. Assessment documentation is of a good standard and the home has better information on which to make a decision about placement. EVIDENCE: The home’s statement of purpose has been further amended to include some of the matters identified in the CSCI inspection of July 2005. Some minor additional details still need to be included to comply with Schedule 1 of the National Minimum Standards, Care Homes for Older People. The inspector examined three resident’s care files. Each of them contained a signed contract/terms and conditions of residency. Good assessment documentation was in place. Resident’s current and past social, medical and mental history was included and from the information staff were able to make a decision about whether they could meet the individual’s needs. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 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 and community psychiatric nurses (CPN’s). The homeowner and the manager are clear about the admission criteria and do not accept as residents, older people whose main needs are around a dementia or have a diagnosis of Alzheimer’s. The home prefers to admit residents following a period of introduction but will accept new residents outside of those arrangements if it is deemed to be in their best interests. Abingdon House is not contracted to provide Intermediate Care. Abbingdon House DS0000018851.V257049.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, 9 and 10. Improvements have been made to the care planning arrangements but more detailed information for staff is needed around care plans and risk assessments. The recording of reviews could be improved. EVIDENCE: Care plans were evidenced on the three care files examined 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 were being prepared through a process of continued development but would benefit from some further improvement. Risk assessments had also been improved but could be developed further. A date and a signature were noted as reviews but there was no evidence that the care plan been considered, amended or improved. The inspector discussed the opportunity to record individual care plans on separate forms and to use the back of the form to record the monthly reviews. Any progress or deterioration should be recorded in more detail and any amendments to the original care plan written up on the front of the form. From more detailed care plans better risk assessments could be developed (again on Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 11 separate forms) records of risk assessment reviews could be noted on the reverse side of the form and any changes put on the front. Newly admitted residents who are unable to maintain 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. An optician visits the home and a local dentist provides surgery and domiciliary visits. Chiropody services are offered for which there is a small charge. The continence adviser provides appropriate products once an assessment of need has been undertaken. None of the current residents are able to self-medicate. An examination of the MAR charts and some medicines in the home confirmed they were being managed appropriately. A homely remedy list has been approved for each resident but the manager told the inspector that apart from simple linctuses the home does not use non-prescribed medicines. Residents who spoke with the inspector were complimentary about the staff and the support that was being provided to them. The home’s policies and procedures support the principles of privacy and dignity and the manager knocked on resident’s bedroom doors before entering. Abbingdon House DS0000018851.V257049.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 and 15. Some activities were being provided in the home. Meals were varied and nutritious and were 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 but is flexible and is dependent upon the availability of staff time and the cooperation of residents. An activities organiser is employed for 10 hours each week and will respond to the needs of an individual or groups of residents. At other times, particularly in the afternoons staff will encourage social interaction amongst the resident group. Three of the residents attend a day centre on two days each week. One of the residents has weekly funding for 20 hours individual support. The homeowner and manager told the inspector that additional staff are provided when an outing is arranged or residents have to be accompanied to a hospital appointment. Residents meetings are held on a bi-monthly basis. The inspector saw minutes from the last two meetings. The agenda covered matters of interest to the resident group and the minutes showed that the meeting was kept short to maintain their attention and their involvement. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 13 The manager told the inspector that visitors are welcomed at any time. A whiteboard in the dining room informed residents of the day’s menu. A choice of two meals was being offered but the inspector was told that if residents don’t like either of the meals provided something to their choosing would be prepared. Residents who made comment about the meals were complimentary about the quality and quantity of food served in the home. Abbingdon House DS0000018851.V257049.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 and 18 Appropriate policies are in place to deal with complaints and to manage any adult protection concerns. EVIDENCE: The home has a complaints policy and procedures in place that are available through the statement of purpose and the service users guide. No complaints have been made to CSCI or directly to the home in the past twelve months. Residents are included on the Electoral Register and those who choose to vote in local and national elections are supported to do so. The home has a copy of Wirral’s adult protection procedures and has a “whistle blowing” policy for staff. Most of the staff have attended a training event organised by Wirral Council to explain the POVA arrangements. Abbingdon House DS0000018851.V257049.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, 20, 21, 22, 23, 24, 25 and 26. The environment was being well maintained. EVIDENCE: Abingdon House is situated in a quiet residential area of Bebbington Wirral. Outside space is limited because of off road parking to the rear of the home but a small, enclosed patio/sitting area is provided. Communal areas of the home are well decorated and furnished in a domestic style. Carpets are fitted throughout the home, except for bathrooms and toilets where an appropriate vinyl floor covering has been laid. Most of the bedrooms are shared. Curtaining provides privacy for washing and dressing and the rooms are large enough to accommodate two beds. Appropriate bedroom furniture is provided for each resident. Prospective residents and their families are advised, when seeking a vacancy, if the available place is in a shared room. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 16 Ramps and handrails are fitted throughout the home and there are assisted bathing facilities on both the ground and first floors. Risk assessments had been undertaken to determine whether individual residents could manage a key to their room. Those who can manage a key and wish to lock their room are provided with one. The home’s kitchen was clean and tidy. Food was being served at the time of this inspection. The temperature of fridges and freezers was being recorded on a daily basis. The staff toilet is accessed through the kitchen. This is not ideal but alternative access can only be gained by going around the outside of the building. The Environmental Health Officer has been made aware of the situation and there are staff notices advising them to wash their hands and not to touch work surfaces as they pass through. There have been no changes to the numbers of baths and WC’s available to residents in the home. On the day of this inspection the home was clean and free from any offensive odours. Abbingdon House DS0000018851.V257049.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): 27, 28, 29 and 30 Staffing levels were being maintained according to previously agreed standards. Opportunities for staff training were being improved. EVIDENCE: The staff rota at the home allows for two care staff to be on duty during the waking day and for one wakeful and one sleeping member of staff at night. In addition the placing authority has agreed to fund an additional 20 hours each week to allow one resident to receive one-to-one support. The homeowner and manager told the inspector that additional staff are brought in to cover outings and accompanied hospital appointments. An additional member of staff had been brought in to cover the manager’s time during this inspection. The home was carrying four resident vacancies at the time of the inspection. The homeowner told the inspector that he keeps staffing levels under constant review and this approach is supported by CSCI. Two of the home’s eight care staff have an award at NVQ level 2 or above whilst another four staff are in the process of completing the training that can lead to this award. Agency staff are not used. The homes recruitment and selection processes were examined and found to be in good order. Appropriate application forms and two references were in place together with confirmation that CRB checks had been carried out. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 18 There was evidence on the staff files examined to confirm that new staff had undergone a process of induction. Training was being provided in infection control, food hygiene, moving and handling, the management of medicines and POVA. Copies of certificates gained by individual members of staff were being kept on their files. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 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 EVIDENCE: The homeowner has appointed someone to manage the home and her application for registration is being processed by CSCI. As Abingdon House is accommodating only 10 residents the manager works alongside care staff and is listed on the rota to provide direct support to residents in the home. The Commission would wish to ensure that some time is put aside for the manager to attend to the maintenance of records, including care plans and to ensure that one-to-one supervision is provided for staff. Evidence was provided on some of the resident’s files to confirm that the homeowner carries out regular satisfaction surveys with those who are able to participate. The manager told the inspector that information from the surveys Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 20 together with the outcomes from resident’s meetings is used to review practices in the home. Staff meetings were being held and minutes kept. Three members of the care staff have left the home since the CSCI inspection in July 2005. As a small care home there are only a small number of staff on duty at the home at any one time. At the time of this inspection the staff got on with their work without constant reference to the manager and appeared to understand the needs of each of the residents they were supporting. The homeowner is an appointee for only one of the residents. He told the inspector that all of the money received on behalf of that resident is handed over when it is received. Some smaller amounts of money are managed for other residents and detailed records of deposits and spend are maintained. Annual staff appraisals were being undertaken and there was evidence that one-to-one staff supervision was being held. However, the process needs to be developed to ensure staff are given appropriate time to consider their current and ongoing performance and to identify any training needs. Information provided by the home prior to the inspection and records tested during the visit confirmed that maintenance and associated records were being maintained and were up to date. Policies and procedures are in place that cover all of the relevant areas listed for a residential care home. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 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.V257049.R01.S.doc Version 5.0 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 OP1 Regulation 4 Requirement The homes statement of purpose should contain all matters identified in Schedule 1 of the National Minimum Standards, Care Homes for Older People. Timescale for action 31/12/05 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. 3. Refer to Standard OP7 OP27OP32 OP36 Good Practice Recommendations The manager should ensure that care plans; risk assessments and reviews are more clearly recorded. 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 supervision should be recorded to identify the matters discussed and any follow up actions to be taken. A copy of the notes should be given to the member of staff. Abbingdon House DS0000018851.V257049.R01.S.doc Version 5.0 Page 23 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.V257049.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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