Inspection on 10/08/05 for Abbots House

This inspection was carried out on 10th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Abbots House 05/03/07

Abbots House 27/04/06

Abbots House 10/01/06

Abbots House 06/12/04

Abbots House 29/06/04

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

CARE HOMES FOR OLDER PEOPLE Abbots House 103 Abbots Road Abbey Hulton Stoke on Trent Staffordshire ST2 8DJ Lead Inspector Wendy Snell Announced 10 August 2005 09:30am 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 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. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Abbots House Address 103 Abbots Road Abbey Hulton Stoke on Trent Staffordshire ST2 8DJ 01782 234888 01782 232938 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Stoke on Trent City Council Miss Melanie Joy Fenton Care Home 39 Category(ies) of 5 DE registration, with number 39 DE(E) of places 6 MD(E) 39 PD(E) Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 5 Dementia (DE) - Minimum age 55 years on admission Date of last inspection 06 December 2004 Brief Description of the Service: Abbots House is a Local Authority older peoples home which provides care for people with a dementia and similar metal health problems. The home is operated by Stoke on Trent Social Services and can accommodate up to 39 people with varying dependency needs. The home has three beds to provide short-term care. There is an attached day centre that caters for a maximum of 25 people and some of the residents of Abbots House like to spend time in the day centre, enjoying the activities and the stimulation that this provides. Located in Abbey Hulton, the home is a two-storey property providing all single bedrooms. (Although at the time of this inspection a married couple were sharing a large single bedroom, which had formerly been a double bedroom.) There are four separate living areas, each having a lounge-dining room, with adjacent bedrooms, bathroom and toilets. First floor accommodation is accessed by a lift. Externally there is a car park and the rear garden offers an enclosed area for residents. The location of this home ensures that there is a wide range of community facilities nearby that can be readily accessed. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on a Wednesday from 9.30am to 4.15pm. During the inspection a number of service users were spoken with as were four visitors. Prior to the inspection the Commission for Social Care Inspection (CSCI) had sent out comment cards to service users and relatives. Ten service users and three relatives comment cards were sent back to CSCI. Four staff were also spoken to about training and care practice within the home. The registered manager was present throughout the inspection. What the service does well: What has improved since the last inspection? Activities are now discussed with service users at ‘lounge meetings’ and there are now more activities and trips out taking place. Paperwork which shows that all staff have had appropriate checks is now available within the home. Staff have also received refresher training in food hygiene. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 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. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 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 standard(s) 3 The service users needs have been assessed which enables staff to support them appropriately EVIDENCE: A random sample of four service user’s care files were inspected and three of these service users were also spoken with about the care they receive at Abbots House. Care management assessment documentation was in place. This documentation outlined background information and information relating to the assessed needs of the service user. The service users spoken with commented positively about how their care needs were met. The manager was aware of the need for assessments of prospective service users to be in place prior to admission. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 & 9 Care plans do not adequately reflect how staff are meeting service users needs on a daily basis. The systems for the health monitoring and the administration of medication are generally good with clear and comprehensive arrangements being in place to ensure service users health and medication needs are met. EVIDENCE: The four care files checked contained care plans however, the plans did not consistency set out in detail the action which needs to be taken by staff to ensure that all aspects of the health, personal and social care needs of the service users are met. There was evidence that care plans are reviewed but this process generally involved no changes to the existing care plan. In discussions with staff all care staff spoken with demonstrated an understanding of the importance of care planning but some felt the process of reviewing was repetitious and that the plans were not always clear and easy to read. The manager stated that a new care planning process specifically designed for people with dementia is to be implemented. A sample of which was produced and shown to the inspector. This must now be implemented as previous Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 10 requirements have been made in respect of this. All staff should be trained in its use. Health needs were recorded within service user’s files. Information about the outcome of health appointments was recorded in a separate file. There was documented evidence that regular contact with health professionals takes place as and when needed. Four relatives who were visiting at the time of the inspection all spoke positively about the care within the home and confirmed that service users have regular health input when needed. The manager stated that there was one service user requiring care for potential pressure areas. Appropriate advice had been sought from the tissue viability nurse and the appropriate equipment and guidance for staff was in place. A relative of the service user confirmed that right equipment was in place and was very happy with the care her relative was receiving. Continence advice is sought when needed. Weight monitoring was also taking place where needed. One service user’s file indicated potential implications of weight gain this was discussed with the manager at the time of the inspection. Advice should be sought in relation to this service users and an appropriate plan and risk assessment must be in place to ensure the service user’s health is promoted. Medication is stored appropriately in a locked cabinet in a locked room. The manager stated that all senior staff that administer medication have completed or were in the final stages of completing medication training. A good medication administration system is in place with appropriate safeguards and policies. A random sample of medication administration records (MAR) sheets and medication were inspected and found to be in order. Appropriate systems are in place for receiving medication from the pharmacist and there was also evidence that a pharmacist visits the home on a quarterly basis. The manager demonstrated a good and thoughtful value base regarding the use and potential misuse of medication with evidence that she advocates strongly on behalf of service users when there are outstanding or concerning issues regarding medication. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 13 & 15 Visitor’s views about visiting the home and the care their relatives receive were positive. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Four visitors were spoken to all of whom stated that there were no set visiting times and that they could visit when it was convenient for them and the service users they were visiting. All stated that they could see their relatives in private and that they were made to feel welcome at the home. A further 3 relatives who responded to the pre inspection questionnaires also confirmed that they are able to see their relatives in private. The visitors all spoke very highly of the staff one said about the care given to her relative that she was ‘very, very happy all the carers are smashing’. During the inspection staff were observed to interact in a relaxed and friendly manner with the relatives who were visiting. Three service users were spoken to about the food within the home all confirmed that they enjoyed the food and that there was always enough. The menus indicate that in general toast and cereals are offered for breakfast apart from Sunday where there is also a cooked alternative. Hot meals and a dessert are offered at lunchtime with a mixture of salads, sandwiches or an alternative light meal for tea. A member of the care staff stated that although there was a Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 12 set meal service users who did not want or did not eat what was offered would be offered an alternative. The cook demonstrated a good understanding of special diets and health and safety arrangements within the kitchen. The main food supplies for the home are stored within the kitchen the cook confirmed that beverages, fruit, biscuits and yoghurts are available at all times for service users. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 The home has a satisfactory complaints system but further work is needed to ensure that service users feel that their views are listened to and acted upon. EVIDENCE: The Local Authority has a detailed complaints procedure that is available in different formats. The home had up-to-date copies of the complaints procedure whereby details of the Commission had been amended and information relating to the complaints procedure was clearly recorded. The final page of the complaints procedure gives details of how to obtain this information in large print or Braille and this has been translated into Urdu, Punjabi and Bengali. The home has a complaints book but has no complaints have been recorded since the last inspection. Ten completed service user comment cards and three relative/visitor comment cards were received at this inspection. One relative and three service users stated that they were unaware of the complaints procedure and would not know who to speak to about their concerns. The manager must review, in a way that is appropriate for the needs of the service users at Abbots House, the complaints procedure to ensure that service users are able to voice their concerns. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 There are outstanding issues in relation to the environment that have been raised by CSCI and the fire authorities, which Stoke on Trent senior management are responding to. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 15 EVIDENCE: There are requirements and recommendations regarding the premises made by the Commission for Social Care Inspection (CSCI) and Stoke on Trent fire service which remain outstanding. CSCI is aware that an audit of outstanding works to the premises has been carried out and that talks are underway regarding the future plans for this home. There are regular discussions between CSCI and members of Stoke on Trent’s senior management team in relation to progression and resolution of these matters. A costed plan of works has also been shared with CSCI. The home is a two-storey property providing all single bedrooms. There is one shared room at the service users’ request. There are four separate living areas, each having a lounge-dining room, with adjacent bedrooms, bathroom and toilets. First floor accommodation is accessed by a shaft lift. Externally there is a car parking area and the rear garden offers an enclosed area for residents. Internally there are appropriate toilet and bathing facilities however, these are not easily identifiable for people with dementia as the door are of a similar design and colour to other doors along the corridor and are therefore indistinguishable. The location of this home ensures that there is a wide range of community facilities nearby that can be readily accessed. The entrance hall has provides a seating area and audio equipment. The communal areas have been tastefully decorated and provide a homely feel. The corridors have been redecorated by the staff and have been completed to a good standard. An inspection tour of the building revealed that alarm calls were missing from some bedrooms. Some service users who would be unable to call for assistance at night had alarm pads under their bedside rugs, which notify staff that they are up and may need assistance. All service users must be able to summon assistance when in their rooms and therefore alarm calls must be available to all service users. It was also noted that a bathroom window frame was in a poor state of disrepair and the window, which was below waist height, was not toughened and did not have a safety film. This must be addressed to protect service users from potential injury. . Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 & 30 There is appropriate vetting and training of staff to ensure that they are fit and competent to do their jobs. EVIDENCE: The home has a recruitment procedure based on equal opportunities. The need for all new staff to be checked against the Protection of Vulnerable Adults (POVA) register was discussed with the manager. Three staff personnel files were inspected which contained the necessary documentation confirming that they had been vetted appropriately with CRB checks and references being in place. It is recommended that the Department of Health POVA guidance be sought to ensure that all senior staff are familiar with this. Pre inspection information completed by the registered manager indicates that a range of training has been available to staff over the past 12 months. Three care staff and the cook were spoken with about the training they had received and confirmed that training is regularly offered to them. A record of all staff training is maintained within the home and where possible this also includes certificates of attendance. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 38 In general service user health, safety and welfare are satisfactorily promoted and protected, however outstanding requirements and safety issues must be prioritised to protect service users from any potential harm. EVIDENCE: The way in which the home handles service user’s monies was inspected and found to be satisfactory. There was evidence of good recording accompanied by receipts, which provided a clear audit trail of monies spent. Any monies taken from a service user’s personal allowance was shown to have two staff signatures with service users also signing for their money if they are able to. A record is also kept of any valuables handed over for safekeeping. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 18 Outstanding concerns have been expressed by the fire service in relation to the physical environment and the lay out of the building. A reduction in service user numbers has temporarily addressed some of the concerns but others have yet to be addressed. Service records were well maintained with evidence that the lift, hoists and fire system had been regularly serviced. The home has an emergency 24 hour contract for the servicing of the lift should be needed. There was service information regarding the gas but there was no certification for the service of the electricity system. This must be sought and made available to CSCI. Fire records were checked and were satisfactory. One staff member spoken with confirmed that she had been present during a fire drill and was aware of the home’s procedures. The manager stated that water temperatures are taken regularly to ensure that the hot water is maintained at an appropriate temperature. Appropriate window restrictors were in place where necessary. A previous inspection found that appropriate environmental risk assessments were in place and that regular Legionella checks are made. There was evidence that all accidents are recorded. Issues in relation to data protection and accident records were discussed with the manager and recommendations made. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 4 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x 2 Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 2 7 Regulation 5(1b)(c3) 15(1) Requirement All service users to have a contract(Previous timescale of 6.3.05 not met) To review the plans of care in to ensure sufficient information is recorded for all aspects of care needs(Previous timescale of 6.3.05 not met) In consultation with the fire officer fit suitable locks to the bedroom doors(Previous timescale of 6.2.05 not met) To provide evidence of Annual Gas Safety testing and Electrical Wiring Check (previous timescale of 31.03.05 partially met elec cert outstanding) Planned dates for the completion of outstanding works as outlined in the latest fire report must be agreed with the fire authority and forwarded to CSCI . The window identified at the time of the inspection must have a protective film or the glass replaced with toughened glass. All bedroom must have an alarm pull cord. The manager must review the complaints procedure within the Timescale for action 30th October 2005 30th October 2005 31 March 2006 Immediate 3. 24 13(4) 4. 38 23(2)(bc) 5. 38 23(4)(a)( b) 30th September 2005 Immediate 6. 38 13(4)(a) 7. 8. 19 16 13(4c) 22(2) 30th September 2005 30th November Page 21 Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 9. 8 13(1)(b) home to ensure that it is understood by and accessible to the service users accommodated at Abbots House. The manager must seek advice from a dietician regarding the service user identified at the inspection and care plans and risk assessments must be altered accordingly. 2005 30th September 2005 10. 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 29 7 38 Good Practice Recommendations The Department of Health POVA guidance should be available to all senior staff. Staff should receive care planning training when the new care plan system is introduced. Accident book enteries should be stored in line with data protection. Abbots House E51-E09 S28862 Abbots House V237244 100805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Stafford - 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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