Inspection on 10/01/06 for Abbots House

This inspection was carried out on 10th January 2006.

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 10/08/05

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 Unannounced Inspection 10 January 2006 09:45 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 Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 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) Stoke on Trent City Council Miss Melanie Joy Fenton Care Home 39 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (39), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (6), Physical disability over 65 years of age (39) Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 Dementia (DE) - Minimum age 55 years on admission Date of last inspection 10th August 2005 Brief Description of the Service: Abbots House is a Local Authority older people’s home which provides care for people with a dementia and similar mental 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 DS0000028862.V277712.R01.S.doc Version 5.1 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 Tuesday morning from 9.45am to 12.45pm. During the inspection four service users, two assistant managers and two care staff were spoken with. Information from the monthly monitoring reports completed by the service manager for Abbots House has also been used within this report. What the service does well: What has improved since the last inspection? The home is in the process of improving the care planning process and system. The new system will provide a clearer picture of the service user’s health, social and welfare needs and will provide an account of service user’s social histories. This is important information for care staff to have in order to know how to meet the needs of individual service users with dementia. Service information relating to gas and electricity is now available within the home. A number of areas relating to the maintenance of the environment have also been addressed. In addressing these areas the manager ensures that service users live in a well maintained and safe home. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 DS0000028862.V277712.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The service users’ needs have been assessed which enables staff to support them appropriately. EVIDENCE: This area was examined at the previous inspection on the 10th August 2005. Comprehensive assessment documentation was found to be in place. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 the following standard(s): 10 There were some positive examples of staff respecting service users’ privacy and dignity. However, some service users were unhappy that they are unable to spend private time in their bedrooms when they choose during the day. EVIDENCE: Four service users were spoken with about living at Abbots House and about issues relating to privacy and dignity in particular. The service users at Abbots House experience varying degrees of memory difficulties and some communication problems. All of the service users spoken with were able to express an opinion; some were able to offer more detail than others. In a discussion about bathing one service user said that staff ‘always make it as private as it can be’. She clarified this point by explaining that bathing is never completely private because they require staff assistance. All the service users agreed that staff always close the door to bathroom or toilet facilities when assisting service users in these areas. One service user commented that he would like to spend more private time in his bedroom but that the bedroom door was locked during the day. He said that staff open his bedroom door ‘when it suits them’. Another service user said that they could have a lie down during the day if they ‘tell staff they are Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 10 tired’. In view of the service users cognitive difficulties the inspector is unclear how this system works for all service users on a daily basis. It was noted during the inspection that in one ground floor lounge three service users were asleep with their heads resting on the breakfast table. The service user’s concerns and this observation were discussed with the assistant manager. The assistant manager stated that some service users isolate themselves in their bedrooms and that sleep patterns are disrupted by service users sleeping throughout the day. She stated that service users can have a lie down if they are tired. She acknowledged that not all service users would be able to ask to lie down. She said that staff refer to the night record book to see which service users have had a restless night and therefore may need a sleep during the day. The assistant manager said that decisions were based on the individual assessed needs of service users. In view of the concerns raised and observations made regarding service users access to their bedrooms the manager must demonstrate how service users wishes and feelings are taken into account regarding limited access to their bedrooms and whether or how agreement was sought from the service user or their representative during the admission or review process. The manager must also clarify how this practice is reflected within the home’s statement of purpose and service user guide. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 the following standard(s): 12 Service users need to know what choices of activities and meals are available within the home. EVIDENCE: At the previous inspection assessments and care plans were examined. The need for more information regarding social needs was highlighted. It is encouraging that the new care plan system soon to be implemented within Abbots House encourages the recording of a detailed social and activities history. This should highlight important information about a service user’s previous hobbies, preferences and capacities. Three service users were asked about choice and activities within the home. One service user said that there were ‘no activities available’, however when this issue was discussed in greater detail the service user could remember some activities taking place. During the inspection it was noted that one member of staff was arranging to take a group of service users to the sensory room within the home as a morning activity. The assistant manager stated that some time is allocated on the staff rota for service user activities. All activities are recorded within an activities file within the home. The assistant manager said that on Saturdays they have singing and dancing activities and that some service users go to a nearby social club. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 12 The manager should consider how information relating to activities is made available to service users within the home. The service users spoken with about the choices they had within the home. The service users said that they liked the meals within the home but one said that he didn’t know what meal he was having until ‘it was on the plate’. Two other service users agreed. It was noted that there were menu boards throughout the home. It is acknowledged that the service users at Abbots House experience difficulties retaining information. However, the manager should review alternative ways of reminding service users what meals are offered within the home. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 the following standard(s): 18 Staff training would enhance the adult protection system within this home EVIDENCE: The home has an adult protection policy, which is in the process of being updated. The assistant manager said that there were no safeguarding issues relating to any service users at Abbots House. The training records of five staff members were examined. It was noted that one staff member had attended a vulnerable adults training course. The assistant manager stated that approximately four staff had received vulnerable adult training and that training had not yet been identified for the remaining staff. Training or refresher training in this area would further safeguard service users from abuse. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 the following 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. 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. There are ongoing discussions with CSCI regarding these issues. A recent fire officer inspection has also identified some structural changes, which need to be made to the internal building. CSCI understands that Stoke on Trent have now evaluated the cost of the work which remains outstanding. In December 2005 Stoke on Trent City Council forwarded the framework of an overarching plan of action to CSCI. There are now ongoing discussions between Staffordshire Fire and Rescue Service and CSCI regarding the contents of the plan. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 15 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. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 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 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 Appropriate staffing levels were in place and good progress has been made to ensure that the staff have appropriate NVQ qualifications to meet service users’ needs. EVIDENCE: The staffing levels at the time of the inspection visit were satisfactory. There were two assistant managers, five care workers, two domestic staff, a cook, an assistant cook and kitchen domestic and an administrator on shift. There were 37 service users resident. The home has a rota system, which records the names of staff and shifts worked. The assistant manager stated that there were no issues relating to staff absence and that there had not been a need to use agency staff as the staff group was stable. The monthly monitoring records for this home indicate that more than 50 of care staff have achieved the NVQ2 qualification as recommended in the National Minimum Standards. This is good practice. The monitoring record states that eighteen staff have achieved NVQ2 and that three staff have achieved NVQ3. A number of staff continue to work towards these qualifications. Two new members of staff were spoken with both confirmed that they had had an induction. An assistant manager has responsibility for ensuring this process is completed. Information relating to the induction process was in place within Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 17 one staff members file. Information relating to the second staff member was not available. The new staff members also stated that they had received regular supervision. It is recommended that there is a record for all new staff members of when the induction process is completed. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 18 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 & 33 The manager is qualified to run the home. Quality assurance systems in the form of questionnaires are in place, however the resulting outcomes for service users are not evident. EVIDENCE: The registered manager has a number of years experience within residential care and has been at Abbots House since July 2000. The monthly monitoring records completed by an older peoples service manager state that the manager has completed NVQ4 award. The manager was not present during this inspection but has responded promptly and appropriately to previous inspection recommendations or requirements. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 19 Staff spoken with stated that the manager managed the home in ‘efficient’ manner. There were good administration and information systems in place which were evidence of efficient working practices. Quality assurance issues were examined. The assistant managers were aware of the questionnaire process, which had been implemented within the home. Two files were available for inspection of completed questionnaires. One file related to professional feedback and another for service users and relatives. Two professionals had completed the forms and relatives had completed nine forms. The form did not include an area, which could be dated, and therefore this information was missing from each form. The monitoring of the information and the outcomes of the quality assurance process was discussed with the assistant manager. It is recommended that the quality assurance forms be reviewed to include an area where the date can be inserted. It is also recommended that any changes in service as a result of feedback be recorded. This will demonstrate how the home is run in the best interests of the service users. There is regular monitoring of this home by the older peoples service managers. This monitoring provides service managers with the opportunity to form an opinion of the standard of care provided in this care home and ensures that the manager promptly deals with any outstanding concerns. It was noted that the previous inspection report was not readily available within the home. Two staff members said that they had not seen the previous inspection report. It is acknowledged that service users move and sometimes destroy information which is displayed for their information but information relating to inspection visits by CSCI should be available to service users, visitors and staff. It was noted that there were no signing in arrangements in place at the time of the inspection visit. It is required that the manager review the signing arrangements for all visitors to the home. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 20 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 X x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x x Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 21 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 OP2 Regulation 5(1b)(c3) Requirement All service users to have a contract (Previous timescale of 06/03/05 and 30/10/05 not met) In consultation with the fire officer fit suitable locks to the bedroom doors (Previous timescale of 06/02/05 not met) There must be a record of all visitors to the home. The manager must demonstrate how service users wishes and feelings have been taken into account regarding limited access to their bedrooms. The outstanding recommendations made by Staffordshire Fire and Rescue to be addressed in timescales agreed with them or by. The manager must demonstrate how the arrangements regarding the limited access to bedrooms by service users, is recorded within the statement of purpose and service user guide. Timescale for action 31/03/06 2 OP24 13(4) 31/03/06 3. 4. OP33 OP10 17(2) 12(3) 11/01/06 31/03/06 5. OP38 23(4)(a) (b) 31/03/06 6. OP10 5(10)(b) 31/03/06 Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 22 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 5 6 7 8 9 Refer to Standard OP29 OP7 OP33 OP33 OP33 OP28 OP18 OP12 OP12 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. The quality assurance documents should be reviewed to include a section for the respondent to insert the date. Any change in service as a result of the feedback from service users, relatives or professionals should be recorded. A copy of the inspection report should be displayed and available to staff, service users and relatives. Induction records should be signed and dated by supervisor and staff member when induction completed. All staff should have vulnerable adults training. The manager should consider how information regarding activities is made available to service users. The manager should consider alternative ways of reminding service users what meals are offered within the home. Abbots House DS0000028862.V277712.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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