Inspection on 06/09/05 for Abbots Leigh Manor Nursing Home

This inspection was carried out on 6th September 2005.

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

Abbots Leigh Manor Nursing Home 26/04/07

Abbots Leigh Manor Nursing Home 03/01/06

Abbots Leigh Manor Nursing Home 25/01/05

Abbots Leigh Manor Nursing Home 30/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Abbots Leigh Manor Nursing Home Manor Road Abbots Leigh North Somerset BS8 3RP Lead Inspector Alison Murray Announced 6 September 2005 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 Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Abbots Leigh Manor Nursing Home Address Manor Road Abbots Leigh North Somerset BS8 3RP 01275 374669 01275 374669 mail@treasurehomes.co.uk Treasure Homes Limited 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) Ms Katheryne Bauer Care Home with Nursing 51 Category(ies) of May accommodate up to 51 persons aged 65 registration, with number years and over. of places Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 51 aged 65 years and over. Staffing Notice dated 25 July 2001 applies. Person in Charge must be a RN on Part 1 or 12 of the NMC register. Date of last inspection 25th January 2005 Brief Description of the Service: Abbots Leigh Manor is registered to provide nursing care for up to 51 residents. Treasure Homes Limited owns the home. Mr Gillespie is the responsible individual for the home, and Mrs Bauer the registered manager. The main house is a converted and upgraded property situated in pleasant gardens with expansive views over the surrounding countryside. Accommodation is provided in mainly single rooms on three floors. All the rooms have en suite facilities. There is a wide range of communal space. A passenger lift provides easy access to all floors. The ramped corridors ensure that wheelchair users can reach all areas of the home. Work has just been completed, to provide accommodation for an additional 14 residents. CSCI is awaiting receipt of the building completion certificate, before these rooms can be formally registered. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive announced inspection. A total of 8 hours were spent in the home. Although a wide range of records were reviewed, the main focus of the inspection was the day-to-day experience of the residents. During the inspection, detailed conversations were held with 9 residents, and three regular visitors. Many of the remaining residents chatted with the inspector during the course of the day. Comment cards were received from twelve residents, and one visiting health professional. Staff were not formally interviewed, but observed as they went about their work. What the service does well: Residents’ health and personal care needs are well met. Staff ensure that residents and their families are made aware of any changes to their treatment. There is a strong sense of teamwork and community in the home. The staff team is well established. Residents commented that the staff were ‘lovely’. One person said ‘I have never needed to find fault with anything’. Many others gave examples of individuals going out of their way to be helpful. Relatives are wellsupported and encouraged to visit. Although not all the management standards were assessed at this inspection, there was clear evidence that the home is effectively and efficiently managed. Residents and visitors praised Mrs Bauer’s leadership. One person commented ‘She is a very capable manager, who sets an excellent tone to the home’. Mrs Bauer and Mr Gillespie place a strong emphasis on staff training. Staff are given very good opportunities to develop and extend their knowledge and skills. Residents and their families are confident that staff can meet their needs. The standard of accommodation provided at Abbots Leigh Manor is particularly good. Rooms are spacious, and the furniture and fixtures of a high quality. Residents, visitors and staff all said that this added considerably to their quality of life. Staff said that the home provides a very good working environment. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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 Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 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 Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 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) 2, 3, 4 and 5. Abbots Leigh Manor does not provide intermediate care, so standard 6 does not apply. A comprehensive pre admission assessment helps to ensure that staff meet the needs of new residents. They and their families are offered good support to help them settle into the home. The written information given to prospective residents needs to be amended to reflect recent changes in the home. EVIDENCE: The statement of purpose and service user guide have yet to be amended to reflect the increase in the number of registered places offered, and the staffing arrangements in the home. Mrs Bauer said that the administrator was on holiday, but had already planned to sort this on her return. Care records of two recently admitted residents were reviewed. These contained evidence of a comprehensive pre admission assessment of the individual’s needs. Detailed information had been received from placing social workers and hospital staff. One lady said that a support worker had brought her to look around the home. She said that this was particularly useful, as she had met some of the staff and residents before she moved into the home. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 9 Some visitors said that they had looked around many care homes, before deciding that Abbots Leigh Manor would suit their relative best. Mrs Bauer and her staff carry out an informal review of each new placement after two weeks. The resident and their family are invited to meet with the named nurse, and discuss how they are finding things. All those consulted felt this was a very good idea. Copies of the review document indicated that ‘niggles and snags’ could be easily sorted out at this stage. Visitors said that their relative had found it hard to settle into the home. They said that the staff ‘could not have tried harder to help’. They had particularly appreciated that Mrs Bauer was prepared to extend the trial period, to allow her to ‘make her mind up’. She had since decided to stay in the home. Mrs Bauer demonstrated a very good awareness of the range of needs that could be met within the home. She gave an example of a prospective resident who she felt could not be accommodated at Abbots Leigh Manor. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10 Residents’ health and personal care needs are very well met. They get on well with the staff, and are treated with respect. EVIDENCE: Care records are stored on the computer, and password protected. Those reviewed during the inspection were well completed and up to date. A specific care plan had been written for each identified need. These care plans had been reviewed and updated regularly. Paper copies were available to guide care staff. The advice given reflected good practice. A number of the current residents have complex health and emotional needs. Care records confirmed the involvement of relevant specialists. Staff in the home work very closely with the local GP, and have good links with the mental health team. Conversations with staff, residents and their relatives confirmed a commendable effort to meet health and personal care needs. Several residents gave examples of very good wound and diabetic care. They felt that this had significantly improved their quality of life. Another person said that staff were helping her to regain her mobility. She said that they encouraged her to stand, Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 11 and walk a few steps, even though ‘it would be much quicker for them to use the hoist’. A significant number of the residents are very frail. It was clear that they would not be able to attend to their own personal hygiene needs. All were well dressed in appropriate clothing. Attention had been paid to their hair and nail care. Several people were being nursed in bed. They looked peaceful and comfortable. Care charts confirmed that staff had changed their position, and offered drinks at regular intervals. The medicine administration procedures were not inspected in detail. Medicine administration records reviewed demonstrated good practice. There was a friendly and relaxed atmosphere in the home. There was evidence of a good rapport between staff, residents and visitors. All the residents and visitors consulted commended the staff team. Comment cards from 13 residents confirmed that the staff respected their privacy, and treated them well. One person said ‘I’ve got my favourites, but they are all very good’. A number of the residents were very confused; several exhibited potentially challenging behaviour. Staff attended to these people with patience, tact, and where appropriate, humour. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15 Residents are able to choose how to spend their day. The range of activities offered suit the majority of their needs. The standard of food has improved since the last inspection. EVIDENCE: All the residents consulted during the inspection said that they could chose to arrange their day as they saw fit. Some commented that they enjoyed the arranged activities, whilst others preferred their own company. They are given the opportunity to take part in a range of activities, from music and movement, to games and bingo. A range of outside entertainers and musicians regularly visit. The local clergy offer good support. During the inspection a communion service was held in the main lounge. This was well attended. Residents confirmed that although staff gently encouraged them to attend group activities, their choices were respected. One person said ‘We all come from very different backgrounds. It would be unrealistic to expect one activity to suit all’. Comments received prior to the inspection confirmed this opinion. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 13 At the moment, the home employs one full time activity organiser. As well as the planned group activities, she also spends time with individual residents. Mrs Bauer said that she plans to appoint a second person in the near future. She hopes that this will increase opportunities for one to one work, and individual shopping trips. Relatives consulted said that they were always made welcome. During the inspection there was a steady stream of visitors to the home. Since the last inspection, a new chef has been appointed to work in the home. The majority of residents felt that the standard of food had improved. They particularly appreciated that the chef came to see them, to ask their opinion of the meals. The meal served during the inspection looked and smelt tasty. The dessert of sliced fruit was served with cream already poured. A number of residents felt that they would rather this (and other sauces) were offered separately. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The complaint procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: The home has a comprehensive complaint procedure. All those consulted said that they would have no hesitation raising complaints or concerns with Mrs Bauer. Staff on duty demonstrated a good awareness of adult protection procedures. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Abbots Leigh Manor offers very good all round accommodation. It provides an attractive and safe place for residents to live. EVIDENCE: Since the last inspection, extensive building work has been carried out to create an additional 7 bedrooms in former loft space on the 2nd floor, and 8 garden floor level rooms. This work has been carried out to a high standard. A new passenger lift, staircase, and a ramped corridor link the new rooms to the rest of the home. The rooms are bright and airy. The heating, lighting, water supply and ventilation provision are in line with NMS 25. All the new rooms are considerably larger than the minimum standard, and have ensuite toilet and wash hand basin. In addition, ten of the rooms are also fitted with wheelchair accessible showers. Other rooms have easy access to a communal bathroom. This is fitted with a fixed bath hoist. The furniture provided is of a good standard, in keeping with the age and style of the home, Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 16 as well as the anticipated needs of the client group. All rooms have a radio controlled call system. All the residents said that they liked their room. Several were keen to point out the beautiful view from their window. The majority had brought pictures and items of furniture with them. The first floor communal lounge and dining room have been recently redecorated. During the inspection, a maintenance person worked to stretch a number of carpets, which had become ‘rucked’ over time. The standard of housekeeping and maintenance was particularly good. Residents said that if they reported a fault in their room, it was fixed very quickly. They also praised the efforts of the housekeeping team. Outside, the rear garden has been leveled, and a large elevated water feature built. This was not operational at the time of the inspection. Mr. Gillespie plans to fit a net under the water surface, to minimize the risk to residents. There are now ramped paths all around the building, ensuring easy access for all residents. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 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) 27, 28, 29 and 30 Robust recruitment procedures help to ensure suitable staff are employed to work in the home. A very comprehensive training programme equips staff with the skills and knowledge to meet the needs of the residents. EVIDENCE: Since the last inspection, staffing levels have been increased to take account of the increased occupancy. New staff teams have been set up, and new allocations introduced. Staff said that it has taken them a few weeks to get used to the increased number of residents, but they felt that this had become easier with time. Mrs Bauer said that she and Mr Gillespie were keeping the staffing levels under review. They were planning to introduce a ‘duty manager’ rota for the senior trained staff. Residents and staff alike thought this was a good idea. The residents said that for a few weeks, staff had taken a bit longer to respond to call bells. All felt that this had improved since the staff got used to the new layout of the home. Mrs Bauer and Mr Gillespie place a commendable emphasis on staff training. All staff receive regular appraisals. At these appraisal meetings, training needs are identified. One of the senior staff has taken on the role of ‘trainer’. She ensures that induction and statutory training is delivered. One of the trained Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 18 nurses has a specific interest in learning and development. She acts as trainer for clinical issues. Mrs Bauer said that the appointment of ‘duty managers’ had identified the need for staff to receive management training. Staff were enthusiastic about the range of learning opportunities open to them. Residents felt confident that the staff had the knowledge and skills necessary to care for them. Staff records were very well completed. Records of newly appointed staff demonstrated a commendably robust recruitment procedure. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 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) 31, 32, 35, 36, 37 and 38 The home is effectively and efficiently managed. Systems are in place to enable staff and residents to comment on the way the home is run. EVIDENCE: Residents appreciate their regular meetings with Mrs Bauer. They said that they felt able to discuss any issues about the running of the home with her. One person commented that if Mrs Bauer had to refuse a request, she always explained why. There was a strong sense of teamwork amongst the staff. Several staff members told the inspector ‘We are a good team. We all work well together’. They demonstrated a commendable pride in their work. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 20 Residents’ financial records were reviewed. There was a clear audit trail of monies received for residents’ individual use, and spent on their behalf. All the records seen during the inspection were well maintained, and securely stored where necessary. The fire log, and maintenance records confirmed that the necessary tests, checks and drills had been carried out. Mrs Bauer has carried out a comprehensive risk assessment of the home. It was clear that this had been reviewed and amended regularly. An oxygen cylinder was being kept in one of the bedrooms. There was no hazard warning sign on the bedroom door. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 4 3 3 3 4 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 x x 3 3 3 2 Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 22 No 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. Standard OP1 Regulation 6 Requirement The statement of purpose and service user guide must be amended to reflect changes in the home. A hazard warning sign must be provided to identify oxygen storage areas. Timescale for action 06/11/05 2. OP38 13.-(4) 06/10/05 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. Refer to Standard OP15 Good Practice Recommendations Staff should offer residents the opportunity to take their meal with or without sauce. Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Riverside Chambers Castle Street Taunton TA1 4AL 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 Abbots Leigh Manor Nursing Home D53-D02 S20295 Abbotsleigh V241698 060905 Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!