Inspection on 20/02/09 for Abbotsbury

This inspection was carried out on 20th February 2009.

CSCI found this care home to be providing an Excellent service.

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

Abbotsbury 01/03/07

Abbotsbury 24/10/05

Abbotsbury 17/06/05

Abbotsbury 27/01/05

Abbotsbury 16/07/04

Abbotsbury 06/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbotsbury Mead End Biggleswade Bedfordshire SG18 8JU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Neil Fernando     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Abbotsbury Mead End Biggleswade Bedfordshire SG18 8JU 01767313366 01767312822 bunyanc@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (Bedfordshire) Ltd care home 32 Number of places (if applicable): Under 65 Over 65 32 32 32 dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 32 to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category Code OP Dementia Code DE Date of last inspection Brief description of the care home Abbotsbury is a purpose built home for older people; it is a part of BUPAs Partnership Homes. The home is situated in a residential area of Biggleswade, on the outskirts of the town centre. It is within walking distance of local amenities and close to a local bus route. The A1 and the main line railway are easily accessible. Care Homes for Older People Page 4 of 28 Brief description of the care home A car parking facility is available on site for visitors and staff. The building is all on the ground floor and offers single occupancy for up to 32 residents. All rooms are attractively decorated and personalised. The home also offers six day/quiet rooms and a smaller dining facility. The home benefits from a sizeable enclosed garden. A mobile library service calls at the home and a hairdressing service is available on site. The charges for care range between £418 and £690 per resident, per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. We, the Commission for Social Care Inspection, undertook this unannounced key inspection on 20 February 2009. We spoke with the manager, 7 residents and 4 staff including an assistant cook. We had a look round the home and viewed a range of records the home must keep. At the time of the visit, there were 31 residents accommodated with one vacancy. We have received a completed AQAA (Annual Quality Assurance Assessment) a document, which gives the manager the opportunity to tell us how the home is Care Homes for Older People Page 6 of 28 meeting the standards and regulations. We have also received surveys from 6 residents and 2 staff. The manager was present throughout the inspection. The last key inspection was carried out on 1 March; an annual service review was undertaken on 27 March 2008. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive assessment for both long term and respite residents are undertaken as part of the admission process; thus assuring the residents identified needs could be fully met on admission. Evidence: The AQAA tells us that Comprehensive written information is provided to all prospective clients, outlining the ethos of Bupa Care Homes and the home, as well as vital information to help with the process of choosing a care home. Evidence demonstrates that a copy of the statement of purpose, service users guide and placement contract is given to all new residents. Case files for three residents, including one person who had previously used this home for respite service were examined. They all contained comprehensive pre-admission Care Homes for Older People Page 11 of 28 Evidence: assessments completed by a member of the management team, prior to an offer of a placement being made. Each file provides detailed information of the residents identified needs and the level of support required. This includes pressure care, mobility, history of falls, continence, medication usage, mental health, personal safety and risk, personal care and well being, hobbies culture and religion and personal preferences. Assessment records are dated and appropriately signed by the person undertaking the assessments. Records show information about the prospective resident is also sought from their representative, health and social care professionals. The prospective resident and their family are able to visit the home and meet with staff and have a meal with the other residents. The manager said that overnight stays can be arranged, if this is required. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed, thus ensuring staff are aware of residents health and personal care needs,and this ensures that they are appropriately met. Evidence: The AQAA tells us that The AQAA tells us that All residents have comprehensive Personal Plans produced with the help of the QUEST assessment tool, which are reviewed monthly and updated as necessary. The care plan is developed with contribution from the resident, their representative and home staff. Information from care plans, residents and staff members indicates that the needs of residents are being identified and addressed very well. The care plan indicates how the identified needs are to be met. Staff members record the care given, progress made and interactions with other people. Identified health care needs are being addressed and observations are maintained, in order to respond to any changes, as noted from the records viewed. Residents are encouraged to sign their care plans where this is appropriate. Most of the 6 residents spoken to were able to identify their Care Homes for Older People Page 13 of 28 Evidence: key worker by name and they provided some good examples of how their key worker helps them daily. Care plans are being reviewed monthly to reflect the changing needs and objectives for health and personal care. There is however some inconsistency in respect of review notes; for example, some of review notes are comprehensive where as others are not. Review notes should be in greater details, in order to reasonably reflect the changing needs for each resident. Also, review notes should include the name of the staff member undertaking the monthly reviews. Once the above issues are addressed, this standard would be fully met. Risk assessments are completed for each resident and these are reviewed as required. All residents are registered with a GP. Other professionals, residents have access to include district nurse and community psychiatric nurse, dentist, optician, chiropodist, and dietician. Without exception, all residents spoken with expressed a high level of satisfaction in the manner their health care needs are being addressed. The procedure on medication is comprehensive and this ensures that staff members administer medication in a safe and satisfactory manner. All care staff including members of the management team are authorised to administer medication; they have all received training in the administration of medicines. Currently, no resident administers their own medicines although this could be arranged following an assessment of any risk involved. Medication administration records for 9 residents were checked and these were satisfactory. The storage and handling of medicines including controlled drugs is safe and efficient. I always receive all my medicines on time, reported a resident. Residents stated that their care is provided in a dignified and respectful manner, and their privacy is upheld. Examples include: I think they are very good and helpful, Staff are so helpful, I cant grumble and Staff always knock and wait for a reply, before entering. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social, cultural, religious and recreational interests of residents are being satisfactorily addressed. The quality and and variety of food offered is of a high standard. Evidence: The AQAA states We ensure that all Personal Plans are individual and based on the choices and preferences of the residents. An activities coordinator is available for 8 to 9 hours weekly and she facilitates a range of activities to suit residents needs. The care staff also provide some activities during the other days of the week. 5 residents spoken with expressed satisfaction regarding recreational activities being offered. Examples of comments include I enjoy my walks around the block and the home, Always activities arranged but I dont take part; my personal preference and I love bingo and various board games, said 3 residents. The care plans for three residents were examined; they show that residents are being assisted to follow the lifestyle of their choice as discussed and agreed at the time of their assessment. Three residents spoken with said they are satisfied with their Care Homes for Older People Page 15 of 28 Evidence: lifestyle at Abbotsbury. Evidence shows that family and friends visit regularly and they are always made welcome. Resident are able to entertain their visitors in the communal areas or the privacy of their own bedroom. Residents are encouraged and they are able to practice their religion and their culture, as they wish. The local vicar visits monthly and offers communion and service. The menu seen provided for a nutritious and varied diet. The dining room is well decorated and staff work very hard to make meal time a socially enjoyable occasion. Provision is made for residents to take their meal in their own room if they so wish. Residents are consulted regularly regarding the menu and their taste and preference. Evidence shows alternative meals are provided if a resident does not like the meals on the menu. All 7 residents spoken to commented highly on the quality and variety of food offered to them. Examples include: Excellent food, Good food, We had fish and chips today, very good really. Dietary needs of the individual resident are well catered for. Snacks and beverages are readily available, even at night time. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding procedures are being implemented to good effect; thus ensuring that residents concerns are listened to and they are protected from harm. Evidence: The AQAA states Bupa Care Homes is currently reviewing its current complaints policy. The current policy has agreed timescales for managing complaints. The information that accompanies the policy is prominently displayed in the home. The policy includes a three tier framework including the home, the regional management team and the national Quality and Compliance department. We were informed that information on how to raise a concern is provided to everyone living at the home. Evidence shows that large posters on the complaints procedure are displayed around the building. All 7 residents spoken to expressed confidence in that staff would respond appropriately if they had any concerns. No complaints, anything you ask staff and they do it for you, said a resident; I dont make any complaints because the home is very good reflected another resident in their survey. There was one minor complaint recorded since the last annual service review of the home on 17 March 2008. The matter was resolved within 28 days. The Commission has not received any complaints about this service. Staff spoken with demonstrated a knowledge of the complaints procedure. Care Homes for Older People Page 17 of 28 Evidence: The home has policies and procedures on whistle blowing and safeguarding of vulnerable adults. 25 staff have received training on safeguarding of vulnerable adults; the remaining 15 members must complete this training, in order to ensure that residents are fully protected from any harm. There have been 2 safeguarding matters which were appropriately reported to the local safeguarding team. The systems in operation should adequately protect a resident from harm. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living at Abbotsbury benefit from a comfortable, clean environment that is well maintained. Evidence: The AQAA states Our kitchen has achieved a 3 Star rating from EHO. The home is supported in maintaining the environment by a central team of experts. We undertook a brief tour of the premises. The decoration and furniture and fittings in the lounge, dining room and bedrooms are of a good standard. Bedrooms are personalised to suit the taste of the occupants. There is adequate space for residents to sit quietly and or meet with their friends. The bathroom and toilet facilities have been adapted to meet the needs of people with a physical disability. Suitable specialist equipment is available and serviced regularly. The home is well maintained. All areas viewed were noted to be clean, tidy and free of odours. Staff were observed to wear suitable protective clothing when carrying out certain activities. Domestic and clinical waste is disposed of in an appropriate manner. There were no health hazards noted. Care Homes for Older People Page 19 of 28 Evidence: Residents spoken with expressed a good deal of satisfaction with their physical environment. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skills of the staff are adequate to provide a good standard of care. The homes recruitment and training processes ensure residents are protected from harm. Evidence: The AQAA indicates We endeavour to maintain agreed staffing levels at all times. We have 71.36 of care staff with NVQ Level 2/3. There were sufficient members of care staff on duty on the day of the inspection to meet residents needs. Staff duty roster for a period of one month was scrutinised and discussion with the manager and staff members indicates that the day and night staffing levels are adequate to meet the assess needs of the residents accommodated. Staff receive induction that covers mandatory health and safety training. I have had a detailed and good induction, which has helped me settle in my job, said a new staff. Evidence shows that staff have received specific training on topics such as dementia, challenging behaviour, care planning, catheter care and medication. Of the current 24 care staff, 19 hold an NVQ level 2 or equivalent. This means that a high ratio (71.36 ) of care staff hold an NVQ Level 2 or equivalent. Care Homes for Older People Page 21 of 28 Evidence: We looked at the recruitment files for 3 members of staff including a new member who had joined the team. They all contain appropriate documentation including application form, references, PoVA First and criminal record bureau checks. Residents expressed a good level of satisfaction regarding the service they receive and complimented staff for their hard work. They are always here and willing to help you, said one resident and The staff are well trained and they are very good, added another. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the staff team is appropriately supported. Completion of all mandatory training would ensure a greater level of safety for residents and staff. Evidence: The AQAA tells us The Home is supported by a national team of Quality and Compliance Officers whose role includes supporting quality issues within the home, auditing and providing guidance on policies, procedures and practice. The manager has been managing Abbotsbury for over 27 years and clearly has the knowledge, experience and skills to run a home for older people. He holds a certificate in care and management since 1994. Staff and residents told us that the manager is approachable and always helpful. The management team members are very supportive and they even help you with care tasks sometimes said a staff. There is good evidence to demonstrate that quality assurance systems are in place to Care Homes for Older People Page 23 of 28 Evidence: seek the views of residents, their representatives and significant others in respect of the quality of service offered to residents. The regional manager carries out monthly visits to the home, in order to ensure that appropriate standards are being maintained. Reports on these visits are available at the home. Residents have their relatives to help them manage their finances. However, there are 18 residents who have individual bank accounts and staff assist them to withdraw their money as and when they need it. Financial records for 3 residents were checked and these were in order. There is a plan for regular staff supervision. Staff interviewed told us they are happy with the support and supervision they receive. Records viewed were found to be in good order. Health and safety are being attended to. Fire drills are carried out once every six months. Considering the size of the staff team and frequency of fire drills, it is unlikely that all members will have the opportunity to participate in at least one fire drill annually. It is therefore recommended that the frequency of fire drills be increased as appropriate. Also, there are 3 staff who must receive training in health and safety. The manager said that action would be taken to address the above issues. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 18 Staff who have not completed their training on safeguarding of vulnerable adults must receive this training. This is necessary so that residents are appropriately protected. 20/05/2009 2 38 13 The 3 staff members who have not received training on health and safety must complete this training. This would ensure the safety of staff and the protection of residents. 20/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The monthly review notes should be in greater details, in order to reasonably reflect the changing needs of each resident. Review notes should also reflect the name of the staff member undertaking the monthly reviews. Page 26 of 28 Care Homes for Older People 2 37 The frequency of fire drills should be be increased as appropriate. This would ensure that all members of staff have the opportunity to participate in at least one fire drill annually. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!