Inspection on 09/11/05 for Abbotsbury

This inspection was carried out on 9th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbotsbury 12/10/06

Abbotsbury 02/06/05

Abbotsbury 11/10/04

Abbotsbury 06/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Abbotsbury Abbotsbury H.E.P. Pettiver Crescent Hillmorton Rugby Warwickshire CV21 4JD Lead Inspector Patricia Flanaghan Unannounced Inspection 9th November 2005 11:30 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 Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbotsbury Address Abbotsbury H.E.P. Pettiver Crescent Hillmorton Rugby Warwickshire CV21 4JD 01788 565700 01788 551580 wandacicholaz@warwickshire.gov.uk 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) Warwickshire County Council, Social Services Department Mrs Wanda Cicholaz Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one person aged under 65 who requires personal care and whose needs can be met by the home. 2nd June 2005 Date of last inspection Brief Description of the Service: Abbotsbury is a Local Authority home for elderly people. It provides permanent care, short stays, day care and four beds for use by elderly people on a re-enablement programme. The home is situated on a housing estate in the rugby district of Hillmorton. There are local shops close by, and car parking spaces are available in front of the home. Abbotsbury provides accommodation on two floors, in four units, each of which has its own communal areas. Day care provision, which is not currently subject to inspection, is sited on the ground floor, together with the kitchen, laundry, staff offices and the hairdressing salon. On each floor there are bathrooms and toilets suitable for people with physical disabilities. As well as the staircase there is a shaft lift to the first floor. All the bedrooms have an en-suite lavatory and wash hand basin. The home is staffed over twenty-four hours. It has a management team of a full time manager; a full time assistant manager and four care officers. There is also a part time clerical officer. There are thirty care assistants in total providing day and night time care. The home employs two cooks, a kitchen assistant, three domestics and a laundry assistant. Abbotsbury does not provide nursing care. Residents who require nursing attention receive this from the district nurse, as they would in their own homes. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second visit of the inspection year and took place over six hours. The inspector spent time talking to the manager, examining records, policies and procedures, talking to residents, a visitor and observing staff working practices. The inspector observed the care being delivered and the excellent interaction between staff and residents. A discussion took place with a number of care staff on duty, who were able to describe how they were meeting the needs of the residents. Following the inspection the manager was asked to distribute questionnaires regarding the service to residents and relatives. The completion of these is voluntary, but prove useful in assessing the various views that are held. No responses had been received at the time of writing this report and any subsequent questionnaires received will be referred to at the next inspection of this service. What the service does well: The layout allows care to be delivered in spacious surroundings, with residents benefiting from communal areas that are bright and airy. One visitor spoken with said that they were happy with the communication from the home in respect of the day to day care of their relative. The residents spoken with were happy with the care provided and felt able to talk to the manager and staff if they had any concerns. Observations during the inspection showed that staff were interacting appropriately and engaging the residents in activities and conversations. Comments from residents included “they (the staff) are lovely and can’t do enough for me”, “ it’s like being at home, I love it here,” “we don’t have to worry about anything, we only have to ask”. One resident considered a particular member of staff a “friend” rather than just a carer. Residents said they are able to make choices in their daily routines, for example, what time they get up and go to bed, whether they join in activities, which gives them some control over their lives. One resident, who was well wrapped up against the cold, was seen sitting outside enjoying the sunshine. Staff have good access to training and this is encouraged and supported by the manager and her management team. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 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. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this visit. Standards 1, 3, 5 and 6 were reviewed at the inspection of 02/06/05 and found to be met. EVIDENCE: Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 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): 9 and 10 Residents are not consistently protected by the home’s policies and procedures for dealing with medicines, which could result in errors being made and risk to resident’s health. Personal support is offered in such a way as to maintain residents’ privacy and dignity. EVIDENCE: The arrangement for the management and administration of medications were observed. The medication policies and procedures were reviewed and it was noted that staff did not consistently follow the home’s medication procedures in all cases. The following issues were identified and discussed with staff and the manager: • • • • • Not all prn medications specified the reason for administration. A small number of omissions were noted in the administration records. Medications transcribed by hand had been written incorrectly. Medications transcribed by hand had not been initialled by staff. MAR sheets did not record dates of changes to prescribed medications. It was not possible to track medication changes in care records. DS0000041957.V266220.R01.S.doc Version 5.0 Page 10 Abbotsbury • • A member of staff was observed to ‘sign’ for the medication before it had been taken by the resident. The number of tablets/capsules in stock at the end of the four-week period are not carried forward to the next cycle, thereby making it difficult to evidence an audit trail. Throughout the inspection it was observed that staff knock on residents’ doors, offer choices and ensure that all personal care and consultations are conducted in private, this assists in maintaining the residents privacy and dignity. The residents spoken with were very happy with the care they received and said the staff always treated them with dignity and respect when assisting them. The described the staff as being “lovely”, “very kind” and said “they were looked after very well”. Staff were observed during the inspection visit to be interacting positively with the residents engaging them in conversations and laughing and joking with them. The staff spoken with demonstrated an understanding of the needs of the residents in their care and were able to describe how they met their personal and social care needs. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 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): 14 and 15 Residents are supported and encouraged to maintain family contact and exercise choice on a daily basis. Residents receive suitable meals in pleasant surroundings, which promotes social interaction and wellbeing. EVIDENCE: Residents spoken with said their visitors are welcome to visit at any time, with one resident advising that she had gone out to lunch that day with her family. Residents confirmed that they make choices on a daily basis including when they get up and go to bed each day. They can also choose when and where they have their meals and whether they want to participate in any of the daily activities. Meals are served by care staff in the dining area within each separate unit presenting a homely environment, which encourages socialising between residents. Meals can also be served in resident’s own rooms if preferred. Choices are available at mealtimes. Each unit has a kitchenette with a fridge, freezer, microwave and dishwasher. Meals were seen to be nutritious and well presented and the residents were seen to eat heartily and really enjoy their meals. The cook is familiar with individual residents likes and dislikes and any special meals required. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 12 A number of residents spoken with on the day of the inspection commented positively on the quality of the food served in the home. One resident said that ‘the food is always good’ and another commented that ‘I really enjoy the meals here.’ Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 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): 16 and 18 Systems for the management of complaints are satisfactory residents can be confident that their concerns are listened to, taken seriously and acted up on. The home has systems in place to protect residents from the risk of abuse. EVIDENCE: An examination of the complaints record, the relevant policy and procedure documentation, and a discussion with staff and residents, evidenced that complaints and grumbles were listened to and dealt with. Since the last inspection no complaints had been recorded or brought to the attention of the commission (CSCI). Complaints observed in the complaints/comments records, included details of investigations and any action taken as a result. Many positive comments and ‘thank you’ cards were seen from appreciative relatives in the comments/complaints folder. No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen and discussions with staff evidenced vulnerable adult protection had been discussed at length during staff induction, training and on-going supervision. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 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): None of these standards were assessed at this visit. Standards 19, 21, 23, 24 and 26 were reviewed at the inspection of 02/06/05 and found to be met or part met. EVIDENCE: The manager advised that arrangements have been made to redecorate 6 bedrooms, 2 communal toilets and the hairdressing room. This refurbishment is due to take place before March 2006. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 15 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): 28 and 29 Abbotsbury is adequately staffed by a team who are committed to ongoing training. This means that the needs of this vulnerable group of people are understood and met. The procedures for the recruitment of staff are satisfactory and protect the residents. EVIDENCE: Training records examined show that staff have attended regular training on the conditions associated with old age. A comprehensive induction training and foundation programme has been implemented for new staff, which meets the National Training Organisation standards. The majority of staff have either attained their National Vocational Qualification Level 2 in Care (NVQ) or are in the process of taking it. Two care staff have NVQ3, 9 have NVQ2 and 5 are undertaking NVQ2. Recent training undertaken by staff include The Principles of Care, Dementia Awareness, Infection Control, Protection of Vulnerable Adults and Safe Handling of Medication. Mandatory training in Food Hygiene, Moving and Handling, First Aid and Fire training for all staff is up to date. The records of two staff members were examined which included a recently appointed staff member. The files contained evidence of suitable Criminal Record Bureau disclosures (CRB), references and all other information as required by this standard. Interview forms are completed at the time of interview demonstrating that recruitment is based on equal opportunities. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 16 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): 33, 35 and 38 Systems are in place to monitor the quality of the service provided and identify areas in need of improvement. Records detailing how resident’s monies are handled are maintained confirming that residents are safeguarded from financial harm. Systems for the management of health and safety are satisfactory. EVIDENCE: From observations made, and discussions with residents, visitors and staff, it was evident that the home was being run in the interests of residents. Quality assurance, including feedback from residents and their representatives, was seen documented. A formal quality system was evidenced. Feedback from residents, relatives and others was also obtained in a less formal manner during reviews and from thank you letters and cards. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 17 The Local Authority have addressed the need for the registered provider or delegated person to visit the home monthly and write a report on the conduct of the care home. No reports relating to this home have been received by the Commission at the time of writing this inspection report. Monies on behalf of residents are held in a central account by the county council. Cash is pooled together in one amount at the home, therefore residents individual cash balances could not be checked. A separate record is maintained for each resident, which details their individual balance. The total amount tallied with what had been recorded on the central account. It is recommended that resident’s monies should be kept individually in the home and not pooled. Certificates were seen during the inspection for the maintenance and service of major systems. Records of staff training were observed with good numbers having attended fire, manual handling and first aid. Systems for identifying staff still to attend training are satisfactory. No health and safety hazards were observed at this inspection. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 18 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 19 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 OP9 Regulation 13 Requirement Timescale for action 30/11/05 2. OP19 23 3. OP33 26 The registered manager shall make arrangements for the safe handling, storage and recording of medication in accordance with the home’s policy and procedure. A clear audit trail of all medication in the home must be maintained The registered provider must 31/03/06 ensure that the home is kept in good decorative repair (Part met - Carried forward from inspection of 02/06/05). The registered provider or 31/12/05 delegated person must visit the home monthly and write a report upon the conduct of the care home. A copy of this report must be left with the manager and a copy forwarded to the Commission for Social Care Inspection (Part met - Carried forward from inspection of 02/06/05) Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 20 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 OP35 Good Practice Recommendations Residents monies should be kept individually in the home. Abbotsbury DS0000041957.V266220.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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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