CARE HOMES FOR OLDER PEOPLE
Abbotsfield Residential Care Home 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS Lead Inspector
Marian Whittam Unannounced Inspection 13th February 2006 11:00 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 Abbotsfield Residential Care Home DS0000022579.V281014.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. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Abbotsfield Residential Care Home Address 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS 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) 01229 829496 Mr Jayendra J Patel Mrs Lata Jayendra Patel Mrs Susan Procter Care Home 30 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (30) of places Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 30 older people (OP) of whom 5 may have dementia (DE(E)). 27th September 2005 Date of last inspection Brief Description of the Service: Abbotsfield is care home registered to provide care for thirty older people, five of whom may have dementia. The home is a detached Victorian property with a modern extension and has been owned by Mr. Jayendra Patel and Mrs Lata Jayendra Patel since 1996. The home is in a residential area on the outskirts of Barrow in Furness about a mile from the town centre, the shops, banks and general amenities. There is good access by road into the surrounding areas and the home is on a bus route to Barrow and the surrounding towns. The home has well kept gardens that resident’s use and this has seating. There is a small car park for visitors and staff at the side of the building. The home has 3 sitting/dining rooms for service users on the ground floor and a lounge on the first floor used largely by residents who want to smoke or for family meetings. The home has kitchen and laundry facilities on site. There is a main stair lift and two smaller chair lifts within the home linking the floors. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours on 13th February 2006. The inspector looked around all areas of the home, talking with residents in groups in the lounges and in private in their bedrooms. Care plans, medication records, records required by the regulations and supporting documentation were examined. Policies and procedures, documents and quality monitoring systems were looked at. All areas of the home were seen and thirteen residents were happy to talk about their life in the home. What the service does well: What has improved since the last inspection?
The home has installed new stair lifts to improve resident’s access and mobility around the home including a battery pack to ensure it can be used during power cuts. The home continues with its ongoing maintenance and redecoration programme for bedrooms and communal areas to improve the environment for residents.
Abbotsfield Residential Care Home DS0000022579.V281014.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. Abbotsfield Residential Care Home DS0000022579.V281014.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 Abbotsfield Residential Care Home DS0000022579.V281014.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 and 4 A detailed assessment and care planning system, including information from other agencies, is in place to provide staff with the information they need to meet resident’s needs when they come into the homes. EVIDENCE: All residents have an individual care plans and a clear and detailed assessment of needs prior to admission and a full needs assessment is done during the first week of admission. The home manager or senior staff do the individual assessment, including on return from hospital to ensure that the home can meet them before residents came to live there. However not all assessments were signed and dated by the assessor. Where applicable social services care management plans are in place as well. Where appropriate other care agencies and professionals are involved in providing information and making assessments of the needs to be met. The assessment records and evidence of consultation with families suggests that the home takes care to make sure that the number of residents admitted
Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 9 with higher levels of dependency does not get too high and affect the care and support given to the other residents. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 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 the following standard(s): 7, 8 and 9 The care planning and medication handling systems in place are clear and consistent to adequately provide staff with the information they need to meet resident’s needs. The staff have a good understanding of residents support needs. EVIDENCE: All residents have an individual plan of care that sets out their health, personal and social care needs. This plan is reviewed regularly and changes identified at evaluation, following medical visits and noted in the progress notes are incorporated into care plans and needs assessments. This provides an up to date plan for staff to work from. There is evidence in care plan records and from resident comments of prompt referral to health care and support services and good working with other agencies. This was evident for one resident where support from the Intermediate support Team had a positive impact on their care. A resident said, “The staff will bend over backwards to help you”. Medication records and storage is in good order however not all residents had photographs in place to ensure a safe system of identification. Controlled drug
Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 11 storage was satisfactory but the controlled drugs register index was not always clear to avoid confusion. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 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 the following standard(s): 12 and 15 A programme of activities and social events is provided that takes into account residents preferences. Dietary needs are catered for with a varied selection of wholesome food that meets resident’s special dietary needs and individual choice. EVIDENCE: The home’s senior carers oversee activities but all staff are involved in providing group and one to one activities. Carers take the lead form residents on what they want to do on different days and a carer was providing armchair ball exercises in one lounge during the afternoon. Residents told the inspector about what they enjoyed doing as part of the activities, such as going out for bar meals, having musical entertainers come to the home and going out for walks with staff. Individual interests are recorded and activities taken part in recorded including religious needs. Residents told the inspectors that they could chose to take part or not as they preferred and one said they enjoyed the company in the home but liked going out with her family or spending time in their room doing puzzles and listening to the radio. Some residents went out to local pensioners clubs for bingo and social occasions. Residents spoken with commented positively on the quality of the food provided, one said it was “very good”; another said “I really enjoy my food” and all spoken with confirmed they had a choice at meals. The four week
Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 13 menus showed a varied and nutritious diet and records were kept of food served. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 The home has a satisfactory complaint system that residents are aware of and residents have confidence in the manager to act on any concerns. There are adult protection procedures in place and staff have received appropriate training on abuse to promote resident safety. EVIDENCE: The home has a clear complaint procedure that is given to all residents on admission and is displayed in the home. The home has not received any complaints since the last inspection and none have been made to the CSCI regarding the home. Residents spoken with felt confident that any complaints or issues they raised would be dealt with quickly. One resident said “ I have never had to complain but the manager is around all day if I wanted to” There are adult protection procedures and policies in place to protect vulnerable adults and current multi agency guidance for staff. Training on abuse and adult protection is provided and training planning indicates staff are about to attend an update. The home had procedures in place for dealing with verbal and physical aggression and gifts to staff. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 The standard of the environment within the home is good providing residents with a well maintained and homely place to live. EVIDENCE: The home is well maintained with regular, planned maintenance and a satisfactory standard of decoration throughout that provides a clean, tidy and homely environment for residents. The sluice facilities are of a good standard to maintain good hygiene. The laundry facilities, although small, are clean and well organised with a laundry assistant 5 mornings a week. The installation of a new stair lift in the home has improved facilities and safety for residents. Outside the gardens are attractive, well kept and have seating for residents. Residents said that they used the garden in the summer months, and enjoyed sitting outside. One resident commented on the high standard of cleanliness in the home saying how pleased they had been when they came to live there to see it was so clean and that “the cleaners pull the beds out to give a good clean underneath as well”.
Abbotsfield Residential Care Home DS0000022579.V281014.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 and 28 The numbers and skill mix of care staff on the rotas and on duty are adequate to be able to meet the current resident’s needs with a well motivated and stable staff team providing consistent care. EVIDENCE: Staff rotas and observation during the visit suggested that the home had a stable staff group providing continuity of care and support for residents. Residents said that the home was “a friendly place” and staff did not change much and knew them well and “our little ways”. There are a high percentage of carers with NVQ level 2 qualifications and some staff have done NVQ 3 in care. The home has an annual training plan and regular updates and the home supports staff well to attend training and updates. Domestic and laundry staff are employed in sufficient numbers and keep the home clean. The home has a full time cook. There are additional staff during the evening period to assist with residents when they go to bed and again in the morning. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 32, 33 and 36 The manager and owners have a clear vision for the home and review aspects of its performance through self review and consultation with residents, staff and visitors. This results in open leadership in the home and in practices that promote the best interests of residents. EVIDENCE: Residents spoken to said their views and opinions were asked for and acted upon to affect the way the home is run and the activities they take part in. There are regular residents meeting and minutes kept and surveys have been used to get other opinions but not for some time. The home should consider doing these annually. Residents confirmed they saw the manager most days and felt happy to raise issues with her. The manager was clear about her role and had a good working relationship with the owner, staff and residents. Residents made positive comments about the staff team and the support they
Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 18 provided. Staff have their own meetings and minutes are kept of the topics discussed. Supervision is given to staff and outcomes and any identified needs recorded for action. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X 3 X X Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO 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 (2) Requirement Photographs must be in place for a safe system of resident identification where they are missing. Timescale for action 31/03/06 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. Refer to Standard OP3 OP9 OP33 Good Practice Recommendations Pre admission assessments should always be signed and dated by the person carrying it out. The controlled drugs book index should be clear. The home should consider annual satisfaction surveys for stakeholders. Abbotsfield Residential Care Home DS0000022579.V281014.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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