Inspection on 17/05/05 for Abbotsleigh Care Centre

This inspection was carried out on 17th May 2005.

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

The inspector 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

Abbotsleigh Care Centre 30/10/07

Abbotsleigh Care Centre 27/02/07

Abbotsleigh Care Centre 22/11/05

Abbotsleigh Care Centre 14/10/04

Abbotsleigh Care Centre 18/06/04

Abbotsleigh Care Centre 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Abbotsleigh Residential Care Home George Street Staplehurst Tonbridge Kent TN12 0RB Lead Inspector Maria Tucker Unannounced 17 May 2005 10:25 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. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Abbotsleigh Residential Care Home Address George Street Staplehurst Tonbridge Kent TN12 0RB 01580 891191 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) Nellsar Limited Care Home 24 Category(ies) of Old age registration, with number of places Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14 October 2004 Brief Description of the Service: Abbotsleigh is a large detached building situated in a rural area on the outskirts of Staplehurst village, which has a range of facilities including shops, library, medical centre, pubs and the village Community Centre. The nearest public transport is approximately ½ mile away. There is car parking to the front of the Home and a garden to the rear. The Home is registered for 24 older people and has 14 single and 4 double bedrooms. Each room has television and emergency call points. There is a shaft lift to the first floor. The proprietors bought Abbotsleigh in June 2003. Staff work a roster that gives 24-hour cover. There are plans for the development of the Home that include the building of an extension. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 10.25am until 1.26pm. Time was spent meeting the senior care staff and going through various records and documentation. About one and a half hours was spent meeting service users. One staff on duty was spoken with. A partial tour of the premises was undertaken. Due to the nature of some of the service users, it is difficult to reliably incorporate their reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and observation followed by discussions with staff and evidencing records held in the home. What the service does well: What has improved since the last inspection? Further progress continues to be made in the care planning recording system and recordings. The proposed improvements in the planned development have been submitted to the CSCI and work is due to start this year. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 6 The risk assessments have been conducted and contained in files as identified during 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. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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, 5, 6. Service users who are unable to visit prior to moving into the home are able to have representatives act on their behalf so that they are supported in their choice. Service users can be confident their needs can be met through a detailed assessment. EVIDENCE: The care and case plan tracking of a recently admitted service user was inspected thoroughly. A copy of a contract, service delivery order from social services detailing the service and the payment was contained in the file. The joint health and social care assessment indicated specific needs relating to cognitive and mental health, the care plans did not reflect these needs or detail as to how they were to be monitored or met. The professionals’ assessment was that a residential care home would be able to meet the needs and would be the best placement. The service user stated they were happy in the home and detailed many things that they liked about it. Service users spoken with stated that their relatives or representatives had helped them to choose the home. Three service users chose Abbotsleigh as they lived local; one person stated that they had been staying in the home for respite care before deciding to move in permanently. The home does not provide intermediate care. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 Service users can expect a good level of care in a warm comfortable relaxed atmosphere. Service users have the freedom and flexibility to do what they choose to do. EVIDENCE: A service users care plan did not fully detail their leisure and recreation activities that they enjoyed. Some things in the joint assessment i.e. a preference to be kept busy and likes to do things around the house were not incorporated into the daily plans as to when and how they had the opportunity to do these. The service user did state that they do put their own cloths away and that “they do the floor while I do the dusting”. There was no evidence that opportunities were given for appropriate exercise and physical activities. Some service users did go outside for a walk or walk freely around the home, which they enjoyed one stated they “go out for a walk with that lady then we sit in the sun”. One service user was seen to be sitting in the dinning room throughout the inspection. Care staff confirmed that no service user had pressure sores. The district nurses notes detailed visits made and treatment given for a sore foot. The care plans recorded health care visits and a service user spoken with stated that if they needed to see a Doctor they asked the staff. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 10 Storage facilities for medication remained inadequate; plans were seen of the proposed development, which will address this. Controlled medication contained in the drugs cupboard matched records. The areas that need firming up from observations made are the procedure for ensuring that service users who are given their medication in their room take them at the prescribed time; that the procedure for recording returned medication includes a book so that details are kept; that medication which has not been given and is currently stored in a pot is monitored and recorded. These are good practice issues so support the homes current policies and procedures. Staff were observed to treat service users with dignity and respect for example the conversations between staff and service users. One service user chose to remain in bed and get up later. This was respected with breakfast and drinks being given. All of the service users were very well dressed smart and tidy. Many had their nails painted, which they said staff did when they had their bath. One service user commented that staff were “a bit fanatic about baths, they are always sticking you in the bath”, another stated that they had a weekly bath, as they would not like one daily. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15, Service users can enjoy a variety of food that is home cooked and plentiful. The leisure activities on offer are limited. EVIDENCE: Lists of daily social activities are on display with afternoon activities planned for every afternoon; these included playing games such as bingo, people coming in to the home for reflexology, music and hairdressing. Some service users felt there was enough on offer others did not, it was difficult to gauge if the activities were of the service users choice and if those who did not join in undertook any other activities. Service users said that their visitors were made welcome, that “anyone can come like your family”. On the day of the inspection home made food was being prepared, fresh food is delivered twice weekly. The cook detailed how menus are changed to offer a good variety. Service users commented “very good food”. The menu was on display one service users said that on “Friday it would be fish”. The dinning room was attractively laid out and meals were not rushed. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 12 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, Service users can feel confident that if they had a complaint they are able to raise these. EVIDENCE: The home has a loose-leaf complaints file. Within this file a list of observations that could have possibly led to complaints were recorded and action taken to resolve them. Evidencing that the home are pro active in identifying potential complaints. Service users spoken with were happy and expressed that they had no complaints, but if they did they would say. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 13 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, 23, 24, 25, 26. Service users live in pleasant surroundings and a warm comfortable environment that they enjoy. EVIDENCE: During the inspection the maintenance person arrived and was given a list of odd jobs that needed attention. The home was very clean and tidy, with little homely touches like the dinner tables being laid and flowers around the home. Service users walked freely around the home and in the grounds making use of the lounge and conservatory and dinning area. It was not inspected if the home has had an assessment made of the premises by a suitably qualified person. The home has an array of wildlife outside to view that the service users enjoy watching. A particular favourite was the squirrels. A service user invited the inspector to see their room and was pleased at how comfortable it was and that they had their own possessions in it, suited to their taste. Another service user who was having a lie in was warm and comfortable wrapped up under the duvet with their call bell next to them, ‘just in case’. Locks were fitted to service users doors and screens provided in shared rooms. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 14 The laundry was small and compact yet very clean with most of the washing having already been done. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 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, 29, 30. Services users can be confident their health needs will be met by a competent staff team. EVIDENCE: The staffing rota had a minimum of 3 staff in the morning and 2 staff in the afternoon on duty. The home has a cook and maintenance person. The rota did not contain a full record off all persons working in the home i.e. the handy person or a record kept of the exact hours worked. A new member of staff discussed their recruitment and induction. Their file contained all items as required and copies of training. The rota detailed dates for staff training. Service users spoken with praised the staff stating that “the staff are nice”, and they “help you when you need them”. Staff spoken with was clear of their roles. During the inspection the relationship between the staff was relaxed and supportive. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 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) 34, 37, 38. Service users welfare is maintained through staff training and good practices of care. EVIDENCE: The manager of the home has recently left; a temporary manager from a sister home is currently managing the home. The home has a planned proposed improvement to the environment and services provided this is in the initial stages of being considered by the CSCI and is part of the homes business and financial plan. Staff stated that they received supervision; a senior care staff said that they were due to start supervising staff but has not done this yet. Service users records were kept secure in a locked cabinet in the office, which was also locked. As far as it is reasonable to ascertain the files contained accurate in date information as they had regular recordings, various assessments and were dated and signed accordingly. One service user stated that they had informed staff of their wishes stating that “if anything happens to me ill go on top of my mother in Maidstone”, they were not aware if this had Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 17 been recorded at the home or by their Care Manager, the staff on duty were unaware of this as it had not been mentioned to them personally. Copies of relevant training for staff on health and safety were contained in a staff file. Staff spoken with was clear about matters relating to health and safety. A recent fire drill had taken place. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x x 3 3 Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 19 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 OP 9.1 Regulation 13 (2) Timescale for action The registered person shall make 17th June arrangements for the recording, 2005. handling, safe administration and disposal of medicines received into the care home. As identified in the text. A copy of the duty roster of 17th June persons working at the care 2005. home, and a record of whether the roster was actually worked. Requirement 2. OP 27.2 17 (2) Schedule 4 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 OP 3 Good Practice Recommendations It is strongly recommended that any specific needs highlighted in the assessments from professionals prior to service users being admitted form part of the overall care plan. It is strongly recommended that where there has been identified the need for specialist services for example cognitive impairments or dementia the care provided is based upon and reflects relevant specialist and clinical guidance. It is recommended that the care plans continue to be developed to reflect their personal choice of activities, and H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 20 2. OP 4 3. OP 7 Abbotsleigh Residential Care Home 4. 5. 6. OP 8 OP 16 OP 22 that opportunites for when these are to occur are identified. It is recommended that opportunities are given for appropriate exercise and physical activity. It is recommended that a hard back, not loose leaf format be used in the recording of any complaints. It is recommended that an assessment of the premises and facilities is made by a suitably qualified person with specialist knowledge of the client group catered for and recommendations for equipment or adaptations are met. Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Abbotsleigh Residential Care Home H56-H06 S42586 Abbotsleigh V226809 170505 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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