Inspection on 30/10/07 for Abbotsleigh Care Centre

This inspection was carried out on 30th October 2007.

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 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 27/02/07

Abbotsleigh Care Centre 22/11/05

Abbotsleigh Care Centre 17/05/05

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 Mrs Sue Gaskell Key Unannounced Inspection 30th October 2007 10:00 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 Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsleigh Residential Care Home Address George Street Staplehurst Tonbridge Kent TN12 0RB 01580 891314 01580 891697 Abbotsleigh@nellsar.com 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) Nellsar Limited Post Vacant Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Dementia (DE) The maximum number of service users to be accommodated is 61. Date of last inspection 27th February 2007 Brief Description of the Service: Abbotsleigh is a large detached building situated in a rural area on the outskirts of Staplehurst village. The village has shops, a library, medical centre, pubs and a community centre. There is a railway station and a bus route about half a mile away. The home re-opened in July 2007 following major refurbishment including a large extension. There is one wing for residents who require nursing care and another for those requiring residential care. The home now provides single room accommodation with en suite facilities, and there is a shaft lift enabling access to services users to all parts of the home. There are communal lounges, separate dining rooms, a sensory room and a hairdressing room. There are mature, well maintained gardens with access for wheelchair users. The Home has a registered manager, a residential manager, head of care, and a team of nurses and carers. The Home also employs an activities co-ordinator, kitchen and domestic staff and a receptionist. The current scale of charges range from £400 - £628.60. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 30th October between 10.00am and 4.00pm. Due to the recent refurbishments, there are currently only 19 residents living in the home. I spoke with four residents, and three residents’ relatives. Some residents have limited communication and therefore I sat with residents for some time in order to see whether they appeared relaxed and comfortable. I also spoke with the registered manager, operations manager, residential manager, head of care and chef. I toured the building and looked at bedrooms and all communal areas. The inspection process also consisted of information collected before and during the visit to the home, and feedback from care managers. The annual quality assurance assessment required by the CSCI was completed in a satisfactory manner. Other information seen included general assessments, risk assessments and care plans, medication records and the duty rota. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. Many of the judgements and all of the overall judgements, eg “health and personal care” and “management of the home”, would have been rated as excellent rather than good had the home been open longer and able to provide evidence of sustainability. What the service does well: The home prepares care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 6 Staff are caring, friendly and well supported. The home provides a homely, safe, clean environment. 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. The summary of this inspection report can be made available in other formats on request. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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 Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People who use the service experience good outcomes in this area. The statement of purpose and service user guide says what service will be offered. Prospective residents can be confident that their needs can be met This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home’s Statement of Purpose and Service User Guide were reviewed and amended prior to the re-opening of the home. They provide residents, prospective residents and their relatives with all necessary information about the home. Copies of these two documents can be made available in large print or Braille if required and are also on a compact disc. Of the six care plan files I examined, three referred to residents who were admitted for residential care, and three for nursing care. All files inspected include comprehensive pre-admission assessments carried out by the home, some with supporting information from health care professionals or care managers. Several residents confirmed that they had visited the home prior to admission and that the manager had also visited them in their own homes or in hospital. A relative of one recently admitted resident said that his pre-admission assessment had been carried out when he visited the home because this was at his specific request. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good outcomes in this area. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents are treated with respect. This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 11 EVIDENCE: All files inspected included reference to all various aspects of daily living including where appropriate, mobility, nutrition, skin condition, behavioural, emotional and sexual needs. The care plans were seen to be reviewed recently and include risk assessments and guidelines on how best to assist residents and details of their condition and any allergies. A key worker system is in place so that the staff who have most contact with residents now have an input into the care plans and reviews. The daily records are clear and contain enough detail to monitor residents’ health and well being. There is further evidence in the care plan of monitoring residents’ health care needs and general well being, eg residents are weighed regularly and referred for specialist care when necessary. Residents have access to local health care services. The local District Nurses call regularly. Although initially residents had to be registered with a local GP on a temporary basis, this issue has now been resolved and residents are due to be registered permanently with another GP. All residents have access to dentists, opticians and other community services. The home has a medication policy which is accessible to staff. Staff confirmed that they do not administer medication unless they have received training, been judged as being competent, and feel confident. There are appropriate records for the receipt, administration and disposal of medication. Separate records are kept for particular types of medication which require special attention. Medication is safely and securely stored in a lockable medication trolley in a locked purpose built room. The room also contains a lockable fridge and a special cabinet for specific medication. There is reference to residents storing and administering their own medication but there are currently no residents where this would be appropriate. Four residents and three residents’ relatives said that the staff are generally very kind and helpful. Support with personal issues is provided in a sensitive manner that respects residents’ choice and dignity. All staff interviewed spoke of the need to treat residents with respect and to consider dignity when delivering personal care. There is specific information in the care plans to give staff guidance on specific personal care needs, eg catheter care. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 People who use the service experience good outcomes in this area. Residents’ lifestyle preferences and expectations are generally met. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans contain a list of residents’ needs, likes and dislikes and preferences. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. I also spoke with three visitors who visit on a very regular basis. They all said that they are always made to feel welcome and offered refreshments and meals. The residents I spoke with said that they generally get up and go to bed at the time they choose although this is not always possible if they require assistance. Residents may take meals in the dining room or in their own rooms. Residents are also given the opportunity of taking part in the Friday lunch club, where a more formal three course meal is served. The food served on the day of the inspection appeared appetising and wholesome and the residents said that it tasted good. Residents confirmed that there is always an alternative to the main midday meal and a wider choice for breakfast and the evening meal. Staff complete a record of whether residents have eaten and enjoyed their meals. The store cupboard contained a wide range of food including fresh fruit and vegetables. Nutritional assessments are carried out and residents are weighed monthly. The home employs an activities co-ordinator who works in both parts of the home and keeps a record of the activities offered. Residents said that the activities include arts and crafts, games and exercise. The residents have the use of a secure garden and there are occasional outings. The home keeps records of any involvement in residents’ finances, with appropriate receipts and records kept. Staff signatures are required for monies taken out either to purchase something on residents’ behalf or when residents spend money on social activities such as going on outings. Staff said that there are no residents at present with different ethnic or cultural needs but former residents have been assisted in following their religious beliefs, The manager said that residents would be supported with personal relationships whatever their gender or choice of lifestyle. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good outcomes in this area. Residents and/or their representatives can be confident complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide includes the home’s complaints procedure. Although it was not possible to confirm this with all of the residents, two residents and three residents’ relatives confirmed that they would feel comfortable in Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 15 mentioning any complaints to the management or staff and confident that any concerns would be resolved. Staff confirmed that they are provided with initial training on safe guarding adults and are issued with a copy of the company’s “whistle blowing” procedures during their induction period. The staff interviewed all showed an awareness of the complaints procedure and of all of the issues concerning safe guarding adults. The home has a copy of the Kent and Medway Safeguarding Adults Procedures. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good outcomes in this area. Residents live in a comfortable, safe, clean environment. This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 17 EVIDENCE: There was a major refurbishment of the home prior to its re-opening in July. This has involved making rooms and corridors more spacious, providing more en-suite facilities, providing a new alarm call system and providing new furniture and carpets. All residents are in single room accommodation, and have en-suite facilities. The building is on two levels and there is a lift and an alarm call system. One resident’s relative queried the fact whether that resident could reach the alarm call button but the home has identified on the risk assessment that the risk associated with a trailing alarm cord would outweigh the benefits. The home is suitable for people with impaired mobility. There is a range of individual aids and adaptations to assist resident’s mobility and independence, including raised toilet seats, specialist baths and showers, walking aids, hoists, ramps and grab rails. There is also a sensory room which is almost ready for use. All of the completed bedrooms and living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. Bedroom doors have locks which are of a type which enable staff to gain access in the event of an emergency. All windows have been fitted with restrictors or other means of reducing risk and all radiators are either covered. There is a secure well-maintained garden and patio with garden furniture which is used by the residents. All areas of the home are clean and there are no unpleasant odours. There is separate laundry room with a commercial washer and a drier. Staff showed a good awareness of health and safety issues. There are disposable hand drying towels and pump soap dispensers in communal WC’s and shower rooms to reduce the risks of cross infection. Disposable wipes are used for personal care. There are lockable sluice rooms, appropriate foot operated bins for particular waste products, and staff confirmed that personal items are disposed of appropriately. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good outcomes in this area. Staffing numbers are adequate to meet the daily needs of the residents. Residents are protected and supported by the home’s recruitment and induction training procedures. Residents benefit from a well trained and supported staff team. This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 19 EVIDENCE: Staffing generally comprises the registered manager, a unit manager and head of care in the respective residential and nursing wings, and supporting nursing and care staffs. There are also adequate kitchen and domestic staff, an activities co-ordinator, and a receptionist. The six staff files that were examined included evidence of sound recruitment practices. Staff said that all staff must be CRB checked and have verbal and written references taken up prior to their employment. Staff confirmed that there is a comprehensive induction training for core issues and then further on-going training. This includes core training for issues such as medication, first aid, moving and handling, health and safety and fire safety, and also specialist conditions relating to the client group. NVQ training is also encouraged. Staff receive regular supervision either from the manager or heads of care and there was evidence of this in staff files. Staff referred to the high level of teamwork, and on-going support from the manager for work and personal issues affecting their work. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People who use the service experience good outcomes in this area. The current management arrangements ensure that the home is being run in a way which benefits residents and staff. The record keeping, and health and safety systems are sufficient to safeguard residents’ welfare, rights and best interests. This judgement has been made using available evidence including a visit to this service. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has extensive experience and nursing and management qualifications. The management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. There are further checks by the operations manager as part of the monthly regulation 26 visits. Staff said that the residents are regularly asked for their views and feelings about activities, meals and how things are done. This is either through talking to individual clients or through questionnaires for residents, and/or their families. The questionnaires include questions on satisfaction with personal support, the quality and quantity of the meals, staff attitudes, complaints and the comfort and cleanliness of the environment. Other quality assurance methods include the weekly senior management staff meetings and an annual business plan. Staff said that the manager and managing director are supportive and that staff morale is good. The manager was very ready to praise the staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that personal items were appropriately disposed of and warning signs in place for wet floors. The fire alarm and emergency lighting are tested regularly. The maintenance file contains current certificates to show that regular checks eg gas, electricity, are carried out. Whilst there are adequate risk assessments on the environment, and for activities involving residents, these would benefit from more detail. Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 22 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 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abbotsleigh Residential Care Home DS0000042586.V350437.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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