Inspection on 29/05/08 for Abbott House Care Home

This inspection was carried out on 29th May 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbott House Care Home 07/09/07

Abbott House Care Home 01/06/06

Abbott House Care Home 30/01/06

Abbott House Care Home 11/08/05

Abbott House Care Home 14/01/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Abbott House Care Home Glapthorn Road Oundle Northants PE8 4JA Lead Inspector Irene Miller Unannounced Inspection 29th May 2008 09:15 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 Abbott House Care Home DS0000060179.V366003.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. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbott House Care Home Address Glapthorn Road Oundle Northants PE8 4JA 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) 01832 277650 01832 275393 abbott_house@shaw.co.uk www.shaw.co.uk Shaw Healthcare (de Montfort) Ltd Mrs Lynda Taylor Care Home 60 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (60) of places Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Dementia, over the age of 65 - Code DE(E). The maximum number of service users who can be accommodated is 60. 7th September 2007 2. Date of last inspection Brief Description of the Service: At the time of this inspection Abbott House consisted of a new 40 bedded building and the existing unit, which is currently registered to accommodate 20 beds making a total registration of 60 beds. The owners Shaw Healthcare (de Montfort) are carrying out a major redevelopment programme. The aim of the programme was to replace the 32 bed 1960’s home with a purpose built 40 bedded home. Phase 1 of the programme has involved residents at Abbott House transferring to the new building. Some residents from a home in Raunds have transferred to Abbott House while their building is redeveloped. Eventually the plan is to demolish the original building at Abbott House. Abbott House provides twenty four hour care for older people, with some who have a diagnosis of dementia. Abbott House is situated on the outskirts of Oundle in East Northamptonshire, and is within walking distance of the town, which has a variety of small shops, public houses and restaurants/coffee shops. The new building consists of two ten bedded units on the ground floor and two ten bed units on the first floor. All bedrooms are for single occupancy and have en-suite facilities. Each ten bedded unit has a lounge, kitchenette and assisted bathroom and toilet facilities. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 5 The original building currently is able to accommodate up to twenty residents. All bedrooms are single occupancy and the home is divided into small units with a large central dining room. Northamptonshire County Council contract all of the beds in the home and the fees are set at a level agreed as part of that contract. The current fees confirmed at the time of inspection are in the region of £504.22. The fee paid by Northamptonshire County Council includes the cost of accommodation, meals, laundry, personal care and activities. The service user guide identifies some of the additional costs that may arise for specific services such as hairdressing. The guide also identifies that there is not a National Health Service dentist in Oundle therefore any dental treatment would need to be arranged privately. The Registered Manager identified that additional costs for residents’ would be personal; items such as toiletries, clothing, newspaper and private chiropody treatment. A copy of the most recent inspection report is available in the hallway of the original building. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The focus of all inspections undertaken by the Commission for Social Care Inspection (CSCI) are based upon seeking the outcomes for Service Users and their views of the service provided. This visit was unannounced and focused on the ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care records of people using the service were sample checked this involved looking through written information available on their care, such as care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). Discussions took place with people using the service, the staff and visitors and observations of staff and service users interactions were made, with an aim to establish if service users were satisfied living at the home. Because people with dementia are not always able to tell us about their experience of the service, we used a formal method of observation called the Short Observational Framework for Inspection (SOFI). This involved spending a period of one hour within the dining area of Old Abbott House observing the care of three people. The observation period gave an indication as to how the service supports the personhood and individuality of people living with dementia. Records in relation to staffing, how the home responds to concerns and complaints, the management of medication and the homes general policies and procedures were viewed. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? The requirements set at the last inspection had been met within the timescales given. Pre assessment of needs is carried out prior to admission to ensure that people using the service have their needs met. The care plans and risk assessments were reflective of the current care requirements. There was evidence of people’s healthcare needs being monitored. There were risk assessments in place for people that required the use of bedside rails to ensure that the equipment is used safely. The medication receipt and administration records were well maintained. Staffing levels are being monitored to ensure that the dependency needs of people using the service can be fully met. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 8 Much work has taken place to merge the Old and the New Abbott House this has included reorganization of all documents between both buildings, this has resulted in an efficient administration system being in place. 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. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 9 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 Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 10 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): Standard 3 (standard 6 is not applicable to this service) Quality in this outcome area is good. Information about the home and services is provided to people considering using the service. Thorough pre admission assessments ensure that peoples needs are met by the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and a service user guide were available in the reception area of the home, and these documents provided information about the facilities, staff, and the care provided at the service. Also within the reception area there was a copy of the most recent inspection report available. The pre-admission assessments within the care plans viewed had been carried out by social services and by a member of the staff prior to admission. The assessments had established the range of needs of the person prior to them moving into the home. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 11 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): Standard 7,8,9 & 10 Quality in this outcome area is good. The information within the care plans provides guidance on meeting the health, and personal care needs of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed indicated that there had been improvements made on the level of information contained within them for staff to follow. There was information on the healthcare needs, to include dietary requirements and there was information on providing individualised personal care. Assessments had been carried out to identify the risks of people developing pressure sores and the assessments informed on the preventative care required to reduce the risk of pressure sores developing. There was information on peoples moving and handling requirements and the support required from healthcare professionals such as the district nurse. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 12 There were risk assessments in place that identified the individual risks surrounding the people living at the home, there was a pro active approach to risk management, with accident records being reviewed to reducing the risk to an acceptable level whilst recognising peoples rights to freedom of movement and choice. Where bedside rails (Cot Sides) were in use there was risk assessments in place, which had identified the reason for their use and the hazards that this equipment can pose to the individual bed occupant. This approach ensures that the risk assessment is individual to the person. Within the care plan of a person that was at high risk of falls, the home had tried to identify the cause and possible contributory factors such as footwear, medication, sight impairment, rise and falls in blood pressure preceding each falls episode. This demonstrated that there was a pro-active approach to ensuring the health, safety and welfare of the people in their care. Within the individual care plans there was information for staff to follow in providing personal care, this information took into account the persons lifestyle choices, and range of capabilities. There were records of people being seen by their general practitioner and other healthcare professionals, such as the dentist, optician and chiropodist. A sample check on the medication of three of the people using the service was carried out, and was found to be satisfactory. During the time spent ‘observing’ within the dining room of the original building people were observed receiving their medication which was administered by the staff. In general the practice was satisfactory, however one person was heard on several occasions to tell staff that they ‘did not want it’ the staff were seen to keep persevering with offering the medication, later in discussion with the staff it became apparent that this person often will refuse their medication. The medication policy identifies that when people refuse their medication their wishes are to be respected, and where possible their medication be reviewed. In this instance the right to choice was not fully acknowledged by the staff. This matter was discussed with the senior member of staff on duty it was taken seriously and verbally confirmed that it would be made clear to staff that this was not acceptable practice. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 13 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): Standards 12,13,14 & 15 Quality in this outcome area is good. The people using the service are provided with a range of activities that meets their personal preferences and daily routines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the individual care plans efforts had been made to obtain information on the social needs, information had been obtained to help create individual life histories that identified important events and important people in the lives of the people using the service. During the visit the people spoken with expressed satisfaction with the services provided at the home, comments such as ‘the staff are very friendly and helpful’, ‘I can speak with any of the staff, they always take time to listen’. Within the communal areas there was activity programmes on display and within the care plans there was records available of the individual activities people had participated in. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 14 The home has good links with the local community and people using the service are invited to in house activities include, Bingo, sing a long sessions, card games and quizzes. In discussion with the staff they said that the Local Oundle & District Council Care Committee supports the home, and an invitation to their Annual Spring Fair was on display on the residents notice board. Also on display were the minutes from the latest residents meeting, the home produces its own newsletter and this was on display On display within the front entrance to the building there was the findings of the latest Service User satisfaction Survey. The local Methodist Church provides worship and prayer services at the home, and Holy Communion is celebrated monthly, in addition the home offers an informal Hymns and Sherry morning. Visitors spoken with confirmed that the visiting arrangements are flexible, and that the staff are always welcoming, staff were observed welcoming visitors into the home. People using the service confirmed that they can choose where to spend their day, people were observed to spend time within their own bedrooms, and within the various communal spaces within the home, and within the outdoor garden seating area. The kitchen was clean and tidy the member of staff working in this area was experienced and had a good knowledge of the dietary needs of the residents. There were records of food hygiene standards being carried out and there were records of individual food preferences and daily diary of meals provided for people using the service. Within the dining room there was a large blackboard with the lunchtime menu on display, the tables were set with fresh tablecloths, napkins and condiments and staff were observed to provide assistance with the lunchtime meal. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 15 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): Standards 16 & 18 Quality in this outcome area is good. The people using the service are provided with information on how to raise any concerns or complaints and staff are trained in recognising abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussion with the people using the service they said they could speak with any member of staff if they were unhappy with the care provided at the home. Within the service users guide there was information available on the homes complaints procedure, which provides information on the contact details for the Regional Manager and Head Office in the event that complaints are not resolved at a local level with the registered manager. Since the last inspection visit the Commission for Social Care Inspection has received no concerns or complaints abut the service. Review of the complaint record held in the home identified that no complaints had been raised at the homes level since the last inspection visit. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 16 Records of staff training demonstrated that all staff are provided with formal safeguarding adults training (POVA) as part of their induction training and that refresher training is also provided. In discussion with staff confirmed that they are aware of their responsibilities for safeguarding the residents’ in their care. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 17 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): Standards 19 & 26 Quality in this outcome area is good. People using the service are provided with a clean homely environment, the new part of the building is modern, light spacious and airy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour was conducted within the old and new Abbott House, during which bedrooms were viewed, the communal areas, laundry and kitchen. The bedrooms viewed were clean and tidy and had been personalised with small items of furniture, pictures and ornaments. In discussion with people using the service they said they were pleased with their bedrooms, in discussion with a visitor they said they were not fully content with the size of the room that had been provided for their relative, as Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 18 it was small, however they understood that this was a temporary arrangement as their relative would be was soon moving into the new Ashfield House. Within the Annual Quality Assurances Assessment (AQAA) records were available to demonstrate that equipment such as the passenger lift, mechanical moving and handling and bathing hoists are regularly serviced. The new building has been built to a very high standard and is spacious, light and airy, all bedrooms are en-suite and the lounges are open plan to include a dining area and kitchenettes. All areas of the home were clean and fresh. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 19 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): Standards 27,28,29 & 30 Quality in this outcome area is good. There is a commitment to staff training to ensure that all staff has the skills to meet the needs of people in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments received from relatives and people using the service about the staff support provided at the home were positive, and observations of care practice indicated that the people using the service are treated with dignity and respect. Staff supervision is provided which involves staff looking at their personal development needs, and areas of further training. Records of staff training were viewed a programme of seven workshops are provided for Team Leaders to include: Dementia Care, Activities, Risk Assessments, Core Values, Care Plans, Staff Supervision, Team Development, Dealing with Concerns, complaints, and Safeguarding. In addition there is training on Staff Management and Administration, Basic & Advanced Medication and Health and Safety. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 20 A sample check of staff recruitment files was carried out and there was evidence that the staff recruitment process was robust, there was records of criminal record bureau (CRB) clearances having been obtained prior to staff starting work and there was evidence of references having been obtained and employment histories having been checked. During the interview process candidates are required to complete a short written exercise based upon an equality and diversity scenario, the purpose of this is to explore the candidates understanding of the importance of equality and diversity being respected. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 21 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): Standards 31,33,35 & 38 Quality in this outcome area is good. The health, safety and welfare of the people using the service is promoted and protected through having effective management systems in place and staff being aware of the needs of the people in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Much work has taken place to merge the Old and the New Abbott House this has included reorganization of all documents between both buildings, this has resulted in an efficient administration system being in place. The Registered Manager holds the National Vocational Qualification level 4 in management, and the Registered Managers Award, Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 22 She has gained the experience and knowledge to effectively manage the service. Staff spoken with said that they enjoyed working at the home and that the training opportunities and support were very good, they confirmed that training in safe working practices such as movement and handling, fire safety and food hygiene is provided. Regular quality audits and satisfaction surveys are carried out and the findings are made available to people using the service and their representatives. The findings from the audits and surveys identify areas for improvements to the service, in addition unannounced visits by a representative of the organisation are carried out regularly to assess the quality of care provided. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 23 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 N/A 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 Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard OP8 Good Practice Recommendations Staff should ensure that the guidance within the homes medication policy is followed where people using the service refuse to take their prescribed medications. Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Abbott House Care Home DS0000060179.V366003.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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