Inspection on 10/06/08 for Abbottswood Lodge.

This inspection was carried out on 10th June 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbottswood Lodge. 14/07/10

Abbottswood Lodge. 26/05/10

Abbottswood Lodge. 14/04/10

Abbottswood Lodge. 28/06/07

Abbottswood Lodge. 18/08/06

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 22/11/2008.

CARE HOME ADULTS 18-65 Abbottswood Lodge Church Lane Swanton Abbott Norwich Norfolk NR10 5DY Lead Inspector Brenda Pears Unannounced Inspection 10th June 2008 10:00 Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 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 Abbottswood Lodge DS0000067884.V366161.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 Adults 18-65. 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. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbottswood Lodge Address Church Lane Swanton Abbott Norwich Norfolk NR10 5DY 01692 538455 01692 538725 abbottswoodlodge@abc-care-solutions.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Abbottswood Lodge Ltd Manager post vacant Care Home 22 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (5), Physical disability (1) of places Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2007 Brief Description of the Service: Abbottswood Lodge is a period residence that has been adapted and extended to provide residential accommodation for up to 22 adults with learning difficulties. The property is in a very rural location outside the small village of Swanton Abbott, south of North Walsham. The majority of places are in single rooms and nine of the rooms are located in a self contained unit in the extension. This has it’s own lounge and kitchenette. People accommodated within the main house generally have higher care needs. The home in addition has spacious communal accommodation and an activities room. The premises stand in extensive grounds overlooking farmland. Fees generally range from around £450 and are dependent on individual needs and support assessed at placement. A statement of purpose and service user guide is kept in the main office and is available on request. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 5 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. This was an unannounced inspection undertaken on the 10th June 2008 and started at 10.00 am. The focus of this inspection was on the previous requirements, on the core national minimum standards and on the quality of life for people living in the home. The methods used to complete this inspection consisted of reviewing records in the home that is known as case tracking. This consists of reading a care plan and all connected documents that support the care plan and provide information to meet a person’s needs. Discussions were undertaken with the manager, people living in the home and also with members of staff. Twelve questionnaires had been received from family members and residents. A tour of the building was carried out plus observations at this time and previous findings all inform the outcomes in this report. What the service does well: What has improved since the last inspection? From the last inspection report, all previous requirements have been addressed and completed. All radiators in communal areas are now covered. The home continues to undertake regular maintenance throughout the building and redecoration of rooms is ongoing, each person is involved in the choice of Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 6 colours and decoration for their own room. Three people invited the inspector to see their rooms and these rooms were clearly personal and private spaces that reflected individual personalities. 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. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A new admissions procedure is in place to ensure the home is able to provide appropriate support. All residents must have a service user guide to provide information that supports and informs those living in the home. EVIDENCE: The current owners have developed and implemented new policies and procedures to support an assessment of needs. The current manager explained that although there have been no recent admissions, the organisational forms and procedures would be used to make sure the home was an appropriate choice before anyone was admitted. A new statement of purpose has been developed and while a service user guide is in place, these have not been given to each resident. Discussions regarding the need for each person to have this information in an appropriate format were undertaken at this time. The manager stated that service user guides will be produced in formats that suit each person and this will provide Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 9 all relevant information, providing contact details of other agencies that can give additional support or information when necessary. The new guides will be given to each person to keep in their rooms for reference and to allow family and visitors to read and discuss if needed. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Although Care plans are orderly, reviewed regularly and show that healthcare needs are met, they are incomplete and could put residents at risk of needs not being met. EVIDENCE: Care plans seen at this time were found to be orderly and new person centred care plans are currently being developed. This new paperwork has been set out for files and staff are currently in the process of completing these. Staff are discussing and developing these plans with each person, making sure that individual hopes and wishes are clearly at the centre of the support being provided. Sections in the new plans included such areas as ‘What I would like to change’, ‘What I want to do’ and areas of physical and emotional needs for both men and women. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 11 Three care plans were seen at this time and these were up to date and had been reviewed. Files contain an index that enables specific information to be easily found. There is a healthcare section that contains information of all healthcare needs, appointments and visits. Care plans have details of needs relating to such areas as moving and handling risk assessments, communication, mobility, sleep patterns and what support is required. Records clearly show that healthcare professionals provide appropriate support and appointments are recorded on care plans seen at this time. However, one incident that was recorded on the daily log in some depth and ended with a hospital visit, was not recorded in the healthcare section or on the hospital visits sheet. Such important information could easily be missed if staff have not read the daily records and go directly to the healthcare section. Observations and comments on questionnaires confirm that staff do treat service users with respect and with due consideration for dignity. One person said that ‘staff are very good’ and ‘I am happy living here’. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. While there are activities undertaken in and outside the home, those people needing additional staff are not getting regular planned outings. EVIDENCE: Comments from people living in the home and their relatives include comments such as ‘staff are always helpful and work with us at all times’ and that people in the home ‘feel cared for’ and that ‘staff treat them well and they feel safe’. Five people living in the home also said they feel happy and safe in the home. Four questionnaires stated that more opportunities to take a ride out and about would be good. One family observed that staffing levels are not always enough to be able to have regular outings. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 13 One person said they are ‘sometimes’ involved in making decisions about the home and one person said that ‘sometimes’ the activities are good. Following a meeting with residents and discussions, a holiday has been booked for a stay at a holiday camp. It is clear from comments made that more effort needs to be made to enable those who are not fully able to take trips out on a regular basis. The numbers of people less able will inevitably increase as residents become older and additional physical difficulties arise. Plans have been made for one person to work in a local charity shop and training has been agreed with support from family and friends. Again, those less able should also have planned developments and goals, the manager explained that the new person centred care plans would identify such areas. Equality and diversity are acknowledged in various areas of live within the home and these specific areas will also be further developed with staff There is currently an activities person who works one day a week. On other days, care staff carry out this role. Daily activities include bingo and crafts, trips to he pub, outings to cinema, garden centres and visits to local chops and coffee shops by the river. Residents were fully included in all areas of this inspection and were encouraged to talk to the inspector and were told why the inspection was taking place. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Where needed, healthcare professionals support people living in the home, providing medical care to support good health and well being. EVIDENCE: Records show that people have access to appropriate healthcare professionals and visits are recorded, to ensure that their needs are met. As previously stated, all health details are not recorded in the relevant section of care plans to fully support people at all times and to make sure the support is up to date and appropriate. Specialist equipment is provided to further meet physical needs and provide the best quality of life that is possible and to support independence. The home has a communication co-ordinator for five days a week and additional support from the learning disability team. It was explained that staff and residents are supported following any significant event occurring in Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 15 the home, such as anyone passing away. Counselling and discussions are offered and everyone is monitored to make sure they are coping with such an incident. Medication storage was seen to be orderly and kept in a way that supports safety. The medication records seen at this time were found to be clearly written and fully completed. Following the last inspection, the home has purchased a medication trolley and all medication is securely stored. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comments from residents and families confirm that staff do listen and act on any issues raised. EVIDENCE: The questionnaires received from people who live in the home all stated that the person knew who to speak to if they felt unhappy about anything. Money is clearly detailed on file and handled by welfare rights and small amounts of cash are securely stored for residents. Access to the safe key and to the medicine cabinet is limited to ensure full accountability at all times. The welfare rights organisation and family members assist with savings or additional money matters. Discussions at this time and the questionnaires received do confirm that people know who to speak to if they have any problems. Observations at this inspection showed that people living in the home acted confidently and relaxed when speaking to staff. The home has support to make sure communication is encouraged at all times and one senior carer has British sign language stage one, making sure people can communicate their needs and any problems. The manager said that further information about complaints is being developed to inform people of their rights in all areas. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 17 There was a file that contains information about issues that have been raised some time ago, but no recent entries. Discussions were undertaken about a formal complaints book and making sure that all matters, large of small, are fully recorded. While there is a complaints policy and procedure, the currently displayed version is very old and not current. There is a new policy and procedure in place that needs to be produced and put on display for visitors. The home has a very open way of working and families said they would speak directly to the manager if there were any problems. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides areas to support a variety of activities and places for relaxation in a comfortable and safe environment. EVIDENCE: On the day of this inspection, two domestic members of staff were not at work and care staff were covering these duties. A tour of the premises showed that rooms and bathroom areas were clean and free from any odours. People were dressed appropriately and the atmosphere in the home was relaxed and unhurried. Radiators in all communal areas as well as bathrooms and toilets have now been covered to ensure the safety and wellbeing of all those living in the home. Risk assessments have been completed and all radiators in individual rooms are being covered using these assessments to make sure the high risk areas are covered first. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 19 Some rooms have picture signs to support those needing this additional prompt, people have keys if they wish following a risk assessment and areas that could pose a risk were locked at this time. Pictures are on display around the home and pictures of staff on duty are also on display. The staff said that this informs everyone and supports those residents who may forget who is due to be on duty at any one time. There is a selection of bathroom facilities, again supporting all needs and choices. The home is bright with a variety of rooms and areas for people to undertake various activities and is surrounded by countryside and open fields. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. While staff appear to be meeting the daily needs of residents, it is clear that some people with higher needs do not have regularly planned outings. EVIDENCE: Staff on duty at this time consisted of the manager, one secretary and two senior members of care staff. The manager was on the rota to undertake care on the day of this inspection. Staff also deal with all laundry duties as there is not an appointed laundry person. Staff stated that people in the home come first, but that they are still aware that clean clothes are needed and that time must be made for this. While staff do work hard to support residents living in the home, it is clear from questionnaires and discussions undertaken at this time, that people who are not independent are not regularly taken out. One person said ‘it would be good to go out for a ride’. It was also stated that one person only ever leaves Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 21 the home if it is for a ride and does not like walking, but again such trips are not a regular occurrence as staffing levels do not always allow for this. Rotas were reviewed and discussions about identifying the senior members of staff on shift were undertaken. Before this inspection was complete, rotas had been adjusted to clearly reflect who was shift leader and when the deputy manager was on shift. Morning shifts have three or four carers on duty and there are three staff on duty for the afternoon shift. For the night time there is one waking and one sleep in member of staff and an on call person at all times. Day time shifts also overlap to provide additional staff at busier times. Staff have undertaken recent refresher training on the safe handling of medication and the manager is making sure that all staff complete this training. All members of staff have achieved NVQ level 2, except for two newly recruited people. Six staff are also undertaking NVQ level three and all staff are trained in food hygiene. Records and discussions with staff confirm that staff meetings are held on a regular basis, supervision and appraisals are undertaken regularly, making sure staff are supported and up to date with all training needs. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in an open and inclusive way, enabling both staff and residents to feel a part of the decision making process. EVIDENCE: The manager has almost completed her studies for the registered manager award. She has worked at the home for eight years as a senior carer and then took up the post of manager. The manager now has set days in the office to undertake management duties and two days on the rota as part of the care team. The manager explained that the care duties keep her fully in touch with all the residents and any Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 23 changing needs and also provide an opportunity to observe routines and practices in the home. Staff confirmed that the manager has an open door policy and will always find time to talk to both staff and residents. A new quality assessment programme is being developed with new procedures to be followed. This will provide information from a variety of sources and assist the home to further develop any areas needing to be addressed. Any equipment in the home requiring regular servicing for the building were checked and found to be up to date, ensuring the property and equipment is safe. The manager said that risk assessments have been completed to make sure all areas of the home are safe and areas posing a risk are addressed. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 x LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 x Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 25 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 YA1 Regulation 5 Requirement That each resident has a copy of the statement of purpose that includes the complaints procedure, in a format that suits the individual. Timescale for action 28/11/08 2. YA14 12 That every resident has a regular 28/11/08 opportunity for outings or activities outside the home, to ensure their needs are met. To ensure that cold storage of medicine meets with set guidelines. That there is a record of any complaint with identified actions, timescales and outcomes, to demonstrate that matters have been dealt with appropriately. 29/09/08 3. YA20 13 4. YA22 22 29/09/08 Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 26 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 YA20 Good Practice Recommendations That a sample signature is on file for all staff signing for medication. Abbottswood Lodge DS0000067884.V366161.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region 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. 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