Inspection on 14/07/10 for Abbottswood Lodge.

This inspection was carried out on 14th July 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Abbottswood Lodge. 26/05/10

Abbottswood Lodge. 14/04/10

Abbottswood Lodge. 10/06/08

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 08/06/2011.

Random inspection report Care homes for adults (18-65 years) Name: Address: Abbottswood Lodge. Church Lane Swanton Abbott Norwich Norfolk NR10 5DY two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lella Hudson Date: 1 4 0 7 2 0 1 0 Information about the care home Name of care home: Address: Abbottswood Lodge. Church Lane Swanton Abbott Norwich Norfolk NR10 5DY 01692538455 01692538725 abbottswoodlodge@abc-care-solutions.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Abbottswood Lodge Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 22 The maximum number of service users who can be accommodated is: 22 The registered person 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 to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home 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 Care Homes for Adults (18-65 years) Page 2 of 10 1 4 0 4 2 0 1 0 Brief description of the care home of North Walsham. The majority of places are in single rooms and nine of the rooms are located in a bungalow next to the main house. This has its 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. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: The Home last had a Key inspection in June 2008 and at that time the quality rating was assessed as being GOOD. Following incidents notified to the Commission we carried out unannounced Random inspections in April 2010 and May 2010. Requirements for improvements were made following the inspection in April 2010. During the inspection in May 2010 we found that these had not been met and further requirements were also made. This report contains information gathered about the Home recently, including during another unannounced visit to the Home, on the 14th July 2010 which was carried out by two Inspectors. During the visit we spoke to the new Manager and looked at a selection of records. The report also contains information provided by the Responsible Individual for the organisation and the new Manager who have sent information to the Commission by email when requested to do so. The previous Manager and deputy Manager left the Home in May 2010 and a new Manager started work at the Home at the end of May 2010. The organisation had not identified the areas of concern prior to our visits despite regular visits made by the area Manager. What the care home does well: What they could do better: Concerns were raised at the time of our visit in April 2010 about the Homes ability to meet the needs of two of the residents and about the decision to admit them to the Home initially. The residents continue to reside at the Home and concerns continue about this. The Manager is liaising with the local authority about the residents moving to somewhere more appropriate. We looked at records relating to the admission of a resident who has only recently moved to the Home. We also spoke to the Manager about this process. There is no pre admission assessment available and no care plan for staff to follow about meeting the residents needs. The Manager said she had carried out an assessment but had not written anything down. The only information available is the discharge letter from the hospital. This states that the resident is aged 66. The Home is registered for residents aged 18 - 65. Care Homes for Adults (18-65 years) Page 4 of 10 A requirement was made for staffing levels to be provided that are adequate to meet the needs of the residents. The Manager said that she will provide the Commission with a copy of the dependency assessment that she has carried out. The Manager said that they do not use agency staff at the Home as the residents may feel unsettled by new staff. We asked the Manager for information about the staff on duty on the day of our visit. This showed that there were two staff who were working excessive hours without suitable breaks between shifts. The Manager confirmed that there were other staff who also worked these type of hours and that she had not realised that there was a problem with this. We issued an Immediate Requirement during this Inspection with regard to this. The Manager told us before we left that she had altered the rota so that staff were no longer working these long hours. We asked to see the recruitment files for the member of staff and the volunteer who have been recruited since the new Manager started work at the Home. The file for the member of staff showed that appropriate checks had been carried out prior to the individual starting work at the Home. However, there were no records at all for the volunteer. We issued an Immediate Requirement with regard to the need to carry out the necessary checks before people are able to work with the residents. A requirement had previously been made for the care plans to be reviewed and to contain clear information for staff about how to meet residents needs by 31st May 2010. A requirement had been made for risks to be identified and appropriate assessments carried out by the 14th May 2010. Neither of these requirements have been met. The Manager told us that all of the care plans, except for six, have been reviewed. We looked at a selection of care plans, including those which were said to have been reviewed, and found that they do not contain the necessary information to provide staff with guidance about meeting individual residents needs. For example, there was no care plan at all for the resident who had recently been admitted to the Home. We looked at a care plan for a resident who is dependent on staff for all their mobility needs. The moving and handling risk assessment had been written in 2007. The care plan for their mobility needs had been updated in 2009 to reflect a change in their health and there were several care plans relating to the residents mobility. However, none of these provided clear guidance to inform staff about skin integrity, which hoist and sling to use, change of positions that were required during the day and night. For the same resident there was an entry in the Record of Health Professionals visit that in June 2010 there had been three visits by the District Nurse to change dressings. There was no care plan with regard to prevention of skin breakdown, of guidance about pressure care, nor any information about why the District Nurse was visiting. In the daily notes there was only two references to blisters but no other information about the care being provided with regard to this. Another care plan that we looked at showed that there was some risk to other vulnerable residents from one of the residents. There was no guidance for staff in the form of risk assessments or care plans for any of the residents involved in this situation. Care Homes for Adults (18-65 years) Page 5 of 10 We were told that one of the residents had epilepsy and when we asked the Manager about their care she was not clear about whether the resident should have one to one care. The records that we saw were also not clear. There was no risk assessment or care plan available for the resident with regard to their epilepsy and their risk of falls. We have concerns about whether the residents health care needs are being met. As well as the examples above we also saw that two of the residents had been assessed as needing to wear glasses. They do not have glasses and there is no information in the care plans relating to this situation. We also noted that in one of the care plans a concern about the resident losing weight had been identified. There was no information in the care plan about how this should be managed or of which health professionals have been involved, if any. We asked to see the weight chart and the Manager was unable to find this. There is an outstanding requirement from the last Key Inspection for residents to have regular opportunities to take part in activities away from the Home. This has not been met. The Home is situated in a very rural location with no access to public transport. The Home has a seven seater vehicle. Some of the residents go to day services during the week and are provided with transport to get to and from these. The Manager said that there are at least two residents who are unable to use the Homes transport due to them needing a vehicle in which they can sit in their wheelchairs. We asked the Manager about the last time that these residents had left the Home and she said that they had not done so in the six weeks that she has been there. Some activities are now being provided within the Home following the appointment of a member of staff to do this. We will look at the provision of meaningful activities at the next Inspection. A requirement was made for all staff to attend Safeguarding training by the 31st May 2010. This requirement has not been met although the Manager said that 12 members of staff are due to attend this training on the 20th July. This will leave 3 members of staff who have not attended this training. A requirement had been made about the need for the Safeguarding procedure to be updated. The Responsible Individual has sent the Commission two revised copies of this but it still needs alterations to ensure that it provides accurate guidance to staff. There was a requirement for staff to have received training appropriate to their roles by the 30th June 2010. This has not been met. The Manager said that no training has been provided since that requirement was made. The organisation does not have a training plan nor is there any evidence of a review of the training needed to ensure that the residents needs are met by the staff team. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 12 It is required that the Home only admits residents whose needs can be met there To ensure that residents needs are met 16/04/2010 2 6 15 It is required that the care plans contain detailed information about how residents needs should be met To ensure that staff have clear guidance about how to meet residents needs 31/05/2010 3 9 13 It is required that risks are 14/05/2010 identified and that appropriate assessments are carried out. To ensure that risks to residents and staff are minimised 4 14 12 That every resident has a regular opportunity for outings or activities outside the home, to ensure their needs are met. 28/11/2008 5 23 13 It is required that the Safeguarding adults procedure is reviewed and 23/04/2010 Care Homes for Adults (18-65 years) Page 7 of 10 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action updated To ensure that staff have clear guidance to follow if needed 6 23 13 It is required that all staff receive appropriate Safeguarding Adults training To provide protection to the residents from abuse 7 33 18 It is required that staffing levels are adequate to meet the needs of residents To ensure that residents needs are met 8 35 18 It is required that staff receive appropriate training to carry out their roles effectively To ensure that staff have the appropriate skills to meet the needs of the residents 30/06/2010 30/04/2010 31/05/2010 Care Homes for Adults (18-65 years) Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 33 18 That staff have suitable breaks between shifts To ensure that residents are not put at risk by staff working excessive hours 16/07/2010 2 34 19 That appropriate recruitment 14/07/2010 checks are carried out To provide protection to the vulnerable residents Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 10 of 10 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!