CARE HOMES FOR OLDER PEOPLE
Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW Lead Inspector
Fiona Stephenson Unannounced Inspection 12th January 2006 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 Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 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. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Abelard Care Centre Address 116-120 Musters Road West Bridgford Nottingham NG2 7PW 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) 0115 9816069 0115 9866487 Kalbro Care Uk Limited Mrs Diane Lesley Bruce Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (5) of places Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service Users shall be within categry OP 36 OP ( old age not falling into any other category ) including 5 PD aged 55 and over 7th September 2005 Date of last inspection Brief Description of the Service: Abelard Care Home is an adapted property situated in West Bridgford, Nottingham. It is registered to provide personal and nursing care for up to 36 older people. The accommodation is over three floors, and has 30 single, and three double bedrooms, with all except two bedrooms providing en-suite facilities. A passenger lift gives access to all floors. There is a communal lounge/dining room, and a smaller lounge for the use of residents. The home has a secure garden to the rear, and there is limited car parking space at the front of the home for staff and visitors. The home is close to the centre of West Bridgford, where residents can access shops, cafes, banks, churches, public houses and doctor’s surgeries. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Thursday 12th January 2006 from 10:00am to 12:35pm and was conducted by one inspector. The inspection was the second statutory inspection for the home for the period 2005-2006, and the inspector’ primary focused on the care standards that were not checked during the previous inspection. To do this the inspector used a method of inspection called ‘case tracking’, which involved selecting three residents and tracking the care, they receive. Two of the three residents case tracked were spoken with, as well as one of their key workers. What the service does well: What has improved since the last inspection?
Since the last inspection, dinnertime has become two tiered to ensure that residents are not sitting for a long time waiting for their meal to be presented to them. Staff have been provided with further training to ensure that correct and safe moving and handling techniques are followed, and to ensure that residents are
Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 6 fully awake and alert before they are moved to prevent injury and to demonstrate respect for their dignity. Staff have been re-trained to ensure that products subject to the Control of Substances Hazardous to Health regulations are properly secured at all times to make sure that the residents are safe from harm. Residents now have their dignity and privacy respected when being weighed, as this no longer happens in a communal area, instead it is done privately. 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. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 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 Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not checked on this occasion EVIDENCE: Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10. Residents’ health and care needs are set out well in their care plans EVIDENCE: The inspector checked the care notes of the three residents case tracked and found them to have clear and up-to-date information about the care needs of each resident. The manager demonstrated a good understanding of the care needs of each resident, and the key worker for one of the residents, also demonstrated a good understanding of the resident concerned. Good links with visiting health care professionals were observed, and good links have been established to support health care needs around tissue viability. Whilst looking around the home, the inspector noted that the privacy of residents was respected through doors being knocked before they were opened. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14. Residents are helped to exercise choice and control over their lives. EVIDENCE: The inspector noted that residents sat in the lounge areas where they preferred to sit, with one sitting on her own in the smaller lounge because she enjoyed the quiet of the lounge, where as others preferred to sit near the television in the larger lounge. For those that wished, residents were doing recreational activities, and one of the residents case tracked said she enjoyed these activities. Another resident who was case tracked, informed the inspector that her visitor comes every day, and he can come whenever he likes. One of the residents case tracked said that she liked the food and was asked what food she wanted each day. She also informed the inspector that she went on trips out with the home and that she enjoyed them. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not checked on this occasion. EVIDENCE: Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Residents live in a safe and sufficiently maintained environment. EVIDENCE: The inspector checked the communal and private areas of the home used by residents who were case tracked. The décor was of a satisfactory standard throughout the home, and new armchairs have been provided for the lounge area. One bedroom checked had a very stained carpet. The manager informed the inspector that this had been identified as needing replaced however they were awaiting an appropriate time to do this, and explained why. The bathroom on the first floor was checked. The tap in the sink was letting out water (this was fixed during the inspection), and the bathroom window was wide open and a potential hazard to residents. The bath chair had what look like dried faeces on it, and there was dried glue on the seat, which looked like it would be rough if skin were to contact it, and therefore be a potential tear hazard. The bathroom itself was not very homely and had an institutional feel to it.
Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 13 The two other bedroom’s checked were satisfactorily decorated and furnished, however the inspector on talking to one of the residents in her room, noted that her glasses were dirty, the call system was out of her reach (she was unable to leave the bed), and her hairbrush and comb were dirty. This resident had been wanting a drink of water but was unable to get one because she could not use the call system. This was an over sight by staff, and the inspector was assured that it was not intended to deny the resident access to this. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff are trained and competent to do their jobs. EVIDENCE: The inspector noted that there is a nurse on duty during each shift and there were good staffing levels at the time of the inspection. The inspector checked the staff files of those who were key workers to the residents who were being case tracked. On checking the files the inspector noted that one did not have a birth certificate on file. The manager thought that because they had the passport details, this was sufficient. The training co-ordinator showed the inspector the training log for staff, demonstrating that staff have undertaken a range of in-house and external training sessions including first aid, health and safety, MRSA, and Venepuncture training. The induction training was also good. The inspector was informed that staff receive detailed Protection of Vulnerable Adults (POVA) training, however this was not on commencement of employment. The induction training does not cover POVA and ‘no secrets’ at any level, although staff are asked to read and sign to say they have read the policy and procedures relating to this. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not checked on this occasion. EVIDENCE: Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 2 X Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? None 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 OP18 Regulation 13 Requirement The registered person must ensure that the window in the first floor bathroom does not pose a risk to residents. The manager must provide CSCI with an action plan regarding ensuring that all staff records include birth certificates Timescale for action 26/01/06 2 OP37 19 26/01/06 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 2 3 Refer to Standard OP19 OP22 OP30 Good Practice Recommendations Ensure that the bath chair in the first floor bathroom is safe for the use of residents, and has been thoroughly cleaned. Ensure that residents have access to the call system at all times. Consider extending the staff induction training to include the Protection of Vulnerable Adults, and ‘No Secrets’ policies and procedures. Abelard Care Centre DS0000063344.V272336.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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