Inspection on 25/02/09 for Abelard Care Centre

This inspection was carried out on 25th February 2009.

CSCI found this care home to be providing an Adequate 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

Abelard Care Centre 07/12/06

Abelard Care Centre 12/01/06

Abelard Care Centre 07/09/05

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 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW     The quality rating for this care home is:   one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynda Dyer     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW 01159816069 01159816487 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kalbro Care Uk Limited Name of registered manager (if applicable) Mrs Emelita M Hurboda Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 36 OP ( old age not falling into any other category ) including 5 PD aged 55 and over Service Users shall be within categry OP Date of last inspection Brief description of the care home Abelard is an adapted property situated in West Bridgford providing personal and nursing care for up to 36 older people. The accommodation is over three floors, in 30 single and three double bedrooms. All except two bedrooms are en suite. A passenger lift gives access to all floors. There is a secure, peaceful and well-maintained garden to the rear, with access via patio doors from the lounge come dining room, where service users can sit comfortably in good weather. At the front of the property is limited car parking space for staff and visitors cars. The home is close to the centre of West Bridgford (around a 15 minute walk for someone with good mobility) and there residents can access a number of shops, cafes, banks, churches and public houses. Care Homes for Older People Page 4 of 29 0 5 Over 65 36 0 care home 36 Brief description of the care home The Manager told us on the day of the inspection that the fees range from £294 to £375 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service, this is called an AQAA (Annual Quality Assurance Assessment). Care Homes for Older People Page 6 of 29 The last key inspection on this service was completed on the 7th December 2006. We received the AQAA back from the manager in good time, the form was well completed and it helped us to plan our visit and to decide what areas to look at. The manager had not identified any areas for improvement over the next 12 months but we discussed this with the manager on the day of the inspection and she had clear ideas of future improvements planned for the home. We also sent out surveys called, have your say, to people who live in the home, staff that work there and visitors. This meant we could get an idea of what people thought about the way the service was run. We had 13 completed surveys back and we have included some of the comments in this report. We have not included comments that could identify the writer as we want people to feel they can be open about the way they feel the service is run. We also reviewed all of the information we have received about the service since we last visited and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking, which involved us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We spoke with two members of staff, three people who live in the home and the Manager to form an opinion about the quality of the service being provided to people living at the home. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who live at the service. We observed people during lunch and in other communal areas to see how staff interacted with the people that live there. What the care home does well: What has improved since the last inspection? What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that are admitted to the home have their needs assessed prior to admission which means staff will be able to plan for their individual needs and know how to care for them. Evidence: The home has a sustained track record of ensuring that people receive an appropriate assessment before they are admitted. People told us that they had received a contract before moving into the home and that they were given enough information before deciding to live there. During this inspection, we examined three peoples records to check that there had been an assessment of the persons needs before admission. There was clear evidence of a pre admission assessment completed by the home and where a Local Authority Care Homes for Older People Page 10 of 29 Evidence: had been involved in the admission, an assessment document had also been completed by them. This means that staff are clear about a persons needs when they are admitted to the home. Intermediate care is not provided at the home and this standard is not applicable. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have up to date and relevant care plans, which give guidance to staff to deliver the appropriate individual care and people are happy with the care they receive. Some of the homes medications procedures are not safe. Evidence: We examined the care plans of the people we case tracked. We saw evidence that the assessment completed for people before they are admitted to the home helped to form the content of each care plan and the basis of how the care will be delivered to individuals living in the home. This means that individual care needs can be met by staff who have the relevant information on how to deliver appropriate care to the people they support. The care plans we viewed contained a wide range of information that focused on how staff should maintain the individuals health care. They included a range of risk Care Homes for Older People Page 12 of 29 Evidence: assessments that identified clear action for staff to prevent the risks occurring. This means that there is a clear risk prevention plan in place to protect people. Where care plans identified risks such as pressure sores, the person was seen to have suitable pressure relieving equipment in place to maintain healthy skin and minimise any sores occurring. The care plans were all up to date, were being reviewed regularly and contained some evidence that people were involved in their own care plans. However the care plans would benefit from having more person centered information such as individual life profiles. This would enable staff to have a better insight into the life of people they support. The care plans would also benefit from being more organised so that people using them can find important information more easily. People living in the home looked well cared for and people we spoke to said things like, They look after me very well here and I get to see the doctor whenever I need to. One healthcare professional told us in a completed survey, They always call for medical advice if there is a concern and they always listen to advice, implement change and monitor health care needs. The main medication storage area was well organised and we observed staff administering medication appropriately. However there were some gaps in the procedures for the safe handling of medicines. We saw external medicines kept in peoples bedrooms that were not being stored securely. This means that the medicines are accessible to other people living in the home. The external medicines were also not dated when opened, which means the staff cannot evidence when the items were opened and if they are still within their shelf life. One record we viewed contained a handwritten prescription which had not been signed or witnessed and two records we viewed had gaps in signatures made by staff administering the medication. This means the home cannot evidence if these people are receiving the medication prescribed for them. One healthcare professional told us, I have always seen staff talking to and treating residents with respect. We saw people living in the home being treated with respect and their having their dignity upheld by the staff working with them. Care Homes for Older People Page 13 of 29 Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live in the home are given the opportunity to participate in recreational activities and maintain social contacts. People receive a nutritious and appetising diet with individual preferences being met. Evidence: On the day of the inspection we observed visitors coming into the home and they were clearly welcomed by staff. People living in the home told us that they had regular visitors and were able to go and see friends in the community. This means that people living in the home are being supported to maintain links with friends and relatives. One person who visits the home told us, The atmosphere in the home is always very pleasant. The home employs an activity organiser, who works four days a week and does activities with groups and individuals. The activities organiser was not on duty on the day of the inspection but we were shown records of people taking part in activities such as trips out and in house entertainers and we saw an activity schedule displayed. Care Homes for Older People Page 15 of 29 Evidence: Peoples daily living could be further enhanced if peoples individual preferences that are identified in their care plan were linked into the daily activity schedule. This would show that people living in the home are having their individual preferences around daily living met. People living in the home told us about trips out they had enjoyed, such as a boat trip. One health care professional told us, The care staff ensure that residents are able to participate in activities appropriate to the residents needs and The home always has a range of activities available for residents to enjoy. We observed people living in the home sitting in the lounge areas and there were groups of people chatting and the staff interacting with them were respectful and mindful of peoples choices. People appeared to be comfortable with the surroundings and able to express their own choice and decisions. Weekly menus were seen on display in the dining area. However they were not accessible to people with mobility impairments and people we spoke to did not know what was for lunch. The meals we saw served looked nutritious and appetising and there was a choice of two hot meals. Staff told us that there is a choice each mealtime and that the cook interacts with people living in the home and will always cater for individual requirements. One person living in the home has wishes around a cultural diet and they told us that staff respect this and the diet is catered for. One person living in the home said, The food is excellent. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally the home takes complaints and concerns seriously and acts on them. However the manager had not taken appropriate action to refer a recent allegation in line with current local safeguarding procedures. Evidence: We have not received any complaints about the service in the last 12 months. The home told us that they have received 9 complaints in the last 12 months, of which 4 were upheld and one is still awaiting an outcome. The home has a complaints procedure on display. The information about how to contact the commission is out of date and it is not accessible to all people living in the home. However people told us that they knew how to make a complaint and that the home has always responded appropriately if they have had to raise a concern. Generally clear records of complaints and any outcome are held and show that the manager takes concerns and complaints seriously. The home has all the local safeguarding referral procedures in place and staff are trained in dealing with safeguarding issues. However there had been a complaint made that should have led the manager to make a safeguarding referral but this had not Care Homes for Older People Page 17 of 29 Evidence: happened. The manager made the referral on the day of the inspection and it is now being dealt with appropriately. Staff that we spoke to gave clear accounts of how they would deal with any poor practice they witnessed in the home and what their response would be. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good housekeeping procedures provide people with clean, pleasant and homely surroundings in which to live. Evidence: On the day of the inspection we found the home to be warm, welcoming and well organised, with a homely atmosphere. Communal areas were well presented and arranged to give a choice of seating and all areas seen appeared to be well maintained. The garden was very attractive and was set out in a way that people could enjoy the views from inside the home, such as the bird table set up in a good viewpoint. People told us that they are able to enjoy sitting in the garden during warmer weather. People told us in surveys and during our visit that the home was clean and fresh and we saw evidence of this in the areas we viewed. Bedrooms were clean, very personalised and tailored to meet individual needs and wishes. Bedrooms contained specialist equipment where needed. This means people that live Care Homes for Older People Page 19 of 29 Evidence: in the home have the right equipment to support their health care needs. The manager told us that the home has infection control policies based on the Department of Healths infection control practice and we observed staff using appropriate protective clothing and they appeared to be following infection control procedures. This means people are being protected from the spread of infection. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good staff recruitment and training procedures, which means that people living at the home should be, as far as reasonably possible, protected from risk. Evidence: On the day of the inspection we saw a positive and warm staff presence. Throughout the day we observed the interaction between staff and people living in the home and found the interaction to be respectful and friendly with evidence of staff supporting people in the home to make choices. There were adequate numbers of staff on duty and there was a good staff presence in the communal areas. Surveys completed by people living in the home said that staff were always or usually available to help them and that staff always listen and act on what they say. One person who visits the home told us, The staff are very caring at all times and the atmosphere in the home is always pleasant. Another told us, They are very friendly and the home seems to be happy, they are very caring. Staff members in the home are supported to undertake external qualifications beyond the basic requirements. The Manager enables this and recognise the benefits of a skilled, trained workforce. However the home may benefit if more staff completed Care Homes for Older People Page 21 of 29 Evidence: training in caring for people with cognitive impairments such as dementia. We examined 2 staff files and found that the home operates a robust recruitment practice that ensures people are properly checked and safe to work with vulnerable people. However, the files were disorganised and it was difficult to find the information we needed. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is evidence that the home is run in the best interests of the people that live there and that the manager supports a team of staff to deliver safe and effective care. Evidence: The Manager has been working in the home for almost five years, was appointed as the manager six months ago and has just completed the registration process with the Commission. She has good people skills and understands the importance of effective outcomes for people who use the service. The managers practice, skills, and knowledge, is based on continuous development, gained through training and enthusiasm for the role. The manager told us in the homes Annual Quality Assurance Assessment that people living in the home and their representatives are given a questionnaire each year so that the home can monitor what they are doing well. We saw the evidence of the most recent completed questionnaires which were carried out last year. Regular residents Care Homes for Older People Page 23 of 29 Evidence: meetings are held and records of these meetings were seen by us on the day of the inspection. This means that people have the opportunity to give their views and opinions about the home. One healthcare professional told us, This care home is always welcoming and professional, staff maintain contact with professionals and have the best interests of the residents as the centre of what they do. The manager told us that they do not manage peoples finances but some people who live in the home have their personal spending money kept for safekeeping. Policies are in place for this and we saw the personal finance documents of two people living in the home and they had clear records in place. This means peoples personal money held by the home for safekeeping is being managed in their best interests. The commission requires managers to send notifications of incidents in the home that may affect people living there. We discussed a shortfall of these notifications with the manager and the administrator and were told that the notifications were being sent to an address no longer used by the commission. If the manager had access to the Internet then she would be able to keep up to date with the changing guidance of the commission more effectively. The home usually employs a maintenance person but this position is currently vacant. Some of the homes maintenance systems are not being kept up to date as a result of this vacancy. The manager ensures that staff are kept up to date with safe working practices and on the day of the inspection we saw staff using these safe practices effectively when delivering care to people living there. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 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 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes 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 1 9 13 Medicines prescribed for external application must be safely and securely stored. This will ensure that all parts of the home, to which people living there have access, is maintained free from hazards to their safety. 24/07/2009 2 18 13 All allegations and incidents of abuse must be followed up promptly and action taken to make referrals in line with current local safeguarding procedures. This will keep people safe. 27/04/2009 3 38 37 The registered person must give notification to the CSCI of any significant event in the care home. To keep the commission informed of events that may affect the wellbeing of people living in the home. 27/04/2009 Care Homes for Older People Page 26 of 29 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 1 7 Introduce individual life profiles to care plans for people living in the home. This will make the care plans more person centred. Organise care plans so that important information is more easily accessible to people looking for information within them. Regular management checks should be carried out and recorded to ensure compliance with regard to medication records being fully completed, containing required entries and to ensure they are signed by appropriate staff. When liquid medicine, ointments and creams have been opened the date of opening should be written on them. This will enable staff to evidence when the items were opened and if they are still within their shelf life. Hand written medicines entries on the medicine administration records should be signed and the signature witnessed. This will minimise the risk of error. Link the individual activity preferences listed in peoples care plans to the daily activity schedule and keep records of these activities to show that all people living in the home are being supported to take part in activities of their choice. Make the daily menu accessible to all people living in the home. This will support their choices around meals provided. The complaints procedure should be made accessible to all people living in the home, including people with impaired mobility. This means that all people living in the home will be supported to make a complaint. The complaints procedure should be changed to include the correct information for people to contact the commission. Staff files should be more organised so that important information is more easily accessible to people looking for documents within them. The home should provide all care staff with training in dementia. This will help staff to support the people they are caring for who have cognitive impairments. Make provision for the portable appliance testing and the 2 7 3 9 4 9 5 9 6 12 7 15 8 16 9 10 16 29 11 30 12 38 Care Homes for Older People Page 27 of 29 water management systems to be maintained. This will keep the maintenance of the home up to date and keep people safe. Care Homes for Older People Page 28 of 29 Helpline: 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 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!