Inspection on 07/09/05 for Abelard Care Centre

This inspection was carried out on 7th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 25/02/09

Abelard Care Centre 07/12/06

Abelard Care Centre 12/01/06

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abelard Care Centre 116-120 Musters Road West Bridgford Nottingham NG2 7PW Lead Inspector Linda Hirst Unannounced 7 September 2005 @10:00 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 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 C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 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 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 Dr Harilal Hansraj Kalaria Mrs Diane Lesley Bruce Care home with nursing (N) 36 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service Users shall be within categry OP Date of last inspection 12/11/04 Brief Description of the Service: Abelard is an adapted property situated in West Bridgford providing personal and nursing care for up to 36 older people. The accomodation 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 cum 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. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive. The people selected for case tracking have limited ability to understand and communicate. Therefore many judgements in this report are from observation, discussion with relatives and reading residents’ records and documents. The residents themselves were not able to help much in this process. Two relatives were interviewed as part of this inspection and the record of complaints, staff files, residents’ finances and the arrangements for medication were all inspected to check that they are in order. A partial tour of the accommodation was done to check previous requirements had been addressed and staff were observed in their duties. What the service does well: The manager makes sure that residents are fully assessed before they come to the home so she is sure that the staff can meet their needs. The care planning system is thorough and well organised and staff have good guidance about how to meet the residents’ needs. Their health needs are properly assessed and well provided for and the system for giving medication is safe and well organised. There are a variety of activities provided at the home and the residents are well occupied. Relatives said the care is good and they feel well informed. The food provided is of a good quality and varied, residents have choices at each meal and these are recorded. Complaints are properly recorded, investigated and concerns raise are acted upon. The staffing levels are good and reflect the dependency needs of the residents. The manager also ensures that recruitment procedures are robust and protect residents from abuse. Residents and their representatives have the chance to comment on the service through both formal and informal channels and their comments are collated and displayed. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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 C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 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 standard(s) 3, 6 Residents are fully assessed before being admitted to the home so that the manager is sure that staff can meet their needs. EVIDENCE: The last person to be admitted to the home was selected for “case tracking” to check that she was properly assessed before admission. There was clear evidence of a pre admission assessment and this covered all of the areas recommended in the National Minimum Standards. This has since been updated and developed into a full care plan to ensure that staff are clear about how the resident’s needs should be met. The manager has made sure that the home can meet this resident’s needs before admission, thus preventing unnecessary moves. Intermediate care is not provided at the home and this standard is not applicable. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 Care plans are clear, detailed and offer good guidance to staff about how to meet the residents’ needs. The residents’ health needs are properly assessed and provided for. Medication arrangements are safe and ensure that residents receive their medication as prescribed by their GP. Some work practices at the home compromise the dignity and privacy of the residents and these matters must be addressed as a matter of urgency. EVIDENCE: The care plans for the residents who were “case tracked” were inspected to make sure they were clear, appropriate and kept under review. The care plans are well organised, detailed and clear giving staff clear directions about how to meet residents’ needs and covering issues of privacy and dignity. There was evidence on all of the plans of residents or their representatives being involved and where this had not been possible, good records were maintained as evidence that attempts have been made to do this. There was evidence of regular review and in addition, the manager oversees the care plans every Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 10 three months and documents any areas where the plans are falling short. The plans are used as working documents and updated as needs change. There is very good evidence that the staff address residents’ health needs well. All residents have their health assessed using approved nursing assessment tools in respect of skin care, nutrition, continence, dependency, infection, mobility and falls. Any areas of risk identified are then translated into a full care plan which details any action required or monitoring. One of the residents who was “case tracked” was being nursed in bed. He looked comfortable and there was a chart in place to monitor positional changes. There is evidence in care plans that pressure relieving mattresses and cushions are provided to minimise risks, nutrition is regularly monitored and weights are recorded. Visits from health professionals are recorded in the plan and indicate that advice is sought as required. The relatives interviewed said the health care at the home was “excellent” and one said that the improvement in his wife’s health was so significant that in some ways he felt she no longer needed the care provided at the home. The medication arrangements were inspected to check they are safe and well managed. The manager has established a contract with Cliniserve to dispose of unwanted and unused medication in line with new guidance. The Monitored Dosage System is used for medication to reduce the possibility of errors in administration. The storage of medication is safe and secure, including controlled medication and those requiring cold storage. The administration of controlled drugs is properly recorded and the countdowns of tablets tally with those remaining in packets, providing evidence of safe practice. The Medication Administration Record evidences that residents receive their medication as prescribed. Staff were observed undertaking their duties with the residents for some time in the run up to lunchtime. Some good and positive interactions were seen between residents and staff but two incidents caused concern. Residents were being weighed in the main lounge/dining room in front of other residents. This is institutionalised practice and does not preserve the dignity and privacy of residents, there is no justification for it. Residents must be weighed in private and away from communal areas. In the second incident, two staff members were transferring a resident using a lifting belt and were having to lift the resident and bear a great deal of weight, it became obvious that the reason for this was that the resident was still asleep during the transfer. This is very undignified and shows a lack of respect for the resident. It is also very dangerous practice and could easily lead to the residents or staff sustaining injuries. The resident was taken away in a wheelchair to the toilet and was still asleep. This issue must be investigated and the Commission notified of the outcome and the manager must ensure that safe moving and handling practice is adhered to at all times. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13, 15 The residents engage in appropriate and meaningful activities in the home and the local community and they are encouraged to maintain their relationships with family members and friends. The diet offered to residents is healthy, balanced and varied and choices are available at every meal. EVIDENCE: An activities organiser is employed to work at the home four days a week in shifts which straddle the morning and afternoon shifts to occupy the residents for most of the day. The relatives interviewed praised the activities and said they were imaginative and varied, some being provided in house, such as entertainers and social gatherings, others in the community such as trips out. Two sets of relatives were interviewed as part of this inspection and they were full of praise for the home. They confirmed that they could visit at any time and that they are always made welcome. They said that they feel the communication between them and the staff is very positive and they feel well informed. A discussion was held with the cook, she offered written evidence that residents are offered choices at each meal and on the day of the inspection Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 12 three different choices had been prepared. Lunch consisted of chicken casserole, ham or mince with mashed or jacket potatoes and mixed vegetables followed by apple and plum crumble. Special requirements are catered for, vegetarian, Diabetic and soft diets are provided and the components of soft diets are blended separately to maintain the colour and texture of food and to encourage appetite. Residents and relatives interviewed said that the food was good and that residents get plenty to eat with choices available. It was noted that some residents were seated at the table in the dining area for a prolonged period of time before lunch began, in some cases for almost an hour. This is a protracted period and it is recommended that steps be taken to try and reduce this time lapse, for example by staggering lunch. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16, 18 Complaints and concerns are properly recorded, responded to and action taken to address issues raised. Residents are protected from abuse and the manager takes appropriate action in the event of allegations being made. EVIDENCE: The record of complaint was inspected to check that concerns are properly recorded, investigated and acted upon. There is clear evidence that the manager takes all complaints seriously and undertakes thorough investigations, there is an acknowledgement where errors have occurred and all complainants receive formal responses to their complaints along with details of how the matters will be addressed. The records were excellent. None of the people interviewed had made a complaint to the home, but they knew what the process was and said they would feel confident in raising concerns and feel the manager would deal with the issues raised professionally. There has been one allegation of abuse since the last inspection and this was referred to the Adult Protection Unit in line with Abuse Procedures. The incident was appropriately investigated and concluded. Incident records were seen and these were well recorded showing clearly the outcome of incidents which occur. The relatives said they had never seen staff respond to residents in a way which gave them cause for concern and said that they had seen staff act with patience in the face of quite challenging behaviour. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 14 Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 21, 23, 25, 26 The accommodation is clean and is continually being upgraded to improve the levels of comfort for the residents. EVIDENCE: The accommodation was partially inspected to ensure that the previous requirements had been addressed. These had all been met and many areas of the home have been redecorated and improvements made. The relatives said that the home was clean and said the improvements were appreciated. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 The staffing levels are appropriate to meet the dependency needs of the residents. The checks on staff are thorough and the systems robust offering good levels of protection from abuse for the residents. EVIDENCE: During this inspection in addition to the manager there was an RGN on duty, five care staff, a domestic, the cook, the maintenance person and an administrator. The activities organiser was not on duty. This is an appropriate level of staffing for the dependency needs of the residents and the relatives confirmed that they felt there were enough staff around most of the time. The staff were said to be “excellent, caring, patient and attentive.” The staff files were inspected as part of this inspection and these were very well organised with clear evidence of all of the necessary documentation and information. There was evidence of Criminal Record Bureau Checks and copies of nurses Personal Identification Numbers along with written confirmation of their current registration with the Nursing and Midwifery Council. A number of oversees staff work at the home and there was good evidence that the manaer has ensured they have appropriate work permits and Home Office clearance to work. These checks safeguard and protect the residents from harm and abuse. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 38 Residents and relatives are encouraged to express their views about the home, both formally and informally and action is taken accordingly. Residents’ finances are well recorded and managed and their interests are well protected. Not all of the staff work in a way which protects the health and safety of residents and the manager must make sure that practice in these areas improves. EVIDENCE: Relative and resident satisfaction surveys are undertaken once a year and the results are collated and displayed on the resident/relatives notice board in reception. The last survey indicates that most residents feel well settled at the home, most feel communication and care are good and there were high levels of satisfaction with the laundry service and range of activities. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 18 Resident/relative meetings are held at the home, and the relatives spoken with as part of this inspection were highly satisfied with the care and communication. The manager is not the appointee for any of the residents’ benefits and only small amounts of cash are held at the home on behalf of residents. The records are maintained by the administrator and these were inspected to make sure the residents’ interests are properly protected. There are well maintained records of income and expenditure and the records tally with the amounts held in individual packets. The records of residents’ finances are well maintained and clearly show their interests are protected. During the tour of the accommodation it was noted that the domestic had removed the toilet seat and attachments and was soaking these in bleach in a sink which was in a toilet located next to the lounge. The door was not secured and this could prove dangerous for residents who are not aware that the sink contains bleach. All products subject to the Control of Substances Hazardous to Health Regulations must be properly secured at all times to ensure the safety of residents. Some of the lifting equipment being used needed cleaning, the manager stated that these were already on a schedule but as they are used frequently it is recommended that they are assessed on a more regular basis and cleaned as needed. Please see the comments made under OP10 about moving and handling practice of residents. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 x 3 x 3 x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x x 3 x 3 x x 1 Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 20 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. 2. Standard 10 10, 38 Regulation 12 12, 13 Timescale for action Residents must not be weighed Immediate in communal areas. Their privacy 7/10/05 and dignity must be preserved. Residents must be fully alert Immediate before they are transferred and 14/9/05 safe moving and handling practice must be observed at all times. The incident identified must be investigated and the Commission for Social Care Inspection informed of the outcome. All products subject to CoSHH Immediate Regulations must be properly 7/9/05 secured at all times. Requirement 3. 38 13 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. Refer to Standard 15 38 Good Practice Recommendations Review the lunchtime arrangements to prevent residents sitting at the dining table for prolonged periods More frequent assessments of the cleanliness of equipment should be undertaken and action taken as necessary. Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Edgeley House RiversideBusiness Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abelard Care Centre C53 C03 S63344 Abelard V247356 070905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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