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Inspection on 19/09/06 for Abercorn House Nursing Care Home

Also see our care home review for Abercorn House Nursing Care Home for more information

This inspection was carried out on 19th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home was clean, homely and welcoming. Residents said that they were treated with respect and that staff were kind and caring. Comments included `the carers are very kind` and `the staff respect my wishes`. A visiting relative said that they were `always made to feel very welcome` and could visit at any time. The registered manager or the deputy manager visit each prospective resident to complete a care needs assessment before offering a place at the home to ensure the home can meet their needs. Prospective residents and their relatives are able to visit the home and meet with residents and staff before making a decision about living there. Residents or, if appropriate their relatives/representatives, are involved in the reviewing of their care plans which provide good information for staff to follow to support the residents and meet their care needs. The resident`s health is protected by the home`s clear procedures for dealing with medicines. The home employs three diversional therapists who are responsible for the programme of activities provided for residents. The diversional therapists know the social and life history of the residents and are able to chat with residents about subjects they are of interest to them. Residents are able to participate in social activities such as concerts, chats and films. Therapists also provide one to one support for residents including nail care and letter writing. Staff respect the wishes of residents with regard to participating in activities. One resident said that they enjoyed joining residents for coffee and chats but sometimes liked to spend time alone in their room and staff allowed them to `make their own decisions`. The menus seen indicated that residents were given a choice of nutritious meals. The home employs a staff member who visits each resident to discuss the choice of meals on offer for each day. Meals served on the days of the visits were well presented and residents said that they enjoyed the food provided. Residents said that they did not have any complaints or concerns about the quality of care provided at the home. They said that if they did have any concerns they would speak with the registered manager who they felt would take any action required. Staff are aware of the procedures to follow should abuse be suspected and have received training in the protection of vulnerable adults. Residents liked their rooms and some had personalised them with small items of furniture, pictures and photographs. The registered manager and deputy manager had discussed increasing staffing levels with the director of the organisation as they felt residents would benefit from additional staff being on duty in the mornings which was the busiest time of the day. This had been agreed and additional staff were being recruited. The organisation is also recruiting a training manager for the home to ensure staff continue to receive the training they require to do their jobs. The registered manager has the qualifications and experience required to run the home in the best interests of the residents. Mrs Olivia Ten Kate has recently recruited a new deputy manager and they are discussing their workloads to ensure they have clear roles and responsibilities.

What has improved since the last inspection?

At the time of the last inspection some medication records were not up to date. Records seen during these visits were up to date. The deputy manager is also implementing new systems for nurses to review and audit medication records. During the last inspection staff were seen to assist two residents with their meals at the same time. Residents who needed assistance with meals on these visits were assisted on a one to one basis in a caring and friendly manner, upholding the dignity of the residents.

What the care home could do better:

Although the home has good fire safety procedures in place the fire drill records seen were not up to date and it was not possible to confirm that all staff members had attended fire drills. The registered manager said that she would ensure all staff had received fire drills and a requirement has been made for the records of staff attendance to be kept up to date. Small amounts of money are held in the home for a few residents. Records are kept for all transactions and the money is stored in individual containers. However the records are kept in one book and it is difficult to follow a trail of money received and the amount of money that should remain. A system of recording where records are kept individually for each resident would allow a clearer audit of the amount received, transactions and remaining sum held.

CARE HOMES FOR OLDER PEOPLE Abercorn House Nursing Care Home Fernhill Road Blackwater Camberley Surrey GU17 9HS Lead Inspector Marilyn Lewis Unannounced Inspection 19th September 2006 09:30 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 Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abercorn House Nursing Care Home Address Fernhill Road Blackwater Camberley Surrey GU17 9HS 01276 32773 01276 34136 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) The Royal United Kingdom Benificent Association Mrs Olivia Ten Kate Care Home 96 Category(ies) of Dementia - over 65 years of age (96), Old age, registration, with number not falling within any other category (96), of places Physical disability (10), Physical disability over 65 years of age (10), Terminally ill over 65 years of age (96) Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users in the PD category must be at least 50 years of age Date of last inspection 16th January 2006 Brief Description of the Service: Abercorn house is a registered care home that provides nursing and personal care for 96 service users in the categories Older Persons, Physical Disabilities and Dementia. A condition of registration allows for up to ten service users over the age of fifty years with physical disabilities to be accommodated at any one time. The service is located in a residential area of Blackwater, close to some local amenities. The Royal United Kingdom Benevolent Society owns the home and also a sister home across the road. Residents are all accommodated in single rooms. Accommodation is provided over three floors, with passenger lifts to allow access to all parts of the home. There are a number of communal lounges on each floor, with the large lounge on the ground floor fitted with a loop system to assist residents using hearing aids to participate in social activities such as concerts. The home has extensive well-maintained gardens that are accessible to service users including wheelchair users. The registered manager stated in the pre inspection questionnaire that fees were from £728 to £805 per week. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days, the 19th and 21st of September 2006. During the first visit the inspector toured the home and met with nine residents, two visitors, two nurses, two carers, two diversional therapists, the catering manager, a GP and the registered manager. Care plans were sampled for six residents and records were seen for medication, complaints, accidents, fire safety and fire drills. On the second visit the inspector met with more residents, staff and the deputy manager. Three more care plans were sampled and records were seen for staff recruitment and training. What the service does well: The home was clean, homely and welcoming. Residents said that they were treated with respect and that staff were kind and caring. Comments included ‘the carers are very kind’ and ‘the staff respect my wishes’. A visiting relative said that they were ‘always made to feel very welcome’ and could visit at any time. The registered manager or the deputy manager visit each prospective resident to complete a care needs assessment before offering a place at the home to ensure the home can meet their needs. Prospective residents and their relatives are able to visit the home and meet with residents and staff before making a decision about living there. Residents or, if appropriate their relatives/representatives, are involved in the reviewing of their care plans which provide good information for staff to follow to support the residents and meet their care needs. The resident’s health is protected by the home’s clear procedures for dealing with medicines. The home employs three diversional therapists who are responsible for the programme of activities provided for residents. The diversional therapists know the social and life history of the residents and are able to chat with residents about subjects they are of interest to them. Residents are able to participate in social activities such as concerts, chats and films. Therapists also provide one to one support for residents including nail care and letter writing. Staff respect the wishes of residents with regard to participating in activities. One resident said that they enjoyed joining residents for coffee and chats but Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 6 sometimes liked to spend time alone in their room and staff allowed them to ‘make their own decisions’. The menus seen indicated that residents were given a choice of nutritious meals. The home employs a staff member who visits each resident to discuss the choice of meals on offer for each day. Meals served on the days of the visits were well presented and residents said that they enjoyed the food provided. Residents said that they did not have any complaints or concerns about the quality of care provided at the home. They said that if they did have any concerns they would speak with the registered manager who they felt would take any action required. Staff are aware of the procedures to follow should abuse be suspected and have received training in the protection of vulnerable adults. Residents liked their rooms and some had personalised them with small items of furniture, pictures and photographs. The registered manager and deputy manager had discussed increasing staffing levels with the director of the organisation as they felt residents would benefit from additional staff being on duty in the mornings which was the busiest time of the day. This had been agreed and additional staff were being recruited. The organisation is also recruiting a training manager for the home to ensure staff continue to receive the training they require to do their jobs. The registered manager has the qualifications and experience required to run the home in the best interests of the residents. Mrs Olivia Ten Kate has recently recruited a new deputy manager and they are discussing their workloads to ensure they have clear roles and responsibilities. What has improved since the last inspection? At the time of the last inspection some medication records were not up to date. Records seen during these visits were up to date. The deputy manager is also implementing new systems for nurses to review and audit medication records. During the last inspection staff were seen to assist two residents with their meals at the same time. Residents who needed assistance with meals on these visits were assisted on a one to one basis in a caring and friendly manner, upholding the dignity of the residents. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 7 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. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 8 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 Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 5 and 6 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. No one is admitted to the home without a full care needs assessment to ensure the home can meet his or her care needs. Prospective residents and their relatives are able to visit the home before making a decision about taking a place there and on admission residents are provided with a written contract giving them the terms and conditions for living at the home. The home does not provide intermediate care. EVIDENCE: The registered manager is currently reviewing the Statement of Purpose and Service User Guide. The registered manager said that either she or the deputy manager visit each prospective resident and complete a full care needs assessment before offering Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 10 a place at the home to ensure the home can meet their care needs. Records seen indicated that the assessments had been undertaken before admission. The assessments covered all aspects of care provision including personal, social and emotional needs. Reports from hospital staff and care managers are used when completing the assessments and relatives are asked to provide information on the family history and social interests of the person. The registered manager said that many of the residents admitted are very frail and unable to visit the home prior to admission but relatives are encouraged to visit and meet with staff and residents. The registered manager said that she spends time with the relatives informing them of life at the home to help them make a decision for their relative. All residents receive a written contract on admission that gives the terms and conditions for living at the home. The contract states what services are provided that are included in the fees and services available at an additional cost such as hairdressing, dry cleaning and telephone in their own room. The home provides respite care but does not admit residents for intermediate care. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 11 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, 9 and 10 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Staff follow clear care plans that provide good information on the needs of the residents and the actions required to meet those needs. Resident’s feel they are treated with respect, their health care needs are met and they are protected by the home’s procedures for dealing with medicines. EVIDENCE: Care plans seen for nine residents gave clear information on the care needs of the resident and the actions required by staff to meet those needs. Plans seen included those for mobility, nutrition, personal care, continence and mental well-being. The plans contained information on the resident’s preferences for the manner in which the care was provided. One plan seen stated that the resident liked to go to sleep with the television on and another recorded the resident’s wishes for the radio to be left on one channel all day. Staff spoken with during the visit were aware of the residents likes and dislikes and had respected their wishes. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 12 Risk assessments were contained in the care plans for all aspects of daily living including moving and handling and falls. Risk assessments had been completed for the use of bed rails for some residents and the staff member completing the assessment recorded the reasons for their use and this was countersigned by the registered manager or deputy manager and the resident or a relative. All care plans and risk assessments seen showed evidence of monthly review and the involvement of the resident or their relatives. Records seen indicated that the home obtained advice and support from GPs and other health professionals including a Diabetic nurse specialist, Parkinson Disease nurse specialist and the Community Eye Care team, to ensure the resident’s health care needs were met. GPs visit the home each day Monday to Friday and on request. The GPs each care for a number of residents so that they have continuity of care but will see any resident who requires assistance when visiting the home. A GP visiting at the time of the inspection visit said that the care provided at the home was very good and that staff always followed his instructions when providing treatment. The home has clear procedures in place for dealing with medicines. The registered nurses on each unit are responsible for the medication for the residents in their area. Medication entering the home is checked by two nurses and recorded and this is also the case for the disposal of unused medicines. Medication records seen had been completed appropriately and records seen for medicines stored in the controlled medicine cupboard matched the stock held. Information and instructions were provided for each resident’s abilities to take their medication, such as swallowing issues. Up to date information was available on the medicines used in the home and staff received training in the administration of medicines. The deputy manager is implementing an audit and review of medication records to assist staff dealing with medicines. Three staff members are due to go on a training course in reviewing medication in October 2006. During the inspection visit staff were seen to speak with residents in a friendly, caring manner and knocked on doors and waited before entering rooms. All residents and visitors spoken with said that staff always treated them respect. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents are able to exercise control over their lives, participate in a programme of activities, receive visitors as they wish and enjoy a choice of nutritious meals. EVIDENCE: The resident’s cultural needs were recorded in their care plans. The records seen for one resident from a different ethnic group gave clear information on the specific needs of the resident and staff spoken with were aware of the actions required by them to meet those needs. Priests and ministers from local churches visit the home regularly and conduct communion services for those who wish to attend. The day before the inspection visit a Harvest Festival service was held at the home. Residents who had attended said that they had really enjoyed the service. The home employs three Diversional therapists who provide a programme of activities for the residents. The therapists are aware of the residents past social history and said that they try to take this information into account when Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 14 developing the programme. Activities offered included coffee and chat, Quizzes, films, and bingo. Some of the sessions are for large groups, some for small groups and on a one to one basis. A men only group has recently started and has proved very popular with the gentlemen residents. Residents are supported to plant bulbs in containers for the garden and in cookery sessions where jam and bread making had recently been undertaken. One of the therapists said that although most of the residents interested in cookery were not able to take an active part in the cookery sessions they enjoyed watching the process. On the first day of the inspection visit it was evident, when spending time with the therapists, who were chatting to a small group of residents that they knew about the resident’s life history and were chatting about subjects of interest to them. Residents appeared to be very relaxed and were participating in the chats. One resident said that she ‘loved’ spending time in the activity groups. Residents had been involved in a Teddy Bears picnic and had decorated cut out teddy bear shapes that had been displayed in the main reception area. The large lounge on the ground floor was used as a cinema in the afternoon of the second day of the inspection visit, when a film was shown to a large number of the residents. Two residents spoken with in the morning said that they enjoyed the film shows and were looking forward to seeing the film that afternoon. The home has its own minibus that is used to take residents out to local shops and places of interest. The therapists said that due to the frailty of the residents trips out were not as frequent now. The home has no restrictions on visitors and residents said that they are able to receive visitors as they wish. One relative visiting at the time of the inspection said that he was always made to feel welcome and was able to stay as long as his relative wished. It was evident during the inspection visit that residents were able to exercise choice over their daily lives. Staff were observed asking residents where they wished to sit and what they would like to drink. One resident said that he enjoyed going to chat groups but sometimes liked to spend time alone in his room and staff respected his wishes. Residents are also offered choice when meals are provided. The catering manager had conducted a survey of resident’s likes and dislikes for food items and from the information obtained had produced menus that contained their favourite meals. Each meal time offered a choice of the main meal which on the first day of the inspection visit was savoury mince with layered potato, or gammon ham salad followed by fruits of the forest mousse and whipped cream, yoghurt or ice cream. Further alternatives were also on offer including poached fish, omelette, cheese and vegetable bake and sausages. The home is able to provide special diets such as diabetic diet and meals that are pureed. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 15 All residents spoken with said that the food provided at the home was good. A comment book is available for resident’s comments and looking at this record indicated that residents were very satisfied with the meals provided and that if a negative comment was made about a food item action was taken to rectify the issue. At the time of the last inspection it was noted that staff were assisting two residents with their meals at the same time. On these visits staff were seen to assist residents on a one to one basis, in a caring and friendly manner. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Residents feel that any complaints will be taken seriously and acted upon and they are protected by staff awareness for the protection of vulnerable adults. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint. Complaints records seen indicated that all complaints are taken seriously and acted upon. Residents spoken with said that they would speak with the registered manager or one of the staff members if they had any worries or concerns. All said that they had no need to make a complaint. A relative spoken with knew how to make a complaint but said that there had never been cause to make one. The relative said that if there were any concerns they would talk with the registered manager whom they felt would deal with the issue quickly. The home has procedures in place to protect residents from abuse, including whistle blowing. Staff members spoken with knew about the procedures to follow should abuse be suspected and records seen indicated that staff received training in the protection of vulnerable adults. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Abercorn provides a clean, safe and welcoming environment for all who live and visit there. EVIDENCE: The home looked clean and welcoming. Visitors to the home are admitted by a staff member and asked to sign the record book on entering and leaving the property to ensure staff know who is in the home at any one time. The organisation employs a maintenance team for the ongoing redecoration and refurbishment of the home. To provide residents with continuity of care the accommodation is divided into four units, provided on three floors with lifts and stairs providing access to each floor. All residents have single rooms with 30 rooms located in two of the Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 18 units, and 26 and 10 in the other units. Residents however meet together in some of the communal lounges for activities such as concerts. The home has a number of lounges, sitting areas and dining areas in each unit. The communal rooms looked light and cheerful. One large lounge on the ground floor has a loop system to assist residents who use hearing aids and this room is used for the main group activities such as concerts and films. Another room used for activities has doors that open into the gardens. Resident’s rooms looked clean and some contained many personal items such as small pieces of furniture, pictures and photographs. Residents spoken with said that they liked their room with one commenting ‘I have everything I wish’. The registered manager said that new residents or their relatives who visited the home before making a decision about taking a place were able to choose the room they preferred, if more than one room was vacant at the time. Specialist equipment was provided for residents assessed as requiring it including pressure-relieving mattresses, hoists and assisted baths. During the inspection visit the registered manager was in the process of obtaining a wheelchair suitable for one resident who found it difficult to leave their room using the chairs available in the home. A call alarm system is in place throughout the home and call bells or pendants were seen to be available and accessible to residents during the visit. One resident said that staff came quickly when she activated her call bell. Sufficient bathrooms and toilet facilities are provided and at the time of the inspection visits all seen looked clean and in good order. The home has pleasant gardens to the rear of the property that has seating areas that are accessible to residents, including those using wheelchairs. An area for car parking is available across the road from the home. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 and 30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The registered manager is taking action to increase staffing levels at busy times of the day to ensure the resident’s needs continue to be met. Staff receive the training to do their jobs and the home’s recruitment procedures protect the safety of the residents. EVIDENCE: The home is divided into four units. Twenty- six residents are accommodated on the ground floor unit, with thirty on each of the first and second floor units and ten in the small wing. Staff usually work on the same unit so that there is continuity of care. The senior nurse on each unit is responsible for the staff rota for the unit, which has at least one trained nurse on per shift. Staff spoken with said that staffing levels are sufficient to support the residents but they are very busy during the mornings. During a recent meeting between the registered manager, the deputy manager and the director of the organisation it was decided to recruit additional staff for the morning shifts, raising the number of staff on each main unit from seven to nine. One of the home’s National Vocational Qualifications (NVQ) assessors has just completed a training course to become a verifier. The home also has three other staff members who are assessors. Twenty of the home’s 51 senior carers Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 20 and carers hold NVQ level 2 and four of those staff members are now studying to complete level 3. The home also employs twelve nurses from overseas who are working as carers and considered to be at NVQ level 3. Recruitment records were seen for six staff members, some of whom had recently been employed at the home. The records indicated that Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had been completed prior to the staff member commencing work at the home to ensure the safety of residents was protected. The records also contained proof of identity and two written references, apart from one file that did not contain references. The deputy manager checked with the home’s administrator who said that verbal references had been obtained while waiting for the written references to arrive. The person taking the verbal references must ensure that they write down the information and keep it on file. Training records seen were not completely up to date but indicated that staff received training in moving and handling and a training session was in progress on the afternoon of the second visit for those staff who required it. Training sessions recorded included those for health and safety, care planning, wound and pressure management, communication and hearing loss, visual impairment and foot hygiene and basic nail care. Trained staff had also attended training sessions in Dementia care and palliative care. Training had been booked for two staff members to attend a training course in Nutritional Care for People with Dementia. The registered manager and the deputy manager said that they were aware that staff training was a very important aspect and were looking to recruit a manager responsible for training in the home. An audit of staff training was one of the issues to be addressed by the new trainer when recruited. Staff spoken with said that they had opportunities to attend training sessions but some trained nurses said that they sometimes were unable to attend due to the need to cover the units. The deputy manager said that the recruitment of additional staff should address this issue. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The registered manager runs the home in the best interests of the residents, who are protected by the supervision of staff and the safe working procedures operated at the home. The lack of clear recording for staff attendance at fire drills could result in a staff member not attending drills and therefore putting the safety of residents at risk. EVIDENCE: The registered manager Mrs Olivia Ten Kate is a registered nurse who holds the Registered Managers Award, Educational and Care of the Elderly qualifications. Mrs Ten Kate has been employed at Abercorn House for fourteen years, first as the deputy manager and as manager since 1998. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 22 The deputy manager has been in post for two months and they are currently discussing their roles and responsibilities. Residents said that they found Mrs Ten Kate caring and staff members said that they received good support from the registered manager. It was evident during the inspection visit that she has a good rapport with residents, visitors and staff. The registered manager said that she operated an open door approach to management and was available to talk with residents, staff and visitors at any time. The registered manager said that meetings were held for residents to obtain their views on the quality of care provided at the home plus feedback was also obtained from one to one meetings. Meetings are also held for relatives. Qualified staff meet every week and the minutes taken are made available for all staff members. A separate meeting is held for night staff. Qualified staff then met with carers to pass on and discuss the information from their meetings. The deputy manager said that she was also arranging regular meetings with care staff. The registered manager said that she also meets with the domestic staff and a health and safety meeting is held once a month. The registered manager said that relatives of residents usually handled their financial affairs. Small amounts of money were held in the home for a few residents. Records were kept of all transactions but the recordings were kept in one book and not individually for each resident. A different system of recording where separate sheets were used for each resident would enable a clearer audit of the amount of money taken in for each resident, documentation of money spent and the balance held. The monies were stored individually and kept in a locked cupboard. However a safe was available in the same room and it would be a more secure practice to keep the monies there. Qualified staff spoken with said that they received supervision from the registered manager and that they in turn supervised the care staff. Training records seen indicated that staff received training in providing supervision. The home had policies and procedures on all aspects of care provision including health and safety. The deputy manager said that the home had recently introduced a ‘policy of the week’, where one of the policies was displayed around the home and staff were asked to read it. Some policies and procedures had not been signed and dated when reviewed to indicate that they had been reviewed annually, to ensure staff had up to date information for reference. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 23 The registered manager has received training in providing staff with fire safety training. Risk assessments were in place for all residents and the property. The home has very good procedures in place for fire drills but records were not available to confirm all staff members had attended fire drills in the last year. The registered manager said that she would arrange for a system to be in place that recorded all staff attending drills and would check that all staff had attended drills as required. Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 2 3 3 2 Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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 OP38 Regulation 23 (4) (e) Schedule 4 – 14 Requirement The registered person must ensure that records are kept up to date for staff attendance at fire drills. Timescale for action 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Abercorn House Nursing Care Home DS0000036926.V307651.R01.S.doc Version 5.2 Page 27 - 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. 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