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Inspection on 01/11/05 for Aberdeen House Residential Home

Also see our care home review for Aberdeen House Residential Home for more information

This inspection was carried out on 1st November 2005.

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

What has improved since the last inspection?

The manager and assistant manager demonstrated the service is committed to achieving the National Minimum Standards and actively seek continuing improvement within the service. A strength within the service is the staff team`s commitment to adapt to the needs of residents as their needs alter. This is demonstrated through the work undertaken in meeting the needs of residents with dementia care needs. Since the last inspection the introduction of a new system of are planning has been successfully established for all residents. This new style of care planning demonstrates a commitment to a person centred care approach.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Aberdeen House Residential Home 20 Stockerston Road Uppingham Rutland LE15 9UD Lead Inspector Paula Dutton Unannounced Inspection 1st November 2005 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 Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aberdeen House Residential Home Address 20 Stockerston Road Uppingham Rutland LE15 9UD 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) 01572 823308 Mrs Linda-Jane Thornalley Mrs Joanne Chapman Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18), Physical disability over 65 years of age (1) of places Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 03/05/05 Brief Description of the Service: Aberdeen House is an 18-bedded residential care home for older people. The home, which is a converted farmhouse, is situated in Uppingham, close to the centre of this rural village. Residents rooms are located on two floors with a shaft lift and a stair lift providing access to upstairs facilities. Residents have access to a communal lounge / dining room, a conservatory and a quiet lounge. There is a well-maintained patio garden outside. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of five hours. The registered manager and assistant manager were available throughout the inspection process. The care services provided to four residents were selected for close examination. This involved viewing each resident’s care plan, daily notes and medication records. Three of the four residents expressed their opinions directly to the inspector. Four other residents talked to the inspector about living at the home. Four residents’ bedrooms were viewed. This process of gathering information is known as ‘case tracking’. This method measures outcomes for residents. What the service does well: What has improved since the last inspection? The manager and assistant manager demonstrated the service is committed to achieving the National Minimum Standards and actively seek continuing improvement within the service. A strength within the service is the staff team’s commitment to adapt to the needs of residents as their needs alter. This is demonstrated through the work undertaken in meeting the needs of residents with dementia care needs. Since the last inspection the introduction of a new system of are planning has been successfully established for all residents. This new style of care planning demonstrates a commitment to a person centred care approach. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 6 What they could do better: There were no statutory requirements nor recommendations identified as necessary at this unannounced inspection. Some issues were discussed with the manager who made a commitment to responding promptly to all points raised: • • • • • • • • • The hot water supply to the front of the premises was measured as 61 degrees centigrade. This did not supply a bath. Radiators throughout the premises were not guarded and therefore did not provide low temperature surfaces. The provision of safe non slip floor coverings. The provision of screening in shared rooms. The completion of risk assessments for specific high risk activities for each resident such as the risk of falls. How choice is offered and monitored for hot meals. Recording in care plans preferences for daily living routines including times to get up and times to go to bed. The introduction of life books. The publishing of quality assurance results to all stakeholders. Since the inspection the provider has notified the Commission that all of the above issues have been fully and appropriately addressed. 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. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 Information is exchanged effectively and equally between residents and the home prior to admission so that each party can make an informed decision about whether or not the home can meet identified care needs. EVIDENCE: The manager stated an assessment process takes place before admission. This involves visiting the prospective resident and completing an assessment. Additionally any assessments completed by an outside professional such as a social worker are also gained. A record file for a resident recently admitted to the home confirmed these actions had taken place. The manager and assistant manager had visited the resident in hospital and had effectively gained information from the resident, health professionals and social workers. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Residents’ health and welfare needs are met through planned care. EVIDENCE: Four residents’ individual record files were viewed. All four files contained care plans which highlighted their personal care needs and health care needs. There was clear instruction to staff on how the identified needs should be met. The home has successfully introducted a new style of care plan which aims to focus on the specific choices made by residents. Evidence showed attention had been given to morning and evening patterns of care. The manager stated preferred times for going to bed would be recorded within the care plan after consultation with residents. Four residents who retire to bed early stated they wanted this time for going to bed (6pm – 8pm). Clear statements highlighted those abilities residents needed to maintain to retain independence. This is good practice. The staff team is commended for the commitment demonstrated to person centred care. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 10 Care plans contained instruction for safely assisting residents to move including the use of specific equipment such as hoist, bed lever, walking frames and wheelchairs. A discussion took place with the manager about the completion of individual risk assessments for high risk activities specific to individual residents such as falls, warfarin in relation to falls and those residents at risk of leaving the building. A commitment was made by the manager to addressing this promptly. Evidence within care plans showed health needs required some activity from care staff such as catheter care and pressure area management. Daily notes showed staff closely monitored health care needs and the outcomes for residents were positive. Evidence indicated the staff team work closely with health care professionals including the District Nurse Team. Observation in residents’ bedrooms found equipment had been gained for health care needs including safe movement and pressure area care. Four residents’ medication record sheets were viewed. All were accurately maintained. A resident stated she had pain management needs and she never had to wait for her medication. Training in medication administration and the use of Monitored Dosage Systems (known as blister packs) had been completed by staff. Five residents made clear statements indicating staff are respectful when communicating. Two residents sharing a bedroom stated they required screening for the purpose of maintaining their privacy and dignity. This was not available at the time of inspection. The manager stated the screens had been put away at the request of the residents and could be made available again. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 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 the following standard(s): 15 Residents’ nutritional needs are met. EVIDENCE: Training provided by Dietectic Services to the staff team has assisted staff in meeting the nutritional needs of residents. Evidence showed nutritional needs are assessed and evaluated regularly. Records showed care plans, nutritional tools and daily notes measured needs, dietary in take and weight. Care plans showed preferences for morning routines. Observation on the day of inspection found a hot meal was available or a cold meal. A resident stated she was not offered a hot alternative. The menu was available which offered one hot meal. The cook was not available during the week of inspection. The manager stated the cook is aware of residents’ likes and dislikes. Two residents stated there was no choice offered at lunch time and they were unaware of the hot meal offered. A commitment was made by the manager to review how menu choices are offered and recorded. A resident did state a choice is offered for the tea time option. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 12 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 Residents can express their complaints and know they will be taken seriously. EVIDENCE: The manager and assistant manager are readily available to all residents and are included as part of the rota in providing direct care. The owner is available on the premises on a weekly basis. Two residents stated the staff team listen to their requests and stated they had no complaints to make. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 13 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, 21, 26 The residents benefit from a generally safe and suitable environment. EVIDENCE: A tour of some of the premises and four bedrooms found all areas were very clean and tidy. A cleaner was available on the day of inspection who stated the staff team like to maintain high standards of cleanliness. One resident was identified as at risk of falls within her care plan and social work assessment. Observation found her bedroom floor covering was an ordinary linoleum covering chosen by the previous occupant. A commitment was made by the manager to review the safety of this floor covering against non slip flooring or carpet. A downstairs bedroom sink had hot water measured as 61.3 degrees centigrade. The manager stated the boiler supplying this room also supplied bedrooms to the front of the property but not to any baths. A bath to the rear Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 14 of the property was measured at 39.9 degrees centigrade. A commitment was made by the manager to address this issue immediately and therefore reduce the risk of scalding. Three bedrooms were noted to have radiators without guards. The manager stated no radiators were guarded throughout the property. The inspector acknowledged that some radiators may have armchairs in front of them which may help to prevent falls against hot surfaces. A commitment was made by the manager to address this issue with the owners. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 15 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, 30 The staff number and skills offered ensure residents’ needs are met. EVIDENCE: The manager stated there are four carers on duty in the morning with one cook and one cleaner. There are three carers including the manager on duty in the afternoon shift. A new position has been created and filled to address times of peak activity in the evening shift. This position is ‘Evening Helper’ from 48pm. This role does not provide direct personal care but increases the time available to carers to focus on delivering personal care services to residents. This is good practice. There is one carer awake on duty during the night with access to an on call worker who could arrive at the premises within 15 minutes. A new member of staff confirmed appropriate checks were completed before starting work including a Criminal Record Bureau check. The training records were viewed for the staff team. The team are commended for their commitment to continuing learning. A range of training has been undertaken over the last six months including National Vocational Qualifications (two carers completing level three), Dementia care training, Person Centred Care for people with dementia, Understanding dementia, Speech and Language Therapy swallowing issues, Dietetic services nutritional training, District Nurse catheter care training, Medication Administration training, Monitored Dosage System training by Boots and planned first aid Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 16 training. As a result of the extensive dementia care training the Activities worker and the manager are working towards introducing Life Books as a tool for diversional therapies particularly for those residents identified as at risk of leaving the building. This is very good practice. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 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 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, 36, 37 The service is well organised and managed thus ensuring residents’ welfare and safety. EVIDENCE: The manager is a Registered General Nurse and has completed management training. Evidence showed the manager and assistant manager undertake regular training to refresh and develop existing skills. The senior team offers staff who have been working at the home in a range of capacities for over 15 years each. This is a strength within the service by offering clear and directional leadership informed by a thorough working knowledge of each job role and responsibility. The manager stated an annual quality assurance exercise is conducted where all stakeholders are consulted including residents and their Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 18 relatives/representatives. A discussion took place about the results being published and made available to stakeholders. The manager and assistant manager stated a planned formal and recorded supervision programme is available to care staff. Evidence showed supervision were noted and countersigned by the care staff member. All record were maintained in line with the Data Protection Act 1998 with entries being factual, signed and dated. Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 X Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 19 Requirement The registered person must comply with the requirements of Regulation 19 when employing staff to work at the home. Timescale for action 03/05/05 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 Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Aberdeen House Residential Home DS0000006456.V261523.R01.S.doc Version 5.0 Page 22 - 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!