Inspection on 16/02/09 for Abi House

This inspection was carried out on 16th February 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abi House 28/01/08

Abi House 10/07/07

Similar services:

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Insight - Eastchurch

Southfields

Thorndene

Magenta

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Abi House 10 St Michaels Road West Worthing West Sussex BN11 4SD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Annie Taggart     Date: 1 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Abi House 10 St Michaels Road West Worthing West Sussex BN11 4SD 01903212018 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Independent Lifestyles Ltd Name of registered manager (if applicable) Mrs Michele Anne Waddington Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Abi House is a care home registered to provide personal care for six service users in the category of Learning Disability. The people currently living in the home all have Acquired Brain Injury. The home is situated in a residential area of Worthing close to the sea front and local shops and amenities. Accommodation is situated over two floors and has a large lounge with a dining area situated near to the kitchen. All bedrooms are single, three rooms have ensuite facilities there are also two additional bathrooms. To the front of the building there is a large courtyard area with a ramp for wheelchair access. The enclosed rear garden has no direct wheelchair access from the house other Care Homes for Adults (18-65 years) Page 4 of 28 care home 6 Over 65 0 6 Brief description of the care home than by a side entrance. The home does not have a passenger lift. The Registered Provider is Miss Donna Hawes and the Registered Manager is Mrs. Michelle Waddington Current fees are one thousand one hundred to one thousand eight hundred and fifty pounds per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: In order to prepare for this visit an AQAA (Annual Quality Assurance Assessment) was sent to the Registered Manager for completion. The document was returned within the given timescales and gave us good information about the services being provided in the home. Surveys were sent to service users, staff and other stakeholders in the home, three service user and three staff surveys were returned and comments from these have been used in the report. We also looked at the last inspection report and any information that we have received about the home since that time The unannounced visit was carried out at 9.30am on 16th February 2009 and lasted for Care Homes for Adults (18-65 years) Page 6 of 28 three and a half hours. During that time we met with the three service users currently living in the home and we spoke with the staff on duty. We tracked two care plans and all supporting documentation including risk assessments and daily records and we looked at the system for storing and administering medication. Records for the running of the business were seen and this included food records, staffing recruitment and training records, health and safety, accident and incidents reports and maintenance checks. The Registered Manager Mrs Waddington was present and received feedback following the visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective Service Users and their families are provided with good information about the services on offer in the home. People have their needs assessed and recorded and contracts are agreed and signed. Evidence: There is comprehensive information in place that gives prospective service users and their families clear information about the services on offer in the home. We looked at the pre admission process carried out for two service users and saw that detailed assessments had been completed and recorded and that service users, their families and other professionals were in involved in the process. Some service users told us that they had been able to visit the home and have short stays before moving in and in a surveys we were told, I was shown pictures of the house before moving in and the move was discussed with my Father. We saw that contracts of terms and conditions of residency are agreed. Two that we sampled had Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: been signed by the service users representative. There was evidence in records that the home keeps peoples assessed needs under review and an example of this was that the home had recently assisted a person to find new accommodation as move on when the home no longer met their needs. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In order to ensure that the staff team have the information they need to safely support service users, comprehensive care plans are in place, risks to peoples safety are assessed and recorded and regular reviews are carried out. Evidence: For each of the people living in the home there is a comprehensive and detailed care plan in place that has been devised with information taken from the needs assessment process. We tracked information for two of the three service users currently living in the home and saw that their care plans contained information about peoples personal care support, daily routines, personal preferences, nutritional and social needs. There was evidence in records and from talking to service users that people are involved in the care planning process and regular reviews and updates are recorded. We saw that the home works in a flexible way to meet service user needs, an example of this was that a service users full annual review had been carried out on a Sunday Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: so that their family could attend. Risk assessments both personal and environmental are recorded and kept under review and the home works with other mental healthcare professionals in order to address the specific needs of people with Acquired Brain Injury. In order to ensure that the staff team have the information they need on a day to day basis, there is a shortened copy of the care plan in each persons bedroom and peoples personal preferences and daily routines are also displayed in their rooms so that they can be easily referred to when service users are unsure of their daily timetable. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have opportunities for personal development and have access to their local community. Plans are in place to support people with their personal development and people are offered fresh, home cooked meals. Evidence: From talking to service users and looking at records we saw that people have access to a number of social activities and are supported to be part of their local community. Care plans detail goals that have been agreed for each persons personal development and daily routines correspond to peoples goals and they support and review progress and improvement. During the visit two people went out for coffee and shopping and another person told us that he worked for three days in the local community centre assisting with a lunch Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: club. The home is supporting another service user to look for employment or work experience and is helping them with making applications and accompanying on interviews. Daily records and activity plans showed us that people are involved in the running of the home, for example with helping with their laundry, cleaning their rooms and cooking and one person told us that she really enjoyed having her nails painted. The home retains the service of an occupational therapist and plans have been put in place to ensure that people with ABI are being supported to develop their skills and independence. Menus and food records show that people are offered a variety of fresh, home cooked meals and they are given a choice. One person has a fridge in their room where they keep drinks and treats and there was a large bowl of fruit on the dining room table. Service users told us they were happy with their lifestyle, one person said, I like it here, my life is better, I like my job, I have a key to the front door and people are very kind to me, Its good. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported with both their physical and mental healthcare needs, they have access to healthcare professionals and medication is being safely managed. Evidence: Each person living in the home has a Health Action Plan in place that clearly directs the staff team in monitoring and supporting service users with both their physical and mental healthcare support. Records show that people have their own doctor and have regular visits to dentist and opticians appointments. The home works with other healthcare professionals to support the specific needs of people with ABI and we saw evidence of input from an Occupational Therapist and advice gained from Headway (a brain injury advisory service) . Records show that people have their own doctor and have regular visits to dentist and opticians appointments. The home works with other healthcare professionals to support the specific needs of people with ABI and we saw evidence of input from an Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Occupational Therapist and advice gained from Headway (an ABI advisory service) . Where people display difficult behaviors, the home works with specialist teams and care managers to compile behaviour management plans and we saw epilepsy and diabetes management plans in place for two people. The home has policies and procedures in place for the safe management of peoples medication and records are in place to show that the staff receive appropriate training. We looked at the medication cupboard and saw that it was in good order and MAR (Medication Recording Sheets) were fully completed and up to date. A service user told us, I can see my doctor when I need to and they (the staff) make sure I get my tablets. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have their complaints and concerns recorded and acted upon and the staff team are aware of their responsibilities regarding protecting people from risk of abuse or harm. Evidence: The home has a complaints procedure, a copy of which is included in the Service User Guide and also displayed in the home. Service users told us that they would feel happy about making their concerns known to the staff team and one person told us, when I moved in here, there was a few little things I was not happy about, I told them ( the staff) about it and they have put everything right. From looking at the complaints book we saw that complaints are recorded and investigated by the Registered Manager, Mrs Waddington and the outcomes fed back to complainants. Training records showed us that the staff team attend training in protecting people from risk of abuse or harm and some people have also attended training on the Mental Capacity Act. The staff on duty were aware of their responsibilities and said that they would report any suspected abuse straight away. The home has made one Safeguarding referral to West Sussex County Council for Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: investigation but the outcome is not yet known. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is bright, homely, comfortable and well maintained. People have personalised their private bedrooms and have the equipment they need to support their independence Evidence: Abi House provides a comfortable, attractive and homely environment for the people who live there. There is a large, bright lounge with modern furniture and people said they enjoyed watching television, listening to music and playing with a new Wii that had recently been purchased. The large kitchen/dining room is accessible for people in wheelchairs and there is a ramp to the front of the building for easy access into the home. The home does not have a lift to the upper floors. Service users have the aids and adaptations they need to support their independence and this includes shower rooms and specialist equipment in bathrooms. Peoples private bedrooms have been personalised to suit their individual taste and people have their own belongings around them. Service users told us that they were happy with their private space and said they were happy living in the home. One bedroom that had been recently vacated was to be redecorated and another had been Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: completed. From looking at records we saw that regular fire and health and safety checks are undertaken, water temperatures are recorded and the home was clean and hygienic throughout. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are being supported by a caring, competent, well trained and well supported staff team. Evidence: From looking at staffing rotas and observation on the day of the visit we saw that there are sufficient numbers of staff on duty to meet the needs of the three people currently living in the home. For each shift there are two carers in place and at night there is either a sleeping in person or one person awake and one person asleep. The Registered Manager is also on site during the day and her hours are in addition to the rota. We saw that in order to ensure the safety of service users, that the home carries out robust recruitment processes. We looked at the staffing files for three people and all contained the required documentation including evidence of an interview, a current CRB (Criminal Bureau Check) and two references. Records showed us that new staff receive a structured induction and shadow more experienced staff until they feel confident. Training records showed us that the staff receive mandatory training and training specific to their role including Understanding Acquired Brain Injury , Best Practice in Care and Challenging Behaviour awareness. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: From talking to service users and observation on the day of the visit we saw that the staff team have a good rapport with the people they are working with and service users described the staff as, really lovely very kind and great. Records show that staff receive supervision and support and have an opportunity to discuss concerns and work practice at regular staff meetings. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed by a competent and caring manager in the best interests of the people who live there and people have the opportunity to give feedback on the service being provided. Some improvements are needed to records of Providers visits and Regulation 37 reporting. Evidence: The home is being run by a Registered Manager who has the skills and experienced to care for people with ABI. Both the staff on duty and service users were positive about the way the home was being managed and described Mrs Waddington as kind and accessible. In order to gain feedback from service users a weekly house meeting is held and quality assurance surveys have been sent to families and other stakeholders in the home. Mrs Waddington has collated the returns and told us that the outcomes will be used in the future development plan for the home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Regulation 26 Registered Providers visits are carried out and and reports were kept in the home, however these have not been recorded on a monthly basis as required. We saw that incident and accidents are recorded and action taken as a result of any identified risks. There were two incidents recorded that had not been sent to the Commission as required under Regulation 37 of the Care Standards Act 2000. There are policies and procedures in place for the safe handling of service users moneys, we checked the records for one person and they were correct. Maintenance records in the home showed us that heath and safety issues are addressed. Staff receive regular fire training, environmental risk assessments are in place and infection control equipment for staff such as gloves and antibacterial hand gels are available. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 41 26 Regulation 26, registered providers visit should be carried out and recorded on a monthly basis This is to ensure that the home is being monitored. 15/03/2009 2 41 37 Incidents and accidents that have an adverse effect on service users must be reported to the Commission This is to ensure that monitoring of the home by the Commission is being carried out. 15/03/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!