Inspection on 28/01/08 for Abi House

This inspection was carried out on 28th January 2008.

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 16/02/09

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 08/07/2008.

CARE HOME ADULTS 18-65 Abi House 10 St Michaels Road West Worthing West Sussex BN11 4SD Lead Inspector Annie Taggart Key Unannounced Inspection 28th January 10:30 Abi House DS0000069442.V358107.R01.S.doc Version 5.2 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 Abi House DS0000069442.V358107.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 Adults 18-65. 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. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abi House Address 10 St Michaels Road West Worthing West Sussex BN11 4SD 01903 212018 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) Independent Lifestyles Ltd Michele Anne Waddington Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2007 Brief Description of the Service: 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 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 £1,128 to £1,591 per week. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. In order to prepare for the visit, surveys were sent to families, the people living in the home and other professionals involved with the home. Three service user, two professional and three family surveys were returned and all commented on improvements to the service being provided. An Annual Quality Assurance (AQAA) had been completed by the home for the last inspection visit and information from this and the last inspection report was also used to inform this visit. The unannounced visit was carried out at 10.30am on 28/1/08 and lasted for three and a half hours. During that time we spent time with the people living in the home, both in their bedrooms and in communal areas and we spoke to the staff on duty and observed staff practice. Three care plans and all supporting documentation such as daily records were looked at and we also looked at four staff records and the system for the recording and administration of medication. During the visit we looked at menus and food records and we asked people what choice they had in the meals that are provided. Records for the running of the business including the quality assurance process, health and safety and incident and accident recording were seen. The Registered Manager was present and received feedback following the visit. What the service does well: Abi House offers a comfortable, homely and attractive environment for the people who live there and there have recently been improvements made in order to address risks and to support people to be as independent as possible. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 6 The people living in the home tell us that they are happy there; that they are offered a range of activities and outings and also have a choice of fresh home cooked meals. The people living in the home, families and other professionals tell us that the manager and staff are kind and caring and that people’s lifestyles choices and independence are respected and supported. What has improved since the last inspection? What they could do better: The home should continue to build on the improvements that have been made and also to continue to monitor that people’s individual needs can be met. To ensure that all risks to service users are minimised, either the staff sleep in room should be locked at all times or a restrictor fitted to the window. A list of approved medication handlers must be added to the medication recording files. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 and 5 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. There is good information available about the home and a comprehensive preadmission process is carried out to ensure that individual support needs can be met. EVIDENCE: There is good information available about the services provided in the home and each person living there had a copy of the Service User Guide in their individual file. We saw records for the pre-admission process carried out for one person who was recently admitted to the home and this showed that a comprehensive assessment had been carried out with involvement with the service user, their family and other professionals involved with their support. The person told us that they had visited the home prior to moving in and said that they were happy with the way the move to the home had been carried out. We also saw evidence that the home supports people to move on, either when they are ready to move into more independent living or if the home can no longer meet their assessed needs. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 10 Contracts of terms and conditions of residency were in place and had been signed by individual service users. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 8 and 9 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home can be confidant that their needs and wishes will be recorded in a plan of care and that they will be protected by good risk assessments being completed. EVIDENCE: For each person living in the home there is a very detailed plan of care in place that had been completed using information from the pre-admission process and with input from service users. The plans are very “person centred” and contain good information to guide the staff team to the support needs of each person. Plans contain personal care preferences, daily living routines, the amount of assistance needed with all daily tasks and routines and daily records are also in place for each person. For some people copies of routines from the support plans are also located in their bedrooms to ensure continuity of care from the staff team. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 12 Each care plan contains assessments covering all identified risks to people both in the home and in the community and all have been agreed with the people they are designed to protect. Monthly reviews are carried out and recorded and there are also records of formal reviews being carried out with care managers and other professionals. The staff team are all completing a distance course in “the principles of care” which includes exercises on good practice and the people living in the home said that the staff team were friendly, treated them with kindness and that their privacy was respected. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 16 and 17 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home have opportunities for personal development and access to their local community. People are supported to be as independent as possible and are provided with a variety of fresh, home cooked meals. EVIDENCE: Part of the care planning process now includes identifying and agreeing personal development goals with service users and these are recorded in individual activity plans, which are reviewed monthly. Records show that people are being supported to gain independence skills, to access the community and for some people to work towards moving on and living in their own home. For one person in particular the detailed routines recorded in the support plan, which have been designed with input from other professionals, has had a very Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 14 positive impact on the person’s quality of life and their communication skills and community involvement has been dramatically improved. For another person there is evidence of them budgeting, buying their own food, and carrying out household tasks and their own laundry. Their individual plans shows that this is in order to enable them to gain skills to help them to move to more independent living. People told us that they go to the shops, to church, cafes and local pubs and one person said they recently really enjoyed a pantomime. Two people also said that it was very important to them to have their computers in their rooms. Another person who has sight difficulties has music and books supplied through the audio library service. During the visit two people were going out with staff to the shops and for coffee and another was visiting their family. The people living in the home said that they were happy there and one person said, “These are nice people, this is a nice place and I am happy here. I know that my life needs support but here I get to do what I want to do and for me that is as good as it gets”. Menus show that a variety of fresh, home cooked meals are provided and the menus and shopping list are completed with service users. In the kitchen, the cupboards, fridge and freezer were labelled with pictorial prompts in order to support people to be more independent. We saw people making themselves drinks and one person also buys and cooks their own food. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home receive good personal health and mental healthcare support, have access to a variety of healthcare professionals and their medication is well managed. EVIDENCE: From feedback in surveys, looking at records and talking to the people living in the home, it is clear that people now have access to a wide variety of healthcare and mental healthcare professionals. Each person has their own local doctor and records show input from psychiatrists, speech and language therapist, occupational therapist, district nurses and other healthcare professionals. Records show that people are supported to attend regular healthcare checks and for one person, who has sight difficulties, advice and support has been gained from the Sensory Advice Service. A Requirement made at the last visit for staff skills improvement has been met in that all staff have now received training in caring for people with Acquired Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 16 Brain Injury (ABI) and also have training in the management of challenging behaviour. In a survey a GP for service users commented, “ The staff are professional and aware of the individual needs of patients and appropriate referrals are made to the surgery”. From looking at records, talking to service users and the staff on duty, we found that the staff team still deal on occasions with a high level of challenges in the home. The staff members said that now that they had attended training they were much more confident about dealing with this and one person said, “we just stay calm and follow the agreed guidelines and we are supported well by the manager”. The storage of medication has been improved and was well organised, with good guidelines in place about possible side effects and the reasons the medications have been prescribed. Risk assessments and plans to support people to eventually manage their own medication were in place and records were current and in good order. Records show that staff receive training in the administration of medication but there was no list of agreed medication handlers in the file. The manager said that she would immediately rectify this. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. Complaints are recorded and acted upon in a timely manner and the home’s policies, procedures and working practices are designed to protect people from the risk of personal and financial abuse. EVIDENCE: The home has a complaints procedure a copy of which is included in the Service User Guide. Two people living in the home said that they would feel confident about making a complaint and both said that the manager would take any complaint seriously and act on it as soon as possible. The complaints book showed that complaints are recorded and outcomes fed back to the complainant in the home’s published timescales. Records show that there have been some complaints to the home from neighbours about noise levels but the manager has dealt these with sensitively and has acted to reduce the risk of this happening again. Records show that the staff team receive training in the protection of vulnerable adults from abuse and the staff on duty were aware of their responsibilities and said that they would report any suspected abuse straight away. We checked the system for the management of service user’s monies and found that in order to protect people, all transactions are recorded, receipts are kept on file and the Registered Provider carries out spot checks regularly. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 18 Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 29 and 30 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home offers a homely, comfortable, clean environment and people say that they are happy with the services being provided. EVIDENCE: Abi House provides an attractive, comfortable, homely environment for the people who live there and since the last visit a number of improvements have been made to meet service user’s individual needs. A large lounge area offers comfortable surroundings and has easy wheelchair access and there is a large dining room/kitchen with two separate dining tables. There are large ramps to the front of the building in order to gain wheelchair access to the home. The rear garden can only be accessed from the front of the house and around the side for wheelchair users as there is a steep step at the back but the person currently using a wheelchair said that they were Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 20 happy with this. The manager said that the home had a portable ramp for use in the rear garden in better weather. Handrails have now been fitted with advice from an occupational therapist for a person with sensory difficulties and an automatic closure has been fitted to the door of the bedroom of a person using an electric wheelchair to allow easier access and support their independence. Advice has been gained for this person for fitting a variety of aids and adaptations to their bedroom and bathroom and the person told us that regular maintenance checks and repairs are carried out to ensure their safety. People’s private bedrooms are attractively decorated comfortable and well furnished and have been personalised with people’s belongings and equipment such as televisions, music centre’s and computers and one person has a keyboard that they told us they enjoy playing. Water temperatures in ensuite bathrooms were at a safe level and regularly tested and recorded and the home was very clean and hygienic throughout. Since the last visit, window restrictors have been fitted to service user’s bedrooms but in the staff sleep in room on the first floor this had not been done. As the door was not locked and the room could possibly be accessed by service users we spoke to the manager about this. The manager said that she would require the staff team to ensure that the door was kept locked until a restrictor had been fitted to this window. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 and 36 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a committed, caring and well trained staff team and are protected by there being a robust recruitment process in place. EVIDENCE: Staffing rotas show that there are sufficient staff on duty to meet the needs of the four people currently living in the home. There are two staff members on each shift with a third person sometimes on duty to help with outings and there is one person asleep and one awake at night. The manager’s hours are in addition to the rota. In surveys, both the people living in the home and families, made very positive comments about the staff team and these included, “ they have a friendly, home-like environment to put residents and visitors at ease and they go out of their way to make visitors welcome”. Since the last visit the staff team have attended a number of training courses to assist with supporting the specific needs of the people they support. This includes all mandatory training, knowledge of Acquired Brain Injury (ABI), Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 22 challenging behaviour management, principles of care, medication management and understanding learning disability. Six people also hold or are working towards the NVQ two or three awards and there are three people currently working on the Learning Disability Awards Framework (LDAF) induction standards. An occupational therapist that visits the home said in a survey, “ ABI rehabilitation is a relatively new area for services especially in a residential home setting. I have found that Abi House has actively sought information about things they didn’t know and have implemented programmes for service users effectively”. In order to ensure that service users are protected there is a robust recruitment process in place. We saw four staff files, including those of people most recently employed. All had the required documentation including a current Criminal Bureau Check (CRB) and two references. Records show that all staff members receive regular supervision with the manager of the home and those people on duty said that they felt well supported. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 39 and 42 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent and committed manager, records are in good order and the people living in the home are protected by the home’s health and safety practices. EVIDENCE: The Registered Manager has the relevant experience and qualifications to manage the home and both service users and the staff on duty said that Mrs. Waddington was friendly, supportive and approachable. There is a great deal of evidence to show that Mrs. Waddington has worked hard to make improvements to the home since the last visit and in a survey a healthcare professional said “ since it’s opening I have seen Abi House develop Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 24 and I am impressed with the service and care that they offer to this client group”. There is a quality assurance process in place, but as the home has not yet been open for a year this has not yet been completed. The manager showed us the process that would be followed, which is a surveybased format and she told us that she is planning to carry this out within the next three months. We saw records for the running of the business including incident and accident reporting and this confirmed that Regulation 37 reports are sent to the Commission as required. Health and safety issues for the people living in the home are well managed, there are environmental and fire risk assessments in place, regular health and safety checks are carried out and recorded and the Registered Provider carries out spot checks during monthly monitoring visits to the home. Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 3 30 3 3STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 3 3 PERSONAL AND HEALTH3CARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 Abi House DS0000069442.V358107.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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