Inspection on 14/11/05 for Abigail Lodge Care Home

This inspection was carried out on 14th November 2005.

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.

Other inspections for this house

Abigail Lodge Care Home 09/12/08

Abigail Lodge Care Home 10/12/07

Abigail Lodge Care Home 13/12/06

Abigail Lodge Care Home 20/06/05

Abigail Lodge Care Home 09/02/05

Abigail Lodge Care Home 21/07/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abigail Lodge Care Home Gloucester Road Delves Lane Consett Durham DH8 7LB Lead Inspector Mr Stephen Ellis Unannounced Inspection 14th November 2005 1:00 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 Abigail Lodge Care Home DS0000000686.V252114.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. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abigail Lodge Care Home Address Gloucester Road Delves Lane Consett Durham DH8 7LB 01207 502405 01207 502439 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) Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons) Judith Mallaburn Care Home 60 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (30), Terminally ill (3) Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Terminal illness up to 3 persons with a terminal illness (palliative care) may be accommodated commensurate with the homes statement of purpose and function and where appropriately qualified and competent staff are provided. Persons in the category of DE and DE(E) may be accommodated commensurate with the homes statement and purpose of function. 20th June 2005 2. Date of last inspection Brief Description of the Service: Abigail Lodge is a care home with nursing. It has two units, each with 30 beds. One is registered to provide care (including 24 hour nursing care) for people aged 65 or older, together with convalescence and palliative care for people aged 55 or older. The other accommodates people with dementia care needs (including 24 hour nursing care). The home is located on the edge of Consett, close to a supermarket and a public house. It was opened in 1995 and is a purpose-built, two storey building. All bedrooms are single with en suite facilities. There is a passenger lift in each unit. The home has large gardens that are well maintained and easily accessible. Abigail Lodge Care Home DS0000000686.V252114.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 4.3 hours. The inspector looked around the building, examined a number of records required to be kept, and spoke with 9 service users, 2 relatives and four members of staff. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 6 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 Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 7 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. All residents who move into the home have had their needs assessed and have been assured that these will be met. EVIDENCE: Residents and relatives said that residents’ needs were fully assessed before they were admitted to the home. They said that these needs were carefully monitored and reviewed. Most were confident that residents’ needs were being fully met by the home. Staff members confirmed this to be the case, but added that they were struggling to cope at times due to low staffing levels on both units. One resident on the general unit said she was thinking of leaving and going to another care home because she believed she had to wait too long for personal assistance from hard-pressed staff. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 8 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): 8 and 10. Residents’ healthcare needs are fully met. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Residents and relatives said that they were satisfied with the healthcare arrangements at the home, including the nursing and medical care. They expressed confidence in the care provided. A typical comment was: “the staff and manager are approachable and lovely”. One resident said: “the staff are very good, outstanding and very helpful”. Another resident said: “the girls are excellent”. Residents and relatives also said that they felt they were treated with respect and their right to privacy was understood and promoted. They gave examples of how staff addressed them and consulted them about their preferences and choices, such as clothing, meals and times of getting up and going to bed. Also, staff would knock on doors and listen before entering rooms. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 9 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 and 15. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents receive a wholesome, appealing, balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Residents said they enjoyed living in the home and could follow activities and interests of their choice. There was a varied programme of social and recreational activities on offer, coordinated by an activities organiser. For example, earlier this month, residents received a visit from an organisation that shows a wide variety of animals and allows people to handle the animals. Several residents said they enjoyed this experience and described it as something quite unique for them. There are also visiting entertainers from time to time. One resident said she enjoyed the monthly religious services held at the home. Another resident said that she enjoyed reading and was able to follow her interest, as she liked. Another resident said she liked to watch television and mentioned a drama she had seen the previous night. Birthdays are remembered and celebrated with a cake. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 10 The home has begun to do ‘life-story’ work with some residents, which involves the resident and their relatives in producing a story about a resident’s life, highlighting important events from the point of view of the resident, and including some pictures and photographs where appropriate. This is often done in ‘scrapbook’ style and can be as short or as long as the resident wishes. The activities organiser and resident’s key worker take the lead in developing the life-story. All residents said they enjoyed the food and beverages served at the home. They said there was a good choice and the meals were plentiful. On the day of inspection, the main meal was being served in the late afternoon and appeared just as residents had described: appetising and wholesome, with good quantities. Some residents said they liked to have a cooked breakfast and they could have one any day except Wednesday and Sunday, when the main dinner is served at midday rather in the late afternoon. Special diets are catered for as well. Most meals are served in the dining rooms at times convenient to residents. However, meals may be taken in other locations and at other times if desired. Staff members are involved in assisting some residents to eat their meals. For example, there are 7 residents on the dementia care unit who receive such assistance. There are also some residents on the general unit who are ‘peg-fed’. Care staff members can be very busy at mealtimes trying to ensure everybody eats well and enjoys their meal. This is another reason for increasing staffing levels to a minimum of 4 care assistants on duty on either unit during the day (8 am to 8 pm). Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 11 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 and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: Residents and relatives said that they had every confidence in the manager and staff at the home. They described them as being approachable, helpful and friendly. They would not hesitate to discuss any concern or complaint with them. They believed they would be listened to and taken seriously if they were to make a complaint. This belief is supported by the home’s record of dealing with complaints, including the sharing of information with the appropriate authorities, such as adult protection agencies, in certain circumstances where the protection of vulnerable adults is concerned. The home has a good record in following adult protection procedures and in investigating complaints fully and fairly. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 12 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. Residents live in a safe, well-maintained environment. EVIDENCE: The home is well maintained, with equipment and facilities being checked and serviced according to maintenance schedules. The home is also subject to regular quality assurance visits by the registered provider’s representative, Gillian Campbell (Regional Manager). There is a full-time maintenance officer who carries out a range of checks, recording his findings (for example, water temperatures) and making adjustments and carrying out repairs where appropriate. Equipment, such as the home’s lifts, is serviced and maintained according to contract with external companies. Any faults are reported and logged, and repairs or replacements are made promptly. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 13 The manager has recently replaced dining room furniture on the dementia care unit. She makes periodic requests to her line managers for authorisation to make improvements, such as upgrades to furniture and furnishings. The home is reasonably well decorated, with the maintenance officer taking responsibility for smaller jobs such as redecorating a bedroom. External contractors do the larger redecorations. Suitable locks have been authorised for the remaining bedroom doors that still require them (about half) and these are due to be fitted by the maintenance officer before the end of the year. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 14 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. There are insufficient numbers of care staff on duty at some critical times during the day and night. This shortage compromises residents’ safety. The home’s recruitment policy and practices support and protect residents. Members of care staff are trained and competent to do their jobs. EVIDENCE: There is a registered nurse on duty on each unit, on each shift, every day. In addition, there are 4 carers on duty between 08.00 and 14.00, on each unit. This number reduces to 3 carers on each unit between 14.00 and 20.00. At night (20.00 to 08.00) there are 2 carers on each unit, plus a registered nurse on each unit. At the time of inspection, there were 28 service users on the dementia care unit; and 28 service users on the general, older persons’ unit. These staffing levels were reported by staff and management to be sufficient, with the exception of the 14.00 to 20.00 shifts (when it is necessary to have a minimum of 4 carers on duty) and the night shifts (when a minimum of 3 carers is required). Occasionally, an additional carer is provided on the dementia care unit at these times, but it is intermittent. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 15 Key staff on both units told me that a fourth carer is needed on both units throughout the day, and a third carer is needed on both units at night (20.00 to 08.00). The reasons given by staff included the high dependency needs of many residents and the layout of the building (2 units over 2 floors). For example, on the dementia care unit, there are 7 residents who require assistance with eating their meals. Some residents require 2 carers to attend to them at one time, for moving and handling, bathing, and support and supervision. There are also a number of residents who are ‘peg-fed’ and need special assistance and supervision. In the context of 28 residents over 2 floors, on each unit, nursing and care staff members are very stretched at times to provide a safe service of quality to residents. This has lead to low staff morale, anxiety and stress, which has now reached a worrying level. Since the last inspection in June 2005, 2 nurses and 5 carers have left. Many blame the high workload, and anxiety about providing a quality service with insufficient staff, for problems with staff retention. The position is made worse if, at short notice, a member of care staff does not come in for work, or a member of care staff has to accompany a resident to hospital. The manager has devised a dependency-rating checklist for residents. This confirms the high dependency needs being experienced by staff. The registered provider must increase staffing levels if the home’s statement of purpose is to be fulfilled. The current staffing levels are inadequate and the safety of residents and staff is being compromised. Staff and management confirmed that there is a comprehensive staff-training programme, including detailed induction and foundation training, infection control and moving and handling, equality and diversity, and dementia care. Residents and relatives said that they found staff to be skilful and competent in their work. New staff members are recruited and employed appropriately, including the application of equal opportunities policy and Criminal Record Bureau checks. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 16 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, 35 and 38. The manager of the home is fit to be in charge, of good character and able to discharge her responsibilities fully. Residents’ financial interests are safeguarded in those situations where the home is involved. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager is experienced, well qualified and competent in her role. Residents, relatives and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable, caring and genuine, a person of good integrity. She expects to complete her Registered Manager’s Award by December 2005, which is a big achievement considering all her other responsibilities and the short timescale she has had to do it in. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 17 Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home looks after residents’ monies, such as pocket monies, clear individual records are maintained. The pooled banking of such monies is made clear in writing to residents and their representatives. In these circumstances, any interest earned on the pooled bank account, is paid into the Residents’ Fund, for the benefit of all residents. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. Residents and relatives expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. Staff training in health and safety matters such as food hygiene, moving and handling and infection control, reinforce the home’s written policies. Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 18 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x x STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 19 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 OP27 Regulation 4, 12, 13, 18, 21 Timescale for action The number of care assistants on 01/12/05 duty during the day (8 am to 8 pm) must be increased to a minimum of four at all times on each unit; and the number of care assistants on duty during the night (8 pm to 8 am) must be increased to a minimum of 3 at all times on each unit. These are minimum requirements for this home, due to the current number and dependency levels of residents. If numbers and/or dependency levels fall significantly, then a reduction in care staffing levels can be considered. If numbers and/or dependency levels increase significantly, then an increase in care staffing levels must be considered. Requirement Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 20 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 Abigail Lodge Care Home DS0000000686.V252114.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Abigail Lodge Care Home DS0000000686.V252114.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. 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