CARE HOME ADULTS 18-65
Abingdon 48 Alexandra Road Southport Merseyside PR9 9HH Lead Inspector
Paul Kenyon Unannounced 19 May 2005 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 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 Stationary 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. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Abingdon Address 48 Alexandra Road Southport Merseyside PR9 9HH 01704 533135 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Raglin Care Limited Mrs Gillian Trickett Care Home 9 Category(ies) of Learning Disability, 9 registration, with number of places Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 9 LD Date of last inspection 29 November 2004 Brief Description of the Service: Abingdon is a care home offering a service to nine individuals with a Learning Disability. The home is run by a local company, which provides a number of services in the Merseyside area. The service is managed by Gill Trickett and Owned by Raglin Care Ltd.The home is located in a residential area of Southport and is located within easy reach of Southport’s main shopping centre. It is close to local amenities. The service operated from a converted detached house with facilities spread over three floors. A large garden is located at the back of the house. There are a number of communal rooms and these are generous in size and number given the number of service users living in the home at present. There is a passenger lift available yet the needs of service users at present do not warrant the inclusion of any specialist aids or adaptations at present. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place in the morning and extended into the early part of the afternoon covering a period of 4 hours. The most part of the inspection involved talking to residents about the support that they are offered. In total the views of five residents was gained about subjects covering the staff team, the level of decision making that they are given and their views of the support they receive at Abingdon. The views of two others could not be gained given that they were not present during the inspection. For the remaining one resident, observations of this person’s interactions with staff enabled conclusions to be made. The service provides support to nine residents in all although one person has left since the last inspection. It is understood that an individual will be admitted yet this is subject to assessments at the moment. What the service does well:
Abingdon is good at providing a safe and supportive environment for its residents. It employs a care planning system that is linked to the needs of residents. Many comments from residents about living at Abingdon were positive and included ‘I like living here’, ‘I have made so many friends’, ‘I will be sad to leave it’, ‘I am happy here’ and ‘I feel safe here’. The service has met many of the national minimum standards measured, which in turn make sure that residents receive a good standard of support. Members of staff are a key group that residents refer to in order that their needs are identified and met. Many residents stated that ‘the staff are brilliant’, ‘the staff are great’, ‘they help you’ ‘they listen to you’ and ‘they tell us what is going on’. The Manager was also described as ‘a very nice person’. This inspection concluded that these positive comments reflected the staff team’s efforts to work with residents and put their needs as central. This has been successful given that no negative comments were raised during discussions. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 6 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. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 5 The home provides residents with an up to date service user guide and individual contracts, which enable prospective residents and their relatives with the information to make informed choices about the home. EVIDENCE: A requirement at the last inspection highlighted the need for the service users guide to be updated. This guide is a document that should provide each individual with the information they need to know about what Abingdon has to offer them. This guide was updated in November 2004 following the last inspection and is available in the hallway for residents to look at. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Resident’s benefit from clear care plans which are reviewed every six months (or more frequently if needed) and are linked to the needs and aspirations of residents. The staff team enable the opportunity for residents to make decisions about their lives and this is done in a meaningful way. Those activities pursued by individuals and involve risk are agreed by residents. EVIDENCE: Four care plans were examined. Two related to residents who are aiming to move into more independent living in the future. The other two related to individuals who have more complex needs. With the first care plans; these are based on those activities linked to more independent living such as domestic tasks, budgeting and independence in medication. These goals have been discussed with these residents. One resident stated that ‘I want to move eventually but I will be sad to go because staff have helped me so much’. For the other care plans, staff support is centred on keeping individuals safe within the home and meeting the complex needs that they have. In one plan, a team involving a number of people who are involved with the individual has drawn up new strategies and these have been included within the care plan.
Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 10 Meetings are held with all residents on a monthly basis. All residents who were spoken with confirmed that they attend the meetings and felt that ‘we go to the meetings’, ‘the staff listen to you’, ‘staff listen to me’ and ‘they tell you about things straightaway’. Risk assessments are available within each care plan. These cover risks within the building, outside in the community and issues of keeping individuals safe. In the four care plans that were looked at; each resident had signed all risk assessments. These are also reviewed as risks change. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 The service supports residents in either continuing on college courses or in using the local community to pursue other activities. Residents are fully aware of the facilities that the local community has to offer. EVIDENCE: One resident said that she goes to college on a regular basis to do maths and English. She stated that ‘she enjoyed it’. Another resident wants to go to college and said that ‘my keyworker will help with this’. For others, activities tend to be more leisure based. Two residents confirmed ‘staff sit down with us each week and we decide what we want to do’. This was reinforced by activity plans for the week that are signed by residents. All residents were asked about local facilities. Comments included, ‘I know Southport like the back of my hand’, ‘yes I know what’s in Southport’ as well as numerous examples of facilities that are available, ‘there are pubs, restaurants and McDonalds either at Kew or by the promenade’. Another resident has access to a caravan. ‘I go there during the week and I enjoy it’.
Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Residents benefit from a safe medication system and some are given the opportunity to be more independent in dealing with their own medication. Some residents are not solely reliant on staff to administer medication. This indicates that these individuals are given independence where it is safe to do so. EVIDENCE: Records are signed each time medication is administered and looking at these records evidenced this. Medication is stored in two lockable cupboards within a further locked room. The procedure for ordering and receiving medication is now in place and all received medication is recorded on each record. Senior staff now have clear guidelines for how medication is ordered. Two people self medicate. The success or otherwise of this is recorded on an evaluation sheet. One person stated that ‘I sometimes need help with this and staff help me’. Both individuals have been risk assessed so that this can be done safely. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 In the main, service users are protected but not fully. Staff need to have the skills and knowledge in order for a consistent response if allegations are made. Some work is needed to ensure that staff are fully trained in abuse awareness and know how to deal with allegations of abuse if they occur. EVIDENCE: One resident has made allegations about issues outside of the service. A list of staff who have attended vulnerable adult training is available and confirms that most staff have attended training in this area, however, not all of these staff have signed the procedure itself to confirm they understand this. This is required. In addition to this, not all staff have attended this training. This is raised as a requirement. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) No standards in this section were looked at during this inspection. EVIDENCE: Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 and 34 Staff are clear about their roles within the service and receive regular training, enabling them to have the skills to listen to residents who feel able to refer to staff when they need to. Recruitment processes are robust and safeguard residents. EVIDENCE: In discussions, one member of staff who was relatively new to the service confirmed that she had had prior experience in the care profession. She considered that she knew what her role was as a support worker and that she ‘enjoyed working there’. Two personnel files were examined and both were found to be in order. They included an indication of the person’s past experience in care, two references, and documents confirming their identity as well as satisfactory police checks. All residents were asked about their views about staff. These did not include any negative comments but included ‘the staff are brilliant’, ‘the staff are great’, ‘they help you’ ‘they listen to you’ and ‘they tell us what is going on’. The Manager was also described as ‘a very nice person’. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 The service has in place policies and procedures, which safeguard the rights of residents. Staff are aware of these policies and work within them. EVIDENCE: The last inspection highlighted a need for all staff to be made aware of policies and procedures. Given the number of these, the Manager has identified key policies such as lone working, whistle blowing, complaints and confidentiality and now incorporates these into staff meetings for discussion. This was evidenced by staff meeting minutes as well as plan drawn up by the Manager available for examination. Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x x Standard No 31 32 33 34 35 36 Score 3 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Abingdon Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 x x x F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 18 YES Are there any outstanding requirements from the last inspection? 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 23 Regulation 13 Requirement Staff who have attended training in the protection of vulnerable adults must sign procedures to confirm their understanomg and awareness. Staff who have not receive protection of vulnerable adults training must do so Timescale for action 30 June 2005 2. 23 13 31 August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Burlington House, South Wing 2nd Floor Crosby Road North Waterloo, Liverpool L22 0LG 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 Abingdon F53 F03 S5355 Abingdon V229986 190505 Stage 4.doc Version 1.30 Page 20 - 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!
