Inspection on 27/10/09 for Abington Park View

This inspection was carried out on 27th October 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC 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

Abington Park View 28/04/09

Abington Park View 30/12/08

Abington Park View 04/07/08

Abington Park View 09/10/06

Abington Park View 10/10/05

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Abington Park View 475 - 479 Wellingborough Road Northampton NN3 3HN Lead Inspector Ms Rajshree Mistry Key Unannounced Inspection 27th October 2009 09:45 DS0000056079.V378108.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abington Park View Address 475 - 479 Wellingborough Road Northampton NN3 3HN 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) 01604 719888 01604 472892 greenpark@msaada.co.uk Msaada Care Limited Mrs Maureen Elaine Keet Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (5), Physical disability of places over 65 years of age (10) Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users who can be accommodated is: 22 The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 22 Physical Disability - Code PD, maximum number of places: 15 Date of last inspection 28th April 2009 Brief Description of the Service: Abington Park View Home is a registered care home providing care to people over the age of 65 years and up to 10 people who have a physical disability. Abington Park View was previously known as Green Park Nursing Home and is part of the Msaada Care Ltd. Abington Park View is situated in a residential area and opposite the large park. It is on a main road approximately two miles from the town centre. There is good public transport and local facilities. All bedrooms have en-suite facilities and there is a passenger lift giving access to all areas of the home. There are a variety of communal areas including a lounge and a dining room on the ground floor and a lounge on the first floor. The Acting Manager provided us with the fees charged. These range from £308.00 to £650.00 per week. There are additional personal expenditure for hairdressing, chiropody, personal toiletries and newspapers. The fees are determined upon individual assessment of needs and requirements. People considering using Abington Park View should contact the home directly to discuss individual needs and requirements. Full details for Abington Park View and any specific requirements can be obtained in the form of the ‘Statement of Purpose’ and the ‘Service User Guide’. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 5 The latest Inspection Report from the Care Quality Commission is available at the home or accessible via our website: www.cqc.org.uk Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for Abington Park View is ‘1 star’. This means the people who use the service experience ‘adequate’ quality outcomes. ‘We’ as it appears throughout this Inspection Report refers to the ‘Care Quality Commission’ (CQC). This key inspection started with the review of the last key inspection dated 28th April 2009, when it was known as Green Park Nursing Home. We looked at the information we had about the management of Abington Park View and the events that affects the well-being of the people who use the service. This included the multi-agency organisations that were involved in the number of complaints and concerns about the quality of care people received and the management of the service. We received from the Acting Manager the completed Annual Quality Assurance Assessment (AQAA) document. This is the home’s self assessment of the standards within the home. We sent out 5 surveys to the people who use the service, which included relative’s surveys. We received 1 survey from a person who used the service for a short respite stay. The response and comment received indicated that they were satisfied with the quality of care and support from the staff, services and the facilities provided. The response indicated people had the opportunity to live the lifestyle of their choice, participate in social events and activities arranged by the home. The response also indicated they knew who to speak with and were confident to complain. The comments received are reflected in this Inspection Report and supports some of our findings. We sent out two health professional survey to the Community Nurse Team, of which 1 was received. Whilst the survey was not completed in full, they did indicate that the Acting Manager was keen to work with health care professionals and noted the improvements made to the environment. We also received information following the last key inspection from the Tissue Viability Nurse. The comments received are reflected in this Inspection Report and supports some of our findings. We sent out 5 staff surveys, of which 3 were returned. The responses indicated staff recruitment was fair; staff receive supervision and training to meet the needs of people who use the service. The responses also indicated there is good information, records and communication systems in place to ensure people’s needs are met safely. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 7 We visited Abington Park View 27th October 2009, starting at 9:45am and lasted over 5 hours. The Acting Manager assisted us during the site visit. We also met with three members from the Msaada Care Ltd’s management team during the site visit. They also provided us with information with regards to changing and improving practices within the service. The main method of inspection is ‘case tracking’. This means looking at the range of health and personal care people receive that is met by the staff at the home. We were unable to case track anyone using the service on the day as there was no one using the service. However, we did read the care records for two people who used the service for short respite stays recently. They both had differing levels of support and dietary needs. The records demonstrated how they were supported to continue living their choice of lifestyle that promoted their health, well-being and independence. We looked at the accommodation offered to people who use the service. This included the communal areas, bathrooms and individual bedrooms. We looked at the staff files that demonstrated staff recruitment, training and the skill-mix of the staff. We read the information people receive about Abington Park View. We looked at the specific records that demonstrated the day-to-day management of the service and how people that may use the service would be informed and consulted about the quality of care. The Care Quality Commission has a focus on ‘Equality and Diversity’ and issues relating to these are included throughout this Inspection Report. What the service does well: Abington Park View provides individual accommodation with en-suite shower and toilet facilities. All the bedrooms and communal areas are large and spacious. There is good lighting throughout the home, which helps people move around the home independently. What has improved since the last inspection? Since the last key inspection there has been significant number of changes and improvements made to home. Abington Park View is the new name for service and no longer provides nursing care. We received an ‘action plan’ from the Registered Person following the last key inspection to address the areas of concerns identified. The requirement and recommendations made at the last key inspection of the service have been addressed. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 8 The information about Abington Park View in the form of the ‘Statement of Purpose’ and the ‘Service User Guide’ has been updated. The system and documentation for completing the assessment of needs, care planning and monitoring has been revised and updated. The Acting Manager is trained to carry out the assessment of needs. There is a new comprehensive care planning system in place that promotes person centred care. All medicines are kept in the locked medication trolley in the locked office. There is a now a clear system for the management of medicines. Abington Park View has undergone a programme of re-decoration to the ground floor and purchased new furniture and furnishing to create a more homely and spacious environment. A number of rooms have changed their usage. For example the front office is now a quiet smaller lounge and the lounge on the first floor has moved to the front of the property. This provides people with an option of using the upper lounge that looks out onto the busy road and the park. Abington Park View has appointed an Acting Manager. Staff have received an range of training and information to enable them to provide the care and support people need. This includes training in fire procedures, infection control, health and safety, moving and handling and safeguarding adults, which means recognising and protecting people from harm and abuse. There is a schedule of staff training and supervision in place to ensure staff are supported and maintain their skills and competence. 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 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. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.2 Page 9 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 Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Standard 6 is not applicable. People using the 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 assessment process enables the home to determine whether the needs of people can be met and ensure they receive the support they need. EVIDENCE: We wanted to find out what information and opportunity people have to help them decide to use this service. The information gathered from the selfassessment completed by the Acting Manager stated; people are provided with a copy of the home’s brochure known as the ‘Statement of Purpose’ and the ‘Service User Guide’. This contains good information about the range of service provided, the type of care and support needs people can expect to receive and the range of facilities within the home. It also set out the aims and objectives of the service, the key policies and procedures by which the service operates including the admission and complaints procedure. The self-assessment Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 11 indicated that this information is available in alternative formats such as Braille, large print and on tape, showing awareness to the various forms of communication needs people may use. We received a survey from a person who had used the service for a short stay. They indicated in the survey that they were given enough information to help them decide to use the service. This showed that people have information about the service available to them and supports the self-assessment received. We wanted to find out if the assessment process helped to identify people’s care needs. The Acting Manager told us they are trained and responsible for undertaking all assessments of the person’s needs before someone moves into Abington Park View. The previous Key Inspection identified that the assessment process was not robust and the person undertaking assessment needed further training. We advised the Acting Manager to ensure the assessment of needs takes into the new requirements under the Mental Capacity Act and the Deprivation of Liberty’s. This looks at how people who are unable to make decisions have their best interest and wishes considered. We looked at the records of two people who used the service recently for a short stay. There was good evidence of the ‘initial assessment of needs’ undertaken with the person before they moved to the home, gathering the information relating to their needs, level of support they require and their preferred choice of lifestyle. There was a further ‘admission assessment’ undertaken, which was comprehensive, compliments the initial assessment and is used to develop the care plan. It contained more information relating to the person’s medical history and medication, daily routines and lifestyle, dietary needs, physical and mobility needs, ability to make decision and mental wellbeing and communication. In addition there is now a ‘social assessment’, which gathers information about the person’s social and leisure interests, family and friends and their life history. The records showed people were involved in all aspects of the assessment process as their views and preferences were recorded. Although we were unable to speak with the people who had used the service, we did receive a survey from one person. They indicated they were involved in the assessment of needs process. The care files also had copies of the statement of purpose, the service user guide, and also a signed contract with the terms and conditions of their stay. This showed there was a clear agreement in place for their stay. The staff survey responses indicated staff received information about new people who use the service, as we were unable to speak with any other staff on the day. Abington Park View does not provide intermediate care. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning, monitoring systems and procedures showed improvements made to meet people’s health and personal care including medication. EVIDENCE: We wanted to find out how the health and personal care needs of people living at the home were met. The information we gathered form the self-assessment stated ‘there are personalised care plans drawn up from various assessments’ and ‘care plans are reflective of individual choices, preferences and include medication and other health support’. Since the last Key Inspection, there has been a change to the category of registration. Abington Park View only provides residential personal care. Health care needs are met by the Health Care Professionals such as the Community Nurse, General Practitioner (GP) and other specialists. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 13 The survey response received from one person who had used the service for a short stay indicated they were involved in developing their care plan. The staff surveys received also indicated staff have information about people’s care needs in the form of care plans. This supported the information gathered from the self-assessment. We read the two care files for the people who used the service for a short stays. The care files contained the care plans, assessments of risks, daily records, health care record and social activities record. The care plans were developed with the person, taking into account their needs, the level of support they required and their wishes. For example one person wanted to have a bath as they had to use a shower in their own home and both preferred to continue managing their own medication. Although we were unable to see how often the care plans were reviewed from the records we saw, the Acting Manager told us these would be reviewed monthly or sooner if necessary. The care plans reflected the safety measures identified from the assessment of risks. These were for moving and handling, falls and nutrition. The individual risk assessments included to continue to self-medicate and drive their own car. This demonstrated people’s individual needs were known and information is provided for staff to help them provide the care people needed, which promotes their well-being and independence. The daily records completed by the staff reflected the care and support needs provided and their well-being. Other records maintained included visits from the Chiropodist and record of attending GP appointments at the surgery with a member of staff. However, there was no other information with regards to the purpose, treatment or advice given. We advised the Acting Manager that a record should be made of this to ensure people’s health and well-being is monitored and promoted. The survey response received from one person that had used the service, indicated that their privacy and dignity was respected. The care records showed that people’s preferences and routines being promoted and respected. The daily records demonstrated people’s privacy and dignity was respected. The surveys we received from one person who had used the service for a short stay and the survey from the Community Nurse were both positive. We concluded that people did have support and access to health support during their short stay at Abington Park View. The comments in the surveys were: “The staff made me feel at home right at the start with their friendly manner” “They are all happy to spend time with any problems” “Myself and colleague …. met with the manager of Abington Park View home on 24.09.09. At the time of the visit there were no residents in the home. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 14 “The manager appears to welcome support and advice and was keen to develop a professionals working relationship”. The Acting Manager showed us the new medication storage and system that would be in use. Since the last Key Inspection, Abington Park View has contracted with the local Pharmacy to dispense prescriptions, provide training and conduct medication audits. We saw that there is a designated area for storing medications. This is in the locked medication trolley in the office at the rear of the home. There is a medication fridge and controlled drugs (strong medicines) storage. The two people that used the service for a short stay managed their own medicines. The assessment of risk and care plans identified their medication that they took. The Acting Manager confirmed that where people continue to manage their medication, prescriptions would be ordered at the same time. This would be done by the Acting Manager. Although we were unable to assess the medication practice and record keeping the Acting Manager described the procedure for giving people their medication and confirmed the only trained staff would do this. We saw two staff files and the Acting Manager showed us the incomplete staff training matrix in the computer. There was evidence of staff receiving an induction, training to support people with their personal care needs, medication, first aid, health and safety, moving and handling and infection control. Following the site visit we did receive an updated staff training matrix showing the training completed by the staff and the programme of training. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a range of social and leisure activities available and a variety of meals offered to people that promote health and well-being. EVIDENCE: We wanted to find out what social opportunities and activities are available to people who use the service. The information we gathered from self-assessment stated, ‘people are involved in all aspects of their lifestyle choices such as the time they wake up or go to bed, meals, daily living, social activities or interests and religious practice’ and ‘links with the local community groups, organisation and Advocacy’ and ‘meals are planned and dietary needs met’. The survey received from one person that had used the service for a short stay, indicated they ‘liked the meals’ and ‘take part in activities arranged by the home’. The care files read for the two people that used the service contained a ‘social assessment’. It had information about the person’s family, interests, hobbies, practising their faith, social and leisure interests and past times. We also saw a Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 16 care plan for social and leisure interests that guided staff to promote stimulation and activities of interest. We saw evidence of the activities people had taken part in, recorded in the individual ‘activity sheet’ and the daily records. For example, entries in the daily records included, ‘went for a walk with staff’, ‘played bridge independently’, ‘read book’ and ‘ …. birthday’. We saw an unfinished jigsaw on the dining table that was being done by the two people who used the service for a short stay. The Acting Manager showed us the location of the library and games, which is now stored between the main lounge and the dining room, making it accessible for people. This demonstrated people were engaged in a range of social and leisure activities of interest, which promoted their well-being. The Acting Manager told us that they plan to recruit an ‘Activity Organiser’. They will take an active role in finding out and planning a range of activities for the people who use the service. People have the use of a number of lounges, the dining room and their own private bedroom to use and entertain their visitors. There are new easy chairs and footstalls in the main large lounge. The front office is now a ‘quiet lounge’ and the lounge on the first floor has been moved to the front of the property looking out onto the park across the main road. We wanted to find out what the meals were like. The information we gathered from the self assessment stated ‘menus are planned, preferences and dietary needs considered, ensure seasonal variations, mealtimes are flexible and staff offer support in a sensitive manner’. The survey received from one person that had used the service for a short stay, indicated they ‘liked the meals’ and stated; “The food is very good and varied”. The care files read for the two people on short stay had details of their dietary needs and preferences. One person had complex dietary needs: gluten/ wheat free and other known allergies. There was evidence of individual preferences and what they were able to eat gathered in the ‘dietary information record’. However, this was not reflective of foods of the world and cultural diets that people may have or prefer. We saw evidence of the meals provided to the people on short stay, which included; chicken, chickpeas and rice, pork vegetables and potatoes to omelette and chips. The Acting Manager told us providing gluten/wheat free diet raised their awareness, highlighted the importance of reading the contents label on food items and showed a variety of meals that could still be prepared. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management system of complaints ensures people concerns are address quickly and staff training protects people from abuse. EVIDENCE: We wanted to find out whether people were aware of the complaints procedure, confident to complain and felt safe and protected at Abington Park View. The information we gathered from the self-assessment completed by the Acting Manager stated, ‘provides a safe and supportive environment, complaints procedure is in the statement of purpose and the service user guide and all complaints are recorded with the actions taken’. The complaints procedure was displayed and is included in the ‘statement of purpose’, which is given to people when they move to the home. The complaints procedure is clear and includes the contact details for the head office of the company, the local authority and the Care Quality Commission (CQC). There were leaflets displayed at the entrance of the home for the local Advocacy Service, which showed people would have information about the support services where they could seek advice from. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 18 The survey response received from one person who used Abington Park View for a short stay indicated they know how to make a complaint. The comment received in the survey was; “they are all happy to spend time with any problems” Although we were unable to speak with staff we did receive staff surveys. The responses indicated staff know what to do should they receive a concern or complaint from the people who use the service or their relatives. Abington Park View received no new complaints from the people who had used the service, their relatives or any other professionals. The Care Quality Commission has received no new complaints or concerns about Abington Park View. We spoke with the Acting Manager with regards to the ‘Mental Capacity Act 2005’ and the ‘Deprivation of Liberty. This means, where a person cannot make a decision for themselves or might be able to make some decisions and not others, which is called ‘lacking capacity’. Following the site visit the Acting Manager confirmed they were booked to attend the ‘Liberty Safeguard Training’ on 17th November 2009. We wanted to find out if staff knew what ‘safeguarding issues’ issues meant and how to deal with any suspicions or allegations of abuse. ‘Safeguarding’ issues means promoting the well-being of people who use the service from harm, risk and abuse. We were unable to ascertain and test the knowledge of staff as there were no staff working at the time of our visit. However, the staff surveys received indicated staff had received training on safeguarding adult’s procedure and the staff training records viewed also confirmed this. The Acting Manager demonstrated a good understanding, awareness and knowledge of the procedures that they need to follow if they witness or suspect abuse occurring in the home. The information we gathered from the self-assessment stated there were no safeguarding referrals and investigations, since the last key inspection. The staff recruitment records viewed and the staff survey responses all confirmed they were recruited with satisfactory pre-employment checks. These included two written references and a criminal records bureau check (crb). This is a check to assess the suitability of the applicant to work with vulnerable people. This demonstrated staff recruitment procedures are following to ensure people are cared for by suitable staff that promotes their safety and wellbeing. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 25 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Abington Park View has improved the home environment significantly to create a homely, clean and a tidy place for people to live in. EVIDENCE: We wanted to find out what type of home and accommodation people live in. The information gathered from the self-assessment completed by the Acting Manager stated they ‘provides a clean and tidy home’ and ‘homely environment’. We also received details of when the equipment such as hoists, heating, fire detections and electrical systems were last tested. The improvements made to Abington Park View include a major refurbishment programme consisting of deep cleaning, re-decoration and purchasing new lounge furniture. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 20 The survey response received from one person that had used the service for a short stay indicated the home was ‘fresh and clean’. The comment received in the survey from the Community Nurse was: “the manager allowed us to view the home and it was obvious that a number of improvements had taken place including re-decoration and altering the use of rooms”. We were shown around the home and found there were significant improvements made to the décor, new lounge furniture and layout of the lounge and dining room. The front office is now a ‘quiet lounge’ and the lounge on the first floor has been moved to the front of the property looking out onto the busy road and the park. All the radiators are covered and blend in with the décor. The platform lift in the dining room has been serviced and maintained and is quieter when in use. The communal space was clean, spacious and welcoming. The corridors are well lit and have a homely feel created by the pictures hung on the walls. We saw the bedrooms on the ground floor, which have been re-decorated. All the bedrooms have en-suite shower and toilet facilities. All the bedrooms that we looked at were furnished. We noted that all the en-suites, bathrooms and toilets had a supply of gloves and aprons, indicating staff would have access to protective clothing when assisting people with personal care tasks. The Acting Manager said the bedrooms on the upper floors will be decorated as people start moving to the home. The Acting Manager said that they are in the process of purchasing some window blinds and pictures for the bathroom to create more warmth and privacy. The Acting Manager confirmed that the Environmental Health Officer carried out an inspection in September 2009. They were satisfied as the requirements from the previous visit had been addressed and there were no new issues. We were told that the Environmental Health Officer is due to re-inspect Abington Park View when there are people living at the home. We wanted to find out what staff training had taken place to ensure health, safety and infection control practices promote people’s safety and well-being. The Acting Manager confirmed the staff received training in infection control, health and safety procedures since the last key inspection. In addition the house-keeper has been re-trained in COSHHE, infection control practices and supervised to ensure best practice is followed. The staff training records viewed showed all staff had completed infection control training. We read the monthly visit report conducted by the Quality Assurance Manager on 7th October 2009. There was evidence of people’s experience of the service with regards to the home environment. For example they commented that they ‘liked the lounge and said that the new chairs were very comfortable’. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment process has improved and the staff training ensures the needs of the people who use the service are met and well-being is promoted. EVIDENCE: We wanted to find out whether the staff recruitment process, the skill-mix and the staffing levels met the needs of the people who use the service. The information we gathered from the self assessment completed by the Acting Manager stated, ‘all staff members employed have gone through a robust recruitment and selection processes’, ‘an induction programme that runs for 3 months, training, scheduled supervision sessions and team meetings’. The survey we received from one person that had used the service for a short stay, indicated ‘staff were available, listened and acted on their requests’. The comment received in the survey included: “the staff made me feel at home right at the start with their friendly manner” The responses received in the staff surveys indicated ‘there were sufficient numbers of staff on duty at all times. Although there were no staff or people living at the home at the time of our visit, we did look at the staff rota for this Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 22 time. It showed there were two staff on duty at all times and the people using the service benefited as they received one-to-one support and attention. The Acting Manager confirmed the staffing levels would increase as people move to the home and would vary depending on their level of support and care they need. This indicated that the Acting Manager was conscious of the need to ensure staffing levels safely and consistently met the needs of the people that will use the service. The Acting Manager told us ‘since the last Key Inspection of the service, ‘staff were re-interviewed to ensure the right staff with the right skills are employed’. We looked at two staff files, both contained evidence of the preemployment checks carried out such as two satisfactory written references, criminal records bureau (crb) checks and a protection of vulnerable adults (pova) check. This is a check to assess the suitability of the applicant to work with vulnerable people. The Acting Manager said checks would be carried out to ensure any overseas applicants have valid work permits. This was consistent with the responses in the staff surveys we received and the information gathered from the self-assessment. We saw evidence of staff induction and training completed in the staff files in the form of certificates. We also looked at the training information held by the Acting Manager on the computer. It showed staff had received a range of training that included: fire, pressure area care, dementia awareness, administering medicines, infection control, food hygiene, moving and handling, safeguarding adults, personal care, health and safety, report writing, stroke awareness and some staff had done the Mental Capacity Act training. This indicated that there were significant steps taken to ensure the staff skills were up to date to meet the needs of people who may use the service. The Acting Manager confirmed that 3 staff are in the completing the National Vocational Qualification (NVQ) level 2, in care and a further 2 staff will be registering to start the NVQ level 2. This equates to over 50 of staff are in the process of attaining NVQ level 2 in care. The Acting Manager showed us the new communication systems that would be used to share and communicate information between the staff. This included the handover sheets, the communication book and the diary, which would have details of appointments, such as hospital appointment. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Abington Park View has made improvements to the management of the service, quality assurance and consultation systems and staff supervision that would promote people’s health, safety and well-being. EVIDENCE: We wanted to find out whether the management of Abington Park View protects and promotes the well-being of the people who use the service. Since the last Key Inspection of this service there have been a number of changes. This included the re-naming of the service to Abington Park View, deregistering the nursing category of registration, refurbishment programme Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 24 whilst there was nobody using the service and the appointment of an Acting Manager. The information we gathered from the self-assessment completed by the Acting Manager stated, ‘the manager has a ‘lead by example’ approach’, ‘communicates effectively the needs of the service users and the needs of the business to the staff team on a daily basis’ and ‘supports and mentors the staff team’. The Acting Manager described their experience of working and managing a care service; trained to undertake assessment of needs, provide care to people, and manage staff. They have already attained the NVQ 2 and 3 and are completing NVQ 4. The Acting Manager said they are in the process of submitting an application to the CQC to become the Registered Manager. We wanted to find out what quality assurance systems, checks and form of consultation would take place with the people who use the service. The Acting Manager informed us that ‘residents and relatives meetings’ would take place monthly and showed us the scheduled dates for these meetings. The Acting Manager said that a quality assurance survey was given to the two people that had used the service for a short stay. The analysis of the surveys was not completed at the time of the site visit. However, following the site visit we received a summary report of the findings, which indicated people were satisfied with the provision, service, care and daily life experienced, the facility, staff conduct and the whole experience during their stay. There was an action plan with timescale, demonstrating the service was keen to improve the service. The comments received from the people who had used the service included: “enjoyed a very relaxing two weeks with very friendly and helpful staff. Thank you …” and “overall I found my stay most enjoyable, the staff couldn’t do enough for me and discuss my new medication with me and also my gluten-wheat free diet, and when I feel I no longer able to look after myself I would not hesitate to come her to live (if they’d have me)”. We also read the compliment Abington Park View received in the form of a card for the two people that used the service for a short stay. The comment in the card said, “thank you all for looking after …. and …., we had a lovely holiday”. We read the monthly visit report, carried out by the Quality Assurance Manager on behalf of the Responsible Individual on 7th October 2009. It demonstrated people who use the service were consulted; records were checked such as care files, menus, residents and staff meeting minutes and health and safety checks on the environment, safe storage of medicines and fire checks. The report was concluded with an action plan that was given to the Acting Manager to address. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 25 The Acting Manager showed us the documentation and described to us the system, where ‘spending money’ is held in safe-keeping for the people who use the service. Whilst we were unable to see a working system of recording and reconciliation it did indicate that people’s money held would be managed with clear recording systems. The staff surveys indicated staff received support from the manager. We were unable to speak with staff to confirm that they receive supervision as there were no staff present on the day of the site visit. However, the staff surveys responses indicated ‘staff do receive support from the manager’. The Acting Manager also showed us the schedule of dates for staff supervision and team meetings up to the end of the year. The information we gathered from the self-assessment completed by the Acting Manager detailed the programmed of routine maintenance, servicing and testing of equipment in the home. Evidence of the fire tests and routine safety checks carried out is recorded and shows these take place. We had received confirmation from the Fire Service that they had carried out an inspection of the service and were satisfied with the service meeting the regulations. The Acting Manager confirmed the Environmental Health Officer had also inspected the service in September 2009 and were satisfied as the requirements from the previous visit had been addressed. We were told that the Environmental Health Officer is due to reinspect Abington Park View when there are people living at the home. The care plans read for the people we case tracked also reflected the safety measured staff should follow to ensure people’s safety. The Acting Manager said the care plans and risk assessments would be reviewed on a monthly basis. The staff training records viewed should staff had received training in moving and handling, infection control, health and safety, which includes using equipment such as a hoist. This showed staff have been trained to ensure people’s need would be met safely and in line with current best practice. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 26 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 3 Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 27 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. 1 Refer to Standard OP3 Good Practice Recommendations The assessment of needs should be reviewed and updated to take into account the ability and capacity of people to make decisions in accordance with the ‘Deprivation of Liberty’ and the ‘Mental Capacity Act 2005’. To ensure a record of any health care support and treatment provided is recorded to ensure people’s health and well-being is promoted. The consider developing the meals checklist to reflect the range of meals and choices available that includes foods of the world and cultural diets. The home should work towards having all the staff trained to NVQ level 2 and above in care. It is recommended that the Acting Manager should consider submitting an application to CQC to becoming the registered manager. To develop a formal annual quality assurance system DS0000056079.V378108.R01.S.doc Version 5.3 Page 28 2 3 4 5 6 OP8 OP15 OP30 OP31 OP33 Abington Park View 7 OP33 where by people who use the service, relatives, health and social care professionals, staff and other stakeholders have an opportunity to comment on the quality of the service. To consider measuring the findings from the quality assurance survey against the statement of purpose to ensure people’s expectations and experiences of the service is consistent with the aims and objectives of the service. This would also assist in the review and updating of the statement of purpose. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 29 Care Quality Commission Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Abington Park View DS0000056079.V378108.R01.S.doc Version 5.3 Page 30 - 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!