Inspection on 02/10/07 for Kings Abbot Rest Home

This inspection was carried out on 2nd October 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kings Abbot Rest Home 10/08/06

Kings Abbot Rest Home 03/10/05

Kings Abbot Rest Home 13/06/05

Kings Abbot Rest Home 01/02/05

Kings Abbot Rest Home 23/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Kings Abbot Rest Home Abbotsway Penwortham Preston Lancashire PR1 0BD Lead Inspector Lesley Plant Unannounced Inspection 2nd October 2007 9:00 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 Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kings Abbot Rest Home Address Abbotsway Penwortham Preston Lancashire PR1 0BD 01772 746817 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) Mrs Julia Caroline Mather Mrs Julia Caroline Mather Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2006 Brief Description of the Service: Kings Abbot is situated in its own grounds in a secluded area of Penwortham, approximately one mile from Preston City centre. Penwortham shops, community facilities and amenities are a short walk away. The home provides accommodation and personal care for up to thirteen residents in five single and four double rooms. All bedrooms have washbasins. Bedroom accommodation is sited on the ground floor and first floor of the home, with a stair lift providing access to the first floor. The lounge, dining room and bathroom are on the ground floor of the home. Well-maintained garden areas surround the home and there is easy access to these outside areas, which provide an extremely pleasant environment for sitting out during warm weather. The lay out of the building and the accessibility of the main rooms and garden areas, make this home suitable for people with mobility difficulties. The home is not registered to provide nursing care, medical and nursing needs being provided by local general practitioners and district nurses. Fees for a place in the home are from £370 to £430 per week. Kings Abbott is owned and run by Mr and Mrs Mather, with Mrs Mather managing the home on a day-to-day basis. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced site visit there were 11 people resident at the home. All of the key national minimum standards, plus the standard relating to staff supervision, were assessed. The inspector spoke to the registered person, who is also manager of the home, a care assistant, the cook, several residents and a relative who was visiting. Information was also gained from the Annual Quality Assurance Assessment completed by the manager. Questionnaires inviting feedback about Kings Abbott were sent to a selection of individuals who have connections with the home. Four were received from health care professionals (three GP’s and a community mental health nurse), ten from relatives, eight from people living at the home and one from an individual who attends for day care. Records were viewed and a tour of the building took place. Time was also spent observing staff and the people living at the home, engaged in daily activities. The inspector was joined by an ‘expert by experience’ for part of this visit. (An ‘expert by experience’ is a person who because of a shared experience of using or needing a service, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in the home.) The ‘expert by experience’ spent time in the communal areas of the home, talking to those living there and then provided feedback to the inspector. Mrs. Mather manages the home on a day-to-day basis and throughout this report is referred to as the matron, the title by which she is known to residents and relatives. What the service does well: This is a small family run home, which provides an intimate and individualised service to those living there. The care records and systems regarding care planning are very good, and give a full picture of the person concerned. This helps staff to provide a more personal and individualised service. Individual differences are recognised and supported, with staff understanding the importance of getting to know the whole person and not just responding to practical needs. Many of the staff have worked at Kings Abbot for some years, providing continuity and stability for those living there. The majority of staff are now qualified and provide a consistently good standard of support. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 6 The people living at Kings Abbot praised the personal qualities and abilities of staff. Comments included; “Staff are very good with any help that I need, in fact they are excellent.” Feedback from relatives was also extremely positive and included; “the carers at the home are always very pleasant, friendly. Best of all they look after the ladies and nothing is too much trouble.” The staff team are well supervised by the matron and deputy manager of the home, which helps to ensure that high standards are maintained. 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. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 8 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 Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. Good assessment information is gathered prior to admission to ensure that the persons’ needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide provide good information for prospective residents and their relatives. Assessment information for three people living at the home was viewed. The matron or the deputy manager of the home are responsibility for the assessment of new residents, both having considerable experience in this area. An initial enquiry form is completed, followed by an assessment meeting, carried out with the individual and their relative as appropriate. Information is Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 10 also gained from relevant health/social care professionals as relevant to the individual concerned. This assessment information is then expanded upon and transferred to the individuals’ care plan book. The assessment information viewed covered a wide range of areas including; social and leisure interests, mental health and mobility. A personal profile is completed, which provides good information about the person, including their likes, dislikes, skills and abilities. Information regarding areas of risk is also gathered. These include any history of falls, mobility problems and potential risks regarding skin viability/pressure sores. A feedback questionnaire, completed by a relative whose mother had recently moved into Kings Abbot, included the following comments. “ The initial meeting with Mr and Mrs Mather was informative and reassuring. Our mother has only been resident for two and a half weeks, but the size/layout of the home, together with the friendliness of the staff, make us feel we have made the right choice.” Kings Abbot does not provide intermediate care or short-term intensive rehabilitation. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. There is an excellent focus on person centred care, with health and personal care needs being met in an individualised way. Medication practices are inconsistent and could pose risks to those living at the home. The people living at the home are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning information for three people was viewed and individuals were spoken to regarding the care provided by staff. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 12 Each person has a care plan book. Assessment information is transferred and further developed to form a clear picture of what help is required and how this is to be delivered. Care plans also include good information regarding each person’s social and emotional needs, and do not merely focus on practical assistance required. There is a good system of reviews, which take place at least every month and more frequently if needs have changed. The matron or the deputy manager sit with the person concerned and talk through the care plan, discussing any issues, which may have arisen. This individualised and personal approach helps to promote a person centred focus, even if the individual has difficulty contributing to the process. In these circumstances a relative would normally be involved. Risk assessments are also reviewed each month. Good daily records are kept, being completed twice each day and giving a picture of how things have been for the person concerned. The people spoken to were very happy with the care they received and relatives also provided a great deal of positive feedback via CSCI feedback questionnaires. Comments included; “My mother receives the very best care. She could not be better cared for.” The care plan books include a section where staff record any healthcare appointments and their outcomes. Equipment for the relief/prevention of pressure areas is provided if required. One lady spoken to explained that staff had arranged for an optician to visit her, she had chosen new frames and was awaiting her new glasses. There is good liaison with GP’s and district nurses. Health care professionals who completed CSCI feedback questionnaires provided extremely positive information about the home. Comments included; “Kings Abbot rest home provides a high standard of individualised care for its residents.” A relative who completed a CSCI feedback questionnaire stated; “Even though mum has only been resident for a short time her mobility and state of mind have improved immensely. This we feel is due to the standard of care received.” The people living at the home who completed CSCI feedback questionnaires all felt that they received the medical and health support they needed. One person commented; “I have done so far and I have no complaints” and another stated, “the matron arranged for me to go to the hearing aid clinic”. This is a small care home, with an excellent focus on person centred care, providing good evidence that the standard of personal and healthcare exceeds the minimum outlined in the National Minimum Standards. Care plan reviews Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 13 are personalised and fully involve the person concerned. Individual differences are recognised and supported, with staff understanding the importance of getting to know the whole person and not just responding to practical needs. The personal profiles and principles of care contained within the care plan book set the scene and highlight the ethos of the home. Medication is safely stored in a medication trolley, which is kept locked when not in use. Only the matron, deputy manager and two senior care staff administer medication, all having undertaken specific training in this area. The pharmacist provides the majority of medication in a pre packaged monitored dosage system. Information leaflets are available for each prescribed medication. The records for medication returned to the pharmacy were viewed. Arrangements have been put in place regarding the administration of controlled drugs, should these be prescribed. The last key inspection identified some shortfalls regarding medication management and a request was made for a CSCI pharmacy inspection to carry out an audit at the home. This took place in September 2006 and a number of requirements and recommendations were made. Medication practices have been reviewed and improved and further training provided to senior staff. However there are still areas of concern. For one person, medication had been administered but not signed as such for a period of over two weeks. This same person also had medication signed as being administered when it had not been given and there were discrepancies in the details of the dosage to be given. Two staff should check all handwritten medication records and regular recorded medication audits must take place. Recommendations and requirements made by the CSCI pharmacy inspector have not been fully acted upon and these must be addressed. It was further advised that the medication administration records include a photograph of the individual and that dividers are used in this storage file. The importance of promoting and protecting the privacy and dignity of residents is highlighted within the written aims and objectives of the home. These principles are also addressed during staff induction and within NVQ (national vocational training) programmes. At the time of the visit all the residents were nicely dressed and clothing appeared well cared for. Staff were observed talking to individuals in a caring and sensitive manner. Relationships between staff and residents appeared to be warm and friendly. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 14 A number of the bedrooms are for shared use. Screening is provided, for privacy when using the washbasin, or receiving personal care. People who are admitted to the home only share a room if this is a definite choice. One person retains a double bedroom, as the lone occupant, as she does not want to share her bedroom. A GP who completed a CSCI feedback questionnaire responded, “they always ask pt (patient) where they want to be seen.” A relative who completed a CSCI feedback questionnaire commented; “All staff always show a caring, thoughtful attitude towards our mother, from our observations to date they always show professionalism. Personality and needs of our mother are recognised and catered for. The residents are treated as individuals, whilst at the same time feeling part of a family.” Comments from people living at Kings Abbot included; “The staff couldn’t be more helpful, everyone is very considerate.” And “They are very attentive and considerate.” Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Activities meet the needs and preferences of the people living at the home and community contact is supported. Meals are well cooked, varied and enjoyed by the people living at Kings Abbott. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Interests and social preferences are recorded on individual files. Feedback regarding activities was generally positive, with staff clearly working hard to meet the preferences and interests of each individual and the group as a whole. National and local newspapers, books and magazines are provided and there is a music system and large television in the lounge. The local mobile library visits once a month leaving a selection of books that people have requested. Local ministers also visit the home. A list of activities is displayed on the notice Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 16 board. Regular activities include armchair exercises, crosswords and quizzes. One person living at the home stated, “I like all those”. Another person stated that she enjoyed the location of the home as, “I can walk out admiring peoples gardens”, but preferred not to join in the group activities. “They try hard, but not everybody wants to be organised. I like quiet myself.” This preference is respected and this individual enjoys short walks in the surrounding area. The matron confirmed that most of the people currently living at the home, enjoy one to one activities or just spending time chatting to staff and that group activities are not always popular. The size of the home and the person centred approach does mean that individual interests can be pursued. For example, one person enjoyed ballet and had been taken to watch a performance, which she had thoroughly enjoyed. Eight people living at the home completed CSCI feedback questionnaires and in response to the question ‘Are there activities arranged by the home that you can take part in?’ three responded always, four responded usually and one responded sometimes. Two relatives made reference to activities on their feedback questionnaires. These being, “a little more stimulation would be good for the old people” and “they need more entertaining.” The ‘expert by experience’ spent time in the lounge and observations during this time included; “Whilst I was there one of the staff ran a general knowledge quiz, which appeared very popular, she told me that she also reads poetry and biographies to the residents. The member of staff who runs these activities is very enthusiastic about helping stimulate the residents and is always on the lookout for new ideas.” One person who completed a feedback questionnaire explained why she had chosen Kings Abbot. “It is near (within my walking distance of) the church, the newsagents, the bank, the shops, the library and the charity shop.” Visitors are made welcome, as observed on the day of the visit. From the evidence outlined above, it appears that staff work hard to meet individual needs and that the majority of those living in the home are satisfied with current arrangements regarding activities and community contact. It may prove difficult to please everyone, particularly those with decreasing motivation. People are supported to retain their independence and exercise some degree of choice and control over their lives. The small size of the home allows for flexibility and means that routines are not rigid. Each person has a cash box where they can safely keep any valuables or private possessions. The Service User Guide explains that individuals can view their care records if they wish to. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 17 A menu is in place but this remains flexible and the cook, in post for 12 years, explained that changes are often made. The cook does the shopping and may see ingredients, which look particularly appealing or changes may be made according to the season or preferences of the resident group. Breakfast, in the main is cereal or porridge and toast, although a small number of people do like a cooked breakfast and this is provided. The small number of residents means that any particular differences or preferences can be readily responded to. During discussion one person stated, I asked for prunes for breakfast instead of grapefruit which they did. The main meal is served at lunchtime and tea consists of a snack meal, with people being able to choose from a number of options, popular choices being kippers, sandwiches or toasted teacakes. The ‘expert by experience’ joined the residents for lunch and reported that the food was well cooked and presented and the portions adequate, and that residents can opt to have any or all of their meals in theirs rooms. Several people living at the home gave positive feedback about the meals, either during discussions or via CSCI feedback questionnaires. Comments included; The food here is excellent, and “always very good and I enjoy them”. Discussion with the cook and a member of the care team confirmed that people who require assistance get support to eat their meals and that at present on person required her food to be finely mashed and needed help with eating. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People are confident that any concern raised would be acted upon. Procedures and good practice help to protect those living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been received since the last inspection. A complaints procedure is on place and is displayed on the notice board at the entrance to the lounge. Details of how to raise concerns are also provided within the Kings Abbot Statement of Purpose and the Service User Guide, given to all residents. The CSCI feedback questionnaire distributed to those living at the home asks, ‘do staff listen and act on what you say?’ and responses included; “Of course. No complaints about the home at all,” “they always listen to me” and “yes and what they say is always kind and helpful.” People also confirmed that they know how to raise a concern should it be necessary and one lady stated, “If I wasn’t happy I would make my views home.” Comments from relatives regarding complaints included; “In the six months my mother has been in the home I have had no reason to complain.” And “any issues have been addressed and we feel we have good communication with all Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 19 the staff.” The small size of the home and the family type atmosphere lends itself to any minor issue being sorted out as it crops up. The home has appropriate procedures in place regarding abuse and whistle blowing. Issues regarding protection and vulnerability are addressed during the induction of new staff and also within NVQ programmes. There are good arrangements in place for the safekeeping of individuals’ personal monies. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home is comfortable, clean and well maintained, providing a pleasant and homely environment for those living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building is safe, well maintained, homely and comfortable, with a good standard of furnishing and decoration. There is good access to local facilities, such as shops. There are five single and four double bedrooms, with washbasins in each room. The large entrance hall and the layout of the building means that there is easy access around the home. There are lovely garden areas, again with good access. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 21 In order to keep this good standard of accommodation, the owners ensure that there is a continual programme of maintenance and decoration. Since the last inspection some of the bedrooms have been refurbished, a new television purchased and new laundry equipment installed. There is only one main bathroom in the home. This does not appear to be problematic and each bedroom does have a washbasin. The owners are aware that the provision of a second bathroom or shower room would improve the current facilities. The home is clean. Care staff are responsible for cleaning within the home, with the night staff also carrying out certain cleaning duties. There are infection control procedures in place and staff undertake food hygiene and infection control training. Feedback from relatives and those living at the home, confirms that a good standard of cleanliness is always maintained at Kings Abbot. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Competent and experienced staff support the people living at Kings Abbot. Not following appropriate recruitment procedures could pose risks to individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this visit there were 11 people resident at the home. Rotas show that there are always two staff providing care support on duty, during the day and evening with, a working night staff on duty each night. There is also a cook employed at the home. These staffing levels were reflected on the day of this visit. Care staff also carry out domestic duties. The matron, deputy manager and senior care assistant work alongside care staff meaning that there is always an experienced member of the team on duty. There has been excellent progress with qualification training for staff. Excluding the matron, there are eight members of staff providing care support. Of these eight staff, five have gained a NVQ (national vocational qualification) at level 2 or above. A number have also gained the level 3 award. This now exceeds the national target of having at least 50 of care staff qualified at Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 23 NVQ level 2. The high numbers of qualified staff at Kings Abbott means that skilled and capable staff support the people living there. The recruitment records for a recently appointed member of staff were viewed. Documentation included an application form and two references. No CRB (criminal records bureau) disclosure had been applied for and no check against the POVA (protection of vulnerable adults) list had taken place. This is a small home, the majority of staff have been in post for a number of years and the recruitment of new staff is not a regular aspect of the management of the home. However, recruiting staff without gaining the proper checks is a breach of regulations and could place residents at risk. The inspector confirmed that staff are able to commence duty once the POVA clearance has been gained, but they must be fully supervised until the full CRB clearance is received. Discussions with staff and observation of records and certificates confirm that there are good arrangements in place regarding staff training. New staff receive an induction booklet, which is worked through and signed off when completed. The core-training programme includes moving and handling, infection control and food hygiene. Records were also seen of staff completing courses relating to dementia and the care of the bereaved. The people living at Kings Abbot praised the personal qualities and abilities of staff. Comments from feedback questionnaires included; “Staff are very good with any help that I need, in fact they are excellent,” “Staff are excellent, always listen to what I have to say and always helpful,” and “The staff are always helpful and caring.” In addition the ‘expert by experience’ was told They take good care of us. Feedback from relatives was also extremely positive and included; “the carers at the home are always very pleasant, friendly. Best of all they look after the ladies and nothing is too much trouble.” Staffing arrangements at Kings Abbot are generally very good, with a highly competent staff team who are well trained and supervised in their work. The staff team has remained stable, providing continuity for those living at the home. The owners confirmed that the recent lapse in following appropriate recruitment procedures would be promptly attended to and the inspector is confident that this is the case. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home is well managed and staff receive very good supervision and guidance in their role. Policies, procedures, good practice and staff training promote the health and safety of those living and working at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Kings Abbot is owned by Mr and Mrs Mather. Mrs Mather, the matron, manages the home on a day-to-day basis and is responsible for all matters relating to Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 25 the care of those living at the home. Mr Mather carries out certain administrative management duties. The matron is registered with the CSCI, trained as a nurse and has many years experience, being responsible for the management of Kings Abbot since it was established in 1988. The matron is supported by the deputy manager, in post for 16 years and a senior care assistant, in post for 11 years. This management team appear to work well together and provide strong leadership in the home. The matron does not have a management qualification, being of the view that her extensive experience equips her to fulfil her management role. Management issues regarding recruitment have been addressed under standard 29 of this report. There are internal and external quality monitoring systems in place. The home has achieved the Investors in People award with a formal review taking place in February 2007. CSCI inspection reports are made available, with the summary of the most recent report being included in the Statement of Purpose and Service User Guide. Residents meetings take place approximately two or three times each year, with the most recent one being held in September 2007. Regular staff meetings are held and the minutes of recent meetings were viewed. There are also many opportunities for people living at the home to share their views, as part of daily communication with staff and the matron. Care plan reviews are another good opportunity for sharing views and a record of positive feedback from a relative was seen regarding the care plan of an individual living at the home. Feedback from both residents and relatives confirms that an open dialogue is encouraged and that opinions and suggestions are listened to and acted upon. There are good arrangements in place for the safekeeping of individual monies. A record is kept of income and expenditure, with transactions being witnessed in most cases by two staff. The accounts for two people were viewed and the balance of money held checked, both being correct. Staff support and supervision is given a high priority at this home. The matron generally works until early afternoon and then the deputy manager commences duty. This means that care staff are continually supported and guided in their work by senior staff. This day-to-day supervision of staff is very good and helps to maintain high standards. The matron or the deputy manager carry out formal appraisals with staff. These take place approximately every two months and records were viewed. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 26 Records of observation of work practice were also seen and these take place approximately twice each year. Discussions with a member of care staff confirmed that the above arrangements take place and that staff feel supported in their role. The regularity of both formal and informal supervision, which includes the observation of work practice is very good and exceeds the national minimum standard recommended. Staff undertake health and safety training such as moving and handling, food hygiene and infection control as part of the core-training programme at Kings Abbot. Regular safety checks and monitoring take place with good records being maintained. Both the fire and rescue service and the food hygiene agency visited the home in 2006 and no issues were raised. Records were viewed regarding checks of electrical appliances, checks of the emergency lighting, checks of water temperatures and the servicing of the fire system. A fire safety lecture takes place each year. Safety certificates regarding the electricity and gas supply to the home were also seen. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 27 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 4 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 4 X 3 Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13(2) Requirement The registered person must ensure an accurate record of receipt, administration and disposal is maintained for all medicines kept in the home.(previous timescale not met) The registered person must ensure all medicines are administered as prescribed. (previous timescale not met) Timescale for action 10/11/07 2. OP9 13(2) 10/11/07 3. OP9 24(1) 4 OP29 19 The registered person must 10/11/07 ensure systems are in place that maintain the quality of medicines handling within the home. A documented audit will achieve this. (previous timescale not met) Staff must not commence duty 10/11/07 until the appropriate checks have taken place. Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 29 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 OP9 Good Practice Recommendations All handwritten records should be double-checked and countersigned Kings Abbot Rest Home DS0000005885.V346989.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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