Inspection on 13/03/07 for Margaret House (Abbots Langley)

This inspection was carried out on 13th March 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 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

Margaret House (Abbots Langley) 03/11/05

Margaret House (Abbots Langley) 26/04/05

Margaret House (Abbots Langley) 24/08/04

Margaret House (Abbots Langley) 11/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Margaret House (Abbots Langley) Parsonage Close Abbots Langley Hertfordshire WD5 OBQ Lead Inspector Julia Bradshaw Unannounced Inspection 13th March 2007 1:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Margaret House (Abbots Langley) DS0000019457.V333167.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. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Margaret House (Abbots Langley) Address Parsonage Close Abbots Langley Hertfordshire WD5 OBQ 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) 01923 261190 01923 299 902 www.quantumcare.co.uk Quantum Care Limited Mrs Isabel Darby Care Home 51 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (51) Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Margaret House is a care home for men and women who are over 65 years, who may also have a physical disability or dementia. The home comprises of six purpose-built units, or bungalows; three, which are for residents with dementia, and two of these are now managed and staffed together. The resulting five units each have its own lounge, dining area and small kitchenette. There are two courtyard gardens outside and also a patio area. Car parking is in an adjacent area to the front of the building. The home is situated in a residential area of Abbots Langley and there is a nearby walkway leading to the High Street where there are shops, pubs and restaurants. For details of the current fees please contact the provider for more details. Information regarding the service is available in the Statement of Purpose and Service User Guide. A copy of the most recent CSCI inspection report is available within the home. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on 13/03/07. The registered manager was not on duty at the time of the inspection therefore the deputy manager conducted the inspection in her absence. There were 49 service users in the home on the day of the inspection. The inspection was conducted in the early to late afternoon. Several service users and their family members were spoken with. General observations were made of the staff’s interaction with service users. Written records and care plan files were also examined. The service users appeared well cared for. Their comments about the care and service provided were all positive. Care staff appeared confidant and said they felt supported and happy to work in the home What the service does well: What has improved since the last inspection? What they could do better: Only 12 hours are allocated per week to provide activities, this offers according to service users a limited activity programme. The deputy manager explained the current arrangements for both menu planning and providing choices of meals for service users is undertaken by Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 6 head office. This system does not take into account or consider service user choice who indicated that they would like some input into the food provided at Margaret House. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 7 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 Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 8 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): 3-5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All new service users have their needs fully assessed before entering the home and are able to visit the home before admittance. In this way both the service user and the care staff can be sure that the persons needs can be met. EVIDENCE: The admission notes and the care plan files of the service users examined confirmed that a full assessment was carried out before a prospective service user was admitted into the home. Records of service users examined contained signed copies of the home’s contract and these listed all relevant information, including the room to be occupied. A copy of the Statement of Purpose and Service User’s Guide were displayed in the reception area of the home on the day of the inspection as they have been at all previous inspections Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 9 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): 7-11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures for medication administration and support at times of illness ensure that service users’ health and well-being is promoted. Residents are treated with respect from the staff and feel confident their privacy will be respected at all times. EVIDENCE: The members of staff were observed to interact very well with the service users and their relatives. The service users appeared relaxed and content. The inspector took the opportunity of speaking to several of the service users who were all very positive about the care they receive and spoke very positively about the caring and professional attitude of the care staff. They also stated that the manager and deputy have daily contact with all service users in order to discuss any issues they may have and to hopefully resolve these immediately. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 10 The care plans examined have detailed accounts of the healthcare and personal needs of the respective service users. It was evident that care plans are maintained and regularly updated. Records of appropriate health checks were seen and good pressure sore monitoring was documented with details of District Nurse involvement. The home has good rapport with the various healthcare and specialist professionals. The service users and their relatives are involved in the plan of care. During the inspection, service users in the higher needs units were seen moved, using handling techniques and hoists, and all practices were undertaken well by staff. Service users spoken to confirmed that staff treat them with respect at all times and knock and wait before entering their bedrooms. There are written policies on death and dying and staff said that all possible care is provided for service users and their families at such times Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 11 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 –15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current hours allocated for activities within the home is inadequate to meet service users expectations. The standard of meals provided is adequate. However, service users have stated that they would like more input at a local level into menu planning. Service users are encouraged to maintain links with family and friends. EVIDENCE: The service users are encouraged to exercise choice and control over their lives. The activity worker is employed for 12 hours per week. The care workers continue to support the activity programme with the activity worker. Some service users comments include “All the activities are carried out in the morning” and” People feel tired in the afternoon as they are bored”. Discussions with some service users, which were supported by the minutes of the service users meetings, show that there are some issues relating to the current arrangements of choosing the meals and menu’s. Service user comments include “ there are too many casseroles and stews” and “people would like more boiled potatoes”. Currently head office is responsible for devising the menus, which does not offer, service users choice or consultation Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 12 with the people using this service. The service users spoken with stated that the standard of meals was both flavoursome and plentiful. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 13 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- 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints process that all service users can access, both formally and informally. Staff have the appropriate training to ensure that service users are protected from abuse and their legal rights are protected. EVIDENCE: An appropriate written complaints policy is in place. One complaint has been received since the last inspection took place, which has been resolved to the satisfaction of both parties involved. Written procedures are in place for Safeguarding Adults (Adult Protection) and a Whistleblowing Policy, which staff spoken to were aware of. There are also policies for handling service users’ money, which were checked at previous inspections and were found to be accurate. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 14 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- 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained and promotes service user safety and comfort. Individual and communal facilities are adequate to meet all service user needs. EVIDENCE: The premises appeared clean, tidy and well maintained. The bedrooms inspected appeared comfortable, neat and clean. Five of the bedrooms also have en-suite facilities. The service users spoken to said that they are very pleased with their bedrooms and the facilities provided. The items displayed reflected their individual lifestyles. There is a continuous programme of redecoration going on in the home. Several areas of the home are in the process of receiving new Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 15 carpets/flooring/curtains. The deputy manager stated that Bungalow 5 is due to be re-furbished throughout. There is emergency lighting throughout the building. The hot water was being delivered at safe temperatures to safeguard people from accidental scalding. There are two smoking rooms in the home. The main kitchen and the laundry were clean and well equipped to meet the needs of the people at Margaret House. Staff confirmed that the procedures followed regarding food preparation and laundry, promoted the control of infection All fire checks were inspected and the latest fire alarm was completed on the 6/03/07.The last fire drill was carried out on the 17/1/07. However, it was not possible during the inspection to confirm when the last bi-annual fire safety check was completed and if there is a current fire risk assessment in place. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 16 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 –30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective and dedicated team of care workers and other supporting staff, who have a good knowledge of the health and assessed needs of the service users. The training programme for staff is structured and consistently maintained for the benefit of both staff and service users. The recruitment process is thorough and complies with legislation to ensure vulnerable people are kept safe. EVIDENCE: All the staff have demonstrated their dedication to their work in caring for the service users in the home. This was further evident by the complimentary remarks received from the service users interviewed during the inspection “They are all so kind and caring”. The members of staff present confirmed that they are given opportunities to attend external and in-house training programmes. Staffing levels provided are adequate to meet service users needs. The deputy manager confirmed staffing levels as 9 care staff plus a duty manager. There are 3 waking night care staff on duty per night. The standard of staff training is of a high standard and records proved that all staff are receiving the mandatory training required including, dementia care, medication training, manual handling, safeguarding adults. It was not possible to verify when the last session of infection control training was undertaken or who took part in this training. There are currently 10 staff that are qualified to Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 17 NVQ level 2. The manager has obtained the registered managers award (RMA). The home and company have a clear commitment to providing excellent dementia care training to all staff. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 18 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): 31,33,35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well managed home where procedures for maintaining records, promoting safety and supervising staff ensure that the welfare of service users is promoted at all times. EVIDENCE: The administration and management of the home are consistently well maintained. The management approach creates an open, positive and inclusive atmosphere. This is further evidenced from the complimentary feedback received during the inspection. The manager works as part of a team with other seniors and those spoken to said that this group works effectively and well. Staff and service users said that they were clear about procedures in the home and that the manager and deputy were approachable and supportive. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 19 The senior staff carry out supervisions to all staff. Staff meetings are held and records showed that meetings were held 18/01/07, 27/9/06 and 19/7/06. Senior meetings were held on 18/01/07, 15/11/07 and 31/8/07. There was a current insurance certificate displayed and is valid until the July 2007. The home has introduced ‘carers’ meetings into the home, which have proved successful and relatives spoken to on the day of the inspection stated that it was a welcome introduction and helped alleviate any outstanding issues and helped the process of information sharing. Not all fire records were available for inspection – please see environment section. However, it is acknowledged that the manager was not present during this inspection. Staff were aware that service users and families could access their records, subject to individual permission and the Data Protection Act. The accident records were well kept, with an overview maintained so that trends could be monitored, and the system complies with the Data Protection Act. The home provides the CSCI with details of all significant accidents and incidents and with regular reports from Head Office staff visits. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 20 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 3. Standard OP19 Regulation 23(4) Requirement All fire precautions/records must be up to date and available for inspection. This includes the biannual fire check and the fire risk assessment. The manager must consult with service users with regard to the current arrangements for choosing their meals/menu’s and improve and promote the opportunity for autonomy and choice. Timescale for action 30/06/07 4. OP14 OP33 12(2) 30/06/07 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 OP12 Good Practice Recommendations The number of hours available with the Activities coordinator should be reviewed so to meet the needs of the service users. Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Margaret House (Abbots Langley) DS0000019457.V333167.R01.S.doc Version 5.2 Page 23 - 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. 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