Inspection on 05/11/08 for Oulton Abbey Nursing Home

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Excellent service.

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

Oulton Abbey Nursing Home 30/11/06

Oulton Abbey Nursing Home 30/12/05

Oulton Abbey Nursing Home 23/08/05

Oulton Abbey Nursing Home 22/02/05

Oulton Abbey Nursing Home 12/10/04

Oulton Abbey Nursing Home 26/03/04

Oulton Abbey Nursing Home 29/09/03

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Maple Lodge

Heathlands

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oulton Abbey Nursing Home Oulton Abbey Nursing Home Oulton Stone Staffordshire ST15 8UP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pam Grace     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Oulton Abbey Nursing Home Oulton Abbey Nursing Home Oulton Stone Staffordshire ST15 8UP 01785814192 01785812421 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Our Lady and St Benedict`s Name of registered manager (if applicable) Mandy Jackson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1 DE(E) - Dementia over 65 years for one named service user. 26 - PD Physical Disability - Minimum age 60 years on admission Date of last inspection Brief description of the care home Oulton Abbey Care Home is a grade 2 listed building converted to a nursing home in 1989. Prior to this the home had been a retreat house and a boarding school. St Marys Church was built in 1853 and forms part of the home. The building has been home to a community of Benedictine nuns since 1853 (St Marys Abbey, also known as Oulton Abbey). The home is situated within the village of Oulton near to Stone in Staffordshire and can be accessed by public transport. The bus stops about 200 yards away and the Care Homes for Older People Page 4 of 28 care home 26 Over 65 1 7 26 0 0 26 Brief description of the care home train station is in Stone (approximately one mile away). Oulton Abbey is registered to take twenty-six people over the age of 60 years with care and nursing needs. This includes individuals referred through care management either from social services or hospital as well as privately funded individuals. Cultural and religious beliefs are a particular consideration and members of all denominations are welcomed. Additional charges apply for hairdressing, chiropody, newspapers and toiletries. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was 30 November 2006. This inspection visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over eight hours by one inspector who used the National Minimum Standards for Older Persons as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Assessment for us. On the day of the inspection, the home was accommodating twenty three people. Care Homes for Older People Page 6 of 28 We spoke with staff, people using the service and their visiting relatives. We also examined records, carried out indirect observation of four people who use the service, and four staff on duty. Four plans of care and four staff records were examined, we also directly observed daily events. We looked at three bedrooms, two communal lounge areas, the dining area, kitchen, and bathing facilities on all floors. We inspected the system of medication administration and storage. The fees charged for the service at Oulton Abbey, are from 368.00-750.00 pounds per week. The fee information included in this report applied at the time of inspection, the reader may wish to obtain more up to date information from the care service. What the care home does well: What has improved since the last inspection? The home has purchased a computer, which will assist the administrator and will modernise the existing systems. The complaints policy and procedure has been reviewed, and is clearly displayed in the main entrance to the home. Care Homes for Older People Page 8 of 28 Staff handbooks on health and safety have been introduced, and have been given to all staff. Qualified staff have completed a mentorship course. This is in order for the home to develop and continue the working relationship with Staffordshire University Student Nurse Placements. The deputy matron has completed the Registered Manager Award. The homes administrator is working towards the National Vocational Qualification in Business. This will increase her knowledge and skills, and shows a strong commitment to this role. 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 set out 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 –03000 616161. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering using the service are provided with helpful up to date information, and can spend time in the home, which helps them to decide if the service is suitable to meet their needs. No person moves into the service without firstly having their needs assessed. Evidence: The Annual Quality Assurance Assessment (AQAA), which was completed by the care manager told us : All residents are pre assessed, and Oulton Abbey feels this is paramount for each resident before admission, in order for the home to meet all the needs that each individual may hold and can be addressed prior to admission, so to make the life changing process as comfortable and effective as possible. This enhances in the building of relationships and friendships with residents and their families, and showing an understanding, for the life changing decisions that may be in place. Care Homes for Older People Page 11 of 28 Evidence: The Statement of Purpose and Service User Guide were discussed with people using the service, and their relatives. People spoken with during this inspection, care plans examined, and feedback from surveys undertaken earlier this year, during the Annual Service Review confirmed that people had been assessed, and had received appropriate information prior to admission. One person said the information we received was very good, We were invited to tea, and spent some time in the lounge afterwards, just talking to people. This had helped them decide if the service would be suitable for them. People also confirmed that they had been provided with a Contract and or Terms and Conditions of Service. Intermediate care is not provided in this home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are upheld and put into practice. Medication systems and processes are safe and secure. Evidence: The Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager told us : The staff at Oulton Abbey work very closely in a team working environment and provide the residents with the excellent care that they require from the staff. Care planning is up to date and agreed with each individual and is personalised to each and every individuals personal care needs whether it be that residents wish to have a daily bath. The staff at Oulton work very closely with the management team and issues are addressed appropriately. Staff work closely with relatives and family members and it is often referred to here as a family environment. We the Commission examined four care plans. We spoke with staff, people who use the service, and their visiting relatives. Staff spoken with could tell us exactly how each of these people were to be cared for. What those staff told us reflected what was Care Homes for Older People Page 13 of 28 Evidence: written in individual care plans. People we spoke to told us I do discuss what I want with staff, and they always do their best for me, my family are made welcome here, they sort out any problems with the manager, theyve got some sort of plan written down for me, I know that they do their best. Visiting relatives commended the care that is undertaken by staff, one person said that the staff are all wonderful here, theyre all very helpful, staff here pay attention to detail, for example flowers in a room for a person returning from hospital. All four care plans contained evidence of pre admission assessments, which had informed the care plan. There was also clear evidence of health professionals involvement, for example physiotherapy, General Practitioner visits, consultation in regard to the tissue viability specialist nurse, and the dietitian. Bed rails and bumpers were in use for individuals, and were being used in conjunction with an appropriate signed risk assessment, contained within the care plan. Various aids and adaptations were in use, including mobile hoists, assisted baths, zimmer frames, and wheelchairs. All of which were well maintained and serviced. The home fully respects the rights of people in the area of health care and medication. They recognise and work with the decisions made by the individual regarding any refusal to take medication, or any specific requests about how their healthcare is managed. A spot check of medication administration systems, which included controlled medication, Medication Administration Records, storage and disposal of medication, revealed that there were no anomalies. The medication policy is currently under review. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in regular, organised, daytime activities of their own choice, which are tailored to meet their needs. They also have access to the local community. Family and friends are made welcome at the home. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : The home employs an activities person for 23 hours weekly, Monday to Friday. The residents needs are paramount to the establishments working ethos. The home recognises all religions, and residents meetings are regularly held. Fund raising activities are held for the local community to attend to provide the funds required to maintain the outings for residents. The activities person is qualified in occupational therapy, she said I always undertake a social assessment before offering a resident an activity. She also said that she recognised the importance of documenting a social history for a person who has dementia, with the help of that persons family or friends. This enabled a more tailored approach and outcome for that person. Activities undertaken included art, crafts, puzzles, discussion groups, reminiscence groups, 1:1 conversation, outings, Care Homes for Older People Page 15 of 28 Evidence: themed events for Christmas, Easter and Summer fetes. We spoke with people who use the service and their visiting relatives about their daily life, activities, and their outings. They confirmed their involvement in the activities organised by the home, and one person said we can join in with activities every day if we want to, but sometimes I prefer just a quiet day. We saw letters and cards which had been sent in by peoples relatives and friends, commending and thanking the manager and staff for their commitment, care and support. The home provides a lounge for activities, and a large main lounge, which is well used by the people using the service, their visitors and friends. Visitors can also be seen in private if people so wish. We asked people using the service about their meals, and the menus. People said the meals are good here, sometimes we get too much to eat, we get a choice, but we can just have cheese and biscuits if we want to. Lunch had just been served upon our arrival, the meal looked appetising, well balanced and nutritious. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service and their family, friends and representatives are given information on how to make a complaint. Complaints and grumbles are acted upon and resolved straight away. The services protection processes ensure that people are not at risk from harm or abuse. Evidence: The Annual Quality Assurance Assessment (AQAA) told us: the home receives very few complaints annually. The complaints procedure has been recently updated and is displayed clearly on the information board in the main entrance. The home addresses any complaint immediately. We were shown letters and cards received by the home, from relatives and friends of people using the service. They praised staff for their commitment, quality of care, support and sensitivity in caring for people. The complaints folder showed that no complaints and or Safeguarding referrals had been received either by the home or by us since the previous inspection. Staff spoken with confirmed that they had received appropriate training in relation to abuse and the protection of vulnerable adults, and that they would have no hesitation reporting any concerns to the care manager. Staff recruitment records evidenced that security checks had been undertaken in regard to new staff. For example, two written references, a full employment history, Care Homes for Older People Page 17 of 28 Evidence: identification and Criminal Records Bureau checks. Finances were spot checked in regard to personal monies held by the home on behalf of people using the service. These were all in order. Receipts are held for all purchases undertaken, these included hairdressing and chiropody services. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : Cleanliness is very high within the home, and any faults that are reported are addressed by the on site maintenance person. Contractors carry out any necessary maintenance on electrics, heating, equipment testing and other services. We continue to maintain the health and safety of all our residents, staff and visitors to the home. Residents and their families can access all facilities, including the gardens, patio, lounges and dining area. The home has an ongoing programme of redecoration, and more recently, staff have been provided with a health and safety handbook. The AQAA confirmed to us that health and safety checks had been undertaken. Bedrooms seen were personalised, comfortable and homely. They had been adapted to suit the needs of the individual. Bed rails and bumpers were in use for individuals, and were being used in conjunction with an appropriate signed risk assessment, contained within the care plan. Various aids and adaptations were in use, including mobile hoists, assisted baths, Care Homes for Older People Page 19 of 28 Evidence: zimmer frames, and wheelchairs. All of which were well maintained and serviced. The care manager informed us that there was an ongoing repair to the homes central heating boiler, which had temporarily disrupted one of the two laundry rooms. However, we noted that the disruption did not affect the service that people received. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to have confidence in the service provided as staff receive ongoing and appropriate training according to their role. There is a good recruitment procedure in place. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : Oulton Abbey pride themselves on recruitment and retention of staff, staff have been employed on a long term basis. Records are kept of all applicants, and there is Equal Opportunities monitoring with all applications. Regular staff meetings are held, and in house bank staff cover sickness and holidays. Staff are provided with the opportunity to enhance their skills through training and education. Staffordshire University students have been introduced on placements in the home,and have become part of the team. The AQAA confirmed that the home continue to strive on the supervision process, and that staff undergo an eight week induction process. This was confirmed during discussion with staff. Staff spoken with said that they were not receiving regular and formal supervision as per the National Minimum Standard (NMS). This was discussed at the time with the care manager, and is a recommendation of this report. Staff recruitment records confirmed that the home has a good system in place for checking identification, two references, employment history, Criminal Records Bureau Care Homes for Older People Page 21 of 28 Evidence: (CRB) and Protection of Vulnerable Adults (POVA). Discussion with staff confirmed that they had received appropriate and update training, including moving and handling, fire, health and safety, and adult abuse. Staff said this is a marvellous place to work for, were a close knit staff team, I really enjoy coming to work, I would always encourage my friends to come and work here. The numbers of staff on duty on the day of the inspection, tallied with the duty rota, apart from one staff member who was off sick. The care manager was in the process of filling that vacancy either by bank staff or by agency. People spoken with and letters and cards seen confirmed that they were very happy with the quality of care received at the home. People said the staff are marvelous, they listen to what you say, and then they do it, I only have to ask staff, and they are always kind and considerate, theres always someone around to ask. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. The service has effective quality assurance systems developed by a qualified, competent manager, ensuring it is run in the best interests of the people who use it. Evidence: The Annual Quality Assurance Assessment (AQAA) told us : We work very closely with the team of staff at Oulton Abbey. The manager covers shifts when staff are on annual leave or have sickness leave. There are good relations between the deputy and the manager, who work very closely with the proprieter in the running of the home. The manager supports the staff and operates an open door policy, ensuring that staff are listened to, trained and appraised. We were shown written feedback from six people using the service following an annual quality assurance survey by the home. The feedback received was very positive. The surveys had covered catering, care, and satisfaction. Surveys had also been sent out Care Homes for Older People Page 23 of 28 Evidence: to General Practitioners, and feedback was awaited in those instances. The deputy manager has achieved the Registered Managers Award. The home has purchased a computer system, which will aid and update the current systems, and will create a modern approach. The AQAA document which is completed by the care manager prior to the inspection visit was returned on time, and showed a much improved format. There had been no complaints and or safeguarding referrals made since the previous inspection. The AQAA also confirmed that Health and Safety checks had been undertaken. Staff spoke highly of the management support they received, and the training opportunities they experienced. Regular staff meetings were held. This was reflected in the low levels of staff turnover, and the high level of staff retained. Staffing levels had been maintained. The manager should at all times provide an excellent role model for other employees. Other professionals see the manager as an imaginitive and effective leader who consistently provides high quality services. They undertake regular training and understand and value opportunities for their continuing professional development. Staff spoken with reported that although they do receive daily instruction and supervision from senior staff, they do not receive regular and formal supervision as per the National Minimum Standard (NMS). Relatives and people using the service spoke highly of the staff and management, and commended the commitment, care and support that they and their relatives received. Regular meetings are held for the people who use the service. People have confidence in the care home because it is led and managed appropriately. People can control their own money wherever possible, help and support is on hand if needed. The environment is safe for people and staff because appropriate health and safety practices are carried out. People receive the right support from the care home because the manager and staff have an open approach that makes them feel valued and respected. Care Homes for Older People Page 24 of 28 Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 36 Care staff should receive formal supervision at least six times per year. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!