Inspection on 05/05/06 for Abbeywood Care Home

This inspection was carried out on 5th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Abbeywood Care Home 21/07/09

Abbeywood Care Home 28/08/07

Abbeywood Care Home 19/04/05

Abbeywood Care Home 05/10/04

Abbeywood Care Home 20/04/04

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

CARE HOMES FOR OLDER PEOPLE Ribble Lodge Nursing Home Ribble Road Fleetwood Lancashire FY7 7BX Lead Inspector Ms Janet Spink Unannounced Inspection 5th May 2006 08:45 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 Ribble Lodge Nursing Home DS0000006076.V287182.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. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ribble Lodge Nursing Home Address Ribble Road Fleetwood Lancashire FY7 7BX 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) 01253 776761 Dr Shanmugam Subbiah Mr Tojo Mathew Care Home 28 Category(ies) of Dementia (28) registration, with number of places Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The service is registered to accommodate a maximum of 28 service users in the category DE (dementia) 19th July 2005 Date of last inspection Brief Description of the Service: This home is registered for twenty-eight residents who are over sixty five. It offers nursing care to people who have dementia. It is in Fleetwood and is within easy reach of shops and the promenade. The home is built on two floors and has a passenger lift for those who need it. The home has eight single bedrooms and ten double rooms. There are no ensuite facilities. There is one large lounge/dining area and a separate room for people who smoke. There is also a small external sitting area at the rear of the building that can be used by people who use wheelchairs. There is a Statement of Purpose, which needs updating to reflect the change of manager and staffing structure. The most recent inspection report is available in the reception area for people to view. At the time of the visit the range of fees was from £358.00 to £447.00 per week with added expenses for hairdressing and chiropody. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and conducted over four and a half hours. The inspection included case tracking two residents who had recently been admitted to the home, observation, discussions with two members of care staff, the cook and the registered manager. A tour of the building was also undertaken. Most evidence was gained from staff and looking at documentation due to service users having dementia. The registered manager had provided the CSCI with information prior to the site visit. What the service does well: What has improved since the last inspection? The manager is now registered with the Commission for Social Care Inspection (CSCI), which was a requirement following the last inspection. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 6 The home has ensured that water safety checks have been carried out to minimise the risk of legionella so that residents are in a safe environment. The number of staff who have achieved National Vocational Qualification (NVQ) level II in care has increased with 50 of care staff now having this award. What they could do better: The Statement of Purpose should be brought up to date to reflect the change of manager and staff structure in the home. A maintenance plan must be developed to identify a long-term strategy for upgrading of bedrooms to enhance the environment for residents. All policies and procedures must be reviewed to ensure that they are relevant to the home. A policy in relation to Equality and Diversity should be produced to ensure good practice in relation to diverse needs at all times. The owner of the home visits each week and provides a monthly report to the Commission as required by regulation. This would be improved by being more detailed. Risk assessments must be carried out for all those residents who are presently provided with bed rails to ensure their safety. Some care plans did not provide sufficient details regarding personal interests and hobbies, which the manager agreed to review for all residents. Some entertainment is provided but this is limited. It is recommended that all staff receive training in medication. This would be beneficial as a refresher for qualified staff, and would be beneficial for care staff in raising awareness of side effects etc. Residents would benefit from having mealtime routines reviewed as presently this is not stimulating for them. Residents who presently share a bedroom should be given the option of single accommodation. This should be discussed with relatives in the event of the resident being unable to make a decision regarding this. The manager is currently undertaking the Registered Manager’s award, and must continue to achieve this so he has an appropriate management qualification. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 7 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. Ribble Lodge Nursing Home DS0000006076.V287182.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 Ribble Lodge Nursing Home DS0000006076.V287182.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home carries out full assessments prior to admission to ensure that residents’ needs are met. EVIDENCE: Documentation was looked at for 2 residents who had recently been admitted. This included full assessment by the home in relation to moving and handling, nutrition, personal care and dietary needs. Letters were on file confirming that the home is appropriate to accommodate the two residents and contracts were also available. A Statement of Purpose was on file, but needs updating to reflect change of manager and staffing. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans are generally good with sufficient detail, however they require further information regarding risk assessments for the use of bed rails. Medication practices are safe ensuring the protection of residents. EVIDENCE: Care plans were looked at for two people being case tracked. There is a need for risk assessments to be carried out in relation to the use of bed rails, which was evidenced from looking in the accident book. Detailed assessments were in place for nutrition and risk of falls. Residents are weighed monthly. There was nobody in the home with any pressure sores and all residents looked well cared for. Some ladies had their hair and nails done and clothes were clean and in good repair. Laundry systems were well managed with residents having their own clothes returned to them. Staff had good understanding of the diverse needs of all residents and were assisting them in Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 11 a respectful manner. Daily notes confirmed that other professionals are consulted when necessary. Medication procedures were looked at and medication is locked in a metal trolley in a locked treatment room. All records were accurate, and a recent visit by the pharmacist resulted in a good report with one minor recommendation that had since been rectified. It was advised that qualified staff receive up to date training in medication practices as a refresher, and care staff have training to raise their awareness of issues around management of medication. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 14 and 15 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the service. Current activities provided do not meet individual service user needs nor are stimulating. Improvements could be made to the provision of social activities so that residents are stimulated. Meal times are not a stimulating experience EVIDENCE: Staff commented that entertainment was limited and this was confirmed through discussion with the manager and observation of daily notes. The inspector discussed the need to look at individual interests and pointed out that this was incomplete in a resident’s care plan. There were no books, videos, CDs etc visible for use by residents. Some magazines were available in the smoke room. The inspector observed Holy Communion being provided for one resident, which is offered weekly. This ensures that she is enabled to continue practicing the religious observances that are important to her. Observation of menu and discussion with the cook identified that mash potato being served on the majority of days. Alternatives were discussed. The cook Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 13 was aware of the needs of people with diabetes and some finger-foods are provided for those who require this. Adapted cutlery is also available for people which promotes their independence. Residents eat in the lounge/dining room and some do not move from their armchairs at meal times. It was advised that practices at meal times are reviewed to become more homely and more of an event for residents. The CSCI document “Highlight of the Day” was discussed and left with the cook. This document provides good practice guidance for residential homes in the provision of greater choice for older people, catering for diversity and supporting independence in a safe way. The cook confirmed that the budget is adequate to supply sufficient meals. The menus confirmed that fresh vegetables and meat are provided. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality outcomes in this area are good. This judgement has been made using available evidence including a visit to the service. The home’s policies, procedures and practice make sure that residents are supported and protected. EVIDENCE: Staff records, certificates and discussions all confirmed that training is continuing to be offered for protection of vulnerable adults. Staff spoken to had good understanding of their responsibilities in relation to the Vulnerable Adult Abuse policy and the home’s Whistleblowing policy. There have been no formal complaints made to the home since the last inspection. The policy remains the same and is displayed for relatives’ information. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21.22,23,24,25 and 26 The quality outcome in these areas is adequate. This judgement has been made using available evidence including a visit to the service. The building is adequate in meeting the needs of the residents, but would benefit from more up grading to bedrooms and consideration given to making it more user friendly for the client group. EVIDENCE: A tour of the building confirmed that some improvements have been made such as decorating the lounge area, provision of new carpets and non-slip flooring in the bathrooms. The maintenance plan was not available at the time of the inspection. Records of water temperature testing carried out weekly by maintenance man were seen in the office. All bedrooms adequate but require some new bedding and redecoration. They are personalised and clean, although some bedding was looking worn. It was recommended that those people sharing should be offered choice of a single Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 16 room and that this should be discussed with relatives for those residents unable to make this decision for themselves. There are sufficient bathrooms and lavatories for people to access. The home is generally well maintained, but there was no electrical certificate available, although an electrician had been out to carry out safety check of installations and appliances. The manager is continuing to pursue this with the contractor and inform the CSCI when the certificate is obtained. All other records of testing of services were satisfactory. The home is clean and suitable infection control procedures are in place. The laundry is situated in an area where soiled items are not carried through areas where food is stored, prepared or cooked. Consideration should be given to making the environment for “user friendly” for people who have dementia such as the use of pictures, bright colours, symbols etc. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 and 30 The quality outcome in this area was good. This judgement has been made using available evidence including a visit to the service. The home provides sufficient staff to meet the needs of people accommodated. Training continues to be a regular feature for all staff. EVIDENCE: This site visit was unannounced and there were 16 residents accommodated. There were 2 managers on duty (the registered manager and deputy) with 3 care staff, a domestic and the cook. The laundry assistant was on rota but was off sick. Rotas for one month were viewed and showed sufficient staff on duty for night and day. It was pleasing that there was no dependency on agency staff, which has been a feature in the past. This provides more consistency in the delivery of care for the residents. There have not been any staff recruited since the last inspection. Staff retention in the home at present is stable. Training is on going and the training plan was seen for this. All care assistants have done Moving and handling, fire safety, protection from abuse and are going to be doing infection control and pressure care. There are 6 members of staff booked for First Aid in the next month. 5 have completed NVQ II and one has completed NVQ level III. Two others are currently doing this. The cook and domestics have also done NVQ training. Dementia care training is ongoing, and staff had a positive attitude towards training. Ribble Lodge Nursing Home DS0000006076.V287182.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37 and 38 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. The home is competently managed, staff are well- supported and residents are accommodated in a safe environment. EVIDENCE: There was evidence of staff meetings being held regularly, which was confirmed by staff and observation of minutes taken. Staff confirmed that regular supervisions and appraisals are provided. The registered provider visits weekly and has been providing the CSCI with a monthly report. The inspector discussed the need for more details in these reports to provide a clearer picture of issues that had been raised and any action taken following the visits by the owner. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 19 Quality Assurance surveys had been sent out by manager and seen by the inspector. All positive responses from relatives regarding the care provided. It was advised that views from others such as health professionals and placing authorities are gained. This home has been successful in obtaining the Investors in People award, which is given to those services who can provide evidence that they support their staff through effective supervision, induction and training. Policies and procedures need reviewing and the manager is aware of the need for a policy regarding Equality and Diversity to be developed. The registered manager is currently undertaking the Registered Manager’s Award. Ribble Lodge Nursing Home DS0000006076.V287182.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 x x 3 x x N/A 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 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 3 3 3 2 2 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 3 3 3 Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 Requirement The statement of purpose must be reviewed to include relevant information about the manager and staff structure in the home. Social interests and hobbies should be addressed on an individual level through care plans. Routines at meal times should be reviewed to make it a more stimulating experience for residents. A current electrical certificate must be obtained to confirm that electrical installations are safe. Risk assessments must be carried out for all residents using bed rails. Timescale for action 05/06/06 2 OP12 16 (2) (m) (n) 16 (20 (i) 05/07/06 3 OP15 05/06/06 4 5 OP19 OP7 13 (4) 13 (4) 05/06/06 19/05/06 Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 22 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 2 3 4 5 6 7 Refer to Standard OP9 OP19 OP23 OP31 OP33 OP37 OP37 Good Practice Recommendations All staff should receive up to date training on safe management of medication. A long-term strategy plan should be produced to address upgrading of the bedrooms. Service users presently sharing a bedroom, should be given the option of single accommodation. The registered manager should complete the Registered Manager’s Award. The reports produced by the registered provider each month should include more detail of issues addressed during the unannounced visit. All policies and procedures must be reviewed to ensure they are relevant to the home. A policy in relation to Equality and Diversity should be developed. Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ribble Lodge Nursing Home DS0000006076.V287182.R01.S.doc Version 5.2 Page 24 - 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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