Care Home: Abbeleigh House

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)
• Queen Elizabeth House

What the care home does well Abbeleigh provides a comfortable environment for people who use the service. Staff are supportive and have a good knowledge of the needs and strengths of people in their care. People who use the service told us that "they look after me well here", "the food is lovely" and "nothing is too much trouble for the staff". Visitors were seen to be welcome and said that they were `very happy with the care provided`, and `couldn`t have found a better place`. Comments on the service included; they "make my mother feel this is her home", "staff are really kind" "They have given back my mums dignity and the staff are always there to help, the family have nothing but praise for them" and "staff are excellent and really kind, dad is very happy here and loves the food". On more than one occasion we were told by relatives that they had seen real improvements in the health and welfare of their relative since moving into the home. Peoples health care needs are well met and recorded. Relatives told us "In general it seems that the staff care about the individual needs It is also nice to see that they do have a choice in what they want to do and in what they eat". What has improved since the last inspection? To further ensure that people who use the service and other stakeholders are consulted on the service a quality assurance system has been put in place with the results of surveys displayed in the home. The assessment format has been improved to ensure that the nutritional needs of people who use the service are taken into account. Some improvements have been made to the environment to support people in finding their way around. Suitable storage for laundry has been arranged so that is does not take up space from people who use the service. Staff have been provided with training on medication and safeguarding adults which assists in protecting people who use the service. The Service User Guide has been updated to include the inspection report. What the care home could do better: Further work needs to be done on making sure that care plans and risk assessments are reviewed on a regular basis. Staff would benefit from training on person centred care and planning. Care plans could be improved by including more detail on the strengths, needs and wishes of people who use the service including social and leisure preferences. To make sure that the wishes of individuals are known and met staff should record the wishes of people regarding terminal care and actions to be taken following their death. Further work could be carried out to improve the environment in line with good practice in dementia care. To ensure the safety of people who use the service staff must check and record the temperature of baths and showers before they support people to get in the bath or shower. The presentation of pureed meals and the use of bibs should be reviewed. In order to ensure that staff are provided with information on up to date practice on dementia care staff need to be provided with on going training and consideration should be given to subscribing to dementia care journals. CARE HOMES FOR OLDER PEOPLE Abbeleigh House 69 Squirrels Heath Road Harold Wood Romford Essex RM3 0LS Lead Inspector Liz O`Reilly Unannounced Inspection 12:20 22 November 2007 nd 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 Abbeleigh House DS0000027827.V354155.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. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeleigh House Address 69 Squirrels Heath Road Harold Wood Romford Essex RM3 0LS 01708 345110 01708 342827 jshoriginal@hotmail.com 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) Masumin Limited Ms Jacqueline Sheila Harrison Care Home 35 Category(ies) of Dementia (35), Old age, not falling within any registration, with number other category (35) of places Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 35 beds to be used flexibly between both categories. Date of last inspection 27th October 2006 Brief Description of the Service: Abbeleigh House offers 24-hour residential care to 35 people over the age of 65 years. The home is also registered to provide dementia care. The accommodation is split between 2 floors, providing 13 single and 11 double bedrooms. The home has a passenger lift. There are two lounges, a dining room, and a visitors’ room. The rear garden is with disabled access to the grounds and there are car-parking facilities to the rear of the property. The home is located on a busy residential road in Harold Wood in the London Borough of Havering and is close to local services and facilities in Romford Town Centre, which are easily accessible by car and by public transport as is the A127. The current scale of charges is from £380.00 to £520.00 per week. There are additional costs for items such as hairdressing, toiletries, chiropody and newspapers. Information is made available to prospective service users via a Service Users Guide, which is available prior to admission. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two regulation inspectors and consisted of a visit to the service, discussion with people who use the service, staff, visitors and the home manager. Surveys were also provided for people who use the service, staff, visitors and other professionals. Judgements made in this report are based information from all of the above sources, the managers assessment of the service and observations made at the time of the visit. What the service does well: What has improved since the last inspection? Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 6 To further ensure that people who use the service and other stakeholders are consulted on the service a quality assurance system has been put in place with the results of surveys displayed in the home. The assessment format has been improved to ensure that the nutritional needs of people who use the service are taken into account. Some improvements have been made to the environment to support people in finding their way around. Suitable storage for laundry has been arranged so that is does not take up space from people who use the service. Staff have been provided with training on medication and safeguarding adults which assists in protecting people who use the service. The Service User Guide has been updated to include the inspection report. What they could do better: 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. Abbeleigh House DS0000027827.V354155.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 Abbeleigh House DS0000027827.V354155.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): 1, 3 &6 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People are given good information on what the service can provide before they make any decision about moving in. No one is admitted to the home unless a full assessment of their needs and wishes has been carried out. This service does not provide intermediate care. EVIDENCE: A Service User Guide gives people information on the service. A copy is given to each person and can help in deciding whether the home is ‘right’ for them. A copy of the guide is also available in the entrance hall. People who use the service and relatives told us that they felt they had enough information to make a decision about moving in. To make sure that the service can meet the needs of each person an individual assessment is carried out before they move in. This makes sure that the home can meet the needs of each individual. Staff can also use the pre admission Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 9 assessments to set up an initial care plan which can be in place when the person arrives. Abbeleigh House DS0000027827.V354155.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Individual care plans are in place and people who use the service are involved in setting these up. Further work could be done to evidence this involvement and to provide more person centred plans. Risk assessments are in place but should be more detailed for individuals. People are treated with respect and staff take care to protect the privacy of individuals. The health care needs of individuals are met. Medication is well managed. EVIDENCE: A care plan is developed for each person. People who use the service told us that either they were involved in setting up the care plan or told staff what they needed and wanted. The care plans should be reviewed each month but this had not been done in some of the plans we looked at. The reviews that had taken place gave little information on outcomes or the involvement of people who use the service. In Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 11 some instances staff had included very good detail on the likes and dislikes of individuals in their care plans. The inclusion of more detail, in all care plans, on the support to be provided and the personal preferences of people, would assist in making the plans more person centred. One care plan indicated that the person had a ‘tendency to become agitated’, there was no risk assessment in place for this potential behaviour and no details of how staff should respond to help this person and ensure other peoples safety. Information on terminal care and dying was not completed in some of the files we looked at. In order to meet the needs and wishes of people at the end of their lives this issue needs to be addressed. We found staff to be very aware of the importance of maintaining privacy and dignity. Staff were also aware of the difficulty of doing so when people are sharing bedrooms. Relatives of one person informed us that they felt staff had given their parent their dignity back. The health care needs of people who use the service are met with good access to GP and other health care professionals. We found good information on the health care needs of individuals on file including information for staff on what to do if individuals are complaining of pain. Staff keep good records on referrals and treatments prescribed. Medication is well managed with good records kept. We observed staff taking care with administering medication and the manager checks the records on a regular basis. To further ensure safe administration, where medication is prescribed to be given “as required” the record should include the maximum dosage, the frequency and the reason for the medication. Abbeleigh House DS0000027827.V354155.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to maintain important family and personal relationships. Activities are arranged in consultation with people who use the service. Individuals make their own choices about their day to day lives including what activities they take part in, the food they eat and where they meet with visitors. EVIDENCE: We saw people who use the service engaged in a number of activities including watching TV, reading newspapers, talking among themselves, talking with staff, spending time in their room and spending time with visitors. Peoples comments about the way they had spend their day included, ‘I haven’t got much planned’, ‘I enjoy watching the old films and ‘I’m waiting for visitors’. People who use the service told us that they can choose to join in activities or spend time in their room or other areas of the home. In order to improve the service consideration should be given to providing training for staff on offering more variety of activities. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 13 Visitors said they were made welcome by staff whenever they visited and were kept informed by staff of any changes in the needs of their relatives. A hairdresser was visiting at the time of our visit. People who use the service were very pleased with this service and the hairdresser was seen to provide different styles to suit individuals. Lunch was seen to be a social occasion, with some people who use the service eating in the main dining room, the upstairs lounge/diner, in the lounge and other people in their bedrooms. Tablecloths or placemats are used salt and pepper was available on the tables. Consideration should be given to improving the presentation of pureed meals with the use of moulds. The use of bibs should be reviewed. People who use the service made positive comments about the food including; ‘you can’t fault the food’, ‘lunch was good’, ‘I enjoyed lunch, it is usually this good’ and ‘I chose the meal, and got what I ordered’. A menu is produced with alternatives and people who use the service are consulted on what is offered. To make sure that everyone is provided with a varied diet, staff keep a record of the food provided for each person. A non denominational religious service is held in the home each week. Staff will arrange for visits by people from other religious centres when requested. Some of the people who use the service go out to religious services in the community. Abbeleigh House DS0000027827.V354155.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure is on display in the entrance hall. Staff training on safeguarding adults assists in protecting people who use the service from abuse. EVIDENCE: Systems are in place for the recording of any complaints along with action taken and outcomes. People who use the service told us they either knew how to make a complaint or had confidence in the staff to “sort out” any problems they might have. No recent complaints had been recorded and the CSCI have not received any complaints about the service. No concerns were raised at this visit. Copies of the local authority procedures for safeguarding adults were seen to be available to staff. Staff are provided with training on the protection of vulnerable adults which ensures that they understand their role and responsibilities in reporting any concerns or suspicions of abuse. Abbeleigh House DS0000027827.V354155.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 & 26 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a comfortable, homely and well maintained environment. All areas of the home were found to be clean and tidy. Changes to the environment in line with current good practice for dementia care could provide improvements. EVIDENCE: People who use the service have access to comfortable communal areas with a large lounge on the ground floor and a smaller sitting room/dining area on the first floor. The large lounge on the ground floor is arranged with seating in clusters which allows people to talk to each other easily. The décor in the first floor lounge gave the impression of quite a bare room and could be improved. Consideration should be given to referring to current good practice on the environment for people living with dementia in this area. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 16 A visitors sitting room and library is available on the ground floor which has been improved since the last inspection. There is a large well maintained garden which people who use the service confirmed they access during good weather and they enjoy looking at when the weather doesn’t allow them to go outside. The home was found to be clean and tidy. Abbeleigh House DS0000027827.V354155.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available on duty to meet the needs of people who use the service. Staff are provided with good opportunities for training and appropriate checks are carried out on staff which assists in ensuring the safety of people who use the service.` EVIDENCE: We found sufficient staff available to meet the needs of the people using the service at the time of our visit. There is a low staff turnover which assists in ensuring consistency in the care provided. People who use the service gave positive comments on the approach of staff. Staff were described as “lovely”, “very helpful” and “patient”. Relationships between staff and people who use the service looked relaxed and staff were seen to treat people with respect. Staff were found to have a good knowledge of the needs and wishes of the people they support. Over 50 of the staff have completed NVQ level 2 training. New staff take part in an induction programme which ensures they are familiar with the people who use the service and systems of working. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 18 In order to continue to meet the needs of all people who use the service staff should be provided with on going up to date training on supporting people who are living with dementia. The appropriate checks are carried out on all staff before they start working in the home including Criminal Records Bureau checks and taking up at least two references. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 19 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 People who use the service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from living in a well managed home. Staff make regular checks to protect the health and safety of people who use the service and visitors. Further checks on hot water temperatures should be done. People who use the service are consulted on the operation of the service. EVIDENCE: The manager has the appropriate experience and knowledge to manage the service. People who live at the home are consulted on the way in which it operates through regular meetings as well as day to day contact with the manager. It was noted that minutes of the meetings are kept but that no information on actions taken about topics brought up by people who use the Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 20 service was entered. In order to show that action has been taken this information should be provided for the following meeting. Quality assurance systems are in place. The manager provides questionnaires for people who use the service, family and other visitors to the home. The results of the surveys were seen to be on display in the dining room and action is taken to address any concerns raised. People who use the service can deposit small amounts of cash with the home for safekeeping. Careful records are maintained of all money held, any deposits and expenditure. Good systems are in place for monitoring health and safety around the building. Weekly checks are carried out on the fire alarm system. Regular maintenance checks are carried out on equipment. It was noted that staff were not keeping a record of the temperature of baths before people who use the service are assisted with bathing. To further ensure the safety of individuals a record of bath or shower temperatures must be kept. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 13(4) Requirement In order to ensure that people receive the support and care they need and wish care plans must be reviewed in consultation with people who use the service and or their representatives on a regular basis. These reviews must include individual risk assessments. In order to ensure that staff are provided with up to date knowledge on the needs of people with dementia staff must receive on going training on dementia care appropriate to their role. In order to ensure the safety of people who use the service staff must check the temperature of the water before they assist anyone into a bath or shower. A record of these temperatures must be kept. Timescale for action 01/03/08 2. OP30 18 01/05/08 3. OP38 13(4) 01/02/08 Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 23 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 Refer to Standard OP7 OP11 OP12 OP19 OP33 Good Practice Recommendations Staff should be provided with training on person centred care which will provide a more individualised service. Information on people’s wishes regarding terminal care and arrangements following their death should be recorded to ensure that their wishes can be followed. In order to provide a more varied and selection of meaningful activities arrangements should be made for staff to receive training in this area. Consideration should be given to following current good practice in dementia care in relation to the environment. In order to show that action has been taken and to feedback to people who use the service a record of actions taken following residents meetings should be kept. Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Abbeleigh House DS0000027827.V354155.R01.S.doc Version 5.2 Page 25 - 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!