Care Home: Abbendon Nursing Home

What the care home does well Abbendon constantly reviews its practice and is always striving to improve the service offered to the people either living in the home or to prospective residents. The service is flexible and reflective and the home`s management team have looked at where they are now and where they want to be in the future. This helps to ensure that the home is able to respond to changing needs, which in turn enables people to maintain as much independence as possible. There is a strong commitment from everyone working at the home that helps to ensure that the quality of care is provided to an excellent standard. Residents are treated with respect and dignity. We found that staff members were able to demonstrate an awareness of the diverse needs of the residents they were caring for. Positive, relaxed and warm relationships were seen to exist between residents, relatives and staff members, those people that commented all said that the manager and staff members were very good. A relative has written on a survey form, "There is proper respect of residents by staff". Routines within the home are flexible, this gives residents some control over their lives and enables them to maintain their independence. A wide choice of meals are offered and the standard of catering is very good. Fully accessible and very well maintained gardens are available for residents and their families to use. What has improved since the last inspection? The home manager has continued to encourage/enable the staff members to undertake training courses and all of them are to have refresher training in order to ensure they are familiar with the Skills for Care Common Induction Standards. Improvements to the facilities, including the fitting of a new shower room have enhanced the facilities available to residents. What the care home could do better: A question on the survey forms for relatives asks, "what could the service do better", one person has responded, "not a lot". We consider that Abbendon is an excellent service so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the very high standard of care provided to the residents at the present time is maintained and where possible improved upon. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbendon Nursing Home 45 Scarisbrick New Road Southport Merseyside PR8 6PE     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: Paul Ramsden     Date: 2 5 0 6 2 0 0 9 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (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 26 Information about the care home Name of care home: Address: Abbendon Nursing Home 45 Scarisbrick New Road Southport Merseyside PR8 6PE 01704538663 F/P01704538663 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Mark J Gilbert,Mrs Wendy J Gilbert care home 24 Number of places (if applicable): Under 65 Over 65 24 dementia Additional conditions: Service users to include up to 24 DE(E) 1 The service may admit one named service user under pensionable age in the category of Dementia. Date of last inspection Brief description of the care home Abbendon is a large detached property that has been converted into a care home. It provides care for 24 older persons who have enduring mental health needs. The home is privately owned and is part of the Dovehaven group. Abbendon is situated in a residential area of Southport close to the town centre, local amenities and public transport. The home is arranged over 4 floors and provides 14 single rooms and 5 double rooms. Abbendon has a lounge on the ground floor and a conservatory on the first floor at the rear of the building. The home has a lift to all floors and ramps are provided for wheelchair access to the main front door. There is ample car parking space and an enclosed garden at the rear. The current fee for the home is £567 per week; this includes a fee of £30 which is in addition to the local authorities fees. This is used to purchase toiletries, small sundries Care Homes for Older People Page 4 of 26 Brief description of the care home such as tights and stockings, hairdressing (except for perms), chiropody, newspapers or entertainment. Further information regarding fees are available from the home manager. A copy of this inspection report can be made available on request from the home or via the Commissions website. Care Homes for Older People Page 5 of 26 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: This unannounced visit took place on the 25 June 2009 and lasted for a total of six and a half hours. Paul Ramsden, Inspector, undertook the visit on behalf of the Care Quality Commission [The replacement body for the Commission for Social Care Inspection, CSCI, since 1 April 2009]. Any references to we or us in the report refer to the Commission. All of the key standards for older people were looked at. Feedback on the findings of the inspection was given to the home manager as the inspection progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed Care Homes for Older People Page 6 of 26 questionnaire that provides us with a lot of information about the service before we go to the home. We looked at the Annual Service Review [ASR] that was carried out last year [This is a review of good and excellent services that takes place between key inspections, good services only have an inspection every two years and excellent services every three years]. Following the completion of the review we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A number of residents, family members and staff were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. Survey forms were sent to a random sample of staff members prior to the inspection and forms for residents and relatives were given to the manager upon arrival at the home. To date we have received completed forms from three relatives and four staff members. What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 26 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 –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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. Information and opportunities to visit before moving in are available and residents are assessed before moving in to ensure their needs can be met at the home. Evidence: The home provides a range of information to prospective residents; these are presented in a Service User Guide and the Statement of Purpose. These documents contain all of the information required and they should provide sufficient information for anybody who is thinking of moving into the home. People are free to visit and look around Abbendon prior to choosing to live there if they want to; they can also stay for a meal and have a trial visit before deciding. If they have any queries they can contact the manager or senior staff members. A visiting relative told us; we looked at other homes but did not like them, Abbendon had by far the best atmosphere and my relative has really come on well. Care Homes for Older People Page 11 of 26 Evidence: Pre-admission assessments demonstrating that the residents individual needs had been assessed in an accurate and consistent way had been carried out for the residents whose files were looked at. The manager or one of the other nursing staff members will usually carry out the assessments and will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. This provides an opportunity to make sure the home can accommodate the person and their individual needs. Where applicable copies of information provided by the Local Authority is also obtained prior to admission. Intermediate care is not provided at Abbendon. Care Homes for Older People Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents care plans seen were well maintained and provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs. Evidence: The manager is responsible for drawing up a residents plan of care. All of the care plans seen were of a very good standard and provided the staff with all of the tools needed to identify any assessed need and how it is to be met. The care plans seen were all up to date and were written in a style that would enable someone reading it to have a good idea of what help and assistance someone needed at that time. Care plans were being reviewed, with input from the residents or their representatives and where necessary re-written on a regular basis. This was confirmed by a visiting relative who said about the quality of care provided at the home; when my relative came here the care went up a couple of gears. Staff members spoken with could show that they had a good understanding of the Care Homes for Older People Page 13 of 26 Evidence: people they were supporting and they were able to meet their diverse needs. Care staff work to a high standard in order to ensure that residents receive the care they need. They monitor a residents health and emotional needs daily and there was evidence to show that people were receiving the appropriate support from district nurses, GPs etc. A named nurse and key worker system is in place [This is a system used in the majority of homes and involves particular staff members working more closely with certain residents]. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit when information about an individual was passed onto the manager. The good communication systems in the home helps to ensure that any issues that have been identified are addressed promptly. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. They were seen to be interacting with individuals in an appropriate way, knocking on bedroom doors before entering and addressing people according to their wishes. The residents spoken with made a number of positive comments about the home and the staff members supporting them. All personal care is carried out in the privacy of a residents bedroom or one of the bathrooms. Abbendon has a written policy on the receipt, administration [including self administration], safekeeping, handling, recording and disposal of medication within the home. The home uses a blister pack system dispensed by a local pharmacist. The arrangements for the administration of medicines during this inspection visit were considered to be good and the residents were being given their medication as prescribed. All senior staff members have received medication training and the home manager audits this regularly. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents using the service are able to maintain contact with family and friends and those spoken with were positive about the home and the support they received. Evidence: Residents were able to move freely around the home and a choice of sitting areas was available. It was seen that routines within the home were flexible and that residents were able to make choices in many areas of daily living; for example, times of rising and retiring, whether or not to join in with planned activities and where to spend time and with whom. The residents and family members spoken with made a number of positive comments during the inspection. Although the home does not have an activities co-ordinator the manager explained that she was due to interview someone for the post shortly. This role is to work with individuals both on an individual basis or in groups and to organise social and other activities for people to participate in if they want to. The manager and staff members currently arrange these and a list of activities was displayed in the entrance area. The home has access to a mini-bus and a trip out is organised every Wednesday. Care Homes for Older People Page 15 of 26 Evidence: Various religious denominations conduct services in the home and residents are free to attend if they wish to do so. They are also able to attend their own church if they are able to. A hairdresser visits the home on a regular basis. Links with the local community are maintained and people are able to go out with their families whenever they like. Meals can be taken in the lounge/diner or in the privacy of a residents own room. There is a menu that has the flexibility to meet individual needs and choices. The catering staff members have a very good understanding of each persons preferences and all of the residents that commented said that the quality of food provided to them was of a very good quality and that choices were available. Special diets can be provided if needed. The kitchen was seen to be clean, tidy, and well organised. We saw the the most recent report [5 May 2009] from Sefton Environmental protection which stated; Very good standards within the kitchen. During a discussion with the cook on duty she was able to show that a very good variety of food, including four roast dinners throughout the week was available. She said there was plenty of fresh fruit and vegetables available and that everything was freshly prepared and cooked. She was fully aware of each residents individual likes and dislikes; we feel that the catering staff members are trying their best to give people what they want. Care Homes for Older People Page 16 of 26 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. Residents and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Evidence: There is a written complaints procedure for the home; this is on display in the entrance area. Information about complaints is also included in the Service User Guide and Statement of Purpose. Those residents and family members that commented said they would inform the manager or another senior staff member of any issues. The home has not received any complaints in the previous 12 months. The manager explained that it was her intention to provide a suggestion box and comment cards for residents, relatives and other visitors to use should they wish to do so. The home has an adult protection procedure [now called safeguarding] that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. The manager was able to demonstrate that she was fully aware of the process to be followed and that the training for staff members in this area was up to date. There have been no safeguarding issues raised at the home since the previous inspection took place. Care Homes for Older People Page 17 of 26 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 facilities and accommodation is of a good standard; this means that residents are living in a safe, homely, comfortable environment. Evidence: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. Abbendon provides an environment that can fully meet the needs of the residents that live there. It is being maintained to a good standard and we did not see any hygiene or cleanliness issues. All bedrooms seen during the visit were personalised, comfortable, well furnished and contained items of furniture belonging to the resident. A visiting relative told us that they had been encouraged to personalise the room. Aids to help maintain independence, for example a call system and bathing aids have been provided. The manager explained that a new shower room had been provided since the previous inspection visit and that a new call system was due to be fitted. There are fully accessible well maintained garden areas available for residents to use. The laundry within the home is well equipped and good systems are in place for the Care Homes for Older People Page 18 of 26 Evidence: care of peoples clothes. Care Homes for Older People Page 19 of 26 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. Staff members work positively with residents and families to improve the quality of life of residents living in the home. Evidence: Nursing and care staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was able to meet the needs of the residents within the home. The staff members were cheerful and friendly. We spoke to a number of staff members during the visit; they all had a very good understanding of their roles and were very knowledgeable about the needs of the residents. Due to the nature of their disability most of the residents were unable to express their views about the staff supporting them, we were however able to assess this by using observation and listening to how they spoke to people and from relatives comments. Those residents that did comment were very complimentary about their attitude and competence. A staff member has written on a survey form; I enjoy my work and we provide a warm/friendly environment for all of our residents, we treat them as individuals and give them the best care. According to the manager and the AQAA 14 of the 18 care staff members are either qualified [11] or are working towards [3] a National Vocational Qualification [NVQ] level 2 or 3 in care, a recognised qualification for people working in the care Care Homes for Older People Page 20 of 26 Evidence: profession. Of the remaining four staff members, one of them is a qualified nurse working as a carer, two are student nurses and the home is trying to obtain funding for the remaining staff member. The staff file seen contained all of the required information and a thorough recruitment procedure was in place for the protection of residents. The homes manager confirmed that all new staff are checked against the POVA list and that a satisfactory CRB disclosure must be obtained before employment commences. New staff members undertake an in-house induction followed by a thorough induction training programme, including adult protection. This meets the Skills for Care Induction Standards. We were able to see the induction record for the most recently appointed staff member. The manager explained that all of the staff members are due to receive refresher training relating to the above Induction standards. Abbendon provides a range of training courses for staff members; this includes manadatory training such as safer handling, fire safety and adult protection as well as other courses such as Dementia and Infection control. Staff members will be receiving training in Equality and Diversity in the near future. The staff members spoken with confirmed that training courses were readily available and that they considered that they were well trained. Care Homes for Older People Page 21 of 26 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 home is being very well run and managed on a day to day basis, this helps to ensure that the needs of the residents are met and that there are appropriate procedures in place to maintain their safety. Evidence: The home manager is very experienced and knowlegable and was able to display a clear sense of direction and best practice. She was able to clearly demonstrate an awareness of the needs of the residents living in the home and how to manage the staff team. The home manager is a qualified nurse and also has an NVQ level 4 in care. She attends courses/training in order develop the skills to fulfil her management responsibilities and is due to undertake training in the new Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 in July. A relative has written on a survey form, The general ethos is good and it comes from the top. There is is a strong and committed staff team within the home who work hard to Care Homes for Older People Page 22 of 26 Evidence: ensure that the quality of care provided is maintained at as high a level as possible. One of the staff members said; The manager is a good leader and sorts care needs immediately, we have a very good staff team and the quality of care is excelent. Another person said; We have a good staff team. Abbendon fully recognises the importance of a quality assurance system in order to ascertain whether residents, relatives/representatives and health and social care professionals are happy with the standards of care being provided. In order to achieve this they use an external company who undertake a survey every year; the results from the most recent one which took place in February 2009 are displayed in the entrance area. This showed that there was a 98.45 satisfaction level within the people who completed the survey. The manager confirmed that the home does not manage any personal finances for residents. All staff members are supervised on a continuous basis; in addition they all receive formal supervision regularly. This helps to ensure that the high quality of care provided to residents is maintained. Any accidents are recorded and the home manager regularly audits these in order to ensure that any trends, for example, a resident having a number of falls are identified and addressed. The home has a comprehensive range of policies and procedures to promote and protect both residents and staff members health and safety. The maintenance records seen demonstrated that the appropriate service contracts were in place. These included, bathing aids, the fire alarm system and the gas and electrical installations. There is a notice in the entrance area that informs residents and relatives that they can look at the homes policies and procedures upon request. We were able to see that the policies are reviewed annually and that staff members are signing to say that they have read and understand the policies being maintained. The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals and that drills and training were also up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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