Care Home: Abbey Chase Residential and Nursing Home Ltd

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What the care home does well The home ensures that all residents have an assessment prior to admission to the home and care plans and risk assessments are then written with the assistance of the residents and /or their representative. A visit to the home is also encouraged where possible. Mealtimes are unhurried and all meals are home cooked with an alternative option being available for each mealtime. Staff are available in the dining room to assist the residents with their meals if required. There is an efficient complaints procedure in place and the home`s processes and staff training should protect the residents in the event of an allegation of abuse. The location and layout of the home is suitable for its stated purpose. All areas of the home are accessible to residents. The home has a staff team that has the necessary skills and experience to meet the needs of the current residents and staff training is ongoing. The management and administration of the home is good with the registered manager and the provider in daily contact with the home. The inspector received positive comments during this site visit, which included; `this is a good home to live in the staff are kind and helpful` and `all staff are caring and friendly and the catering is of a high standard`. What has improved since the last inspection? The provider has continued the programme of decoration and refurbishment, which improves the environment for the people using the service. One requirement was made following the inspection in August 2006 for the home to obtain the local authority`s safeguarding adults procedures. This has now been met. What the care home could do better: No requirements have been made as a result of this key inspection. CARE HOMES FOR OLDER PEOPLE Abbey Chase Residential And Nursing Home Ltd Abbey Chase House Bridge Road Chertsey Surrey KT16 8JW Lead Inspector qLesley Garrett Unannounced Inspection 28th August 2008 10:30 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 Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.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. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbey Chase Residential And Nursing Home Ltd Address Abbey Chase House Bridge Road Chertsey Surrey KT16 8JW 01932 568090 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) admin@abbeychase.co.uk Abbey Chase Residential and Nursing Homes Limited Mrs Jean Short Care Home 62 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (62), of places Physical disability over 65 years of age (2) Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. People requiring Nursing Care may be admitted to the home from the age of 60 years. Up to 60 persons may receive Nursing Care. Up to two of the older people accommodated may be in the category PD(E), people with a physical disability. Up to five named people accommodated may be in the category DE(E), older people with Dementia 10th August 2006 Date of last inspection Brief Description of the Service: Abbey Chase Care Home is privately owned and operated by Abbey Chase Residential and Nursing Homes Limited in premises situated next to the River Thames in a rural part of Chertsey. Accommodation is provided in fifty-three single rooms and five shared rooms. The gardens are well maintained and are accessible with a shaded central courtyard with seating areas also available. There are arrangements for disability access, which includes ramps and pathways. The home has ample car parking facilities. The range of fees in the home is from £560 - £885. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This inspection of the care home was an unannounced ‘Key Inspection’. Mrs L Garrett Regulation Inspector carried out the site visit and the registered manager represented the service. Also present for some of the inspection process was the home’s provider. For the purpose of the report the individuals using the service will be referred to as people who use the service or residents. The inspector arrived at the service at 10:30 and was in the home for seven hours. It was a thorough look at how well the home is doing. It took into account information provided by the home and any information that CSCI has received about the service since the last inspection. The Commission had sent questionaires to people associated with the service. Some replies were received and will also be used to assist with this report. The home had supplied the commission with a documented Annual Quality Assurance Assessement (AQAA) some detail of which has been included within the report. We looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the home’s care plans, daily records and risk assessments, medication procedures, staff files and a variety of training and health and safety records. From the evidence seen by the inspector it is considered that the home would be able to provide a service to meet the needs of residents who have diverse religious, racial or cultural needs. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The provider has continued the programme of decoration and refurbishment, which improves the environment for the people using the service. One requirement was made following the inspection in August 2006 for the home to obtain the local authority’s safeguarding adults procedures. This has now been met. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 7 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. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.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 Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. People wishing to use the service only move into the home following an assessment and if they feel confident that their needs can be met. EVIDENCE: The manager stated that she carries out all of the pre-admission assessments. The assessments were sampled and found to be detailed giving the manager sufficient information to make a decision about the care needs of the people using the service. We spoke to a recently admitted resident who stated that the manager had given her plenty of information prior to her admission. This resident also confirmed that the staff had made her very welcome and had settled her in well. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 10 Both the service user guide and statement of purpose were available at the home and to all people using the service. The home does not provide intermediate care beds. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 11 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 People who use the service experience excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Health and personal care for people using the service is based on their individual needs. Respect, privacy and dignity are maintained at all times with medication procedures being followed. EVIDENCE: Four individual plans of care were sampled. They were found to be of a good standard with clear documentary evidence that people who use the service/and or their representative had been consulted. The plans contain completed assessments and then individual care plans are drawn up which included personal care needs. Suitable risk assessments are in place for all areas of the residents’ daily lives in order to promote independence whilst ensuring personal safety and wellbeing. Other risk assessments that are written by the staff are nutrition and skin integrity. Daily records were also in place, which were clear to read Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 12 and contained the staff signatures. The manager said that care staff write in the individual plans of care and the registered nurses then countersign them. The home has access to two general practitioner (GP) surgeries. They visit the home whenever they are called and will also complete reviews every three months on the people using the service. The manager stated that they are all a good support to the home. The resident that had been admitted to the home the day before the inspection confirmed that she would be seeing the GP that week and this had been arranged by the staff. The home also has healthcare support from other professionals and these include the Parkinson nurse specialist, the palliative nurse specialist, dietician, and speech and language specialist. The individual plans of care were observed and individual entries had been made in the records for those people that had visits from these specialists. Medication is supplied from a local pharmacy and supplies are delivered every month. The manager stated that the home had recently obtained the book ‘Handling of Medicines in Social Care’ and their internal policy had been revised to reflect this policy. The manager stated and records confirmed that the homes nurses receive training in medication every year. Part of the medication round was observed and medications were only signed for following administration. Sample signatures of the nurses were all in place and no gaps on the medication administration record for the people using the service, which had been case tracked was observed. The manager stated that the privacy and dignity of people using the service is maintained at all times. Most of the rooms are for single occupancy and are en-suite. Care is delivered in their own room or en-suite facility. The bedrooms that are shared have screens available to maintain the privacy for personal care for people using the service. The preferred name that residents wish to be addressed by is documented in their notes. Staff were observed to knock on bedroom doors prior to entering and talking appropriately to the residents. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 13 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 the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. People using the service are able to make choices about their lives and recreational activities meet their expectations. The food served at the home is of a high quality. EVIDENCE: The home employs a full time activities organiser who on the day of the visit was on annual leave. Two members of staff had asked the manager if they could stay on shift and organise an afternoon of bingo for the people using the service. The manager explained that the activities organiser had the opportunity to take annual leave at short notice not leaving time to organise activities but that the staff members had been very good volunteering to take sessions. The activity organiser keeps a biography of all people using the service and an activity care plan. A variety of activities are on offer, which include painting reminiscing, flower arranging and the occasional exercise class. Every year the home has a summer fete and the manager said this had also happened this Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 14 year. At Christmas the people using the service enjoyed a pantomime. The home has a church service every month and the manager stated that the home has access to other religious denominations when required. One resident said in a completed survey that there are plenty of activities but they preferred not to join in. Another resident said on the day that they looked forward to the activities as it made them go out of the room and socialise. Family and friends are welcome at the home at any time. On the day of inspection we observed many visitors in and out of the home. One relative told us that she visits every day and is made very welcome by the staff. The manager said that local schools visit for special occasions for example Christmas and Easter and entertain the people using the service with songs or Carols. The manager, and staff spoken to on the day, all confirmed that people using the service are given as much choice that is possible in their daily lives. The manager stated that the individuals choose their lunch and carers in the home allow them to choose the clothes they are to wear that day. Post is delivered to their bedroom unopened and each room visited on the day had been personalised. It was observed that people using the service could have their own furniture in their bedroom and pictures are hung on the wall for them if requested. The kitchen had an environmental health inspection in July 2008 and no requirements or recommendations were made. On the day of the visit it was observed that tables were laid with tablecloths and napkins and staff were offering choices of food. One resident said ‘the catering is of a high standard with a good choice of menu’. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 15 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 & 17 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. People using the service are protected by the home’s complaints and safeguarding adults procedures. EVIDENCE: The manger stated that all people using the service and their relatives have access to the home’s complaints policy. The policy was displayed on the wall in reception. During a tour of the building all residents that were asked confirmed they would know how to make a complaint. The manager said that during the last year she has not received a complaint but that she would keep a log of any complaints that would be available for inspection. The home has the local authority’s safeguarding procedures and the home’s local policy matches these procedures. Staff spoken to had knowledge of the steps to follow in the event of witnessing any abusive behaviour and were also aware of the whistle blowing policy. The manager stated that accessing the local authority’s safeguarding training had been difficult, so she delivers this training on a one to one basis. It was recommended that she should access the formal training to ensure that her knowledge is current and then cascade new information to the staff. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 16 The home has had two safeguarding referrals during the last year and both have been concluded. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment. EVIDENCE: The atmosphere at the home was calm and quiet with some of the people using the service observed sitting in the lounge and some remaining in their bedroom. The location and layout of the home remains suitable for its stated purpose. The home is well maintained and all areas of the home, including the garden, are accessible to all people who use the service. The provider told us that he is constantly upgrading, refurbishing and decorating the home whenever it is needed. The provider also showed us the plans he has for some of the rooms to change to single en-suite instead of shared rooms. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 18 Training records observed and the staff spoken to confirmed that infection control training had taken place. The manager stated that this training takes place regularly and staff spoken to on the day had good knowledge of these procedures. Hand washing facilities were available to staff with liquid soap and paper hand towels all in place. The housekeeper stated that the laundry is covered seven days a week. She completes an audit for the bedrooms every day to ensure that they rooms are cleaned thoroughly. One returned survey said ‘care is delivered in a pleasant and comfortable surroundings’. Another said ‘my bedroom is always kept spotlessly clean’. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 19 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 the service experience excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Staff in the home are trained and skilled and in sufficient numbers to support the people using the service. Recruitment practices are robust which protect the individuals living at the home. EVIDENCE: The home had a relaxed atmosphere and staff were observed to undertake their tasks in a quiet and orderly manner. We observed staff interactions with people using the service all of which were professional and supportive. The staff in the home during the day were relaxed and calm with the residents. Comments received on the day were all positive about the staff in the home. One person said ‘the staff are good, very good and caring’. Another said ‘I am really settled here the staff always have a big smile’. The staff rotas were observed which confirmed that the home has appropriate staff for the residents that they have. The manager stated that dependency levels of all the residents are assessed and staffing levels can be changed if required. The rotas also confirmed that nurses and carers are also supported by other staff and these include a receptionist, who answers the telephone, a Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 20 housekeeping team, which includes the head housekeeper, and a chef and kitchen staff. The manager said that most staff have now achieved the National Vocational Qualification (NVQ) at level 2 and some have achieved level 3. Records sampled confirmed this and staff spoken to were knowledgeable about the qualification. The housekeeper has also achieved level 2 in housekeeping. This training is ongoing within the home and available for all new staff. Three staff recruitment folders were sampled and it was observed that all the necessary information that is required was in place. One folder it was noted did not contain a reference from the previous registered manager of the service. The staff member and manager confirmed that she was on annual leave and the staff member was keen not to have her application delayed. The manager stated that it was planned to get a further reference from her on her return from leave. The training records for the home were observed and confirmed that mandatory training takes place. Staff confirmed that they receive regular training and this included safeguarding adults, health and safety, manual handling and fire awareness. Specialist training is also available. Staff have undertaken training in dementia and palliative care, and equality and diversity is also planned for this year. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 21 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 excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. The management of the home is based on openness and respect and has an effective quality assurance system in place. EVIDENCE: The registered manager has been in post for five years and has the necessary qualifications and experience to manage a care home. She holds regular supervision with the staff and ensures that regular audits of work practices are carried out. The provider is in daily contact with the home and has an office on site. The manager and provider work closely together for the benefit of the staff and people who use the service. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 22 Effective quality assurance systems are in place within the home and the manager stated that all people using the service and their relatives are surveyed every year. The home also seeks the views of visiting healthcare professionals. The results are then viewed and an action plan drawn up where necessary to address any notified shortfalls in the service. The home does not manage the finances of any of the people who use the service. The manager explained that anything they need to pay for; For example the chiropodist or hairdresser will be paid by the home and either the resident or their representative will be invoiced. All people using the service have a lockable draw in their bedroom to allow them to keep small amounts of money or valuables safely. Review of documented records, which included those kept at the home and the AQAA, demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 23 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations It is recommended that the registered manager and any senior members of her team attends the local authority’s safeguarding training and incorporates this into her own training at the home. Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Abbey Chase Residential And Nursing Home Ltd DS0000017587.V368970.R01.S.doc Version 5.2 Page 26 - 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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