Care Home: Abbey Grange

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What the care home does well Before being admitted people had their needs assessed. This helped to make sure they would receive the right care and support they needed. Important information needed to support them in every day living was recorded. Residents living in the home were given a contract. Residents benefited from very good person centred care planning. This meant they were cared for in a way that took into account their wishes on how they wanted staff to attend to their needs. They also benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Resident`s benefited other specialist support where needed, such as healthcare. Visiting medical professionals considered the staff at Abbey Grange worked well with them for the benefit of the residents. `It is a pleasure to be working with staff in the home who appear to have high standards and a good rapport with both staff and residents,` Relatives who provided written comments considered the care provided to be very good. Comments included, `Residents very happy and well cared for,` and `from what I could see it was laughs all round and first class`. `Has been very flexible and caring in adapting accommodation, and providing additional care as my mother has deteriorated.` Residents who gave their views during inspection were very happy with the care they received and considered staff to be `very kind`, and `staff are very good to deal with`. And `They are always available when I need them.` The right of residents to be treated with dignity and respect was included in staff training. Staff are commended for the care and attention given to resident`s appearance, and how in the course of their duties they were respectful to residents. Residents spoke very highly of the staff, and said there was never any question of their privacy being compromised. Residents stated, `They look after us very well to say you are very old, can`t complain`. And `I am well looked after and treated with great kindness`. There were no unnecessary rules imposed on residents and their routines in the home were flexible and special to them. Residents were satisfied with the activities and entertainment provided at the home. Birthdays and festive celebrations were catered for. Visiting arrangements were very good and the meals provided met with resident`s tastes and choice, and needs. Staff were observed as courteous and attentive when assisting those residents requiring support. The complaints procedure was clear which helped residents, relatives and visitors have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. The home was very well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Visitors to the home wrote, `Very good for both cleanliness and decor. The balance in maintaining period features with modern is very good`. And `Clean smelling and very pleasant environmentfaultless`. Information received at the Commission for this inspection showed all essential maintenance had been carried out, for example electrical checks. Recruitment of staff was thorough and met with regulatory requirements. Staff interviewed said they enjoyed their work and felt supported by management. Training was provided and a high percentage of care staff holds a National Vocational Qualification in care level 2 or above. The level of staffing maintained, training provided, and supervision of staff was good which meant competent qualified staff cared for residents. Residents considered staff as being `very good`. Written comments from relatives and professionals visiting the home included, `The staff are always very friendly and professional, overall good standards`. And, `The care given to all service users is to a very high standard. All the staff are trained to a very high standard.` There was a warm and friendly atmosphere in the home. Team work among staff and management was very good. Comments received from staff included, `This is a very good home with plenty of training compared to the ones I have worked at`. `I feel we have very good training and support`. People living and working in the home were `listened to`. They had regular meetings to have their say on issues that affected them. Systems were in place to approach residents, relatives and visiting professionals to give their view on the quality of services and facilities in the home, as part of Quality Assurance. The home was run in the best interests of the residents. What has improved since the last inspection? To make sure applications for employment are safe, verbal references are no longer accepted alone. The owners have introduced good quality assurance monitoring and there was evidence the views of residents was taken seriously and the home is run in their best interests. To make sure staff have their say as a group, formal staff meetings are held. This will help to ensure staff can discuss in more detail how the home is managed and how resident`s needs are catered for. Formal residents meetings are held to allow residents to discuss any issue they may have together. Records of one to one meetings with residents are made enabling staff and management know how they view their care and life in the home in general. A new wet floor shower has been installed giving residents more safe bathing options. Bedrooms have been upgraded providing residents with a pleasing environment. What the care home could do better: Where the dosage indicates one or two tablets may be administered, the number of tablets given must be recorded. The practice of dispensing medication into `medicine pots` that will be given later, is not in line with current best practice. Employers should be approached to provide references rather than people the applicant has worked with, or as an addition to such a reference. This will ensure information provided is valid and will fully support a decision made to employ that person. Policies and procedures should be reviewed and ammended where necessary in line with current good practice. Key inspection report Care homes for older people Name: Address: Abbey Grange 18 Glen View Road Burnley Lancashire BB11 2QN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Marie Dickinson     Date: 0 1 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 29 Information about the care home Name of care home: Address: Abbey Grange 18 Glen View Road Burnley Lancashire BB11 2QN 01282453158 01282425983 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Linda Jane Harris care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 25 Date of last inspection Brief description of the care home Whincroft is a family run care home, offering 24-hour personal care and accommodation to 24 older people. The house is a semi-detached property located in a residential area on a fairly busy road on the outskirts of Burnley. There are attractive enclosed gardens, accessible to residents, on-street parking, and a bus stop outside the home. On the upper ground floor there is a lounge with conservatory, two dining rooms and seating in the entrance hallway. There is a shared lounge and four selfcontained units on the lower ground floor. Various aids are provided to help with mobility and independence, such as handrails and facilities for disabled people in bathrooms. Bedroom accommodation is on three levels, on the lower and upper Care Homes for Older People Page 4 of 29 Over 65 25 0 Brief description of the care home ground and first floors. There are 16 single and 4 double rooms, 11 bedrooms have ensuite facilities. Some of the rooms (units) are fitted with kitchenettes. Star lifts are available, to help residents to access first floor and lower floor bedrooms. The home provides recreational activities and outings. Information abvout the service including the current level of fees is available from the home. There are additional optional charges for hairdressing, chiropody, and toiletries. Care Homes for Older People Page 5 of 29 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: A key unannounced inspection was conducted in respect of Abbey Grange on the 1st September 2009. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager. This gave us numerical information, such as the number of staff trained and of regular maintenance of essential equipment. Staff records, care records and policies and procedures were assessed. The inspection included talking to residents, staff on duty, the provider, and an inspection of the premises including residents bedrooms Other information was considered such as the homes annual quality assurance survey and comments recorded in Surveys returned to the Commission from staff, residents and relatives. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Older Care Homes for Older People Page 6 of 29 People. Care Homes for Older People Page 7 of 29 What the care home does well: Before being admitted people had their needs assessed. This helped to make sure they would receive the right care and support they needed. Important information needed to support them in every day living was recorded. Residents living in the home were given a contract. Residents benefited from very good person centred care planning. This meant they were cared for in a way that took into account their wishes on how they wanted staff to attend to their needs. They also benefited from the support of a named worker referred to as a Key worker who took responsibility for their personal care. Residents benefited other specialist support where needed, such as healthcare. Visiting medical professionals considered the staff at Abbey Grange worked well with them for the benefit of the residents. It is a pleasure to be working with staff in the home who appear to have high standards and a good rapport with both staff and residents, Relatives who provided written comments considered the care provided to be very good. Comments included, Residents very happy and well cared for, and from what I could see it was laughs all round and first class. Has been very flexible and caring in adapting accommodation, and providing additional care as my mother has deteriorated. Residents who gave their views during inspection were very happy with the care they received and considered staff to be very kind, and staff are very good to deal with. And They are always available when I need them. The right of residents to be treated with dignity and respect was included in staff training. Staff are commended for the care and attention given to residents appearance, and how in the course of their duties they were respectful to residents. Residents spoke very highly of the staff, and said there was never any question of their privacy being compromised. Residents stated, They look after us very well to say you are very old, cant complain. And I am well looked after and treated with great kindness. There were no unnecessary rules imposed on residents and their routines in the home were flexible and special to them. Residents were satisfied with the activities and entertainment provided at the home. Birthdays and festive celebrations were catered for. Visiting arrangements were very good and the meals provided met with residents tastes and choice, and needs. Staff were observed as courteous and attentive when assisting those residents requiring support. The complaints procedure was clear which helped residents, relatives and visitors have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. The home was very well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Visitors to the home wrote, Very good for both cleanliness and decor. The balance in maintaining period features with modern is very good. And Clean smelling and very pleasant environmentCare Homes for Older People Page 8 of 29 faultless. Information received at the Commission for this inspection showed all essential maintenance had been carried out, for example electrical checks. Recruitment of staff was thorough and met with regulatory requirements. Staff interviewed said they enjoyed their work and felt supported by management. Training was provided and a high percentage of care staff holds a National Vocational Qualification in care level 2 or above. The level of staffing maintained, training provided, and supervision of staff was good which meant competent qualified staff cared for residents. Residents considered staff as being very good. Written comments from relatives and professionals visiting the home included, The staff are always very friendly and professional, overall good standards. And, The care given to all service users is to a very high standard. All the staff are trained to a very high standard. There was a warm and friendly atmosphere in the home. Team work among staff and management was very good. Comments received from staff included, This is a very good home with plenty of training compared to the ones I have worked at. I feel we have very good training and support. People living and working in the home were listened to. They had regular meetings to have their say on issues that affected them. Systems were in place to approach residents, relatives and visiting professionals to give their view on the quality of services and facilities in the home, as part of Quality Assurance. The home was run in the best interests of the residents. What has improved since the last inspection? What they could do better: Where the dosage indicates one or two tablets may be administered, the number of tablets given must be recorded. The practice of dispensing medication into medicine pots that will be given later, is not in line with current best practice. Employers should be approached to provide references rather than people the applicant has worked with, or as an addition to such a reference. This will ensure information provided is valid and will fully support a decision made to employ that Care Homes for Older People Page 9 of 29 person. Policies and procedures should be reviewed and ammended where necessary in line with current good practice. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 29 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 11 of 29 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. The admission process ensured peoples needs were properly assessed. Contracts issued, protected residents legal rights. Evidence: Records showed that prior to any service being provided peoples needs had been assessed. This helped to make sure they would receive the right care and support they needed. It also meant a record of what people wanted and what was important to them when receiving care was made. Records kept of the most recent admission showed how planned admissions were managed. An assessment had been completed by social services and this information made available to the home. The manager had visited the resident and carried out a further assessment of needs, that included for example health and personal care, mobility, and nutrition. The assessment record supported the decision to offer a place at the home, and admission was agreed with all concerned. Care Homes for Older People Page 12 of 29 Evidence: All residents had a contract. Those funded by a local authority were issued with a financial contract. This was to agree to the funding arrangements made on their behalf, and people knew how much they would have to pay. All contracts seen on resident files were signed by the resident agreeing to the terms and conditions of residence. Information received at the Commission for this inspection informed us, each resident is looked at individually and take into account their choice and preference. This helps to make sure the assessment is a more person centered approach that has taken into account what people want and what they say. Individual risk assessments had been completed to help staff to know what they need to do and be aware of, to care for individuals safely. Care Homes for Older People Page 13 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents had good care plans, risk assessments, and a named key worker, which supported them to ensure their health and personal care needs being met in a consistent way. Evidence: Residents surveys, returned to the Commission indicated that they always receive the care and support they needed. Residents who were spoken to made positive comments about the care and attention they receive at Abbey Grange. For example they said, The staff look after us very well, and we are looked after. Treated very well. And Staff are available when I need them and are very helpful. Staff worked to a key worker system, having responsibility to make sure care needs were personalised for residents. Care planning was very good and linked very well to residents assessment of needs. Needs identified such as personal care, mobility, communication, personal safety, medication, medical, and social were listed. How identified needs were to be supported was very clear and person centred. This showed what staff were expected to consider throughout the day in meeting peoples needs. Care Homes for Older People Page 14 of 29 Evidence: For example, the support they required with getting dressed such as managing buttons and gave detail of personal wishes of residents for staff to know about when providing care. Relatives were happy with the standard of care given. Written comments included Has been very flexible and caring in adapting accommodation and providing additional care as my mother has deteriorated. Records showed they were involved in care reviews, and kept up to date with important issues regarding their relatives care. Comments recorded from professionals visiting the home spoke very highly regarding the standard of care. Comments included the care given to all service users is to a very high standard, and It is a pleasure to be working with staff in the home who appear to have very high standards. Care staff who were spoken to during inspection considered they were given enough information about residents to do their job well and considered residents were very well cared for. Written comments from staff included, I feel residents are first priority and are given care to a very high standard. Residents benefited additional specialist support where needed. This included health care. All residents were registered with a GP and accessed local services either in the community, or were supported by visits to the home by health care professionals. This included visits from the district nursing team for nursing intervention required such as applying dressings. Pressure care was promoted and pressure-relieving aids were used on medical advice. Risk assessments had been completed for moving and handling and were used as guidance for staff to help care for residents safely. People at risk of falls, pressure sores, poor nutrition and other risks had also been identified. This enabled staff to know what to look for and help prevent these happening. Observations were made of wheelchairs being used safely. The rights of residents to be treated with dignity and respect was included in staff training. Residents spoke very highly of the staff. There was never any question of their privacy being compromised. Observations showed staff respectful, and personal care provided in privacy such as toilet doors shut and residents spoken to discreetly re these needs. Complimentary remarks about the staff were made, such as very good, and helpful. Staff were instructed on the basic principles of care. Staff and management are commended for their efforts in maintaining peoples dignity in the home. Observations showed care and attention had been given to residents appearance, and staff showed how in the course of their duties they were respectful to residents. Communication difficulties had also been considered such as poor hearing and sight. Care Homes for Older People Page 15 of 29 Evidence: The home operated a monitored dosage system for the administration of medication. Residents had the opportunity to say how they would like their medication managed. An appropriate recording system was in place to record the receipt, administration and disposal of medication. Where the dosage indicates one or two tablets may be administered, the number of tablets given must be recorded. The practice of dispensing medication into medicine pots that will be given later, is not in line with current guidance. The supplying pharmacy audit the medication on a regular basis. Care Homes for Older People Page 16 of 29 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 were given opportunity to live a fulfilling life, which meant they were supported to take part in chosen activities, access community resources and keep in touch with families and friends. The meals provided were sufficient in providing for their tastes, choices, and diet. Evidence: The residents preferences in respect of social activities had been recorded as part of their assessment. Activities for residents were organised and offered variety. Comments from residents returned to the Commission as part of the inspection show everyone thought there were activities arranged by the home they could join in. One resident said they would like to go out on trips more. This issue however had been addressed as part of improvements the home intend to make. Comments from quality assurance monitoring included, From what I could see it was laughs all round, first class. And, a very good rapport with both staff and residents. There were no institutional practices observed or commented on by residents. Care plans included a daily living plan with preferred routines recorded to support residents personalise their day. Observations showed residents appeared to have freedom of choice over their lives within their capability. For example several residents said they Care Homes for Older People Page 17 of 29 Evidence: got up when they wanted and went to bed when it suited them. Visiting arrangements were very good. Residents were able to receive visitors at any time and were able to entertain their guests in private. There was evidence seen in care records that relatives regularly visited the home. Recorded comments in quality assurance monitoring in the home included Welcomes visitors, and very professional and helpful. Residents were also supported to continue with their chosen religion. This was recorded in residents assessment and daily living plans. Residents bedrooms were personalised. They were able to bring in personal possessions and furniture with them and were supported to arrange their rooms how they wished. Some were managing their own affairs; relatives were supporting others. Advocacy information was available for any resident requiring this service. Residents could choose where to eat their meals. Those residents spoken to during inspection said the food was very good. They said they had choices all the time and could have something different if the choices on offer were not to their liking. Comments included, I get breakfast in bed, and the meals are always nice and hot, choice of two meals. Residents who provided written comments for this inspection said they liked the meals. Menus seen offered variety and choice and servings were generous in portion. Care had been taken to ensure staff knew what support residents required for example if their meal was to be cut up or a resident needed feeding. Meal times were observed as being unhurried and relaxed. Staff were courteous and attentive when serving meals and assisting residents where required. Dining facilities were pleasant and attractive. Care Homes for Older People Page 18 of 29 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. The complaints procedure was available and used properly, which helped residents and other people have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted Evidence: The complaints procedure was given to residents when they were admitted to the home. A complaints recording system was in place. The procedure gave clear directions on whom to make a complaint to and the timescales for the process. Any issue raised was quickly dealt with by the manager who said people are very open and would say if they had any concern. An anonymous complaint was received on at the Commission in relation to resident care and medication. This was investigated by the provider and a full satisfactory report sent to the Commission. No issues were identified relating to the allegations during this inspection and the standard of resident care very good. However some basic improvement in medication practice was required. Residents and relatives, who were consulted, showed they knew who to talk to if they were not happy. People were confident to use the complaints procedure. All residents who provided written responses to the survey from the Commission knew how to raise any issue of concern and who to speak to if they were not happy. Quality assurance carried out by the home showed residents, relatives and visiting professionals Care Homes for Older People Page 19 of 29 Evidence: considered the home to provide, high standards. Residents were encouraged to say what they wanted and were asked regularly if everything was all right. Staff working at the home said they were trained in adult protection and were aware of the written abuse policies and procedures, which included whistle blowing. They knew their responsibility in this area and were confident they would report bad practice if ever the need arose. Knowledge and understanding in this area was checked during supervision sessions. In addition to this staff training was provided regularly to ensure new staff understand procedures. However the current procedures in the home should be updated to reflect current guidelines for reporting safeguard issues. Contractual arrangements for new staff ensured a formal agreement for staff to comply with the homes policies and procedures for example the ruling on nonacceptance of gifts, or being involved in wills or bequests. Care Homes for Older People Page 20 of 29 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 home was well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Evidence: Abbey Grange is a large semi-detached property located in a residential area on the outskirts of Burnley. There are attractive enclosed gardens, accessible to residents, on-street parking, and a bus stop outside the home. Accommodation provided is on three levels and provides good options for residents using the service. On the upper ground floor there is a lounge with conservatory, two dining rooms and seating in the entrance hallway. There is a shared lounge and four self-contained units on the lower ground floor. Star lifts supported residents to access first floor and lower floor accommodation. Bedroom accommodation is on all floors and provides mainly single room accommodation with a good percentage having en suite facilities. Bedrooms were comfortable and accommodated residents personal possessions. Some of the rooms (units) open onto the garden and are fitted with kitchenettes that created bungalow type living accommodation. Bathing and toilet facilities were very good. The home was found to be very well maintained with evidence of a continuing Care Homes for Older People Page 21 of 29 Evidence: programme of upgrading facilities. For example a new wet floors shower room and work was in progress to upgrade a bedroom ready for a new admission. Various aids were provided to help residents with mobility and independence, such as handrails and facilities for disabled people in bathrooms. The home was furnished and fitted to a very good standard. Lounge areas were comfortably furnished, spacious and residents said they were very pleased with the home and facilities it offered. Outdoor areas were pleasant with seating areas in the garden for residents use during good weather. The home was found to very clean during inspection, and policies and procedures were in place for staff to follow in maintaining standards and good levels of hygiene. Good arrangements were in place to reduce the risk of infection. Relatives and visiting professionals also commented on the environment. Written comments included, Very good for both cleanliness and decor. The balance in maintaining period features with modern is very good. Home very relaxing. More importantly no unpleasant smells. And Clean smelling and very pleasant environment-faultless. Care Homes for Older People Page 22 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers of staff employed, training provided, and relatively safe recruitment practices, meant residents should be protected, and their needs effectively met. Evidence: Rotas completed showed the compliment of staff was sufficient to cover all essential duties in providing care, and maintaining essential standards in the home such as hygiene and catering, and senior staff were on duty at all times. Staff files showed recruitment checks to be complete and met with legislative requirements for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check being applied for, prior to employment. Good interview notes had been taken. References had been received; however it is advisable that employers be approached to provide references rather than people the applicant has worked with or as an addition to such a reference. This will ensure information provided is valid and will fully support a decision made to employ that person, and make sure that person, the provider, residents, and staff are fully protected. Staff were issued with a contract of terms and conditions of employment, and given induction training that covered their probationary period of work. Staff who provided written comments for the inspection said they had received induction training, and training relevant to their role as carer. Records showed the induction training Care Homes for Older People Page 23 of 29 Evidence: programme given, covered essential training in basic principles of care, and safe working practice issues, such as moving and handling residents, and health and safety. Information received at the Commission showed that the majority of staff had completed National Vocational Qualification in care level 2 and above. Records showed learning opportunities were very relevant to the homes purpose in providing good care. All staff interviewed felt they were much appreciated for their work and were valued in the home. They said there was a good team spirit and everyone knew what to do throughout their shifts. Written comments from staff regarding what the home did well included training, activities, good support, manager and seniors are always there for me. And This is a very good home with plenty of training compared to the ones I have worked at. I feel we have very good training and support. Professional visitors to the home commented on the staff employed. They wrote, The staff are always very friendly and professional, overall good standards. And, The care given to all service users is to a very high standard. All the staff are trained to a very high standard. Care Homes for Older People Page 24 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed and run in the best interests of the people living there. Evidence: The provider Mrs Harris is both experienced and qualified to manage the home. She is supported in her role with senior carers having delegated responsibilities to ensure the welfare of the residents and staff, and commitment for training, and health and safety is on going. Since the last inspection Quality Assurance had been introduced in the home and relatives, residents, and other leading professionals were given the opportunity to have their say. Outcomes of these surveys showed overall they were very satisfied with the service. For example one relative wrote, The staff are always very friendly and professional, overall good standards. Tutor, It is a pleasure to be working with staff in the home who appear to have high standards and a good rapport with both staff and residents, Police, Very professional and helpful. Home very relaxing. Care Homes for Older People Page 25 of 29 Evidence: Quality Assurance also included an Investor In People award. (IIP) There was evidence of a continuing investment to improve overall standards in the home, such as improving the environment and staff training. Information received at the Commission from the home informed us how they had improved their service as a result of listening to people. They had a large conservatory built to make the communal lounge a more pleasant environment for residents, adapted menus to residents favourite meals, and provided a wet floor shower room. They also said they were intending to make all bedrooms en suite facilities where possible and continue to upgrade bedrooms. Staff considered management were very supportive as they worked alongside them. They were realistic in their expectations and supported them with training opportunities. Staff said they had regular supervision and met throughout the day to discuss resident care. They had formal meetings. Policies and procedures were available for reference, however these need to be updated to ensure they are in line with current good practice. Insurance cover was in place to meet any loss or legal liabilities. The home encouraged residents/relatives to manage their own financial affairs. Systems were in place to manage residents pensions, monies and charges and payments. Secure storage was available. The health, safety, and welfare of residents and staff had been considered. Written working procedures and training opportunities were provided and all new staff members were given induction and essential health and safety training. Information received at the Commission showed equipment had been serviced and that installations and maintenance checks were ongoing. Health and Safety risk assessments had been completed and health and safety policies were available. Care Homes for Older People Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Where the dosage indicates one or two tablets may be administered, the number of tablets given must be recorded. The practice of dispensing medication into medicine pots that will be given later, is not in line with current good practice. Employers should be approached to provide references rather than people the applicant has worked with, or as an addition to such a reference. This will ensure information provided is valid and will fully support a decision made to employ that person. Policies and procedures should be reviewed and amended where necessary in line with current good practice. 2 29 3 37 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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