Care Home: Abbey House

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Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbey House Abbey House Heortnesse Chertsey Meads Chertsey Surrey KT16 8LN     The quality rating for this care home is:   two star good 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: Vera Bulbeck     Date: 1 4 0 1 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Abbey House Heortnesse Abbey House Chertsey Meads Chertsey Surrey KT16 8LN 01932568275 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Jean Kennedy The registered provider is responsible for running the service care home 3 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 1 3 dementia old age, not falling within any other category Additional conditions: 0 0 The age/age range of the persons to be accommodated will be Over 60 years of age Within the category/categories `OP` (Older People) one of whom may be `DE(E)` (Older Person with Dementia). Date of last inspection Brief description of the care home Abbey House is a small care home on the outskirts of Chertsey town. The home provides care and accommodation for 3 people over 60 years of age, and who may have dementia. The service users accommodation is on the ground floor of the owners home, and Care Homes for Older People Page 4 of 26 Brief description of the care home consists of three single bedrooms with en-suite facilities, and situated close by is an assisted bathroom and toilet with adapted facilities for service users with mobility issues. There is also a kitchen/diner and a large sitting room/formal dining room with direct access to a pleasant garden. 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: two star good 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: The quality rating for this care home is 2 star. This means the people who use this service experience good quality outcomes. Fees from 1st April 2008 range between 550 pounds to 650 pounds per week. The previous key inspection was undertaken on 29th January 2007. This unannounced visit formed part of a key inspection and was carried out by Vera Bulbeck, Regulation Inspector on 7th and 14th January 2009. On the 14th January Rosemarie James, Regulation Manager was also present. The Registered Manager was present as the representative for the establishment on the 14th January 2009 and on the 7th January the staff on duty represented the management. The inspection process took into Care Homes for Older People Page 6 of 26 account detailed information provided by the manager and any information that the Commission has received about the service since the last inspection. A tour of the premises took place. On the day of the visit the inspector spoke with two service users and staff on-duty. Prior to the inspection, survey forms were sent to service users, their relatives and/or advocates and to staff employed at the home. Survey forms were returned by two members of staff and three relatives, the G.P also completed a survey. Some of the comments made to the inspector and made on the survey forms are quoted in this report. The home had completed an annual quality assurance assessment (AQAA) and service users care plans, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit and the relatives, staff and G.P who participated in the surveys. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. Each service user is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the service users identified needs. This home does not offer intermediate care. Evidence: The inspector was advised that, on the first enquiry from a prospective service user or their representative, the service user or their representative will be invited to visit the home. Following the initial visit to the home, and if the service user wishes to continue, the manager will visit the service user and carry out a pre-admission assessment this may be in their own home or in the hospital, to ensure that the home can meet the service users needs and wishes. Two care plans were sampled during this visit. In each case pre-admission assessments had been carried out to ensure that the home could meet the service users identified needs. However these documents need to be signed and dated. Data provided in the homes AQAA does not identify any Care Homes for Older People Page 10 of 26 Evidence: service users with specific religious, racial or cultural needs at this time. However, from the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Care Homes for Older People Page 11 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. Personal care and health care support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practises are in place to ensure the safe administration of medication. Evidence: The home has a small and close care team and the staff demonstrate an in depth knowledge of each individual service users needs, abilities and preferences in how they wish their care to be delivered. The care plans sampled during this visit were based on pre-admission assessments and had been drawn up shortly after each service users admission to the home and included risk assessments. These care plans set out the actions which need to be taken by care staff to meet the health, personal and social care needs of the service users. Daily notes need to be more informative and detailed and should reflect the care provided. These daily notes demonstrated that any changes or new concerns are promptly acted upon, although not always added to the care plan. The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled Care Homes for Older People Page 12 of 26 Evidence: and found to be generally in order. However there was some discrepancy regarding the recording of medication for a service user who only requires medication when necessary. On the day of the first visit the records were not available. On the second visit the manager produced the missing MAR sheet. In the AQAA, to demonstrate what the home does well, it states that service users are treated with respect and dignity is maintained at all times, whenever receiving personal care. During the tour of the home staff were observed to always knock before entering the service users bedrooms and all interactions observed between staff and service users was seen to be caring and respectful. A survey returned from a GP stated I am very happy with the care offered to the residents also the home has experienced carers, excellent staff always on duty, a very caring team. Care Homes for Older People Page 13 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. The activities provided by the home are individualised to each service user and include contact with the local community both within and outside the home. Contacts with family and friends are encouraged. Meals are well-balanced and varied with individual choices and preferences catered for. Evidence: The routines of daily living are arranged to suit individual service users preferences and choices. This was confirmed by the manager and staff on duty. The manager stated that on some weekends they hire a film and service users are able to use the lounge to watch the film. The home has a dog names Beauty and the service users are very fond of the dog. There are no restrictions to visiting times. Staff support and encourage service users to maintain family links and friendships inside and outside the home. Service users are able to choose, which activities they attend or participate in. Their individual bedrooms were seen to contain many personal possessions, which were arranged to suit their individual wishes. During the good weather the home arranges a number of outings, service users are invited to go on. These include pub lunches and Care Homes for Older People Page 14 of 26 Evidence: visits to the garden centre. Menus sampled showed that the home offers a varied and well-balanced menu, with service users able to choose alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal was taking place during this visit, the food was well presented and looked appetising, the atmosphere in the kitchen was pleasant and relaxed. The member of staff on duty stated she knows the service users likes and dislikes and if they wanted something different she is happy to cook a meal of their choice. Staff are able to support service users who may require help with their meal. In the AQAA, to demonstrate what the home does well, the manager stated that relatives and friends are informed of Abbey House policy on maintaining relatives and friends involvement, and support of the service user after they have moved into Abbey House. The annual quality assurance reflects that the home does this very well, by visitors always responding that they feel very welcome when they visit Abbey House. Care Homes for Older People Page 15 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. All the staff have received appropriate training to ensure service users are protected from potential harm or abuse. Evidence: The home has a complaints procedure in place that is available to all service users and their relatives and is also included in the service users guide. No complainant has contacted the Commission with information regarding a complaint or allegation made to the service since the last inspection. There is a whistle blowing policy in place and the home has a copy of the latest Surrey Multi-Agency Procedure for the Protection of Vulnerable Adults. The two members of staff who work in the home confirmed that they had received the training and were aware of the procedures to follow. In the AQAA, to demonstrate what the home does well, the manager stated that Abbey House has a whistle blowing procedure. The staff are trained in the detection of any kind of abuse, however minor. The registered manager sees the service users every day and is vigilant and experienced to detect even the minimal deviation from the philosophy of care. Any/all allegations of abuse would be followed up immediately and all action taken is recorded. Care Homes for Older People Page 16 of 26 Evidence: Service users spoken with were not able to say if they felt safe at the home. However observation by the inspector, service users were happy and contented in their surroundings. 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 location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the service users with clean, pleasant and homely surroundings in which to live. Evidence: Service users spoken to were unable to express their satisfaction with the accommodation provided at the home. However one service users relative visits everyday and clearly would comment if she was not happy with the home. The home was toured during this visit and found to be very clean and hygienic. The manager stated the maintenance and redecoration programme for the home was ongoing whenever necessary. The service users mainly spend time in their bedrooms, both service users have their own television and both bedrooms are located close to the kitchen. The member of staff stated service users spend most of their time in the kitchen. Service users eat in the kitchen and staff mainly sit doing any paper work in the kitchen. The service users rarely use the lounge or dining room apart from special occasions. Laundry facilities are sited on the ground floor with a washing machine, tumble dryer and ironing facilities all suitable for the needs of the service users at the home. Care Homes for Older People Page 18 of 26 Evidence: In the AQAA, to demonstrate what the home does well, the manager stated that the home is immaculate and homely. The garden is nicely laid out where residents can sit in the summer and enjoy. On the day of this visit the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are two members of staff employed and able to meet the needs of the service users. The home has a staff recruitment and training programme, which incorporates all areas needed to ensure, as far as reasonably possible, that service users are in safe hands at all times. Evidence: The staff rota evidenced that one member of staff is on duty in the morning and one in the afternoon. The morning care worker also does a sleeping in duty from Monday to Friday, and at weekends the registered manager covers the shifts and does the sleeping in duty. The registered manager is also on duty during the week and undertakes office duties and care practise. Both staff returned surveys and no comments were made on either survey apart from answers to one question and one said they provide a good level of care and the other one stated we give the best care. Both care staff hold a National Vocational Qualification (NVQ) level 2 in care. During this visit the files of both members of staff were sampled. Both files were seen to contain proof of identity, two references, a completed application form and details of an enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) Care Homes for Older People Page 20 of 26 Evidence: list checks had been obtained. Both staff confirmed they had been supplied with a copy of the General Social Care Council (GSCC) code of conduct and practise. Staff induction is in line with the new, mandatory Skills for Care common induction standards and the inspector was advised that staff would be supervised until they have completed their induction. Both staff working in the home has been employed at Abbey House for some considerable time. Staff are booked on additional training and updates as the courses become available. The registered manager also undertakes training with staff to ensure they are kept up to date with their training needs. In the AQAA, to demonstrate what the home does well, the manager stated that a lot of time is spent with service users two staff live on the premises, care is very much provided on a one to one level. One member of staff commented that she was very happy with the level of training provided by the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. Evidence: The manager is experienced and qualified and her management style is inclusive and the service users benefit from the ethos, leadership and clear management approach of the home. A total of two care staff questionnaires were returned to the inspector. From observations made on the day and from comments made on the staff questionnaire it is clear that the home have a close and happy staff team. The home has an effective quality assurance and monitoring system in place that is Care Homes for Older People Page 22 of 26 Evidence: based on seeking the views of the service users and their relatives. The inspector was advised by the manager that the home carry out yearly service user and relative surveys. The manager stated that the home does not handle the financial affairs for service users. Health and safety monitoring check sheets were sampled and the majority were found to be maintained and up to date, apart from the testing of the weekly fire alarms tests. The last recorded date was 26/11/08. The inspector advised the staff to seek the advice of the fire officer as the fire service is now visiting all care homes to ensure appropriate fire procedures are in place, including an up to date fire risk assessment. All staff have received the required safe working practise training and updates. Staff were observed to be following appropriate health and safety practises as they went about their work. In the AQAA, to demonstrate what the home does well, the manager stated that she has over 15 years experience in the management of the relevant care setting and has NVQ Level 4. The registered manager has continued to train, and can demonstrate that she has undertaken further training to update her knowledge, skills and competence, whilst managing the home. Mrs Kennedy, the registered manager has completed a Dementia Care course in January 2009. The registered manager ensures safe working practises by: ensuring effective training on moving and handling and by providing mechanical aids and by continuous supervision. All interactions observed between the staff and service users were inclusive, caring and respectful. 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: 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 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!