Care Home: Abbey House Nursing Home

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What the care home does well The home works hard to provide people with a wide variety of social and recreational activities and this is constantly being improved upon. People who use this service and their relatives tell us that, "Staff are friendly and create a homely atmosphere". "Well organised and always runs smoothly whatever happens", "Happy welcoming atmosphere and always willing to listen". Menu options are varied, nutritious with plenty of choice. Meals are well-presented and people`s views are constantly sought, listened to and acted upon. What has improved since the last inspection? The two outstanding requirements from the last inspection regarding medication recording practices and the use of ointments and creams have been met and procedures have been introduced to lessen the likelihood of any recurrence. This is discussed in the Health and personal care section of this report. The home continues to reevaluate the service that it provides to people. They continue to expand on activities available to people and make changes and improvements to the physical environment. What the care home could do better: There were no requirements or concerns as a result of this inspection. Key inspection report Care homes for older people Name: Address: Abbey House Nursing Home 2 Abbey Hill Netley Abbey Southampton Hampshire SO31 5FB     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: Chris Johnson     Date: 3 0 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 28 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 28 Information about the care home Name of care home: Address: Abbey House Nursing Home 2 Abbey Hill Netley Abbey Southampton Hampshire SO31 5FB 02380454044 02380456989 abbeyhousenetley@btconnect.com http/www.abbeyhouse.org.uk/ Millennium Care Homes Limited care home 48 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 48 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following category : Physical disability (PD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Abbey House is located on the edge of Netley village and approximately 3 miles from Southampton city centre. It is within easy reach of local amenities in the village including, churches, shops, pubs, restaurants and an attractive country park overlooking Southampton water. The home is set in well-maintained gardens including a sensory garden, close to the historic ruins of Netley Abbey. Originally a large Victorian house, the building has been converted and extended for use as a care home. Accommodation is provided on 3 floors and there are passenger lifts and stair lift that Care Homes for Older People Page 4 of 28 Over 65 48 0 0 48 Brief description of the care home provide access to all areas of the home. Other facilities include a number of lounges, one of which is on the first floor a dining room, assisted baths, and a laundry service. The bedroom accommodation comprises thirty-four single and seven shared rooms; twenty-seven of the single rooms have en suite facilities. Care Homes for Older People Page 5 of 28 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: The purpose of this inspection was to assess how well the home is doing in complying with regulations, assess compliance with previous requirements and to assess what the outcomes are for people who live at this home. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out over one day on 30 September 2009. We arrived at the home at 10:45 and completed the visit at 20:15 During the visit we looked at all key standards. Any regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Care Quality Commission and the predecessor organisation the Commission for Social Care Inspection. The Commission for Social Care Inspection carried out an Annual Service Review (ASR) Care Homes for Older People Page 6 of 28 of the home on 31 October 2008. This did not change the commissions opinion of the service or raise any issues for concern. We requested that the manager complete an Annual Quality Assurance Assessment (AQAA) prior to this inspection. This was sent to us within the agreed timescale, was very detailed and proved to be an accurate reflection of the home. This document forms part of the evidence for this report. During this visit we looked at the physical environment including, peoples bedrooms and all communal areas of the home. We examined records, policies and procedures. We talked to people who live at the home and some members of staff. We observed staff during their day-to-day interactions with people living at the home. We also sent surveys to twenty members of staff and twenty people living at the home. At the time of writing this report we had received completed surveys from twelve people who live at the home and ten members of staff. The manager was present during the visit to answer questions and discuss issues and verbal feedback was provided to her at the end of the inspection. Care Homes for Older People Page 7 of 28 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 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 8 of 28 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 28 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 homes assessment process is thorough, lessening the chance of someone moving into the home whose needs cannot be met. Evidence: Previous inspections of the home have found there to be a thorough assessment process in place. When we visited in October 2007, we found this outcome area to be good the judgement on that occasion was; The pre admission assessment process was detailed and contained very good information about the needs of people prior to moving into the service. The intermediate care service was well managed with dedicated staff to the satisfaction of people using it. The Annual Service Review (ASR) carried out on 31 October 2008 did not raise any concerns in this outcome area. Care Homes for Older People Page 10 of 28 Evidence: The annual quality assurance assessment (AQAA) completed by the manager prior to our most recent visit stated, We have a very comprehensive, individualised pre admission assessment to establish whether our home can meet the needs of the potential service user. We accept service users whose assessed needs can be met within our registration criteria. If a placement is not available, then an explanation of why this is not possible will be given to the proposed service user. For service users who are referred to the home via the PCTs rehabilitation team, we obtain a summary and assessment. The final decision with regard to the suitability of the placement still rests with the management team of the home. We looked at the assessment information for a sample of people who had moved into the home since our last visit. These provided us with evidence that each person had been assessed appropriately prior to moving in and as described within the AQAA. Feedback from surveys, discussion with people living at the home and their relatives was that they had been given sufficient information about the home prior to moving in and that this information had helped them in making the choice to move in. In discussion with people during the visit and their relatives they confirmed that either themselves or their representative had the opportunity to visit the home, see the room available and had been given written information about the home. Care Homes for Older People Page 11 of 28 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. People are fully supported with their health care needs and have access to a range of specialist health care support. People receive personal support in the way they prefer and according to their needs. Evidence: During our visit to the home we looked at the care plans and associated documents such as risk assessments and medication records, in respect of four people. We talked to people and their relatives to gain their opinion of the standard of health and personal care that they received. People spoken with or whom completed a survey all made positive statements regarding the care, help and support that they received. The results of surveys were that seven out twelve people said that they always received the care and support that they needed, four answered usually and one person responded sometimes. Ten people said that they always received appropriate medical support and two people told us that they usually did. Most staff were of the opinion that they were always provided with up to date information about the needs of the people they supported or cared for. Care Homes for Older People Page 12 of 28 Evidence: During the visit we requested all documentation in respect of four people. We chose the people ourselves as they represented a cross section of people at the home with different needs and abilities,some of whom had moved into the home since the last inspection. This included someone assessed as requiring intermediate care. Full and detailed care plans were available for all four people. Care plans and risk assessments had been reviewed on a monthly basis or more frequently as was necessary. Each of the four care plans looked at provided detailed information, with clear and specific guidance as to the level of assistance that people required with their personal care needs. The information recorded in the care plans addressed peoples abilities with regard to personal care and daily living and provided evidence that peoples independence is promoted. Risk assessments had been completed as necessary and risk management plans were in place to address any identified risks. We were able to discuss with some people their care needs and these were as described within the care plans. Following the last inspection of the home carried out on 3 October 2007, two requirements were made regarding the management of medication. From examination of medication records in respect of four people and discussion with the manager we were satisfied that these requirements have now been met. From examination of the records it was evident that staff were following correct administration recording procedures. Medication was stored safely and correctly. The home had a written medication policy and clear procedures. The home has a policy that only trained nursing staff are allowed to administer medicines. All staff undergo training before being able to administer any medication and regular auditing of the medication stock and records had been introduced since the last inspection. People living at the home have told us that they receive appropriate medical support. The AQAA told us that since the last inspection,Provision of GP cover has improved for service users with provision of a morning set aside each week solely to review residents health needs. From discussion with the manager this arrangement was working well. From examination of records held at the home we saw that people had access to a range of services such as GPs, Dentists, Opticians, Chiropodists and District nurses. This was supported through conversations with people. Health care records were well maintained and demonstrated that the home liaised with health care services and referred people to specialist services as appropriate. Care Homes for Older People Page 13 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home works hard to provide people with a wide variety of social and recreational activities and this is constantly being improved upon. Relatives and visitors are made to feel welcome and people are supported to keep in touch with friends and family. Menu options are varied, nutritious with plenty of choice. Meals are well-presented and peoples views are constantly sought, listened to and acted upon. Evidence: The last inspection carried out on 3 October 2007 found this outcome area to be excellent. Evidence provided in the annual quality assurance assessment (AQAA) provided a lot of information and supporting evidence to demonstrate that the home has continued to provide excellent outcomes for people in this outcome area. To support this we asked people who live at the home their views. The results of surveys returned to us were that ten people said that there were always activities that they could take part in and the two remaining respondents said that there usually were. Discussions with people who live at the home reiterated this. Care Homes for Older People Page 14 of 28 Evidence: Since the last inspection the home had employed a second social activity organiser and this had enabled them to provide more activities for people on an individual basis and in as a group. During the morning of our visit an external activities person visited the home and facilitated a range of physical activities with a large group of people. We observed this activity and saw that people requiring additional support to take part were supported by the homes activity co coordinator and other care staff. This enabled everyone in the room to take part with appropriate support. Later in the day about nine people took part in a game of bingo in the dining room . Again there was plenty of staff support provided so that everyone who wanted to could take part. The activity organiser had adapted large cards for one person who was partially sighted. This meant that they were able to take part in the game independently. Both of the above activities had been planned in advance of the inspection and were delivered as per the activity schedule. In discussion with one of the activity organisers it was apparent that they were passionate about their role and were constantly seeking new ways to engage people. The activity organiser produces a regular newsletter to keep everyone up to date with what is going on in the home and any changes that may be planned. People are also invited to have their say about anything they feel may be relevant to them. Each person living at the home had a social activity care plan and samples of these were seen. The activity organiser meets with each person on an individual basis to discuss and make plans for individual or group activities in line with their wishes and interests. The service user guide to the home states that, There are no visiting restrictions at Abbey House. Visiting times are tailored to your individual needs and circumstances. Your rights will be respected if you refuse to to see a visitor. During our visit to the home several people received visitors at different times of the day. Everyone is asked to sign on arrival at the home and examination of the visitors book showed that people are receiving visitors at all times of the day without restriction. This was supported through discussions with people during our visit. Since the last inspection the home had established a resident representative. They were spoken with during the visit and as they had only recently accepted the role they had not had much time to become active. However people spoken with confirmed that they had resident meetings and one person said that as a result of one meeting they had requested as a group that they would like a larger television for the lounge and this had been actioned. The home has a planned menu that is rotated on a four weekly basis. There were photographic copies of menus on display within the home to help people make Care Homes for Older People Page 15 of 28 Evidence: choices. One person told us that staff gave them a call about eight o clock every morning to ask them what they would like for breakfast. They said that they could choose between a full cooked breakfast or cereals. They also said that there were always two choices for dinner and that they enjoyed the tea and cakes in the afternoon. The manager told us in the AQAA that, Abbey House encourages service users to invite family or friends to have a meal with them if they so choose. We spoke to relatives and people who live at the home and one relative said, The food is very good I have stayed for a meal several times. The choice on offer is good. Another person who lives at the home said, I like the food, staff come round everyday with menu choices. There is plenty of choice for breakfast, including a cooked breakfast. The AQAA stated, Abbey House aims to provide a range of meals which include fresh ingredients that appeal to service users. Fresh fruit is available at all times. Service users have several choices at all mealtimes and they have the flexibility about where they decide to eat. Each service user has a dietary assessment and this includes information about special diets, likes, dislikes, utensils and presences about eating environments. Service users select their own menu choices and for those service users who are not physically able to choose they are assisted to communicate their choices with help from the Hostess. Mealtimes are encouraged to be relaxed with social interaction between service users and staff. Those service users who require assistance are helped by the care team in a respectful, discreet and dignified way. Evidence seen on the day, previous knowledge of the home, results of surveys and conversations with people would substantiate the above. Care Homes for Older People Page 16 of 28 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 homes policies and procedures serve to protect those who live there. Evidence: The last inspection of the home carried out on 3 October 2007 found this outcome area to be Good. The judgement on that occasion was that, The complaint process was well managed and the service users were confident that their complaints would be listened to. Staff had clear understanding of adult protection and ongoing training ensured that the service users were protected. The subsequent annual service review undertaken 31 October 2008 did not raise any concerns in this outcome area. At the most recent inspection people living at the home told us that they knew who they could speak to if they were unhappy and most knew the process for making a complaint. Staff were equally aware of the procedure to follow. In discussion with relatives they commented that they had been given information regarding the complaints procedure when their relative first moved in. The home had maintained a complaint log listing concerns raised and action taken as a result of any investigation. Examination of the complaint log demonstrated that the home had dealt with concerns or complaints as described in the written policy and procedure. In discussion with the manager she demonstrated a clear understanding of peoples Care Homes for Older People Page 17 of 28 Evidence: rights and had undertaken Mental Capacity Act training. Where appropriate assessments had been undertaken and submitted to the appropriate authority if it was deemed that the home may need to place restrictions upon people for their own safety. Examination of staff training files demonstrated that staff receive training in adult protection procedures and the manager reported that they had added more content to training in relation to safeguarding issues. Care Homes for Older People Page 18 of 28 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. People benefit from living in a comfortable, safe and clean home. Evidence: During the visit to the home we saw all communal areas and several bedrooms. On arrival, the home was found to be clean and tidy and smelt pleasant. The home has demonstrated on previous occasions that they had an ongoing programme of refurbishment. Improvements in the last twelve months included; the replacement of several sets of bedroom furniture, the replacement of ten armchairs, improved lighting in some areas, redecoration of two communal areas, refurbishment of communal shower room and toilet and the provision of additional storage facilities. The annual quality assurance assessment (AQAA)stated that future plans were to continue to redecorate and replace furniture and to construct a weather canopy at the front entrance to protect people who live at the home from inclement weather. The construction of the canopy had been completed at the time of this visit. People who returned a survey or whom were spoken with told us that the home was kept clean. One person said, The home is kept clean, my room is vacuumed daily and my bathroom floor is washed daily. We saw recorded evidence that the home had carried out regular checks and audits of Care Homes for Older People Page 19 of 28 Evidence: the physical environment and that action had been taken to address maintenance issues. The home had a laundry where all the laundry for people living there is undertaken internally. The laundry was fitted with two washing machines with sluicing programmes and two tumble dryers. Staff practices observed indicated that they we aware and followed infection control procedures. Gloves and aprons were available. Communal areas were fitted with disposable towels and liquid soaps. Care Homes for Older People Page 20 of 28 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. Staff are employed in sufficient numbers to meet the needs of people living at the home. They are well trained and undergo a thorough recruitment process. Evidence: The last inspection carried out on 3 October 2007 found this outcome area to be good and the annual service review (ASR) undertaken on 31 October 2008 did not raise any concerns. During our most recent visit we looked at the staff rota for the day of the visit and this proved to be a true reflection of the actual staff on duty. We also saw that the staff rota had been planned for the forthcoming weeks and that arrangements had been made to cover staff leave. Staff were asked whether there were enough staff to meet the individual needs of all the people who live at the home one person answered Always and everyone else responded, Usually. The number of staff on duty were as described in the annual quality assurance assessment (AQAA). The following staff were on duty during the morning of our visit; the manager and deputy manager, nine care staff, two registered nurses and an activities organiser. In addition to this there was an administrator, a part time business administrator providing administrative support to the manager, a housekeeper, three cleaners, a chef and catering assistant, a host to assist and serve Care Homes for Older People Page 21 of 28 Evidence: people their lunches and a maintenance person. The rota was well organised and detailed and had been planned to ensure that there was an even split between NVQ qualified staff and senior care staff on each shift. The home operates with a minimum of two registered nurses per shift however from looking at the rota on some occasions there were three or four rostered to work and this was dependant on such factors as what was planned for the day. Previous inspections of the home have demonstrated to us that the home carries out a thorough recruitment procedure. The Annual Quality Assurance Assessment (AQAA)provided evidence that this is still the case. The results of staff surveys were that all staff confirmed that they had been through a thorough recruitment process and that their induction had been thorough. During the visit we looked at the recruitment records of three members of staff who had been employed by the home since the last inspection. We saw that the home had followed an appropriate recruitment process and that this included; the submission of an application form and an interview. In all three cases two written references had been obtained and Criminal Records Bureau and Protection of Vulnerable Adults checks had all been completed prior to the staff commencing work at the home. Evidence was seen to verify that all three members of staff had been inducted into the home. One of the three staff members had only just started working at the home and was supernumerary on the rota while they underwent their induction. The homes induction programme covered fire safety, orientation to the home, an introduction to people living at the home, health and safety and manual handling. All staff had been given the code of conduct and ans an employee handbook and been made aware of policies and procedures of the home and the individual care plans for people. staff files examined also demonstrated that all new staff had completed an induction programme that was linked to the Skills for care induction standards. All staff were of the opinion that they received training appropriate to their role, that helped them meet peoples needs, kept them up to date with new ways of working and provided them with enough knowledge about health care and medication. Staff records showed that staff receive training in core areas such as health and safety, medication, first aid and abuse. People were generally very complimentary about the staff. One relative commented, I feel very satisfied that my mother is being cared for in such a well run, first class nursing home. All the staff are very caring and show so much love and kindness to all the residents. Another person said, Staff are friendly and create a homely atmosphere. Several people who returned a questionnaire commented on the Care Homes for Older People Page 22 of 28 Evidence: friendliness of the staff. One person did remark, On the whole the home is very friendly. However there are a few members of staff that are not so forthcoming. Comments from staff included; The staff are friendly to each other and work well as a team. I enjoy working at Abbey House. The people I work with are nice. The residents are lovely and for most part there is a great atmosphere Our observations were that staff were friendly and supportive toward the people living at the home. Staff and people living at the home were observed to be relaxed in each others company. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a consistently well managed and safe environment. Peoples views are taken into account and the home is constantly re evaluating the standard of service, care and support that it provides. Evidence: The registered manager of the home is also a registered nurse with a number of years experience in the care of older people. Since the last inspection of the home the manager has achieved the Registered Managers Award. The annual quality assurance assessment (AQAA) completed by the manager prior to this visit proved to portray an accurate assessment and reflection of the service and was very detailed. The manager has demonstrated that she has been able to sustain the level of support provided to people at the home as found at the last inspection in 2007. The home had two outstanding requirements made at the last inspection regarding medication. Evidence gathered as part of this inspection has demonstrated that these requirements have been met and no further requirements or issues of Care Homes for Older People Page 24 of 28 Evidence: concern have been raised as a result of this visit. Data recorded in the Annual quality Assurance Assessment(AQAA) told us that policies and procedures are kept under regular review and examination of a sample of these confirmed this. The AQAA also gave details and evidence that maintenance checks, tests and servicing of equipment are carried out on regular basis. Evidence seen during the visit substantiated this. The home had several systems and methods in place to evaluate and monitor the quality of the service that it provided. A senior manager within the organisation visits the home on a monthly basis and carries out an audit of the standard of care being delivered. Records showed that during these visits people living at the home were consulted and spoken to staff were interviewed, the environment and upkeep of the home was monitored and records were examined. We saw an annual planner detailing the frequency of audits to review areas such as complaints, accidents, care plans, the annual development plan, and medication. In addition to this the management team hold regular quality assurance meetings. The provider visits the home weekly and satisfaction comment cards are regularly sent to people living at the home and or their relatives. Other systems and routines are carried out such as bedroom audits, staff questionnaires every six months, staff training audits, an annual assessment against all national minimum standards and regular resident and relative meetings. The home does not generally handle peoples money. They provide people with lockable storage facilities for money and valuables. They do have the facility to look after valuables on behalf of people. We Examined the records of three people had asked the home to look after valuables or small sums of money. A log had been maintained of any property looked after on someones behalf such as cash or jewellery. every item had been documented and listed. The homes policy requires the signature of two members of staff whenever someone wishes to put something into safekeeping or asks for it to be returned. Everything had been signed and detailed as per the policy and items and cash balances were correct with entries in the log. Storage facilities were safe and each persons items were stored separately. Care Homes for Older People Page 25 of 28 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 26 of 28 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 27 of 28 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. 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. 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