Care Home: Abbey Rose

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What the care home does well Abbey Rose provides a homely and comfortable environment and has a relaxed atmosphere. The home is well appointed, comfortable and clean. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. Residents confirmed that they felt well treated and are encouraged to exercise choice in their daily lives. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with other people in the home, with their families and friends and to maintain links with the local community. Meals are varied and choices are available. Sufficient numbers of trained staff are on duty throughout the day and night to be able to meet the current needs of the residents. The home is well managed and organised with the care, contentment and safety of residents being central to the way the home is run. What has improved since the last inspection? An extension to the promises providing additional bedrooms and improved communal facilities and the programme of thorough refurbishment has been completed. In accordance with the findings of the previous inspection arrangements for pre admission assessment, care planning, medicine handling and recruitment processes have been improved to ensure residents are cared for by suitable staff who have sufficient knowledge of their needs and circumstances to be able to properly meet them. What the care home could do better: This report contains no requirements for improvement. There are some recommendations including for clarification of the policy and procedure for the safeguarding of vulnerable people, for additional processes of internal audit and expansion of the fire safety escape plan. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbey Rose Cedar Avenue St Leonards Ringwood Hampshire BH24 2QG     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: Gloria Ashwell     Date: 1 2 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 21 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 21 Information about the care home Name of care home: Address: Abbey Rose Cedar Avenue St Leonards Ringwood Hampshire BH24 2QG 01202877764 01202874624 abbey.rose@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr John William Watts,Mrs Audrey Martha Watts care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 24. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Abbey Rose is owned by Mr and Mrs Watts and is managed by Mr Mark Burchfield. The home is registered to accommodate service users in the category of OP (older people) for personal care; the home is not registered to provide nursing care. Since the last inspection registered numbers have been increased from 18 to 24, following completion of an extension to the premises. Accommodation is provided on the ground and first floor levels with a communal lounge, sunroom, dining room, kitchen, laundry and communal bathing and toilet facilities. Bedrooms are on the ground and first floor and many have en-suite hygiene facilities. The first floor is reached by a passenger lift. Care Homes for Older People Page 4 of 21 Over 65 24 0 Brief description of the care home Abbey Rose is close to the village of St Ives, where there are local shops and post office. Ringwood, a small market town, is approximately 2 miles from the home, accessible by local buses. Fees are charged weekly; the fee range quoted by the manager at the time of inspection was (per person) £362 to £550. Up to date information on fees can be obtained from the service. Care Homes for Older People Page 5 of 21 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 service is 2 stars. This means the people who use this service experience good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Commission for Social Care Inspection. This inspection was unannounced, the inspector arrived at 10.30 on 12 November Care Homes for Older People Page 6 of 21 2008, toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with registered manager Mr Burchill discussed and examined documents regarding care provision and management of the home. During the inspection, particular residents were case tracked, for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. In advance of the inspection an Annual Quality Assurance Questionnaire was completed by Mr Burchill and returned to the Commission, the information it contained has been used to inform the findings of this inspection. During this inspection compliance with all key standards of the National Minimum Standards was assessed. 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 21 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 21 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. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. Evidence: The records of 2 residents admitted since the last inspection included details of pre admission assessments carried out by the registered manager while visiting the prospective residents at their previous addresses.In advance of making the decision to enter the home the prospective residents or their representatives visited the home to view the premises and meet residents and staff.Following pre admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Care Homes for Older People Page 10 of 21 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. Evidence: The care records of 4 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. Medicine handling is carried out by staff trained in this work. Residents wishing to do so can manage their own medicines in accordance with a risk assessment process, none of the currently accommodated residents manage their own medicines. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. To promote good practice it is recommended that the book in current use be replaced with a purpose made Controlled Register.Residents spoken to during the inspection said they are Care Homes for Older People Page 11 of 21 Evidence: treated with respect and their privacy and dignity is protected at all times. Care Homes for Older People Page 12 of 21 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 have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. Evidence: The home arranges seasonal activities and celebrations and frequently engages visiting entertainers e.g. on the afternoon of the inspection day a singer was booked to attend.A visiting exercise therapist attends the home once every two weeks to lead a gentle fitness session.Visitors are welcome at any time and those spoken to during the inspection said they are always made to feel welcome and placed at ease by the staff.Residents believe they are shown respect and properly treated and comments made during the inspection included I love it here, they (the staff) are all so nice and Its excellent.Meals provide good nutrition and are liked by residents. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. Residents said they have plenty to eat and the quality of meal provision is very good. Care Homes for Older People Page 13 of 21 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. People know how to complain and are confident their complaints would be listened to. Residents are safeguarded against risks of abuse in its various forms. Evidence: Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home has a complaints policy and procedure. No complaints have been received and there have been no allegations or investigations regarding the safeguarding of vulnerable adults.All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults, but information on reporting and investigating alleged or suspected abuse should be improved to ensure staff have appropriate guidance. Discussion with the Registered Manager confirmed his understanding of the correct procedure. Care Homes for Older People Page 14 of 21 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 is comfortable, clean, well equipped and suited to the needs of residents. Evidence: Abbey Rose is a traditionally built house, set in its own grounds. On the day of inspection the home was clean, tidy and comfortable throughout. There were no unpleasant odours.The home has recently undergone extensive refurbishment including redecoration, replacement of carpets and most furnishings, and completion of building work to extend the premises and provide additional bedrooms and improved communal areas. There is a large lounge, sun room and separate dining room.Resident accommodation is on the ground and first floors. There is a passenger lift in the home, enabling easy access between the floors.All bedrooms are for single occupancy and most have ensuite hygiene facilities.There are bathrooms equipped for the use of persons requiring assistance.The laundry room is equipped with equipment compliant with hygiene requirements, including a sluice cycle washing machine. Care Homes for Older People Page 15 of 21 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 home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Evidence: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision.The records of a recently employed staff member was examined and found to contain all essential information including written references and evidence of identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. The home has developed and implemented a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities.There is an enthusiastic approach to staff training and all staff undertake and as necessary update training in core subjects including fire safety, moving and handling, food hygiene and emergency aid. Care Homes for Older People Page 16 of 21 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 properly managed and maintained in the best interests of service users. Evidence: Mr Burchfield holds the registered managers award and the National Vocational Qualification at level 4 in care. He his supported by a deputy manager with the same qualifications. Both are suitably experienced.Prior to this inspection the home completed an annual quality assurance assessment (AQAA), which they submitted to the Commission for Social Care Inspection. This identifies what the home considers they do well and sets out any plans for improvement over the next twelve months.The home has recently completed a survey of residents opinions of the standard of meal provision but quality assurance monitoring has not been implemented as a core management tool so this report contains an associated recommendation.With the exception of safekeeping small amounts of money for some residents, the home does not manage the finances of residents. Residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to Care Homes for Older People Page 17 of 21 Evidence: do this on their behalf.There are good processes for staff recruitment, induction and formal supervision.There was insufficient evidence that all accidents to residents are thoroughly investigated with findings reflected in the care plan, to ensure that future risks are minimised. A policy and procedure for the management of accidents should be developed and implemented, to include evidence of investigation and the periodic audit of accident details e.g. of time, place, person, activity, to identify any trends or high aspects of risk.Records indicated that fire safety equipment is routinely checked and tested at the required frequencies and during the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. It is recommended that the fire safety assessment and escape plan be expanded to make specific reference to the currently accommodated residents. Care Homes for Older People Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 Homely remedies must only be given after ensuring that they are suitable for the person to take. All handwritten entries on Medication Administration Records (MARs) must be signed, and countersigned by another competent person, to confirm their accuracy. Balances of actual medication must match records. Only medicines belonging to individuals are to be given to them, with the exception of homely remedies purchased by the home. A system must be put in place to track the balance of homely remedies kept in the home. 01/01/2008 Care Homes for Older People Page 19 of 21 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 A commercially produced Controlled Drug register should be available to ensure that in the event of such a medicine being prescribed, the home can comply with handling requirements. The policy and procedure for reporting and investigating alleged or suspected abuse should be improved to ensure staff have clear and correct guidance. There should be continuous self monitoring of the service, using an objective, consistently obtained, reviewed and verifiable method and internal audit should take place at least annually. A policy and procedure for the management of accidents should be developed and implemented, to include evidence of investigation and the periodic audit of accident details e.g. of time, place, person, activity, to identify any trends or high aspects of risk. The fire safety assessment and escape plan should be expanded to make specific reference to the currently accommodated residents. 2 18 3 33 4 38 5 38 Care Homes for Older People Page 20 of 21 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 © (2008) 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 21 of 21 - 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!