Care Home: Abbey View

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What the care home does well People only move into the home once an assessment of their needs has been completed and agreed that the home can meet their needs. People are supported in their daily lives to make decisions and involved in the updating of their care plans. The auditing of medication is robust ensuring that people are protected. People who use the service tell us they are treated with respect. The home works hard to help people ensure their expectations of life in the home are met both through recreation and physical needs. People are supported to maintain contact with people in the community who are important to them. People are encouraged to eat a balanced diet in surroundings of their choosing. People are consulted about the environment they live in which is well maintained, warm and decorated with thought of the people who live there. The home is clean and hygienic which maintains the dignity of the people living there. Staff who work in the home receive the training they need to do the job well. The home is run by a person who understands the needs of the people living there. the views of the people living in the home form the basis of the services development. systems are in place to ensure the health, safety and welfare of the people living and working in the home is promoted and protected. What has improved since the last inspection? At the last inspection there were three requirements and two recommendations. To ensure that people knew who to complain to if they were unhappy the complaint procedure needed to contain information on the contact details for the local authority and primary care trust. This information is now available in the complaint procedure. Not all staff had received training in safeguarding which meant that the home could not say it fully protected people living there. all staff have now received training in how to protect vulnerable people from abuse. Staff recruitment records were not as robust as they should have been and some staff had started work before the protection of vulnerable adults check had been returned. this meant recruitment was not safe and did not fully protect the people living in the home. We found that this had improved and the requirement was met. We also found that the recommendation regarding care plans giving clear and specific information had improved. Care plans provide information on how care is to be delivered and it is done clearly so that all care staff know what to do to meet an individual`s needs. The home has a quality assurance process in place in which it has a development plan for the future. What the care home could do better: At the end of this inspection there is one recommendation, to ensure that people in the home are fully protected the safeguarding procedure should be consistent in the information it provides. By which we mean the information on the flow chart should match the written information in the document so that no one is confused about what to do. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbey View Fairfield Coldharbour Sherborne Dorset DT9 4HD     The quality rating for this care home is:   three star excellent 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: Tracey Cockburn     Date: 1 1 1 2 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 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 View Fairfield Coldharbour Sherborne Dorset DT9 4HD 01935813222 01935813889 abbeyview@coltencare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Joanna Ellis Type of registration: Number of places registered: Colten Care Limited care home 55 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home may accommodate a maximum of 30 service users who require nursing care. The home may accommodate one service user, name known to the CSCI, under the age of 65 in the category of PD. Date of last inspection Brief description of the care home Abbey View is a purpose built care home located on the outskirts of Sherborne in Dorset a few minutes walk to the Old Town and all amenities. It has good public transport links with both a railway station and numerous bus links. The home is registered to accommodate a maximum of 55 older people in 23 single and 2 double rooms on the ground floor and 24 single and 2 double rooms on the first floor. A passenger lift allows access to all floors. All rooms have en-suite toilet facilities and there are 3 assisted bathrooms on each floor. There are 3 lounges and two dining Care Homes for Older People Page 4 of 26 Over 65 55 0 Brief description of the care home rooms plus an activities room available over two floors and hairdressing facilities, which are regularly available to all residents. The home offers off road parking for staff and visitors and there is also an attractive, well maintained garden and patio area, which is easily accessible. Colten Care Limited owns the home, a company who have a number of care homes in Dorset and adjoining counties, and is managed on a day to basis by the Registered Manager, Mrs Joanna Ellis. Colten Care Limited aims to provide residents with a secure, relaxed and homely environment in which their care, wellbeing and comfort are of prime importance. At the time of the inspection the weekly fees range from 582pounds to 806pounds. Additional charges are made for hairdressing, chiropody, newspapers, manicures and dry cleaning. See the following website for further guidance on fees and contracts: www.oft.org.uk 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: 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: This was a key inspection, the first one in two years. We visited the home without any warning. It is a large home and two inspectors completed the site visit. We sent survey forms to the home for the people who live there and the staff who work in the home. We also sent out survey forms to people who come into the home on a regular basis such as health care staff. We received survey forms back from twenty two people who live in the service, ten staff who work in the service and four health care professionals. We looked at care files for four people to give us an idea of how care is provided to people we also talked to those people and the staff who provide care to them. We looked at the records the home has for managing medication and how they check that staff are doing the work correctly. Care Homes for Older People Page 6 of 26 We looked at the way the home is maintained and we talked to people about what life is like for them in the home. We also talked to care staff including the social carer and activity organiser. What the care home does well: What has improved since the last inspection? What they could do better: At the end of this inspection there is one recommendation, to ensure that people in the home are fully protected the safeguarding procedure should be consistent in the information it provides. By which we mean the information on the flow chart should match the written information in the document so that no one is confused about what to do. Care Homes for Older People Page 8 of 26 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 9 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 10 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. People who are considering using this service are given information in a variety of different formats to enable them to make a choice and a detailed assessment of their individual needs is completed before they move into the service. Evidence: The annual quality assurance assessment submitted by the home states that the pre admission process is managed by the matron and deputy. They told us that they provide information to people in a variety of formats including a virtual tour on the website. They also told us they encourage people to try out the service from sampling meals to joining in activities and a short stay. They also told us in the AQAA that pre admission assessments are done at a location which suits the individual. They told us that an admission is only agreed when it is evident that the service is able to meet all the needs of the person. At the site visit we found that the pre admission assessment was thorough, we looked Care Homes for Older People Page 11 of 26 Evidence: at five files and the documentation included the pre admission paperwork, individual needs assessment, life diary and end of life information. In one survey form returned to us a person who uses the service said I came for three weeks before deciding to stay Care Homes for Older People Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The annual quality assurance assessment submitted by the home says that they endeavour to balance risk with safety to promote individual choice. The Annual quality assurance assessment also says that all care plans are reviewed monthly and that people who use the service complete a life diary. The assessment also says that care staff receive daily reports which note the physical, psychological and social aspects of each person. The Annual quality assurance assessment also states that the home has comprehensive procedures and policies regarding management of medicines and the manager completes monthly medicine audits using the providers audit tool as well as monthly audits completed by the registered nurses using the audit tool from the pharmacist. The manager states that each month 25 of all care plans are audited. We looked at the files for four people who use the service, we found there was very Care Homes for Older People Page 13 of 26 Evidence: good information on how people need to be supported, there was detailed information on how staff need to provide care in order to meet peoples needs. Daily records were sensitively written with good information on all aspects of the persons life. We found that the life diaries are completed well and give a personalised view of the individual and their life. We found that reviews are taking place each month and that people who live in the home are involved in the reviews. We found that people have the equipment they need and are able to see health care professional when necessary. We found when talking to staff they understand people well and know how to support them sensitively. We looked at how the home manages medication and they do this well both training staff and ensuring that audits are completed. We found they systems they have in place ensure the safety of the people living in the home. Care Homes for Older People Page 14 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. People who use this service are able to make choices about their lifestyle. The service works with people to meet their expectations of living in the home. Evidence: The annual quality assurance assessment completed by the manager states that: care planning incorporates residents individual choices as appropriate with the aim to enable each resident to lead as full a life as possible they also tell us they have introduced a life diary and my daily life plan which enables each person to express their lifestyle choices. The home has an activity organiser who works forty hours a week aiming to provide a minimum of five activities each day. a weekly programme is distributed in advance. The home also has a social carer programme which responds directly to the needs of people. The social carer schedule allows companionship and entertainment for frailer people living in the home. The activity organiser visits everyone in the home at least twice each week. The social carer has contact daily with people who are frailer. We observed the social carer during the site visit. We also observed a daily news activity in the lounge which people who were about to participate in said was very good. Care Homes for Older People Page 15 of 26 Evidence: People who live in the service made a variety of comments about the food, many people said it was very good. Some people said meals vary on the whole the evening meal is the least satisfactory supper can be boring and sometimes unpleasant and other comment about food was good variety and well cooked Several people said there was not enough fresh vegetables. People are able to eat their meals in several different locations around the home. Care Homes for Older People Page 16 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. Improvements to the information in procedures and staff training mean that people living in the home are protected. However further amendments are need to the safeguarding policy so everyone is clear on the reporting of an alert. Evidence: The safeguarding policy has a flow chart which shows the correct procedure. The information in the separate text document mentions the Dorset multi agency policy but states that the operations manager and the registered manager will decide whether they involve the police or social service in any investigation. When discussed with the manager she was very clear that any safeguarding alerts would be reported in the first instance to social services and it was there decision about how the investigation proceeds. All accident forms include investigation and outcome and use body maps. The manager says that they audit the accidents regularly. All staff now receive safeguarding training and this was confirmed in discussion with both the deputy manager and staff working in the home. The complaints procedure has been updated since the last inspection and now contains the correct information on who to contact locally. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in surrounding which are maintained to a very high standard making the home a comfortable place to live. Evidence: There is an visit annually from an interior designer who listens to the views and opinions of the people living in the home and takes them into account when decorating the home. The communal areas of the home are decorated to a high standard. Rooms are personalised with an individuals own belongings. We found the home to be warm throughout. It was a very cold day at the time of the site visit. The home has a programme of routine maintenance and the home provides an extremely comfortable environment in which to live. Records show that a variety of outside agencies have attended the home to undertake the routine maintenance of, Fire safety equipment, Gas installation, Lift and Hoists. The grounds are safe and attractive and accessible for people living in the home. A call bell system is available in every room. All areas of the home were clean and there were no unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be Care Homes for Older People Page 18 of 26 Evidence: available. 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. Improvements in recruitment ensure that people using the service are protected. Improvements in training for staff give them the information and skills they need to understand and care for people using the service. Evidence: We received ten survey forms back from staff who work in the home. We ask them questions about training, recruitment and support they receive in the home. They told us: I feel I could have done with more training especially when it comes to helping people with dementia The annual quality assurance assessment submitted by the home in October 2008 stated that dementia care training had been set up for all care staff that month and was schedules to start on 27th October 2008. The annual quality assurance assessment states that 75 of all care staff have or are training to achieve their National Vocational Qualification at level two or three. There are also six members of staff who are working towards National Vocational Qualifications at level two relating to housekeeping, infection control, hospitality and cookery. Staff also told us: it would be nice to spend more time with each resident and another member of staff wrote: it would be nice to have an extra member of staff so that we could spend an extra bit of time to help them. A health care professional who wrote to us said: staff are willing to take advice about mobility and manual Care Homes for Older People Page 20 of 26 Evidence: handling. Another health care professional told us Improve communication between staff During the morning of the visit we observed staff respecting peoples wishes about how they prefer to get up. Staff were also seen discreetly observing an individual and deciding when they should assist them. Staff were observed being friendly, communicating with each other about the needs of people and working well as a team. At the time of the inspection there were eight health care assistants on duty and two registered nurses. There were also three domestic staff, one laundry person, the deputy and the manager on duty as well as the social care member of staff. We looked at the recruitment files of three people who work in the home. All staff started working after the criminal records bureau and protection of vulnerable adults check had arrived. The requirement made at the last inspection has been addressed. All other recruitment checks had been appropriately completed. One person told us the staff are brilliant 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed by someone who is skilled, experienced and very competent and puts the needs of the people using the service at the centre of good practice. Evidence: Since the last inspection the manager has attended training in the mental capacity act as well as palliative care. The annual quality assurance assessment says: there are good lines of communication from home management to company management and the companys aims and objectives are cascaded to staff. Some health care professionals who responded to the survey forms sent to them felt that communication was not as effective as it could be, one person said I sometimes find my instructions have not been communicated to the other staff adequately One health care professional said that the home had an outstanding matron and good knowledge of individuals The annual quality assurance assessment also states that the service has developed Care Homes for Older People Page 22 of 26 Evidence: links with the local fire service and agreed to have twice yearly evacuation drills the first of which was on 14th October 2008. All staff have completed mandatory training. The home has a robust quality assurance process in place and listens to people who use the service. 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 1 18 The registered provider should amend the safeguarding policy and procedure as the flow chart and advice in the text are not the same. This could be confusing for any staff needing to raise an alert. 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). 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