Care Home: Abbeyfield Edward Moore House

What the care home does well This two-story building was purpose built in 1980. Its location provides access to community facilities, and its site and layout are fit for its stated purpose.The new manager has made a promising start with the building and various aspects of the operation of the home, person centred care planning and the staffing arrangements. Residents have spoken highly of the care they receive. The home have sufficient numbers and suitably qualified caring staff to ensure needs are met. The home provide excellent lifestyle choices for their residents. The Manager is commended for the improvements made to the quality of care received at this home. What has improved since the last inspection? The home`s AQAA told us about a number of improvements since the last key inspection, as a result of listening to people who use the service: There have been improvements to the information systems. Improvements to the home`s medication arrangements are underway. There have been improvements to the environment and to the residents` activities. For example the home has been celebrating residents` birthdays by consulting them individually about the kind of birthdays they would like, and this has resulted in tea parties, sing-a longs, live entertainments, games, and other social activities. As a direct result of listening to residents, a Thanksgiving service was arranged, and the plan is to introduce services of worship. The home has also taken on Occupational Therapy and Social Work students to organise activities and events. There have been improvements to the home`s arrangements for complaints and Protection. There have been improvements to the home`s staffing arrangements in that the manager has been working to make the home less dependent on agency staff; to make the recruitment process more positive; to engender more job satisfaction (e.g. with more training opportunities); and to manage staff sickness more effectively. She is reporting that team working and staff morale have improved. And staff (particularly the Assistant Manager and senior carers) are being empowered to make informed decisions. There have been improvements to the arrangement and organisation of the home in that senior carers have been allocated to each unit to take responsibility for the health and personal care of the residents there. Each resident has been allocated a key worker. CARE HOMES FOR OLDER PEOPLE Abbeyfield Edward Moore House Trinity Road Gravesend Kent DA12 1LX Lead Inspector Jenny McGookin Unannounced Inspection 10:00 27 October 2008 th X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Edward Moore House Address Trinity Road Gravesend Kent DA12 1LX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (If applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01474 321360 01474 533712 The Abbeyfield Kent Society Mrs Mojibola Roseline Olusesan Care Home 39 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Dementia (DE) maximum number of service users 29; service users in Rumcroft, Punchcroft and Brandycroft units Old age, not falling within any other category (OP) maximum number of service users 10; service users in Sherrycroft unit. The maximum number of service users to be accommodated is 39. 2. Date of last inspection 6th November 2007 Brief Description of the Service: Abbeyfield Edward Moore Residential House is one of a group of nine residential care homes in Kent owned by the Abbeyfield Kent Society, a Christian based charitable organisation and member of the National Abbeyfield Society. It was purpose built in 1980, in a quiet residential area, within easy access to a railway station, bus routes. Gravesend town centre is about half a mile away and the A2 is within a mile. This two-story property is detached and is divided into four self-contained wings or units. These are called Punchcroft, Brandycroft, Rumcroft and Sherrycroft. Edward Moore is registered to provide accommodation and personal care for 39 older people. At any given time 29 of these may have dementia in various stages. Two bedrooms originally set up as a double room have been retained as doubles, in one case to suit its long-term occupants. All the other bedrooms are used for single occupancy. A stairwell and passenger lift connect both floors. All of the bedrooms and bathrooms are fitted with a call bell system. There are 6 parking spaces at the front (2 of which are disabled parking bays) and a further 6 at rear. There is also a small amount of off-street parking. The weekly fee for residence in the Service runs from £353.63 to £461.25. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 5 Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is based on two site visits, the first of which was unannounced and the second of which was by prior arrangement a week later. Both visits were used to inform this years key inspection process; to check progress with matters raised from the last key inspection (November 2007); and to review findings on the day-to-day running of the home. The inspection process took fourteen and three quarter hours overall. It involved meetings with two residents over lunch one day, and another resident separately over lunch the second time we visited, as well as two visiting relatives. We had meetings with a number of individuals representing a range of functions of the home - the Manager; Assistant Manager; three senior carers; a carer; the homes cook and a member of Abbeyfields Response maintenance team. We also observed interactions between residents and staff at various stages throughout our visits. We issued a selection of feedback questionnaires for distribution to residents, relatives and visiting professionals. Feedback was only obtained from one relative, in time for the issue of this report. Any others will be used to inform the Commissions intelligence in due course. Consideration was given to the Annual Quality Assurance Assessment submitted by the home’s new manager in September 2008, ahead of its due date. The AQAA is a self-assessment that focuses on how well outcomes are being mate for people using the service. It also gives some numerical information about the service. The inspection involved an examination of records, including two residents case files, to track their care and a selection of personnel files. The environment was assessed during this inspection. What the service does well: This two-story building was purpose built in 1980. Its location provides access to community facilities, and its site and layout are fit for its stated purpose. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 7 The new manager has made a promising start with the building and various aspects of the operation of the home, person centred care planning and the staffing arrangements. Residents have spoken highly of the care they receive. The home have sufficient numbers and suitably qualified caring staff to ensure needs are met. The home provide excellent lifestyle choices for their residents. The Manager is commended for the improvements made to the quality of care received at this home. What has improved since the last inspection? What they could do better: There are no requirement or recommendations made at the inspection. Please contact the provider for advice of actions taken in response to this Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 1, 3, 4, 5, 6 Prospective residents and their representatives benefit by having access to the information needed to decide whether this home would meet their needs. Prospective residents can feel confidant that their needs will be properly assessed. This home does not provide intermediate care. EVIDENCE: There is an Information pack for prospective residents, which contains one document intended to be a combined Statement of Purpose and Service User Guide and a range of loose-leaf documents, usefully describing a range of facilities, services and service principles. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 11 One resident told us she’d made the decision to come into residential care herself, and liked the idea of a charitable organisation. This home had been recommended by someone who had carried out work there. Two visiting relatives told us this home was chosen on the basis of discussions they’d had with their funding authority and healthcare professionals. Other Abbeyfield publications, display material and newsletters would be on view to visitors. We found good evidence of preadmission assessments carried out by the home, in residents’ own homes or hospital, which routinely take any assessments carried out by funding authorities into account. Feedback confirmed that prospective residents (where able) or their representative could visit the home before the admission, to meet the staff and other residents. In common with other homes in the Abbeyfield group, a trial stay of one month is available. All the residents spoken to said they were very happy with the choice of home. On their admission, the home carries out further assessments and risk assessments. The home can demonstrate its capacity to meet the needs of residents. See section on “Environment”; the section on “Health and Personal Care” for a description of services provision; and the section on staffing for information on deployment and training. This home provides respite care but it does not provide intermediate care. Should the home provide rehabilitation and/or convalescence, all the elements of National Minimum Standard 6 will apply. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 7, 8, 9, 10 Residents can be confident that the health and personal care, which they receive, is based on their assessed individual needs. Residents can be confident that the principles of respect, dignity and privacy are put into practice. EVIDENCE: Two residents’ files were selected for case tracking on this occasion, to represent the latest admissions (i.e. over the past year). In common with other homes in the Abbeyfield group, the format of the care plans used by this home properly identifies a range of health and personal care needs in the first instance, and these are supplemented by daily reports, a wide range of assessments (including risks, which generate action plans) and records of contact with healthcare professionals. A “Carers’ Summary” file provides staff with the key details for ready access, in each case. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 13 Evidence was seen of care plans having been discussed with service users. The manager has ensured that each resident has an allocated key-worker to ensure a meaningful rapport can be built up with them thereon. Feedback indicated that the daily routines are generally as flexible as healthcare needs and staffing levels will allow. Two bedrooms, originally set up as double rooms, have been retained as double rooms (in one case to suit its long-standing occupants) but all the rest are used for single occupancy. This effectively means personal and health care can be given in privacy. We found good evidence of in-house evaluations and audits of these documents, to keep them current. The home also relies on its rapport with residents and their relatives to update the care plans – there are no formal multi-disciplinary reviews as such, except those led by funding authorities. The manager has been actively meeting with a wide range of healthcare professionals to improve the home’s communication with them: twelve GP surgeries, District Nurses, Impact Team, Care Managers, Chiropodist, Dentists, opticians, Audiologists, and the emergemcy services. There are regular awareness sessions for staff in all the areas of health and personal care needs of the residents. One relative told us he was “always notified of hospital appointments”. The residents and relatives we spoke to were very appreciative of the level of care given. When asked what was good about this home, one relative told us, “The 24-hour care. The staff are very friendly”. The home uses the Monitored Dosage System of medication dispensed by a pharmacist who is not local over a 4-week cycle. It has a small medication trolley, which needs to be emptied and restocked for each medication round, though this is not ideal, we were assured the manager is looking for alternative provision. Assurances were given that it is kept properly secured when not in use. The home has Abbeyfield’s own corporate policy on medication, but staff did not, when asked, have ready access to the Royal Pharmaceutical Society Guidance on medication or to an up to date directory on drugs, for reference. This is recommended to keep practice safe. There were no gaps or anomalies in the medication administration records seen on this occasion, but we were aware of two medication errors since the last inspection visit. We were assured that corrective action was taken in each case. Records confirm that only senior staff are trained to administer medication, and this training is kept updated, to keep people safe. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. 12, 13, 14, 15 Residents are able to exercise choices over their daily lifestyle and social activities and can keep in contact with family and friends. Residents can be confident that the social, cultural and recreational activities offered by the home will be tailored to meet their expectations. Residents can be confident that they will receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: When asked what was good about this home, one member of staff told us, “It promotes person-centred care in practice. I look at individuals individually and make them feel dignified, loved, valued. I try to make sure they continue to have the kind of life they had before coming into the home”. The home has delegated the role of activities co-ordinator to one of the senior carers. It has a weekly programme of activities, which is on display, and a colourful photo album on each unit to illustrate and commemorate them. It Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 15 also maintains an activities feedback file which details each activity, who participated and their comments and feedback, so that their value to residents can be properly judged. There are one-to-one chats and we were told one resident with communication difficulties is assisted to make choices with picture cards and books this way. This is exemplary practice. We were particularly interested to see the biographical information provided in each resident’s file we looked at, which should provide talking points and leads for person centred care planning. This information is planned to be incorporated into the individuals care plans. We did see aspects of people’ lives feature in the home’s activities and facilities. Examples included reminiscence – memories of Gravesend, Dartford musical memoirs, the roaring twenties and discussions about local newspaper articles. The home has taken on Occupational Therapist and Social Work students to promote this aspect of its operation, and the manager told us she is planning to get the local community more involved. We were told that one resident likes to write to Government Officials about current affairs. A picture of a circus animal seen on display in one area of the home is there because of one resident’s background. We were told about another resident’s interest in antiques and how individual items are made talking points in discussions; and how one resident used to be a policeman and occasionally has visitors from the police force today. One senior carer has suggested residents be supported to have Internet access. This is an inclusive approach by the home and to be commended. Examples of other, more generic, activities include: quizzes, a magazine and book group, letter games, Bingo; exercises (soft ball and balloon games, bowling, dancing, walks around the garden); craft sessions (e.g. making cards); pampering sessions (hair dressing, nail care). There are singsongs, entertainers (e.g. an Elvis impersonator), TV and film events, horoscopes and “bets” on the Grand National. Some residents like to carry out light domestic tasks such as baking (one resident used to be a baker), folding towels, sorting out laundry items (one used to stack shelves in a supermarket), dusting and polishing. Birthdays are celebrated with activities of the individual’s choice e.g. live entertainment, games. And seasonal events are celebrated, such as Thanksgiving, Easter etc. As with other homes in the Abbeyfield group, religious preferences are properly identified as part of the initial assessment and care planning process. There are regular services on site. The manager told us she particularly wants to develop this aspect of the home’s operation. As is often the case in our inspections, residents were not individually able to give us many examples of any particular interests or hobbies being actively promoted by the home, but confirmed the home had activities for them if they wanted. Participation is always a matter of personal choice. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 16 Two relatives told us that the resident they visited tended to stay in her room watching TV and reading, but had never tended to go out when she was in her own home. She now refers to her room as her home. They told us she had made friends with another resident and that they spent time together. The home has a communal TV in each lounge, and two of these have Digiboxes to increase residents’ viewing choices. The home also has its own stock of DVDs, videos etc. None of the TVs has a Loop system, for use with hearing aids but we were told this was due to environmental interference. Residents can choose when to go to bed or get up, and what to do during the day, but tend in practice to have their own fairly set routines. They were observed being supported to make some choices and decisions during the day of this inspection. Residents are able to have visitors at any reasonable time. The home is well placed for links with the local community (see also section on “Environment”). There is a communal payphone at the foot of the stairwell which does not have the benefit of a cordless handset available. A number of the bedrooms do have telephone points and residents can have lines installed in their own bedrooms, at their own expense. Assurances were given that residents receive their mail unopened unless other arrangements have been made by an individual. Catering needs are properly identified as part of the preadmission process and updated or amended thereon. There is a choice of two menus for each main meal and we were assured alternatives are always available. We were told that the home has been using preferred local sources of fresh produce, but this is currently subject to decisions about centralising provision at a corporate level, which the cook is hoping to influence. Some special diets can be catered for, for example the cook told us how she provides diabetic and salt-free meals. One resident has difficulties swallowing so the cook liquidises their meats and mashes their potato. There is some adapted cutlery available on the units such as left and right handled spoons. Meals in one unit are served from trolleys, in others it is served ready plated, according to ability. Records are maintained of the options chosen by individuals, as required. Two relatives told us that the resident they visited had intake problems before she came into this home but had been eating regularly since then, putting on weight and looking better for it. A resident told us they had good meals every day. Another told she liked “the fact the food was home cooked – nothing is processed or pre-prepared”. She told us the main meal was lunch but “breakfasts are huge meals”. She liked to have porridge for breakfast but they could also have bacon and eggs, cereals etc. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 17 The inspector joined residents for lunch on both visits, the meals appeared well prepared and well presented. The pace was unhurried and congenial, involving friendly banter between the staff and residents. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 16, 17, 18 Residents and their representatives can have confidence that the home’s culture is to take concerns and complaints seriously. Residents can feel confident that they are protected from abuse and will have their legal rights protected. EVIDENCE: Abbeyfield has a clear complaints procedure, which is in a leaflet included in the Information Pack given to prospective residents and it is also available on request. The home keeps a register of complaints, as required, in a loose-leaf ring binder. We were assured access to its contents is restricted to those properly authorised. This is subject to quarterly audits and it might be beneficial if these findings were included in Abbeyfield’s own unannounced monthly inspections, so that the company is always aware of emerging issues. There were a range of complaints registered with good evidence of the home’s responses. Abbeyfield has procedures to ensure that service users are safeguarded from abuse in all its forms, including police and criminal record checks on Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 19 prospective staff - and staff confirmed their commitment to challenge and report any incidences of abuse, should they occur. The home has information on independent advocacy services on display but we were told there are currently no advocates involved in representing any residents. Families and friends tend in practice to be relied on to provide this. Records indicate that since the last inspection 10 staff have had training in the new mental capacity legislation, and there are ongoing “awareness sessions” on Adult Protection and Mental Capacity, to ensure rights are properly promoted. We can confirm that no complaints or adult protection proceedings have been raised against the home since the last inspection (November 2007). Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, generally well-maintained environment, which encourages freedom of movement as far as they are individually assessed able. EVIDENCE: This home was purpose built in 1980, so in some ways it has suitable design features and as an existing registration is not required to meet the new National Minimum Standards, any new build the premises would have to comply. It is half a mile from Gravesend town centre, with all the community and transport links that implies. It is within one mile of the A2, and within ten minutes walk to bus routes, linking it to Gravesend Town Centre, Greenhythe and Bluewater shopping centre. There is a small convenience store within 2 minutes walk and 2 pubs. This is reported to be a safe neighbourhood. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 21 Onsite parking is adequate (6 parking spaces at front - 2 of which are disabled parking bays, and a further 6 at rear), and there is unrestricted kerb-side off site. Measures are in place to keep the premises secure against unauthorised access, including keypad access. Relatives know the code, which is changed periodically to keep people safe. We were assured that residents can come and go freely, subject to risk assessment. This home has a large garden to the front and rear, featuring a paved patio, tables, chairs and a gazebo, as well as a raised fishpond stocked with goldfish. Since the last inspection, the number of hours worked by the home’s gardener has been increased, to improve the site and to keep it well maintained. Residents have made suggestions about the type of plants they would like to see in the Garden. The layout of this home is accessible, safe and reasonably well-maintained. Comfortable temperatures were being maintained throughout, though a number of windows were reported to be in need of draught proofing. The home is now largely odour-free, only one bedroom required better management. We were assured that health and safety have become top priorities. The residents have a choice of four lounge/dining areas (including kitchenette facilities in each case for snacks), and they are each spacious. The furniture tends to be domestic in style and of good quality, and there were homely touches everywhere. Since the last inspection, several areas have benefited from redecoration or refurbishment, with more in prospect. Non-slip flooring has replaced some carpets in the communal areas. Residents were given the opportunity to choose the colours of floorings used. All corridors and doorways are wide enough to allow the passage of wheelchairs and mobility aids; and there is a shaft lift and staircases to access all floors, so that residents can move about as independently as possible. All areas are linked with a call bell system to keep people safe. Specialist provision is in place and includes hand and grab rails, wrist operated taps, adapted baths and lifting equipment, including hoists. This list is not exhaustive. The plan is to have better storage arrangements for the wheelchairs, hoists and Zimmer Frames we saw around the property. This home is registered to provide accommodation and personal care for 39 older people. At any given time 29 of these may have dementia in various stages. Two bedrooms originally set up as a double room have been retained as doubles, in one case to suit its long-term occupants. All the other bedrooms are used for single occupancy. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 22 One bedroom is just under 11 square metres, and 29 bedrooms are between 11-12 square metres, which would make them all unsuitable for use as bedrooms if this were a new registration – but exemptions apply to older buildings. 6 are larger than the National Minimum spatial standard. A number of bedrooms have telephone points, and television points - and all are linked to a call system facility, to summon help in an emergency. Fourteen bedrooms, selected at random, were inspected on this occasion, and evidenced reasonably well maintained and personalised. Seven had new carpets and others had non-slip flooring - we were told the residents were involved in choosing the colours. The overhead lighting in all the bedrooms appeared very dull (though one resident said she liked this) and some bedroom lights did not work when we tried them. This could make moving around the rooms unsafe. This was fed back to the Manager. This home has four communal bathrooms (with Parker baths) and nine communal WCs i.e. all reasonably close to bedrooms and communal areas. However, we were told that two of the bathrooms are rarely used – one was being used to store a hoist and the lock on one of the bathroom doors had been effectively disabled. This requires assessment. All the maintenance records seen were up to date and systematically arranged. . Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. 27, 28, 29, 30 Residents benefit from a staff team, which is available to them in sufficient numbers and is trained to fill the aims of the home and meet the changing needs of residents. EVIDENCE: This home’s staffing arrangements are designed to ensure that (excluding the Manager and Assistant Manager) there should always be: • 5 care staff and a senior carer on duty during the mornings (7am till 2.20pm) and • 4-5 care staff, plus a senior during the afternoons (2pm till 9.20pm). • At night there should always be 3-4 waking staff from 9.10pm till 7.10am, with an on-call system as a back up. The Manager and Assistant Manager work flexibly between 7am and 5pm on weekdays, and we were told that unannounced spot checks are carried out to keep people safe. We can confirm that there have been no concerns raised with the Commission about the home’s capacity to maintain these staffing levels. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 24 The home has ready access to a bank of flexi staff and agency staff, but the manager has been working to keep the number of agency staff to a minimum, so that residents have some continuity of care. This home has one cook who works from 6.30/7.00am till 2.00pm, and a kitchen assistant who works from 8am till 2pm. There is also a kitchen assistant who works for 4 hours in the afternoons. At any given time every morning there should be 3-4 domestic staff and one of two laundry staff (who alternate and also cover evening shifts) An examination of three personnel records, selected at random, confirmed feedback from staff that this home has a systematic recruitment process to comply with the key elements of the standard. This process includes a range of checks (identity, work status, references and criminal records) to keep people safe. New staff are then subject to comprehensive induction training and an ongoing programme of training and “awareness” sessions thereon, to ensure expected practice standards are maintained. Staff and records confirmed that there is a sound level of investment in mandatory training (e.g. moving and handling, medication, food hygiene, First Aid and Health and Safety, COSHH and infection control) to keep the service users safe. Some specialist training such as dementia care, care planning and mental capacity was evident in the files we looked. One resident told us “staff are good. I like the way they talk to people with dementia – quietly and with compassion”. Another told us how impressed she had been with one senior carer in particular, how much she felt the senior carer cared. She said, “If we were wanting something sorted out, she would come back in 20 minutes and she’d have it sorted out”. One senior carer told us, “Everything we do, we do for the residents. We even use our own time. Overall the care staff are a happy group. There is teamwork and our care standards are good. Residents are not left to wait. I love the interaction”. We were told that all staff are required to undertake NVQ training upon the successful completion of their probation period. The AQAA told us that 27 permanent staff already have NVQ Level 2 accreditation or above. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. 31, 32, 33, 36, 37, 38 The home is run for the benefit of residents in that the management and administration of the home is based on openness and respect. The quality assurance system could to be strengthened. EVIDENCE: At the time of our inspection visits, the Commission’s registration process had yet to confirm Mrs Mojibola Olusesan as this home’s registered manager, but this process was completed on 30th January 2009, in time for the final publication of this report. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 26 Abbeyfield has formal annual business planning processes, which the home contributes to with projects but it does not as yet have its own business plan. We were shown one quality assurance feedback exercise and are aware that the home has a suggestion box so that comments can be submitted anonymously. Feedback from residents and other stakeholders will be crucial to the success of this process, which is intended to evaluate the home’s performance against its stated aims and objectives. There are clear lines of accountability within the home and the Abbeyfield organisation; and staff and residents we spoke to have confirmed that the management and staff team is invariably accessible and supportive. The management are to be commended for the excellent provision of lifestyle choices at this home and staff interactions and numbers evidenced residents benefit from well trained quality staff. There was evidence (recorded and anecdotal) that staff were receiving formal, documented staff supervision sessions, though the frequency of this varied from 2-3 monthly and did not include line management supervision for the manager herself. We saw some evidence of periodic appraisals, to ensure staff development needs are met. The home maintains a file of all its health and safety checks, to keep people safe. Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 2 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 3 Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeyfield Edward Moore House DS0000023928.V374156.R02.S.doc Version 5.2 Page 30 - 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. 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