Care Home: Abbeymoor Nursing Home

What the care home does well The staff have worked hard to continually the care and service provision in the home. Care plans are being brought up to date using a person centred approach to care delivery.They are completed on how the person wants to be supported and looked after. The home has it`s own bus and people now make choices about where they go and also enjoy a range of activities both inside and out of the the home. Staff are now aware of how their behaviour affects others. They were all very respectful, patient and encouraging. There are good links with other professionals to ensure people`s needs are promoted. Complaints and concerns are being listened to and action and outcomes recorded.One visitor said, "it`s much better and I can go to the office if I am concerned or I can just talk to the staff." There has been a progressive and active recruitment programme since September 2008 and staff are receiving training so that they can provide a good standard of care to people with complex needs. The manager has a good understanding of the areas which need to improve and he and the staff have worked hard to address the requirements from the last inspection report. No requirements were made during this visit to the home. What the care home could do better: The Statement of Purpose and Service User Guide needs to be developed and a copy provided to everyone living in the home. The mealtime experience, choices and quality of food needs to be improved. Further work is needed to develop a person centered approach to care. The refurbishment and redecoration of the home needs to continue. The specialist chairs must be replaced. Bins still need to be foot operated with suitable lids and all light and call cords need to be easily cleaned to prevent the spread of infection. People should have unrestricted access to the home unless it is subject to identified risk. The manager should progress with application to become registered. The requirements from the last inspection need to be actioned within the given timescales and staff need to continue to develop the service provision for the people living in the home. Inspecting for better lives Random inspection report Care homes for adults (18-65 years) Name: Address: Abbeymoor Nursing Home 5 Market Lane Swalwell Gateshead Tyne & Wear NE16 3DZ one star adequate service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Irene Bowater Date: 0 3 0 3 2 0 0 9 Information about the care home Name of care home: Address: Abbeymoor Nursing Home 5 Market Lane Swalwell Gateshead Tyne & Wear NE16 3DZ 01914880899 01914888202 abbeymoor@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 0 0 dementia learning disability physical disability Conditions of registration: Date of last inspection Brief description of the care home 5 3 40 Abbeymoor Nursing Home is a two-storey care home that provides care for up to forty people between the ages of eighteen to sixty five years with complex neurological conditions. The home is of traditional brick and tile construction and it is located in a residential area, close to the Gateshead Metro Centre. It is close to the local shops, recreational facilities and transport links to both Gateshead and Newcastle upon Tyne. Access is through the car park, via a steep slope, but there is level access to the building. There are two separate units, which have communal lounges and dining Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home rooms. And there are small kitchenettes where people can make drinks and snacks. On the ground floor there is limited access to the garden and patio area. This floor also has a large conservatory and games room. The home has forty single bedrooms many with en-suite facilities. Throughout the home there are specialist bathrooms, toilets and shower facilities. The majority of people living in the home have their fee rates individually costed by the Home Manager. The funding comes from various sources, for example, different Local Authorities and Primary Care Trusts who provide the continuing care funds. The free nursing care element is included and this amount is set nationally. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: The random inspection was carried out to look at the way the home has responded to the requirements made at the last key inspection. The visit was undertaken on Tuesday 3rd March 2009 and during the visit the manager was available to assist with collecting the information needed. Staff in the home are working hard to review and update all of the care plans. Some work has been completed and are now showing that they are person centred, detailed and easy to understand. They are being written with the person and their representative and give information about how the person wishes to be cared for. Detailed risk assessments are completed and updated monthly. These include dependency, Waterlow scoring for the prevention of pressure ulcers, continence, nutrition, using the Malnutrition Universal Screening Tool (MUST), falls risk and related health risks should anyone smoke. Information about likes and dislikes are recorded, for example one person dislikes fruit and vegetables but likes potatoes, bacon sandwiches and tea with two sugars. One person is supported for all meals by a member of staff and although they can manage some finger foods, these need to be in small pieces. Another plan records that although healthy eating is promoted this person will always decide to choose the other option. Staff clearly record when advice has been sought from other professionals including tissue viability nurses, GPs,Neuropsycologist, dieticans, occupational and physiotherapists. Staff are also starting to complete care plans for behaviours that may challenge in more detail and have support from the Companys Brain Injury rehabilitation team and Gateshead Aquired Brain Injury team in completing risk assessments and plans. Several people have specialist chairs and profiling beds and need full support from staff to move around the home. The care plans gave clear instruction of how this happens and includes details of specific hoists and slings. There was clear information about use of thickened fluids and making food custard consistency to prevent aspiration and choking risks. Plans also show lots of information about diet and the individual and how the staff are acting in their best interests by involving other professionals and advocacy services. Daily progress records are clear and show how staff are supporting people to take risks and start to choose how to spend their day. A range of activities now take place and there are photographs recent events including the celebration of Chinese New Year. A pancake race was completed on a flatish road outside of the home on Shrove Tuesday and on the day of the visit there was lots of Care Homes for Adults (18-65 years) Page 4 of 11 activity preparing for Red Nose Day and St Patricks Day. The conservatory is now being used fully for activities and events and everyone said how much better this was. The home has its own mini bus and staff said people are asked where they want to go and the programme includes visits to Richmond, Lake District, Tynemouth, and Otterburn Mills. Through training and supervision staff are now aware of how their behaviour affects others. They were all very respectful, patient and encouraging. There was lots of joint laughter and banter between everyone. The home was a much more relaxed happier place. A named nurse and key worker system has been introduced so that both staff and people living in the home can build relationships and develop a more personal approach to care. Complaints and Safeguarding are now being appropriately managed. No complaints have been received since the last Key Inspection and one concern raised about a possible safeguarding is being dealt with by the multi disciplinary team. Training records show that staff have completed safeguarding training with the Local Authority and in house. They have also had conflict resolution, whistle blowing and dealing with complaints training. A relative said that its much better and I can go to the office if concerned. Upstairs has been redecorated and the nurses station relocated to where a small dining room was. There are two large lounge dining areas with kitchen facilities for people to use on this unit. The smoking room remains sparsely furnished but the carpet has been replaced with laminate flooring. The furniture and decoration on the downstairs unit is looking tired and worn mainly through constant use. Bedrooms are nicely furnished and have plenty of personal items which reflect lifestyles and personal taste. Many of the lounge chairs and pool table have been removed from the conservatory so that people with wheelchairs and large specialist chairs can use this area for activities. At least three of the large specialist chairs are very worn and torn and there has been some discussion about who is responsible for replacing them.If this is an assessed need the home should provide the specialist equipment. There has been little change to toilets, bathrooms and shower facilities. The flooring to bathroom 33 will be replaced during the next round of refurbishment. Sluices are now locked and the home was clean and odour free. Bins still need to be foot operated with suitable lids and all light and call cords need to be easily cleaned to Care Homes for Adults (18-65 years) Page 5 of 11 prevent the spread of infection. There has been a progressive and active recruitment programme since September 2008. Currently there are thirty seven people living in the home. The off duty shows that usually there are three qualified nurses on duty supported by ten to twelve carers during the day and there are plans to increase night staffing levels. In addition to nursing and care staff there are two activities organisers, domestics, laundry, cook, kitchen assistants, maintenance staff and a full time administrator. A detailed training programme has been introduced from October 2008 and is ongoing. Training includes, Infection Control, whistle blowing, care planning, activities, dealing with swallowing difficulties,sensory deprivation, health and safety, continence, conflict resolution and Safeguarding Adults. In addition staff have completed statutory training and specialist staff are available and are providing training in Aquired Brain Injury and Huntingtons Disease. The home now has a manger who has been employed since September 2008. He is a first level registered nurse and has vast experience in the health care sector. He has gained a good understanding of the issues in the home and an action plan with timescales has been produced to show how things will be put right. During the last six months quality assurance systems have been put in place. People living in the home now have a voice and meeting are held with them so that they can help develop the service. Staff meetings are help and they are kept informed of events and actions taken to improve the service. Staff, without exception, said that there had been a vast improvement and they felt valued and supported by the manager. The in house maintenance records are now being completed as required on a weekly and monthly basis. These include fire, water temperatures and emergency lighting. What the care home does well: The staff have worked hard to continually the care and service provision in the home. Care plans are being brought up to date using a person centred approach to care delivery.They are completed on how the person wants to be supported and looked after. The home has its own bus and people now make choices about where they go and also enjoy a range of activities both inside and out of the the home. Staff are now aware of how their behaviour affects others. They were all very respectful, patient and encouraging. There are good links with other professionals to ensure peoples needs are promoted. Complaints and concerns are being listened to and action and outcomes recorded. Care Homes for Adults (18-65 years) Page 6 of 11 One visitor said, its much better and I can go to the office if I am concerned or I can just talk to the staff. There has been a progressive and active recruitment programme since September 2008 and staff are receiving training so that they can provide a good standard of care to people with complex needs. The manager has a good understanding of the areas which need to improve and he and the staff have worked hard to address the requirements from the last inspection report. No requirements were made during this visit to the home. 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 2. Care Homes for Adults (18-65 years) Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 1 5 The registered persons must 04/05/2009 ensure that the Service User Guide is written in plain English and made available in different formats. This will make sure people understand what the home is offering so that they can make the right decision about moving in. 2 7 13 The registered persons must 27/02/2009 ensure that people are able to make decisions about their lives and record in the care plan reasons why choices and decisions are limited or prevented. The registered persons must 05/01/2009 ensure that all food including liquefied meals are presented in a manner, which is appealing in order to maintain appetite and nutritional status. The registered persons must 02/03/2009 continue to improve the variety and content of the food provision. This will make sure everyone receives a nutritious diet which meets their individual 3 17 12,13 4 17 16 Care Homes for Adults (18-65 years) Page 8 of 11 need. 5 27 23 The registered persons must 02/02/2009 ensure that the flooring in bathroom 33 is replaced,tiles in shower room cleaned and bath chairs cleaned after each use. This will make sure that peoples privacy is maintained and the bathrooms meet peoples needs. 6 29 16 The registered persons must 02/02/2009 ensure that appropriate specialist chairs are provided to meet the needs of individuals. This is to ensure that people have suitable specialist equipment that is clean,safe and suitable for use. 7 35 18 The registered persons must 08/06/2009 ensure that the staff receive specialist training. This will ensure peoples complex health and social care needs are met at all times. 8 36 18 The registered persons must 29/06/2009 ensure that staff are supervised as part of every day practice and have formal supervison with senior staff. This will make sure that staff are supported and guided to carry out their role effectively and ensure they provide a good standard of care. Care Homes for Adults (18-65 years) Page 9 of 11 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 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. 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