Care Home: Abbots Lawn

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What the care home does well Needs are assessed prior to admission and the required information is given to prospective admissions. Care needs are met with respect, equality and diversity is addressed. There is excellent activities provision and nutritious meals are served in a pleasant and unhurried manner. Complaints and protection issues are addressed. What has improved since the last inspection? People who use the service if desired have their own bank accounts and money is not held by the home. The requirements of an Environmental Health report have been met. What the care home could do better: The management of controlled drugs to be improved, as numbers of tablets present did not correspond with the number recorded in the controlled drugs book. The prescribing and supply of controlled drugs to be discussed with the general practitioner and the pharmacist to prevent overstocking. CARE HOMES FOR OLDER PEOPLE Abbots Lawn Sylvan Way Bognor Regis West Sussex PO21 2RS Lead Inspector Sheila Gawley Unannounced Inspection 9th June 2008 10:30 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 Abbots Lawn DS0000014342.V365169.R01.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. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbots Lawn Address Sylvan Way Bognor Regis West Sussex PO21 2RS 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) 01243 823288 01243 821049 a-newman@btconnect.com Mrs Susan Rosalind Newman Care Home 37 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Mental disorder, excluding learning of places disability or dementia (0), Mental Disorder, excluding learning disability or dementia - over 65 years of age (0) Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (NC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) 2. Mental disorder, excluding learning disability or dementia (MD) The maximum number of service users to be accommodated is 37. Date of last inspection 5th June 2006 Brief Description of the Service: Abbots Lawn is a care home with nursing, registered with the Commission for Social Care Inspection to provide care for up to thirty-seven people in the category MD/E (Mental disorder elderly) and DE (Dementia). The establishment is situated in a quiet residential road in Bognor Regis, close to the sea front. It is a well decorated and well maintained property with all but two of the bedrooms having ensuite facilities. Mrs S Newman privately owns the service, and is also applying to be the registered Manager. The fees charged are £410-£650 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit as part of the inspection process was carried out on 09/06/08. Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Care Inspection. Three people who use the service were case tracked during the inspection. People who use the service and staff were spoken to on the day. We were in receipt of comments from surveys we had sent to people who use the service. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. Staff and people who use the service spoken to on the day stated that they were happy in the home. The premises were toured. The registered provider, who is applying to be the registered manager, facilitated the inspection and any documents required on the day were made available. All of the outcome groups assessed today were rated as good or excellent. What the service does well: Needs are assessed prior to admission and the required information is given to prospective admissions. Care needs are met with respect, equality and diversity is addressed. There is excellent activities provision and nutritious meals are served in a pleasant and unhurried manner. Complaints and protection issues are addressed. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this 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. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 7 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 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 8 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): 1,2,3 People who use the service experience good quality in this outcome area because needs are assessed and information needed to make an informed choice is available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Contracts were seen to be in place along with up to date terms and conditions, which include fees, what is included, and room to be occupied. People who use the service have their needs assessed prior to admission. In the care plans inspected these assessments were seen and were comprehensive including communication, mental wellbeing, medical need, personal need, vision, mobility, continence and pressure area assessment. People who use the service spoken to confirmed that they had this assessment. Care management plans were also seen in care plans in which Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 9 social services detailed the care needs they wished to see being met. New documentation is being put in place to further improve the recording of social history. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 10 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): People who use the service experience good quality all needs are assessed and met, set out in a plan and residents are treated with respect. There were some shortfalls in the handling of medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents had a plan of care. Their care plans were inspected and they contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs. This included mental, physical and social need, nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered, moving and handling, nutrition and pressure area risk. There were daily records and evidence of monthly review and weight is monitored. There is a key worker system in place. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 11 Access to specialist health support is available as required including general practitioner and community mental health team. A chiropodist and optician visit the home. The people who use the service spoken to confirmed this. Medicines are received, and stored, correctly. Not all drugs administered were correctly signed for and for one person who uses the service one medication had run out. There are not any people who use the service self-medicating at present. Controlled drugs are appropriately stored. The controlled drug for one person was inspected and there was found to be a large quantity, with three bottles in use and the number of tablets present, 114 did not correspond with the number recorded in the controlled drug book, 116. The registered manager stated she will speak to the general practitioner and pharmacist regarding the quantities of the drug supplied. Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. People who use the service spoken to stated that care is offered as assessed. One person who uses the service commented, “I find the staff most helpful”. A person who uses the service who was upset was managed in a sensitive and caring manner which was calming. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 12 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): People who use the service experience good quality in this outcome area because the lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities coordinator is employed and there are activities Monday to Friday. This includes music, exercises, Karaoke, board games, and dominos, I Spy. The people spoken to confirmed this. People who use the service can be involved in the local community, some can go into town alone and others are accompanied. One person who uses the service attends a club and plays darts. Another person spoken to state that they have choice in what they do such staying in their room if they wish, but that the staff motivate them and do not “ let you hide away”. Surveys are in place to consult people who use the service on leisure activities. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 13 There are also seasonal events such as summer and Christmas parties. People spoken to stated that clergy would be called if requested and they confirmed the receipt of Easter eggs and Christmas presents from the proprietor. Visitors are welcome at all times and are offered refreshment. The proprietor discussed her attempts and difficulty in sourcing advocacy services for the people who live in the home. The AQAA stated that daily routines are flexible and that people are encouraged to exercise choice and control in their lives. People spoken to confirmed this. People can have keys to their bedrooms and keep them locked if they wish. Staff demonstrated an awareness of peoples likes and dislikes in routine. When I arrived in the home the chef was observed serving drinks in the lounge and asking people who use the service what choice of meal they wished for lunch. The choice of food for the meal was also displayed on a board in the dining room. When the lunchtime was later observed people were seen having the meals requested. The chef was spoken to and menus show that a varied and nutritious diet is available. People who use the service spoken to stated that they enjoy the meals. Comments from people who use the service included “The food is lovely”, “The chef ask us what we want”. “ Good home cooking and you can ask for something else”. The kitchen meets the requirements of a recent Environmental Health Department report. To meet the varied needs of people who use the service the food for those requiring pureed diet is prepared and served separately and people receive help in an unhurried and respectful manner. Snacks and sandwiches are available on request. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 14 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): 16,19 People who use the service experience good quality in this outcome area because complaints are listened to, the home learns and adapts when they receive complaints and people are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA stated that the home has a complaints procedure. This was seen on display in the hallway and it is also made available in the Statement of Purpose and Service User Guide. People spoken to stated that their concerns and complaints would be dealt with. One person who uses the service.spoken to stated that the proprietor is very approachable. One complaint that the Commission had received regarding an allegation that information was not shared with all family members was discussed with the proprietor and she spoke of how the home learned from the process and they now have a different approach when sharing information with families. There are safeguarding procedures in place and staff spoken to are aware of the processes to follow. Staff files contained evidence of safeguarding training. The home communicates well with the Commission and all incidents are notified according to the regulations. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 15 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 16 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): 19,20, 22, 24,26 People who use the service experience good quality in this outcome area because they live in a well-maintained homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home externally and internally is decorated to a good standard. There are two lounges and a dining room. It was neat, clean and free from offensive odours. It has comfortable homely furnishings. Radiators are covered. There is a well-maintained garden with seating which people who use the service were seen to enjoy. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 17 The specialist equipment required to meet the needs of people who use the service is in place. There are sufficient wheelchairs, hoists and assisted baths and there are grab rails. Bedroom a are comfortable with contemporary furnishings. The bedrooms are personalised according to the wishes of people who use the service. All rooms except two have ensuite facilities. There are plans for further extension, which would allow for the provision of ensuite facilities in all rooms. The proprietor has been purchasing specialist beds to maintain the safety and comfort of those nursed in bed. The home was neat, clean and free from offensive odours on this occasion. All taps have thermostatic controls. There are sufficient assisted baths to meet the needs of people who use the service. There are suitable laundry facilities sited away from areas of food storage and preparation. Washing machines have the required programmes. Shortfalls in the management of laundry identified on the last inspection have now been rectified. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 18 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): 27-30 People who use the service experience good quality in this outcome area because needs are met by suitably qualified staff This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rota showed staffing levels were sufficient to meet the needs of residents. There is domestic support and a chef. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history. Criminal Records Bureau Clearance and POVA check, two references, identity documentation, and photograph were all in place. The comments received on surveys received were positive indicating that people find the staff helpful. One person who uses the service commented, “All the staff are helpful”. There is a staff-training programme in place which staff spoken to confirmed they attend. Training records were seen in staff files. The training provided Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 19 includes food hygiene, moving and handling, fire, infection control, first aid and health and safety. There is also ongoing training on dementia and other mental health issues. There was a recent mental health update from the Community Psychiatric team manager. The staff have had training in antidiscriminatory practice to address equality and diversity issues. There has been training in confidentiality, diabetes and supervisory development. All but three of the carers have achieved the National Vocational Qualification Level 2 in Care. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,38 People who use the service experience good quality in this outcome area because the home is run in the best interests of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is not a registered manager at present and the registered provided is applying to the Commission. She is a Registered Nurse who maintains her registration with the Nursing and Midwifery Council. The AQAA states that quality assurance systems are in place. Evidence of this was seen in the home. Surveys are in place for people who use the service, Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 21 relative and health professionals. The results of these surveys are collated and issues identified are acted on, such as problems highlighted with the laundry system which has now been rectified. The results are published in the Service User Guide. There are weeklystaff meetings. The home has a Vision and Mission statement which sets out the aims and objectives of the home. The home does not manage any financial affairs for people who use the service and people have their own bank accounts, managed with famly or solicitor help if neccessary Staff supervision is in place , evidence of supervision was seen and staff also confirmed that this takes place. The registered provided stated that she often identifies trends in issues raised at supervision and therefore can act on these. The registered provided ensures the health, safety and welfare of people who use the service by the provision of mandatory training. The home meets the requirements of the local Fire Authority and Environmental Health Department. Substances hazardous to health are stored securely. Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 22 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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 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 2 X 3 X 3 3 X 3 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP9 Regulation 13 (2) Requirement The registered provided to ensure the safe handling and recording of controlled drugs Timescale for action 31/07/08 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 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 24 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 Textphone: 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 Abbots Lawn DS0000014342.V365169.R01.S.doc Version 5.2 Page 25 - 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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