Care Home: Abbots Leigh Manor Nursing Home

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What the care home does well Care plans accurately reflect the individuals` needs and how they will be met. People who live in the home and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The home has a loyal and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects ofdaily life in the home. Interactions with staff on duty are friendly and relaxed. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs of controlled drugs which will help protect the health and wellbeing of people living in the home. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. Abbots Leigh is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, exceeds the standards. People benefit from a well run home, under the leadership of an effective manager who has suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. What the care home could do better: The home is well organised and managed by an effective, stable management team that promotes the views and interests of all people who use the service. The home has continued to improve following the last inspection in order to maintain their three star excellent rating. All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. Random inspection report Care homes for older people Name: Address: Abbots Leigh Manor Nursing Home Manor Road Abbots Leigh North Somerset BS8 3RP three star excellent 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. 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: Wendy Kirby Date: 1 6 0 6 2 0 1 0 Information about the care home Name of care home: Address: Abbots Leigh Manor Nursing Home Manor Road Abbots Leigh North Somerset BS8 3RP 01275374669 F/P01275374669 mail@treasurehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Katheryne Bauer Type of registration: Number of places registered: Conditions of registration: Category(ies) : Treasure Homes Limited care home 66 Number of places (if applicable): Under 65 Over 65 66 old age, not falling within any other category Conditions of registration: 0 May accommodate up to 66 persons aged 65 years and over. Person in Charge must be a RN on part 1 or 12 of the NMC register To admit a named individual (Variation application 4.5.06) aged less than 65years, for general nursing care at the home. Date of last inspection Brief description of the care home Abbots Leigh Manor is registered to provide nursing care for up to 66 residents. Treasure Homes Limited owns the home. Mr Gillespie is the responsible individual for the home and Mrs Bauer the registered manager. Care Homes for Older People Page 2 of 12 Brief description of the care home The main house is a converted and upgraded property situated in pleasant gardens with expansive views over the surrounding countryside. Accommodation is provided in mainly single rooms on four floors. All the rooms have en suite facilities. There is a wide range of communal space. A passenger lift provides easy access to all floors. Care Homes for Older People Page 3 of 12 What we found: This was a random inspection conducted by one inspector over approximately five hours. In line with the Care Quality Commissions current methodology this random visit was completed instead of a full key inspection. A key inspection reviews all of the key National Minimum Standards. A random inspection is a more focused, targeted visit and no new rating of a service is given. The previous excellent rating awarded for this service in 2007 remains in place at this current time. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report in 2007 where the home received an excellent rating. The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained detailed useful information about what the home considers it does well and what plans they have for further improvements in the coming year. We have used examples from the AQAA in this report to support our own observations during our visit to the home. We sent surveys Have Your Say to people who live in the home and staff. Comments received from the surveys will be referred to throughout this report. During our visit we spoke with people who live in the home, the registered provider, the manager, and staff members who were on duty. Comments received will be referred to throughout this report. We looked at individual care files, which included pre admission assessments, care plans and risk assessments. We spent time in all communal areas of the home and looked at the bedrooms. This what we found: Pre admission assessments, are comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. The AQAA states, We complete a detailed pre admission assessment for all prospective residents. The assessment is carried out by the home manager or duty manager and, whenever possible, the senior carer who will be involved with the residents care also attends. This assessment procedure forms an initial relationship between the staff members and the prospective resident and if the outcome of the assessment is positive Care Homes for Older People Page 4 of 12 then we ensure that these members of staff are on duty to welcome the new resident on admission to the home. People wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We spoke with the manager who clearly demonstrated the importance of pre admission assessments in order to ensure that the home can meet individuals identified needs. The AQAA states, An assessment will consist of collating evidence from numerous sources to fully assess the individuals past and present physical and mental health and their likes, dislikes and preferences. This information enables us to establish whether or not we will be able to manage the present and future needs of the individual. Prospective residents can be assessed either in their own home, in hospital or at Abbots Leigh Manor, whichever is most appropriate for the individual. We include a psychological assessment in our pre admission assessment process which was drawn up with advice from a community consultant. Following the assessment a provisional care plan is drawn up and the care team becomes familiar with this prior to the residents admission. We hold a care meeting prior to admission with all key members of staff present which the family and or resident may attend. This ensures that the resident is known prior to admission and can therefore be made to feel more welcome on admission. Plans for future improvements include, reviewing their pre admission assessments to include sections that relate to The Mental Capacity Act and Deprivation of Liberty Safeguards. Care documentation is held and managed electronically, plans showed consistency in assessing, planning and evaluating care as required. The manager has good audit systems in place and the AQAA tells us that, Care audits are carried out quarterly. We take the results of these audits very seriously and make changes if required. In addition, the manager randomly audits care plans and gives feed back to the trained staff responsible for those care plans. Care plans are completed with regards to health and social needs including, psychological, emotional, and cultural needs which demonstrates that the home takes an holistic approach to the provision of care. The plans are person centered, including personal preferences and like and dislikes. Plans tell staff that people have specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. Regular care reviews take place for people living in the home, which can include family members and care staff wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Staff agreed in their surveys that they had up to date information about individuals needs and confirmed that care plans were reviewed at least monthly unless there were any other significant changes. Care Homes for Older People Page 5 of 12 All ten surveys received from people living in the home said that they always received the care and support they need, that staff are always available when they need them, that staff listen to what they have to say and that they receive all the medical care they need. We spoke with staff who demonstrated good relationships with individuals and were knowledgeable about the care needs of those living in the home. Comments received from people living in the home included, They look after us very well, we have good company and we are never bored, There is a very satisfying atmosphere, if one has to be in a home, it should be this one, people really care about you here, I cant think of anything that is not done well, They are very patient with me and get me whatever I want and The home provides excellent nursing care and individual attention. Policies and procedures for receiving, storing, administering and disposing of controlled medications were examined and discussed. All systems in place are very effective, well managed and audited. The home actively promotes individuals to exercise choice and control over the lives they choose to live.There does not appear to be any unnecessary rules and daily routines are flexible within the home. We saw evidence that people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed in discussion with individuals and through observation during our visit. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms and there are several semi private seating areas around the home and in the gardens. The AQAA tells us, We have open visiting arrangements and we welcome families and friends into the home at any time. Families are able to stay for meals with their relative if they wish. We offer residents the chance to hold family gatherings for quite large numbers in the home. This enables the resident to take on the role of host as they would have done when in their own home. Some visitors provided comments on the surveys we received including, The home creates a caring community that embraces residents, visitors and staff, Communication with relatives is very good, We are always made to feel welcome and it is so enjoyable to visit and My family visit a lot and staff are so friendly to them. Abbots Leigh is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, exceeds the standards. Abbots Leigh is a large detached Georgian house, which had been sympathetically extended over the years. It is approached up a long tree lined drive and provides parking for several cars. The house is surrounded by its own extensive gardens and adjoining fields, affording people in the home countryside views and plenty of wildlife. The home and its gardens are well maintained and the inside has been tastefully decorated throughout, it provides a safe peaceful home for people to live in. Care Homes for Older People Page 6 of 12 Lounges and dining rooms are decorated, furnished and carpeted to a very high standard. They retain many original features lending character and homeliness, including ornate fireplaces, cornices and ceiling roses. People were sitting in these rooms throughout and the day, resting peacefully, reading newspapers, and talking amongst friends. There are a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide corridors and pathways, passenger lifts, specialised bathing facilities, grab rails, and assisted toilet facilities. We walked around the inside of the home and viewed some of the bedrooms and bathrooms. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. Rooms have adjustable beds and good quality matching bedroom suites, soft furnishings, lounge chairs, and a small table. There have been various improvements made to the home since the last inspection in order to enhance peoples lives, including a bar where people can enjoy a drink together and socialise. Plans for this year in the AQAA include, We plan to erect a summer house so that residents can make more use of the garden regardless of the weather. We plan to gradually replace the existing televisions with new flat screen sets. In addition we will purchase large, flat screen televisions for the communal lounges. The home has a housekeeper and domestic staff seven days a week. The house was spotless throughout. Comments received about the environment included, The service provides beautiful, well cared for surroundings indoors and outdoors, The home is exceptionally clean and tidy and Its always clean and fresh, its a beautiful place to live. The relationships between staff and people living in the home are good and create a warm positive environment to live in. The people are cared for by skilled staff that are trained, supported and supervised by management. The manager told us that staffing levels are indicative of needs and the level of care required and confirmed that levels of staff would rise should dependency levels increase. We know that the home also increases the levels of staff at certain busy times of the day to ensure that needs are met. People living in the home and staff agreed that there were enough staff to meet their needs. When there have been staff vacancies permanent staff will often cover extra shifts to provide continuity. The AQAA tells us, We have a very stable, highly motivated trained nurse team with good management experience and skills. We have an experienced team of care staff. The majority of our staff are long serving and totally committed to our residents and to the core values of Abbots Leigh Manor. When we recruit new staff we are careful to maintain the balance and skill mix of the team. The home believes it is paramount to find suitable staff in order to fulfill the roles and responsibilities expected of them. The home is vigilant in taking their time in this process so that they can find the right person for the job where they have the right skills and attitude to look after and care for people. It is hoped that by taking their time and recruiting the right people for the job will help ensure that staff are committed and Care Homes for Older People Page 7 of 12 remain in the home. People are supported and protected by the homes recruitment policy. We know that the home follows a good recruitment procedure. This will help ensure that people living in the home will be further protected. Records contain completed application forms with a full employment history, two or more written references and Criminal Records Bureau CRB disclosures. Staff confirmed that relevant checks had been completed before they started working in the home. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and all staff are conscientious in attending training relevant to the care needs of the people they are caring for and those relevant to the roles they perform. Staff surveys said, We are getting more opportunity to develop our knowledge and we are being encouraged and supported to attend more study sessions We are given plenty of opportunity to develop our knowledge and Employee development through on site and outside training is encouraged and supported by the management. Peoples needs and best interests are central to the management approach in the home. The manager has worked as the registered manager for eleven years. The manager demonstrated good effective leadership and management skills that relate to the aims and purpose of the home. After a lot of hard work and commitment the registered provider, manager and staff are a stable team that are committed to providing quality of care for the benefit of the people in their care. The staff at the home are very committed to the people living in the home and the roles and responsibilities expected of them. They are empowered by the manager to continually monitor and evaluate the services they provide to people. We received very positive feedback from the staff. Comments included, Under the efficient management, the home gives importance to the residents needs and treats them with dignity, Our ideas and suggestions are listened to by the manager and proprietor and if approved are acted upon, We have an excellent manager and an excellent boss, the home is doing very well, there is no doubt about that, I feel we have an approachable manager who is always willing to listen and discuss our views and Abbots Leigh is a lovely caring home and we are good at keeping residents safe and happy, I like the way we have resident led care and that we support and encourage diversity. What the care home does well: Care plans accurately reflect the individuals needs and how they will be met. People who live in the home and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The home has a loyal and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects of Care Homes for Older People Page 8 of 12 daily life in the home. Interactions with staff on duty are friendly and relaxed. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs of controlled drugs which will help protect the health and wellbeing of people living in the home. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. Abbots Leigh is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, exceeds the standards. People benefit from a well run home, under the leadership of an effective manager who has suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. 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 Older People Page 9 of 12 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 10 of 12 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, 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 Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission 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 Older People 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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