Care Home: Abbotsbury

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What the care home does well The manager was unavailable during the visit due to annual leave. Records were found to be easy to read, organised and accessible. The staff on duty demonstrated their competence and knowledge of the systems in place and provided assistance with any queries made. The home provides clean and comfortable accommodation. There was a pleasant atmosphere and residents and staff were observed to interact together. Sufficient staff were on duty to meet the resident`s needs. Equality and diversity is promoted through the policies and procedures in place to ensure staff incorporate this into their daily care practices. A recent BBQ was held in a marquee and all residents, family and staff attended. What has improved since the last inspection? Training has been provided in many areas of the statutory training required to ensure that residents are cared for safely. All staff are now trained in moving and handling, first aid, health and safety and COSHH (control of hazardous substances). Staff who administer medication are trained to conduct this safely. Some `gaps` in staff training were identified for a small number of staff employed in food hygiene, infection control and fire safety. This was agreed to be provided by 30th September 2008 and is noted in the section `What they could do better`. Care records are more detailed, easy to read and accessible to staff to ensure residents` needs are met. Care plans are reviewed regularly to assess changing needs.A key worker system is in place where a designated member of staff is responsible for a small number of residents to manage their individual care needs and provide positive outcomes. All policies and procedures are up to date and a `policy of the week` is displayed for staff to read and sign to acknowledge understanding of. Supervision now in place and staff records viewed and staff spoken with confirmed this. A weekend cook has now been employed. Some private rooms have been decorated. The exterior is presently being repainted. What the care home could do better: As stated in the above section further training is required for a small number of staff in fire safety, food hygiene and infection control to ensure they are equipped with the skills to carry out their roles. This was agreed to be provided by 30th September 2008. All residents should be provided with the choice of having a key to their room for privacy and records made to show this. One resident is unable to have a key as his room is used as a fire exit. Audrey Tan agreed to contact the fire department for advice. The radiator in one resident`s room, discussed at the visit, requires attention, as the resident is unable to control the temperature. National Vocational Qualifications training for staff should continue so that 50% of the care staff obtain an NVQ qualification in care. The induction programme should be provided be provided in line with `Skills for Care`. So staff have the skills and knowledge of the service and care needs required. Training in abuse should continue to be provided to all staff employed. The manager should complete her application for registered manager. Emergency lighting (monthly), fire alarm checks (weekly) and water temperatures must be conducted and records made. This is to ensure the safety of the residents accommodated. These records had been completed atthe required times prior to the annual leave of the deputy manager who conducts these tests. A nominated person should conduct the tests in her absence. The radiator in one room on the second floor needs attention, as this is unable to be controlled by the resident. A unit in a resident`s room on the top floor needs attention due to damage. Paper towels should be provided in the laundry and communal areas to avoid cross infection. The toilets and bathrooms are in need of upgrading and redecoration. To raise the standard provided. Countersignatures should be obtained for all written entries on medication administration records (MAR). Daily menus with alternatives should be clearly displayed for the residents. The staff should ensure that resident`s laundry does not go astray and that the residents wear their own clothes at all times. Residents should be encouraged to wear suitable footwear to avoid risk of trips and falls. Staff should encourage residents who refuse showers or baths to ensure that their personal care needs are being met and monitored closely. Records should be maintained of resident`s personal care given or refused. CARE HOMES FOR OLDER PEOPLE Abbotsbury 25 Park Road Southport Merseyside PR9 9JL Lead Inspector Elaine Stoddart Unannounced Inspection 09:00 12 August 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 Abbotsbury DS0000065441.V363264.R03.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. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsbury Address 25 Park Road Southport Merseyside PR9 9JL 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) 01704 537117 0870 762 8881 Ramos Healthcare Limited Manager post vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2007 Brief Description of the Service: Abbotsbury is a care home providing accommodation for up 21 older people who need personal care and support. Ramos Health Care own the home. The manager Carole Dacre is yet to be registered with the Commission. The home is situated in a quiet residential area not too far from the centre of Southport and its amenities. It is within easy reach of the local park and public transport. The accommodation is a large detached 3-storey building with 19 single rooms and 1 double. All rooms now have single occupancy There is a large well-kept garden to the rear and side of the property and parking at the front. The home is well maintained internally and externally with good quality furniture and fittings. Communal areas consist of two lounges and a dining room. There is a passenger lift servicing all floors. Disabled access is available by a ramp to the front entrance and a portable ramp is provided for the steps in to the doorway. Equipment is available to assist those residents with a disability. A call bell system is available throughout. The current rate of charges is £360.00 to £380.00 per week. Abbotsbury DS0000065441.V363264.R03.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. The inspection took place over one day for a period of eight hours. An Expert by Experience took part in the inspection process for approximately four hours. An Expert by Experience is a person who, because of their shared experience of using services and/or ways of communicating visits a service with an inspector to help get a picture of what it is like to live in or use the service. A tour of the communal areas and some resident’s rooms was conducted. A selection of care staff and service records were also viewed. All the core standards were assessed. During the inspection four residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. The manager, Carol Dacre was on holiday at the time of the visit. Audrey Tan, a Ramos Health Care representative, four staff members and six of the sixteen residents were spoken with and their views obtained of the service. Survey forms ‘Have your say about….’ were also given to residents to complete. Comments received from the surveys and discussions, which took place, are incorporated within this inspection report. Discussion with a number of residents during the visit required further investigation by the manager/owner. A summary of their findings will be forwarded to the Commission on completion. An AQAA (annual quality assurance assessment) was completed by the manager, prior to the site visit. The AQAA comprises of two self-questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service, including staff numbers and training. Details from the AQAA are threaded through the report. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Training has been provided in many areas of the statutory training required to ensure that residents are cared for safely. All staff are now trained in moving and handling, first aid, health and safety and COSHH (control of hazardous substances). Staff who administer medication are trained to conduct this safely. Some ‘gaps’ in staff training were identified for a small number of staff employed in food hygiene, infection control and fire safety. This was agreed to be provided by 30th September 2008 and is noted in the section ‘What they could do better’. Care records are more detailed, easy to read and accessible to staff to ensure residents’ needs are met. Care plans are reviewed regularly to assess changing needs. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 7 A key worker system is in place where a designated member of staff is responsible for a small number of residents to manage their individual care needs and provide positive outcomes. All policies and procedures are up to date and a ‘policy of the week’ is displayed for staff to read and sign to acknowledge understanding of. Supervision now in place and staff records viewed and staff spoken with confirmed this. A weekend cook has now been employed. Some private rooms have been decorated. The exterior is presently being repainted. What they could do better: As stated in the above section further training is required for a small number of staff in fire safety, food hygiene and infection control to ensure they are equipped with the skills to carry out their roles. This was agreed to be provided by 30th September 2008. All residents should be provided with the choice of having a key to their room for privacy and records made to show this. One resident is unable to have a key as his room is used as a fire exit. Audrey Tan agreed to contact the fire department for advice. The radiator in one resident’s room, discussed at the visit, requires attention, as the resident is unable to control the temperature. National Vocational Qualifications training for staff should continue so that 50 of the care staff obtain an NVQ qualification in care. The induction programme should be provided be provided in line with ‘Skills for Care’. So staff have the skills and knowledge of the service and care needs required. Training in abuse should continue to be provided to all staff employed. The manager should complete her application for registered manager. Emergency lighting (monthly), fire alarm checks (weekly) and water temperatures must be conducted and records made. This is to ensure the safety of the residents accommodated. These records had been completed at Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 8 the required times prior to the annual leave of the deputy manager who conducts these tests. A nominated person should conduct the tests in her absence. The radiator in one room on the second floor needs attention, as this is unable to be controlled by the resident. A unit in a resident’s room on the top floor needs attention due to damage. Paper towels should be provided in the laundry and communal areas to avoid cross infection. The toilets and bathrooms are in need of upgrading and redecoration. To raise the standard provided. Countersignatures should be obtained for all written entries on medication administration records (MAR). Daily menus with alternatives should be clearly displayed for the residents. The staff should ensure that resident’s laundry does not go astray and that the residents wear their own clothes at all times. Residents should be encouraged to wear suitable footwear to avoid risk of trips and falls. Staff should encourage residents who refuse showers or baths to ensure that their personal care needs are being met and monitored closely. Records should be maintained of resident’s personal care given or refused. 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. Abbotsbury DS0000065441.V363264.R03.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 Abbotsbury DS0000065441.V363264.R03.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): Standards 1,2,3,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to prospective residents, who can visit to view prior to admission. Assessments are completed in good detail to ensure residents’ needs are met. Standard 6 was not assessed, as this service is not provided. EVIDENCE: The AQAA reported that prospective residents are invited to visit to view the home and join residents and staff for lunch or tea. Information on the service provided is found in the statement of purpose and is available for prospective residents in the entrance area. A number of residents’ contracts of terms and conditions were viewed and these contained information on fees and charges for extras, such as, chiropody and papers. Residents/or relatives sign to acknowledge the contract. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 11 Four assessments were viewed and contained detailed information on the residents’ care needs, which included their personal care, diet, sight, denture care, hearing, mobility, falls, continence, medication, mental state and any social and cultural needs. Residents’ wishes at the time of their death are recorded sensitively. Comments from residents’ surveys were positive regarding the care and support provided. One resident spoken with said, “I am very happy with the home. It’s much better than the last one. My daughter is very pleased with it too and visits often.” Abbotsbury DS0000065441.V363264.R03.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): Standards 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained staff administer medication safely. Residents have access to health care professionals to ensure their needs are met. EVIDENCE: Four care plans viewed gave detailed information on the residents care needs. Information recorded in the plan looked at all aspects of care. These include safety, communication, eating, continence, mobility, pain, bathing, equal opportunities and medication. Care needs identified the resident’s needs and the action to be taken by staff to provide positive outcomes. Care plans evidence regular reviews undertaken by the key workers on all areas of their care. Staff spoken with confirmed that there is sufficient information available to them and said the new key worker system is working well. Where possible care plans are signed by the residents/or their relative. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 13 All health care visits are recorded in each resident’s daily records file. Some residents are diabetic and some require catheter care. The district nursing services attend to check blood levels and monitor catheter care. Discussion took place with staff regarding a number of residents who regularly refuse to bathe. Staff confirmed that refusals are noted in the bath records. Staff should continue to encourage the residents to have support with personal care, monitor their progress and record all personal care given/or refused. One resident spoken with confirmed that staff assist him while bathing and said: “Always with dignity” Staff keep up to date with residents needs via daily reporting in the residents communication books and by discussion during day/night handovers. During inspection it was noted that one resident had no shoes on as she said her slippers were too small. Staff should encourage residents to wear suitable footwear to avoid the risk of trips and falls. Medication policies and procedures are in place and available to staff. Monthly drug audits are undertaken by the manager to assess staff competency and ensure the safe administration of medication to residents. All medication administrations are signed and medication is securely stored. All staff who administer medication are trained. To ensure the correct dosage of medication is recorded staff should countersign all written entries on the MAR. Staff were seen to treat residents with dignity and respect and were polite at all times. Residents are able to choose to join in activities, have their meals in their rooms. Comments from a resident spoken with: “I choose to spend the days in my room and go out to a local shop for a newspaper at tea-time. I have always been a bit of a loner” Dying and death wishes are assessed by the manager and recorded sensitively in their care plan for staff reference. The new key worker system ensures the staff are more involved in residents day-to-day care, maintaining their records and involved in regular reviews. Residents were observed to spend time in the lounge, own rooms or access the community independently. Residents should be given a choice to have a key to their own rooms for privacy and their wishes recorded. One resident is unable to have a key due to his room being a fire exit. Audrey Tan agreed to contact the fire department for advice on this issue. Abbotsbury DS0000065441.V363264.R03.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): Standards 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a balanced diet and are encouraged to maintain contact with family, friends and the community. EVIDENCE: The AQAA reported that the activity programme has been improved and that routines are flexible to resident’s needs and there is a choice of meals available. Discussion with staff on duty, a management representative and a number of residents confirmed that activities are provided. These include flower arranging, movie sessions on a big screen monthly, quizzes and gentle exercise sessions. A recent BBQ was held in the garden and all residents, staff and relatives were invited to attend. A bouncy castle was hired for the children who attended. An activity organiser is employed twice a week and a trolley is provided for residents to purchase drinks and snacks. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 15 Staff spoken with said that they are organising a visit by a ‘donkey’ for the residents in the home. A weekly evening event is held where residents have a sherry or a beer of their choice. A variety of comments were received from residents spoken with and surveys received regarding the activities provided. Residents spoken with said: “There are quizzes but I do not want to join in” “I enjoy television and am hooked on sport and looking forward to the football season” Comments from surveys received on activities: “I like to help others to join in and I join in sometimes” Some residents are able to access the community independently and one resident said: “I get out daily and my daughter visits often and is very happy with the home” Menus are displayed but not in a clear manner for residents to read. Alternatives are available but not displayed on menu board. It is recommended that menus are displayed clearly with alternatives. The cook who has worked at the home for 15 years said: “They can have what they want. I love it here” Discussion with the cook confirmed there is now a weekend cook employed who she is supporting to settle in. This is an improvement as the staff on duty used to cook all weekend meals. It was noted that the cook’s food hygiene training has just expired and it was confirmed that further training will be provided by September 30th 2008 and a requirement made in this report. A number of residents are diabetic and require special diets. On arrival in the morning the cook was baking scones and rhubarb crumble for the day. Staff spoken with said they see each resident daily to tell them what their food choice is. The dining room is pleasant and the residents had their meals in an unhurried manner with staff assistance where required. Comments from resident surveys received include: “Meals always good” “Very good meals” Comments from residents spoken with: Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 16 “Meals are good Monday to Friday but the other days awful. No choice offered in meals” “Food very good’ but no choices. I used to enjoy a kipper and would like one again” “Food very good” Residents are able to see visitors in the privacy of their own rooms. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 17 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): Standards 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and abuse policies and procedures in place protect the residents. EVIDENCE: The AQAA reported that a complaints policy and procedure is in place and displayed. This was confirmed at the visit and is available to residents and visitors. A copy of the local Sefton and Liverpool ‘Safeguarding Adults’ procedures are available to staff. Staff spoken with confirmed their understanding of the action to take should a concern be raised. Some staff have received training in abuse and this is recommended to continue for all staff employed. Discussion with a number of residents during the visit required further investigation by the manager/owner. A summary of their findings will be forwarded to the Commission on completion. Comments from residents’ surveys received: “I know who to speak to” “Staff usually act on what I say” Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 18 A complaints book is in place and records kept. All complaints received are investigated and recorded. The service has dealt with safeguarding issues in the appropriate way by involving the social services and/or the police. All residents’ personal allowances are recorded by the manager, receipts held and signed for. Residents are encouraged to handle own affairs where possible. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 19 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): Standards 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, safe and clean environment. EVIDENCE: AQAA reported that the service has introduced a refurbishment plan. A number of rooms have been decorated and the outside is being re painted and there is scaffolding in place outside the home. Further improvements are planned and these include a new kitchen to be fitted in September 2008. All communal areas viewed were found to be clean and tidy. Some resident’s rooms viewed were found to be clean and contained personal items. Comments from residents’ surveys received: Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 20 “The home is always clean” Comments from residents spoken with: “Very happy with room” “My room is cleaned at least once a week and that the cleaner is good” One resident spoken with said he was unable to control the radiator in his room but he said is happy, as he likes it warm. A unit in a resident’s room on the top floor needs repair. A recommendation made for these to be attended to. Another resident said he is unable to have key to his room, as his room is a fire exit. This was discussed with Audrey Tan at the visit who agreed to seek advice from the fire service. Some residents have keys to their rooms and other confirmed they do not wish to have one. A recommendation is made that all residents are offered keys and a record of their wishes recorded. The communal areas include two lounges, a dining room and a hairdressing room. All areas were found to be comfortable and clean. Residents were observed to use the lounges to sit and chat with other residents and staff or watch TV. No activities were taking part on the day of the visit. The laundry was found to be clean and resident’s clothing was labelled to avoid losses. Some residents however commented that clothing goes missing. This was discussed with staff during the visit and a recommendation made that key workers try to make improvements to avoid this happening and ensure all clothing is labelled. Also recommend are paper towels in all communal areas to avoid cross infection. The toilets and bathrooms are in need of upgrading and redecoration to improve the standard and are recommended in this report. All rooms are single occupancy and there are sufficient toilets and bathrooms available with assisted bathing facilities for residents use. Grab rails are available throughout and call bell system for resident use to call for assistance. A passenger lift is available to all floors. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 21 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): Standards 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and selection procedures are robust to protect the residents. Staff training must continue to ensure the staff are equipped with the skills to carry out their roles safely. EVIDENCE: The AQAA reported that of the twelve staff employed four have NVQ Level 2 and five are working towards this. All checks required prior to staff employment are carried out to ensure the safety of the residents. These include Criminal Record Bureau (CRB) checks. The AQAA stated that the manager aims to develop a more detailed induction process. It is recommended that National Vocational Qualifications training for staff should continue so that 50 of the care staff obtain an NVQ qualification in care. Induction is provided for new staff and is recommended that it be provided in line with ‘Skills for Care’ and their progress monitored by the manager. Since the last visit a staff training matrix has been developed to show which staff are trained and those in need of updating. A lot of staff training has taken place to bring staff up to date. Further training is required for a small number of staff in fire safety, food hygiene and infection control to ensure they are equipped with the skills to carry out their roles. This was agreed to be Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 22 provided by 30th September 2008. Additional training takes place in areas such as dementia care, which provides staff with knowledge of the client group they care for. All staff who administer medication are trained to ensure this is carried out safely. Training in abuse should continue to be provided to all staff employed. Staff spoken with and comments from surveys received confirmed that training has been provided. At the time of the visit there were sufficient staff on duty to meet residents’ needs. These included three care staff, a cook and Audrey Tan. Two waking night staff provide night cover. Comments from residents’ surveys received: “Staff very good” “The staff are always polite” A multi cultural staff group of staff are employed. Some comments were received from residents spoken with regarding difficulties in communication with non UK staff. The AQAA reported that this is being addressed by the manager to encourage staff to communicate effectively and take ownership of the home. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 23 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): Standards 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is run in the best interests of the residents. EVIDENCE: The manager is qualified in NVQ Level 4 and experienced in care of older people. The manager is yet to be registered with the Commission. The manager been in post for over twelve months and has made improvements to meet the requirements and recommendation made. Improvements have been made in the development of a training matrix, ongoing training although some gaps, improved care records, reviewing of care plans and introduced key workers and ensure staff are involved in day to day care of the residents. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 24 All policies and procedures are now up to date and a ‘policy of the week’ is displayed for staff to read and sign to acknowledge understanding of. Supervision is now in place and records viewed and staff spoken with confirmed this. The manager was unavailable during the visit due to annual leave. Records were found to be easy to read, organised and accessible. The staff on duty demonstrated their competence and knowledge of the systems in place and provided assistance with any queries made. Positive comments were received from residents spoken with during the visit: “Carol bends over backwards to please people” Staff spoken with commented: “Carol and Elaine (Deputy) are very supportive” “I had supervision last week” Consultation takes place with residents and relatives annually to obtain their views. All residents and relatives were surveyed in June 2008 and the findings are displayed in the entrance hall. Relatives - 92.2 satisfied with service. Residents – 90 satisfied. The AQAA reported that all certificates for services, such as gas are up to date. A spot check of some certificates confirmed this. All accidents and injuries incurred are recorded. A fire risk assessment on the building was completed in July 2008. Emergency lighting (monthly), fire alarm checks (weekly) and water temperatures must be conducted and records made. This is to ensure the safety of the residents accommodated. These records had been completed at the required times prior to the annual leave of the deputy manager who conducts these tests. A nominated person should conduct the tests in her absence. This was discussed and agreed with Audrey Tan at the visit and a recommendation made. All residents’ personal allowances are recorded by the manager, receipts held and signed for. Residents are encouraged to handle own affairs where possible. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 25 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 3 2 Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 26 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 OP30 Regulation 18 Requirement The manager must provide further training for a number of staff in fire safety, food hygiene and infection control to ensure they are equipped with the skills to carry out their roles. This was agreed at the visit to be provided by 30th September 2008. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP8 Good Practice Recommendations Residents should be encouraged to wear suitable footwear to avoid risk of trips and falls Staff should encourage residents who to refuse showers or baths to ensure that their personal care needs are being met and monitored closely. Records should to be maintained of resident’s personal care and those who refuse. Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 27 2 3 OP9 OP15 Countersignatures should be obtained for all written entries on medication administration records (MAR). Daily menus with alternatives should be clearly displayed for the residents. The radiator in one room on the second floor needs attention, as this is unable to be controlled by the resident. A unit in a resident’s room on the top floor needs attention due to damage. Paper towels should be provided in the laundry and communal areas to avoid cross infection. The toilets and bathrooms are in need of upgrading and redecoration. All residents should be provided with the choice of having a key to their room and records made to show this. Contact should be made with the fire department for advice, as one resident is unable to have a key to his room as is it used as a fire exit. The staff should ensure that resident’s laundry does not go astray and that the residents wear their own clothes at all times. Paper towels should be provided in communal areas to avoid cross infection. The manager should provide a full induction programme for all care staff in line with ‘skills for care’. The staff programme of NVQ training should continue to achieve 50 of staff with a qualification in care. Abuse training should continue for all care staff. The manager should make an application to CSCI to be appointed as the registered manager. 4 OP19 5 OP24 6 OP26 7 8 9 OP26 OP27 OP28 10 11 OP30 OP31 Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Abbotsbury DS0000065441.V363264.R03.S.doc Version 5.2 Page 29 - 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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