Care Home: Abbotsfield Residential Care Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Feedback about the service from people living in the home and their families was very positive. Comments from people living there such as "excellent caring staff who look after you really well" and "friendly faces who always seem to care" were received. A relative commented that "Abbotsfield is a very well run home and the residents are well looked after". All residents are fully assessed prior to admission to ensure all needs can be identified and met. Family members are invited to be part of the assessment process and admissions are sensitively managed. Care plans are in place to ensure the staff have the information to meet the resident`s assessed needs. The service has a good staff training programme so people living there receive care from trained and competent staff who are sensitive to their needs. People living in this home are encouraged to exercise choice and control over their own lives and maintain their interests inside and outside the home. A range of activities are made available to residents if they wish to join in and the manager is looking at ways to improve the range of activities already on offer. Residents are provided with a well maintained, clean, and comfortable place to live. Meals served at the home are of a very good standard and residents told us they enjoyed the food and always had a choice. What has improved since the last inspection? Since the last inspection the service has continued to maintain and improve its training opportunities for staff and include equality and diversity training to promote best practice for resident`s care. Both the Manager and Deputy manager have completed their Registered Manager Award/ NVQ Level 4 qualification improving and developing their management skills. Work has been done to improve the grounds for residents. A water feature has been built that is attractive and residents said they like. The activities provision is being improved with efforts being made to introduce more recreational opportunities for people such as crafts activities. The home has been gathering information to promote equality and diversity and take this into consideration for all those using the service and audit this. The service has maintained a good level of service that it seeks to maintain and improve where it can. What the care home could do better: Although overall the home has a good standard of record keeping and adheres to good practice guidance there was a lapse in the recruitment procedures. The registered manager must not employ any person to work at the home unless they have confirmation of a satisfactory police check and a satisfactory check of the POVA register in order to protect people living in the home. This does not appear to be a usual state of affairs but must not happen again as it allows a potential risk to resident`s interests Also where telephone references are taken for employees a clear and detailed record should be kept of the information provided. Medication handling is good and to further improve the manager should consider using protocols for the medicines that are prescribed to be given topeople `as required`. This would help staff make sure that such medicines are given only when residents need them. The residents say they are asked their views about the home but for good practice results of any quality monitoring exercises and surveys should be collated and available for viewing. This way people can see the results of their views in the actions being taken. CARE HOMES FOR OLDER PEOPLE Abbotsfield Residential Care Home 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS Lead Inspector Marian Whittam Unannounced Inspection 10:30 27 November 2007 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 Abbotsfield Residential Care Home DS0000022579.V346152.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. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsfield Residential Care Home Address 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS 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) 01229 829496 jeffpatel@tiscali.co.uk Mr Jayendra J Patel Mrs Lata Jayendra Patel Mr Jayendra Jhaverbhai Patel Care Home 30 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (30) of places Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people 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: Code OP (maximum number of places: 30). Dementia over 65 years of age: Code DE(E) (maximum number of places: 5). The maximum number of people who can be accommodated is: 30. Date of last inspection 30th October 2006 Brief Description of the Service: Abbotsfield is a care home registered to provide care for thirty older people, five of whom may have dementia. The home is a detached Victorian property with a modern extension and has been owned by Mr. Jayendra Patel and Mrs Lata Jayendra Patel since 1996. The home is in a residential area on the outskirts of Barrow in Furness about a mile from the town centre, the shops, banks and general amenities. There is good access by road into the surrounding areas and the home is on a bus route to Barrow and the surrounding towns. The home has well kept gardens that residents use and this has appropriate seating. There is a small car park for visitors and staff at the side of the building. The home has three sitting/dining rooms for service users on the ground floor and a quieter lounge on the first floor used largely by residents for family meetings and privacy. The home has kitchen and laundry facilities on site. There is a main stair lift and two smaller chair lifts within the home linking the floors. Fees payable at the home are £373.00 to £434.00 a week as at the time of the visit. There are additional charges for hairdressing and private chiropody, personal toiletries, papers and magazines, personal travel and some entertainment The home makes information about its services available through its service user guide and statement of purpose and its colour brochure. These are available from the home. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit to Abbotsfield Residential Care Home forms part of a key inspection. It took place over one day and we (The Commission for Social Care Inspection, CSCI) were in the home for six hours. Information about the service was gathered in different ways: • Annual Quality Assurance Assessment document completed by the manager identifying what the service does well and what could be improved. This was returned to CSCI in good time before the visit. • The service history • Interviews with residents and staff on the day of the visit. • Observations made in the home during the visit. • Completed questionnaire survey forms from people using or coming into contact with the service. We looked at care planning documentation and assessments to ensure the level of care provided met the needs of those living in the home and made a tour of the building to inspect the environmental standards. Staff personnel and training files were examined and medication records and handling. A selection of the service’s records required by regulation were examined. . What the service does well: Feedback about the service from people living in the home and their families was very positive. Comments from people living there such as ”excellent caring staff who look after you really well” and “friendly faces who always seem to care” were received. A relative commented that “Abbotsfield is a very well run home and the residents are well looked after”. All residents are fully assessed prior to admission to ensure all needs can be identified and met. Family members are invited to be part of the assessment process and admissions are sensitively managed. Care plans are in place to ensure the staff have the information to meet the resident’s assessed needs. The service has a good staff training programme so people living there receive care from trained and competent staff who are sensitive to their needs. People living in this home are encouraged to exercise choice and control over their own lives and maintain their interests inside and outside the home. A range of activities are made available to residents if they wish to join in and Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 6 the manager is looking at ways to improve the range of activities already on offer. Residents are provided with a well maintained, clean, and comfortable place to live. Meals served at the home are of a very good standard and residents told us they enjoyed the food and always had a choice. What has improved since the last inspection? What they could do better: Although overall the home has a good standard of record keeping and adheres to good practice guidance there was a lapse in the recruitment procedures. The registered manager must not employ any person to work at the home unless they have confirmation of a satisfactory police check and a satisfactory check of the POVA register in order to protect people living in the home. This does not appear to be a usual state of affairs but must not happen again as it allows a potential risk to resident’s interests Also where telephone references are taken for employees a clear and detailed record should be kept of the information provided. Medication handling is good and to further improve the manager should consider using protocols for the medicines that are prescribed to be given to Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 7 people ‘as required’. This would help staff make sure that such medicines are given only when residents need them. The residents say they are asked their views about the home but for good practice results of any quality monitoring exercises and surveys should be collated and available for viewing. This way people can see the results of their views in the actions being taken. 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. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 8 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 Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 9 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, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are assessed to make sure the home will be able to meet their individual needs and have the information and support they may need to make an informed choice about moving in. EVIDENCE: The home’s admission process includes a thorough pre admission assessment of individual needs. The home manager and deputy visit people to make an assessment of their needs and what they want from the service and they ensure that individual care needs assessments are carried out for each prospective resident before they come to live in the home. Admissions do not take place without this information and consideration is also given to the needs of those people already living in the home before a place is offered to someone. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 10 There are trial periods for new residents, during which time the home’s assessment is continued to see that needs are being met and make sure the resident’s are settled and happy living there. Survey responses supported this and one relative said, “staff are pleasant and always pass on any information to me” and “we had a trial period and the information we were given was very good”. Information is gathered from other agencies and where appropriate a social services management plan is obtained by the manager and held on file for information. Discussions with the manager and deputy manager evidenced that assessments and admissions are carried out in a professional and sensitive manner involving the individual, their family or representative where appropriate. One relative said the service was, “good at helping new residents settle in, putting them at ease and making them feel they are really being cared for”. The home’s Statement of purpose is currently being updated to reflect new procedures and changes in the staff and organisational structure that have taken place and is available in the home. The home can provide this information in other formats if required. The home also provides a useful colour brochure for families and prospective residents that includes photographs of the communal areas, bathrooms and bedrooms to give people an idea of what to expect when they visit. There is also a copy of the latest inspection report displayed in the foyer for anyone to read if they wish. The service does not provide intermediate care. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 11 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): NMS 7, 8,9 and10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care that people receive is based on their individual needs and preferences and their choices and dignity are respected at all times. EVIDENCE: We looked at the care plans for four people and the information provided covered areas such as mobility and the risk of falls, skin care, diet and nutrition, health care and personal care. The care plans are being reviewed monthly and changes have been made to care plans following this, for example one person had altered mobility needs that increased their risk of falls and this change was clear in their care plan for staff to follow. The care plans provided a good picture of people’s conditions and changes that had happened and action to take although not always reflecting the person’s perspective on this but rather the caregivers. Although we saw that staff were able to identify the needs of the residents and meet them in a Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 12 personal and caring manner resident’s perspectives were not obviously central to the care planning approach. The manager is addressing this and is keen to find ways to make sure their involvement is clear. Records of healthcare visits and support from GP’s, district nurses and specialised services such as mental health nursing and medical professionals are kept and the actions taken. Survey responses from medical professionals confirmed that the home had good working relationships with other services and one doctor described the relationship as ”excellent” and that if the service needed more information to be able to meet their patient’s needs they always asked and “consulted appropriately”. They also said they found the home’s approach to be “non restrictive” and “always” support people to live the life they choose. We spoke with several residents in the lounges and their rooms and they confirmed that their opinions are sought about their personal care and life in the home generally and said they felt their privacy and dignity is being respected. There was evidence from observation and from their care plans that they are involved in making choices about their care. We looked at the medication procedures and found that the residents are protected by safe systems for handling medication. Staff have been given training on safe administration of medication and the relevant policies and procedures and reference books are readily available for them. The home keeps records of medicines it receives from and returns to the pharmacy. There was evidence of good safe practice in recording medication changes and variable dosed of medicines and this promotes resident’s safety and reduces the risk of errors. The service provides information on medicines and drugs for staff reference. This good practice would be further improved if the manager considered using protocols for the medicines that are prescribed to be given to people ‘as required’. This would help staff make sure that such medicines are given only when residents need them. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 13 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): NMS 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides social and leisure activities within the home and outside according to people’s preferences and capabilities and there is variety and choice in the food on offer to them. EVIDENCE: The home encourages relatives and friends to visit and residents say there are no restrictions on when people can visit them. Relative’s surveys show that families and friends feel they are made welcome in the home. The routines at Abbotsfield are very flexible and generally meet the needs of those living there. Residents told us they get up and retire whenever they wish and are able to come and go as they want and the manager and staff support them to pursue outside interests. One lady told us she was going out to play bingo at a social club she uses and others that they go to church. The service does make regular provision for religious observance in the home for those who want this and pastoral care. The weekly activities programme is on display in the foyer outlining group activities and the visits by the hairdresser and the library service. One person Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 14 told us they liked the card games in the afternoon and doing small jobs for the staff like folding the napkins ready for lunch. Some people used the garden or went for short walks with staff and there are weekly armchair exercise sessions. The weekly bingo sessions in house and quizzes were also popular. One relative said, “The social activities within the home are very good”. Currently the manager is introducing new craft activities to try to meet people’s requests. Another told us how good Christmas Day was in the home when everyone dined together and the food was “perfect”. We discussed with the manager and deputy the plans for what people wanted to do over the Christmas period and a party was planned and a brass band which residents told us they particularly liked and had requested before. There were also plans for those who wanted it to go to the pantomime being put on locally. We observed lunch being served and obviously enjoyed by the residents. Some residents liked to have a glass of wine or sherry with their lunch and others different soft drinks that staff brought for them. Lunchtime was seen to be a social and relaxed time with some residents helping to prepare the dining room and with the residents and staff enjoying a chat. All residents appeared to have their own preferred places in the dining room and were helped there by the staff at mealtimes if the were unable to go to the dining room by themselves. Aids to promote independence such as plate guards were used to help people remain independent at mealtimes. If needed staff were seen to offer discreet assistance. The menus being used are varied and nutritious and we had the opportunity to speak to the new cook during the visit and said she was enjoying it very much. There is a choice at all meals and special diets are catered for. The kitchen, that was refurbished last year, was very clean and well organised and the cook showed us the cleaning and catering records. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 15 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): NMS 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an accessible complaints system that residents and relatives know and have confidence in. There are procedures in place to protect resident’s welfare and staff are given training in adult protection procedures. EVIDENCE: There are suitable procedures in place for recording and dealing with complaints. The complaints policy and procedure is part of the guide for the people using this service and there was also a copy on display. The manager said that there had been no ‘formal’ complaints for some considerable time and The Commission for Social Care inspection (CSCI) have not received any. The manager was clear about the importance of dealing with any concerns, however small, quickly so they did not get to be formal complaints. Matters are recorded where they have arisen and been attended to in care plans and through staff supervision. The manager audits the complaints system as part of the overall quality monitoring in the home. We spoke with several people living in the home and all were aware of how to make a complaint and who to make it to. One person told us that” the staff and boss are very good and will sort out any problem, I am very satisfied with the service”. Discussions with the manager, staff and people living in the Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 16 home evidenced that there is an open culture in the home where both residents and staff feel free to voice their opinions. Records show that where residents have raised any matters about their care the manager and deputy have acted quickly to put it right and monitored the situation to ensure improvement. Medical professionals surveys indicated that they felt any issues they raised would “always” be responded to appropriately. The service has internal policies and procedures for the Protection of Vulnerable Adults (POVA) and a copy of the Local Authority’s procedure was also seen to be available to staff along with employee guidance on POVA. The manager followed appropriate guidance and has referred one matter since the last inspection through adult protection procedures. This was investigated and dealt with by the appropriate agency to protect the interests of residents and staff. Staff are given training on protecting vulnerable adults and recognising abuse and this is also covered during staff induction period and through their NVQ level 2 training course. There is information and procedures for staff on whistle blowing. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 17 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): NMS 19,20,21,22,23,24,25 and 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 home that is clean, warm and comfortable and is suitable to meet their needs and promote their independence. EVIDENCE: We conducted a tour of the building looking at the environmental standards within the home. The home is being well maintained with regular, planned maintenance attended to by the home’s maintenance person. There is a satisfactory and homely standard of décor throughout and it was clean, tidy and comfortable. The manager carries out a premises audit to identify what needs to be repaired, improved or replaced and staff also have a system for reporting anything they find that needs attending to. The home’s maintenance plans for the coming year include the redecoration and re carpeting of the Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 18 rooms in the home’s extension and the replacement of vanity units in bedrooms and some new furniture. Outside the gardens are well kept and a water feature has been built to enhance the garden area. The service is also developing recycling processes including composting facilities to be ‘greener’ and this is something residents can be involved in. Resident’s bedrooms that we saw have a satisfactory standard of décor and furnishings. Many people have brought personal possessions, ornaments, pictures and items of importance to them. This helps make the bedrooms a more personal and homely place for the people living there. There are some shared rooms that can pose problems for privacy but all have screens. It is made clear to people before admission if they will be sharing and that they can move to a single room when one becomes available if they want to. Although one person told us they liked sharing a room for “the company”. There are sufficient bathrooms and toilet facilities for people as bedrooms do not have en suite facilities but all have wash hand basins. The bathrooms and communal toilets are fitted with appropriate aids, call bells and adaptations to ensure the safety of those using these facilities. There is plenty of communal space with three lounge/dining areas downstairs and a quiet lounge upstairs that is often used for family visiting. The service’s statement of purpose states these environmental standards so people are aware of this when thinking of coming to live there. Residents and relatives told us that the home is always clean and comfortable and we found that is was well lit and warm throughout. The home has policies and procedures for infection control and good practice seen in the use of protective clothing by staff. The home has a laundry assistant, and the laundry facilities, although small are neat and tidy. Resident’s told us that the laundry service was good and their things came back quickly. There are systems in place to test water temperatures to prevent risks from Legionella and to minimise the risk of scalds. There is a well equipped sluice room with a disinfector sited well away from resident areas to promote good hygiene. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 19 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): NMS 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient well trained and competent care staff on duty day and night to support and meet resident’s needs. A lapse in the home’s usual recruitment practices could potentially put people at risk. EVIDENCE: Staff rotas and observation of staff deployment during the visit indicate that the home has a competent staff group providing continuity of care for residents. There have been some staff changes recently but overall the staff group is a stable one with several long serving staff. There were enough staff on duty to provide care and support during the day and night and more staff at busier periods such as the evening to help people as they want to go to bed. The manager and deputy are in the home 5 days a week and there is always a senior carer on each shift with two care staff. There is a senior carer on call system for the two night staff to use if they need support or advice. We looked at the staff rotas and domestic, maintenance and laundry staff are employed in sufficient numbers and keep the home clean and fresh. The home has two part time cooks covering the week. There is also part time Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 20 administrative support for the management team. All this makes sure carer time is spent with residents not in doing other duties. Staff told us they enjoyed their work and morale among the staff team was good. Staff we spoke to said they feel supported in their work and that the manager appreciates family commitments and supports staff when they need it. All staff spoken with felt that if they had any problems in their work the management would act quickly to support them and sort out problems early. Records of formal supervision indicate that this is the case and personal issues and family responsibilities as well as workplace relationships form part of individual supervision. Training is well supported and resourced in the home and NVQ training is well established with well over 50 of staff holding level 2. Records show that staff are provided with, and participate in training courses suitable for the work they are doing including domestic and catering staff. There is an induction programme for new staff covering moving and handling and adult protection and orientation to the home. Staff have individual training records showing that mandatory training is done as well as areas such as equality and diversity training, dementia awareness, medication handling and some have done training on the new Mental Capacity Act. We looked at recruitment processes and records and found that generally the home’s procedures have been followed with staff having references in place and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks before starting work. However during the recent period of staff turnover records show one new member of staff had only one reference and no proof of CRB or POVA First checks received before they started work in the home a few days previously, although applied for. Also the records for two other relatively new staff members showed that they had start dates for work several days before their POVA First and CRB checks had been confirmed. These lapses in an otherwise well managed recruitment process could place residents at potential risk. Even though the staff were supervised by other staff on induction the home must follow its own recruitment procedures and the regulations in obtaining all safety checks first to try to ensure that residents are not put at any risk. We discussed this lapse in good recruitment practice with the manager and deputy who accepted the importance of sticking to their procedures and the need for 2 references. They told us a verbal reference had been taken in the interim and it was recommended that when this is done a clear record of the information provided be kept. Staff have a three month probationary period and performance is monitored and recorded and additional support given if needed to improve. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 21 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): NMS 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a qualified, experienced manager who gives the interests and care of those living in the home a high priority. EVIDENCE: The manager and deputy manager have both just completed their NVQ Level 4 Registered Managers Award and both said they had found this very beneficial and helped their managerial development. Both undertake a variety of training to keep up to date and inform their practice, including team building and appraisal courses and Mental Capacity Act Training. Staff told us that both are approachable and open in their management styles. Staff members told us, “They are good to work for” and “you can talk to them, they are good that Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 22 way”. We observed that there is an open door policy for residents who came into the manager and staff offices to ask about matters and express worries that were dealt with efficiently. The manager monitors the quality of the service using annual audit tools and seeks residents and relative’s opinions and views generally. In this way the manager can identify areas that need improving or what people want from the service and help to plan ahead. For example changes were made to the menu at resident’s request and new activities. At present the manager is reviewing and updating the service’s polices and procedures to make sure they reflect good practice and legislation and this is reflected in the changes being made to the Statement of Purpose. It is recommended that any findings from surveys should be collated and displayed so resident, relatives and staff can see that their input has effects on the service provided. Residents told us their views and opinions are welcomed and acted upon to affect the way the home is run and the things they do and take part in. We saw resident’s coming to the office to do this and those we spoke with were clear about feeling free to “ speak my mind”. Staff have their own meetings with the management. There were detailed records of staff supervision taking place. At supervision a range of issues are discussed, practice issues, such as medication, training needs, personal issues such as family commitments and working relationships to try to maintain good working relationships and areas of practice that need improving or addressing. Overall the management deals quickly with any issues that arise through supervision and monitors the actions taken. The manager has systems in place to ensure the home is run safely. Water temperatures are checked, fire safety equipment is tested and risk assessments are completed and reviewed. Records and servicing contracts indicate that the home has systems, training and practices to promote resident health and safety. Records show that servicing and maintenance of equipment is being done as needed. Staff have been given fire training and appropriate training on moving and handling. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 19 (4) Schedule 2 Requirement The registered manager must not employ a person to work at the home unless they have confirmation of a satisfactory police check and a satisfactory check of the POVA register in order to protect people living in the home. Timescale for action 10/12/07 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 OP9 Good Practice Recommendations The manager should consider using protocols for the medicines that are prescribed to be given to people ‘as required’. This would help staff make sure that such medicines are given only when residents need them. Where telephone references are taken for employees a clear and detailed record should be kept of the information provided. The results of any quality monitoring exercises and surveys should be collated and available for viewing so DS0000022579.V346152.R01.S.doc Version 5.2 Page 25 2. 3. OP29 OP33 Abbotsfield Residential Care Home people can see the results of their opinions and the actions being taken. Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Abbotsfield Residential Care Home DS0000022579.V346152.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!