Care Home: Aberdeen House Residential Home

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What the care home does well People living at Aberdeen House enjoy the home cooked food. People living at Aberdeen House enjoy a clean and comfortable environment. Staff receive good levels of training and support, with half being trained in National Vocational Qualifications in Social Care, to level 2 . Staff have a good awareness of the needs of people living in the home. We saw staff treat people living at the home with dignity and respect. Residents we spoke with told us that the staff treat them well, and they are well looked after. Visitors are made welcome at Aberdeen House. The home has a stable staff and management group, and does not need to use agency staff. What has improved since the last inspection? Care planning and risk assessments have improved to support the health and safety of people living in the home. The service has bought new `moving and handling` equipment to help residents who need help in moving from one place to another. The service has bought a new low rise bed to improve the safety of one resident. The service has bought new scales to support staff in monitoring the weight of people whose weight changes are of concern. The service has improved the administration, storage, and recording of medicines. What the care home could do better: The service could continue to improve care planning so that the care plans reflect the knowledge that staff have of each resident. The service could look at improving the dining experience for people who live at the home, and encourage residents to sit at a dining table to promote social engagement. The service could look at whether the number of staff working in the afternoon are sufficient to provide more than just basic care to residents living at the home. The service should ensure that medicines stored in a fridge, are stored in a separate fridge to that used to store food. Key inspection report Care homes for older people Name: Address: Aberdeen House Residential Home 20 Stockerston Road Uppingham Rutland LE15 9UD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Fiona Stephenson     Date: 1 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Aberdeen House Residential Home 20 Stockerston Road Uppingham Rutland LE15 9UD 01572823308 F/P01572823308 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Linda-Jane Thornalley Name of registered manager (if applicable) Mrs Joanne Chapman Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: No additional conditions of registration. Date of last inspection Brief description of the care home Aberdeen House is an 18-bedded residential care home for older people. The home, which is a converted farmhouse, is situated in Uppingham, close to the centre of this rural village. Service Users rooms are located on two floors with a shaft lift and a stair lift providing access to upstairs facilities. Service Users have access to a communal lounge / dining room, a conservatory and a quiet lounge. There is a well-maintained patio garden outside. Details about the weekly fees can be obtained from the Registered Manager or provider, there are additional costs for hairdressing, toiletries, transport, chiropody and Care Homes for Older People Page 4 of 25 Over 65 18 1 0 0 1 9 1 1 2 0 0 9 Brief description of the care home dry cleaning. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. The last key inspection was November 2009. The Registered Provider, Manager and the staff in the home helped us during the visit. The visit started at 9.45am and finished at 2.30pm. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and their relatives, - talking to staff and management, - watching how people are given support, - looking at records. Care Homes for Older People Page 6 of 25 We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CQC, and it tells us what the provider thinks about the service they deliver to people who live at Aberdeen House. We also looked at the surveys called Have your Say About.. which are sent out to people who live and work at Aberdeen House. We received three back from people who live at Aberdeen House, and four back from staff who work at the home. All three surveys from people who live at Aberdeen House were positive. They told us that the home is always fresh and clean and they always receive the care and support they need. They told us that staff are usually or always available when they are needed, and they usually or always enjoyed the food provided. Comments made were: they look after us very well, the food is very nice, and we have a good laugh...they are all very kind to me which is important they do very well on the care side...very pleased with what the homes doing..the staff are very good the home covers all aspects of my needs..its OK as far as Im concerned. The four staff who responded to the survey were positive about working at Aberdeen House. They told us they get regular support from their manager, and that they have had training that helps them to do their work safely and effectively. They thought there was either always or usually enough staff on duty to meet the needs of people who live in the home. Staff told us: Its a caring home with a family environment where everybody is treated equally This home provides a safe and loving home for vulnerable people. staff really do care and d their best to ensure that residents are comfortable...this is a nice place to work and has a pleasant atmosphere which visitors often remark on. Aberdeen house is very homely, everyone is made to feel like its home...all our residents are cared for very well. One person commented I think the interior could be up-dated. We spoke with five people who live at Aberdeen House during our visit, and one relative who was visiting the home during the inspection. Everyone we spoke with was very positive about the care being given at the home. We spoke with four members of staff during our visit to the home who told us about working in the home and gave us their views. All staff spoken with were happy working at Aberdeen House. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the Care Homes for Older People Page 7 of 25 report to make sure we respected their confidences. Care Homes for Older People Page 8 of 25 What the care home does well: What has improved since the last inspection? What they could do better: The service could continue to improve care planning so that the care plans reflect the knowledge that staff have of each resident. The service could look at improving the dining experience for people who live at the home, and encourage residents to sit at a dining table to promote social engagement. The service could look at whether the number of staff working in the afternoon are sufficient to provide more than just basic care to residents living at the home. The service should ensure that medicines stored in a fridge, are stored in a separate fridge to that used to store food. Care Homes for Older People Page 9 of 25 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service carries out appropriate assessments to ensure it meets the needs of people who wish to live at Aberdeen House. Evidence: At our last inspection of the service in November 2009, we looked at the written information given to people who use the service and we were satisfied that people receive information to help them make an informed decision. This time we chose not to check on this again, but spent time speaking with a new resident and staff to find out whether the staff were aware of her needs. The new resident had only been living at Aberdeen House for three days, but staff knew what her needs were, and these had also been documented in her care plan. The resident told us she had settled in well and staff had been very supportive of her. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides good health and personal care to people living at Aberdeen House Evidence: We looked at the records of the people we case tracked, talked to people living in the home, and visitors to the home, and watched how staff provide care and support people living at Aberdeen House. We saw that staff had a good awareness of the health and personal care needs of people who live at Aberdeen House. We saw that care plans had improved since our last inspection, and appropriate risk assessments had been undertaken on areas such as nutrition, and moving and handling. We did not think however, that the information in the care plans was as detailed as the knowledge that staff held on each resident. For example, one care plan said that a residents behaviour could be challenging at times, but it didnt say why this might be the case, or what to do to reduce the chances of behaviour becoming challenging. But on speaking to staff, there was a clear understanding of the issues. We looked at the way staff handled and gave medicines to people who live at Care Homes for Older People Page 13 of 25 Evidence: Aberdeen House, and we also looked at how they recorded the giving of medicines. We saw that the Medication Administration Records (MARs) were accurate and clearly showed what medicines had been given, to who, and by whom, and the time they had been given. We saw that medicines were stored in the proper cupboards. At the time of the last inspection, no one living at the home needed their medication refrigerated, but now a resident does need medicines stored in one. The service is currently storing them in the fridge in the kitchen. They are aware this is not good practice and are ordering a small fridge for medicines. We checked the records for the administration of controlled drugs, and for the disposal of medication and were satisfied this is being done appropriately. We watched the way staff supported people living at Aberdeen House and saw they treated people living in the home with respect. This was done in a number of ways by giving people time to say what they wanted, knocking on the doors of peoples rooms, and by how staff responded to requests. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Aberdeen House experience a satisfactory daily life. Evidence: We looked at the records, and spoke with staff, people living at the home, and their relatives about daily life at Aberdeen House. We saw that visitors are made to feel welcome in the home, and we saw them coming to see their relatives at various times during the time we were there. We were informed that the service has links with Uppingham School, with the young people at the school coming into the home once a week to talk to residents. We were informed that the service has supported one resident whose daughter lives a long way from Aberdeen House, to make use of a befriending service. The resident also spoke to us about this person. We saw that although activities are provided in the home (a person comes into the home twice a week to support activities), activity planning is not person centred, and not tailored to the needs of individual service users. We saw that the service does not make good use of the resources it has to engage Care Homes for Older People Page 15 of 25 Evidence: residents on a daily basis. For example, staff could read out newspaper articles and magazine stories, and use these as prompts for reminiscing or talking points. Residents do not sit at a dinner table for their meals. The manager told us that this is their choice. However by sitting with lap trays, residents are not having the opportunity of different company, and having a more interesting and social meal time experience. They are also not moving to a different room and observing new things. We saw two residents in the same chair for the whole of the time we were at the inspection. We looked at the menu and saw the meal provided on the day of our visit. We saw that residents enjoyed their food, and particularly the home made Lemon Meringue pie. Residents told us they enjoyed the meals provided at Aberdeen House, and the choices available. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service works well in dealing with complaints and protecting people living in the home. Evidence: The AQAA informed us that there have been four complaints about the home in the last 12 months Two of the complaints were upheld, and one is currently under investigation. The CQC has not received any complaints from relatives or people using the service since the last key inspection. Management have worked hard to meet the requirements made at the last inspection, and as a consequence of this residents living at the home are more protected. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Aberdeen House, live in a comfortable, safe, and well maintained environment. Evidence: We looked at the communal living areas of Aberdeen House, the bathrooms, and some of the bedrooms used by people living at the home. We found all areas of the home to be clean and tidy, and with no unpleasant smells. The communal lounges were comfortable and homely, although the conservatory, which had nice views of the garden appeared not to be used. We saw sufficient hoisting equipment in the home to meet the needs of people living at Aberdeen House. Not all bedrooms at Aberdeen House are single rooms. For those who share, there are screens to provide privacy. We were told that people only share if it is a positive choice to do so. All bedrooms looked at had been personalised by the people who use them. The bedroom furnishings are adequate to meet the needs of people living at the home, although some are looking a bit worn. The bathrooms have the equipment necessary to support people having a bath or shower in safety. The service employs a maintenance worker who regularly checks that all equipment Care Homes for Older People Page 18 of 25 Evidence: used in the home is working well and is safe to use. Care Homes for Older People Page 19 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is adequate staff to meet the needs of people living at Aberdeen House. Evidence: We focused on the staffing numbers at Aberdeen House, as recruitment and training of staff was looked at during the last key inspection in November 2009. We observed there to be sufficient staff to support residents during the morning and early part of the afternoon. We were told that from 2.00pm until the end of the night shift, there are two members of staff on duty. There are 18 people who live at the home. The AQAA told us that 10 residents need the support of two people in helping with their care, and 12 in going to the toilet. We were told that the two staff on the afternoon shift not only have caring responsibilities but are charged with the responsibility of providing the tea time menu, and ensuring that people eat their food. Both staff and residents spoken with told us that they felt there were sufficient staff on duty during the afternoon to meet the needs of residents. We were also told there is always a member of staff on-call to help out if there is a need. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team work hard to support the needs of people living at Aberdeen House. Evidence: The management team consists of the owner/manager, the registered manager and the deputy manager. All have worked at Aberdeen House for many years. The owner and manager are RGN trained, and the deputy has a NVQ 3 in social care. Both the manager and deputy manager have recently undertaken further training in Team Leadership. We saw an open and inclusive atmosphere during our inspection. The management team have an open door policy for staff, to come and talk to them if they have any concerns or issues about the management of the home and the impact this might have on people living there. Staff confirmed to us that they could speak to management if they had concerns. Residents also told us they could speak to management about the service they receive. Care Homes for Older People Page 21 of 25 Evidence: At the last inspection a number of requirements were made for the service to comply with. We saw that all the actions we required the service to undertake have been completed, thereby improving the quality and safety of care to people who live at Aberdeen House. Care Homes for Older People Page 22 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The manager should continue to work with her staff team in improving care records, to make them more person centred, and to ensure the information that staff know about residents is captured effectively in the care planning process. The manager should ensure that medicines which require refrigeration, are stored in a fridge used only for the storage of medicines. The manager should look at improving the activities and stimulation for each individual resident in the home; and look at how activities can be incorporated into every day living at the home. The manager could consider improving the dining experience, and encourage residents to sit at the dinner table. Management should consider whether the afternoon shift would benefit from additional staff help, particularly at tea time. 2 9 3 12 4 15 5 27 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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