Care Home: Abiden Rest Home

What has improved since the last inspection? Since the last inspection, a brochure had been produced to provide the residents with an overview of the home. This meant the residents had access to suitable and relevant information about the services and facilities available in the home. The care plan format had been improved and updated to provide staff with more information about the residents` needs and preferred routines. This meant that the staff were provided with clear guidance about how best to meet residents` needs and preferences. The risk assessments had been reviewed on a monthly basis and updated when necessary. This ensured that the staff had access to up to date information about how to manage and respond to identified risks. The medication records had improved and staff were recording accurate details of the medication administered to the residents. This ensured that the residents were given their medication in a safe and consistent manner.Abiden Rest HomeDS0000009469.V375202.R01.S.docVersion 5.2Page 7Several improvements had been made to the premises to promote the residents` safety and comfort. For example, the office had been completed, six bedrooms had been redecorated, new carpets had been fitted and new washbasins had been installed. Some communal area had also been redecorated, including a lounge and a new fire alarm system had been installed. Appropriate records and checks had been obtained prior to staff commencing work in the home. This ensured that all new staff were fully checked before they had access to the residents. The care manager had completed the Registered Manager`s Award and the team leaders had completed NVQ level 4. This meant the management team had achieved appropriate qualifications to ensure the smooth running of the home. What the care home could do better: The electrician had identified remedial work on the electrical safety certificate. The registered person must therefore ensure that this work is carried out to ensure the electrical installations meet the necessary standards. Key inspection report CARE HOMES FOR OLDER PEOPLE Abiden Rest Home 22/24 Rosehill Road Burnley Lancashire BB11 2JT Lead Inspector Mrs Julie Playfer Unannounced Inspection 11th May 2009 09:00 DS0000009469.V375202.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abiden Rest Home Address 22/24 Rosehill Road Burnley Lancashire BB11 2JT 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) 01282 428603 Mr John Alexander Pinder Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Abiden Rest Home DS0000009469.V375202.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 service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling with any other category - Code OP The maximum number of service users who can be accommodated is: 22 Date of last inspection 21st May 2008 Brief Description of the Service: Abiden Rest Home is registered to provide accommodation and personal care for 22 Older People. The home is situated within easy access of the town centre and public transport routes. The gardens are attractive and have patio areas, which are readily accessed by the residents. Accommodation comprises of 18 single rooms, 8 of which are ensuite and 2 double rooms both ensuite. There is a chair lift to the first floor. Communal space is provided in 3 lounges, 2 of which have a television and the other is used as a quiet room. There is a separate dining room. The home also has two assisted baths and one shower room. At the time of the inspection (May 2009) the scale of charges ranged from £386.50 to £392.00 per week. The registered provider made information available to prospective residents by means of a statement of purpose and service users guide. This document was usually given to relatives and/or prospective residents on viewing the home or at the point of assessment. Copies of previous inspection reports can be viewed in the home or obtained from the Commission’s website at www.cqc.org.uk Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. A key unannounced inspection, which included a visit to the home, was conducted at Abiden Rest Home on 11th May 2009. The inspection was carried out by one inspector, however, the report refers to “we” as it was written on behalf of the commission. We lasted visited this service on 21st May 2008. At the time of the visit there were 15 residents accommodated in the home. During the inspection we spent time with the residents, looked round the home, read some of the residents’ care records and other documents and talked to the staff, the care manager and the registered person. We also consulted our records about the service. As part of the inspection process we used “case tracking” as a means of gathering information. This process allows us to focus on a small group of people living at the home, to assess the quality of the service provided. Prior to the inspection, the care manager completed an Annual Quality Assurance Assessment known as AQAA, which is a detailed self assessment questionnaire covering all aspects of the management of the home. This provided us with useful information and evidence for the inspection. Satisfaction questionnaires were sent to the home for distribution to the staff and the residents. Two questionnaires were returned from the staff and two were received from the residents. The responses from the questionnaires were collated and used throughout the inspection process. What the service does well: Current and prospective residents were provided with appropriate written information. This ensured the residents were aware of the services and facilities available in the home. Prior to moving into the home the residents needs were assessed and discussed. This enabled the registered person and prospective residents to determine whether or not their needs could be met within the home. All residents had a care plan based on their assessment of needs. The plans provided clear guidance for staff on how to meet peoples personal, health and social needs. The plans were supported by risk assessments, which meant that the staff had good information about how to manage and respond to any areas of identified risk. The daily routines were flexible and designed to meet the needs and wishes of the residents. This meant the residents were able to choose their preferred Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 6 lifestyle and their individual preferences were recognised. The residents could choose to have a lie in and breakfast was served at a time to suit their preferences. The residents spoken to felt they were well cared for and the staff respected their rights to privacy and dignity. One resident told us, “The staff are very kind and we have a laugh together”. The residents were served varied and nutritious meals and were given a choice of food at every mealtime. All the residents spoken to liked the meals, which they described as lovely and very nice. Visitors were welcome in the home at any time and residents were supported to maintain good contact with their family and friends. This meant the residents could continue to play a part in family life. A relative spoken to was satisfied with the quality of care provided and felt that the residents were looked after in a caring and sensitive manner. The residents were provided with clean comfortable bedrooms and could personalise their rooms, with their own belongings. The sitting areas were decorated in a homely fashion, with a variety of armchairs, footstools, side tables, ornaments and pictures. The residents were aware of the complaints procedure and knew who to speak to in the event of a concern. This meant the residents had the opportunity to resolve any queries at an early stage. A good percentage of staff had achieved NVQ (National Vocational Qualification) level 2. This is a recognised qualification for staff involved in the care profession. What has improved since the last inspection? Since the last inspection, a brochure had been produced to provide the residents with an overview of the home. This meant the residents had access to suitable and relevant information about the services and facilities available in the home. The care plan format had been improved and updated to provide staff with more information about the residents needs and preferred routines. This meant that the staff were provided with clear guidance about how best to meet residents needs and preferences. The risk assessments had been reviewed on a monthly basis and updated when necessary. This ensured that the staff had access to up to date information about how to manage and respond to identified risks. The medication records had improved and staff were recording accurate details of the medication administered to the residents. This ensured that the residents were given their medication in a safe and consistent manner. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 7 Several improvements had been made to the premises to promote the residents’ safety and comfort. For example, the office had been completed, six bedrooms had been redecorated, new carpets had been fitted and new washbasins had been installed. Some communal area had also been redecorated, including a lounge and a new fire alarm system had been installed. Appropriate records and checks had been obtained prior to staff commencing work in the home. This ensured that all new staff were fully checked before they had access to the residents. The care manager had completed the Registered Manager’s Award and the team leaders had completed NVQ level 4. This meant the management team had achieved appropriate qualifications to ensure the smooth running of the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. Abiden Rest Home DS0000009469.V375202.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 Abiden Rest Home DS0000009469.V375202.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 and 6 People using the 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 residents had their needs properly assessed and they were provided with appropriate written information to enable them to make an informed choice about where to live. EVIDENCE: Written information was available for residents in the form of a statement of purpose and service users guide. The guide and the statement of purpose had been combined into one document and was available for reference in each of the bedrooms. Since the last inspection, a brochure had been produced to provide the residents with an overview of the home. This meant the residents had access to suitable and relevant information about the services and facilities available in the home. The residents who completed a questionnaire indicated that they had received enough information prior to moving into the home. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 10 Residents funded by the local authority were supplied with an individual service agreement and privately funded residents had been issued with a contract with the home. A copy of the contract was included in the service users guide. The contract was easy to read and was presented in a clear format. This meant that residents were aware of the terms and conditions of residence and knew what they could expect from the service. The case tracking process demonstrated that the residents had their needs assessed prior to admission by a social worker and/or a member of the management team. The pre admission assessment was carried out in at a convenient time and place for the prospective resident, to ensure they had the time and opportunity to participate in the assessment process. Copies of the preadmission assessments seen covered a range of individual needs including personal, social, health and cultural needs. It was evident admissions were not made to the home in the absence of a full needs assessment. This meant the registered person could be confident that the staff had the necessary skills and knowledge to meet the assessed needs of prospective residents. Following the assessment of needs a letter was sent to prospective residents and their families to confirm that the residents needs could be met in the home. This meant residents could be assured that the home was a suitable place for them to live. The registered person confirmed that prospective residents were invited to spend as much time as they wished in the home prior to making the decision to move in. This enabled the person to meet other residents and staff and experience life in the home. Following admission, the contract stated that a trial period of eight weeks was offered to every new resident, so both parties could make sure the placement was successful and the residents individual needs could be met. Abiden Rest Home DS0000009469.V375202.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the 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 health and personal care received by residents was based on their individual needs. Care practice took full account of the residents privacy and dignity and appropriate arrangements were in place to manage medication. EVIDENCE: Three residents files were looked at in detail as part of the case tracking process. All three files seen contained a care plan, which was based on the residents assessment of needs. The plans were supported by records of personal care, which provided information about changing needs and any recurring difficulties. The records had been made on a daily basis, to ensure staff were provided with up to date details about the residents well being. The records were detailed and the residents needs were described in respectful and sensitive terms. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 12 The care plans covered the residents personal, social, health and cultural needs and provided staff with clear guidance on how best to meet these needs. This meant staff had up to date information about the residents needs and preferences. Staff who completed a questionnaire indicated that they were given up to date information about the needs of the residents. Since the last inspection, the care plan format had been updated, to provide staff with more information about the residents needs. The new style plans were detailed and incorporated the residents personal preferences and daily routines. This meant staff were aware of how the residents wished to spend their day and they were thus able to provide individualised care dependant on each residents preferred lifestyle. The residents and their families had been consulted wherever practicable during the development and review of their care plan. Written records seen on the personal files demonstrated that the care plans were reviewed each month and a record had been made of any changing needs. Healthcare needs were considered during the assessment process and included within the care plan. This meant that staff were provided with information about how to monitor and respond to specific medical conditions. There was written evidence within the personal care notes to indicate that the residents accessed NHS services and received specialist support as necessary, for instance the District Nursing Team. Charts were maintained to monitor the residents weight, to ensure any fluctuations were noted and acted upon. Risk assessments had been carried out as necessary, in respect to moving and handling, pressure sores, falls and nutrition. The risk assessments were supported by risk management strategies, which provided staff with guidance on how to manage and reduce any identified risks. This meant the staff were able to respond consistently and safely in to any identified risks. Since the last inspection, the risk assessments had been reviewed on a monthly basis and updated when necessary. This ensured that the staff had access to up to date information about how to manage and respond to any risks. The residents spoken to felt the staff respected their rights to privacy and dignity and all made complimentary remarks about the staff, for instance one person said, They (the staff) are very caring and helpful. The residents, who completed a questionnaire, indicated that they received the care and support they needed. One person commented, They look after us well”. The staff were observed to interact with the residents in a positive manner and they referred to the residents in their preferred form of address. During discussions with staff they demonstrated an awareness of treating people with respect and considering their dignity when providing personal care. Written documentation such as the Residents’ Charter also emphasised the importance of maintaining the residents’ rights to privacy and dignity. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 13 Policies and procedures were in place to cover the management of medicines and were available for staff reference in the main policy and procedure file. The home operated a monitored dosage system of medication, which was dispensed into cassettes by a local Pharmacist. Appropriate records were maintained in respect to the receipt, administration and disposal of medication. Since the last inspection, the record keeping had improved, as such information from the prescription label had been accurately transcribed onto the medication administration record and staff had signed the administration records after they had given the medication to the residents. All staff designated to administer medication had received accredited training. Suitable arrangements were in place for the storage and administration of controlled drugs. Abiden Rest Home DS0000009469.V375202.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to exercise choice and control over their lives and were supported to maintain good contact with their family and friends. The residents were provided with a nutritious and varied diet. EVIDENCE: The residents preferences in respect of social activities were recorded and considered as part of the assessment and care planning processes. A range of activities was planned and implemented by the registered person and staff. These included nail care, hairdressing, dominoes, arts and crafts and professional entertainers. The residents were encouraged and supported to participate in the activities as they wished. Residents spoken to during the inspection said they enjoyed participating in the various activities. The residents were consulted on a daily basis about what activities they wished to pursue. The residents were given the opportunity to go on trips outside the home in fine weather. Information about forthcoming activities was displayed on notice boards around the home. On the day of inspection, the residents Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 15 were observed to be reading newspapers, chatting to staff and watching the television. Information in the AQAA indicated that the residents’ birthdays were celebrated along with various festivals throughout the year, including Valentines Day, Easter, Christmas and Halloween. The residents were supported to continue with their chosen form of religion and a representative from the local church visited the residents for communion and prayers approximately every six weeks. A church choir visited the home each month. One resident also attended a local church on a regular basis, which enabled her to stay in contact with friends and members of the congregation. The routines were flexible and were primarily designed to meet the needs of the residents. The residents spoken to said they had a choice in the times they got up and went to bed. One person said, I decide each morning, but I usually like to get up early”. The staff were observed to seek the residents views throughout the inspection and the residents spoken to felt comfortable to comment on life in the home. The residents had the opportunity to develop and maintain important personal and family relationships. There were no restrictions placed on visiting times and residents were able to receive their guests in private, should they wish to do so. Refreshments were offered to visitors, to ensure they felt welcome in the home. Relatives spoken to during the inspection were satisfied with the quality of care. One person commented, The care is excellent, they never forget that the residents are people and they always uphold their dignity”. The residents spoken to said they liked the food provided. There was a choice of food each mealtime and residents were asked prior to each meal what choice they wished to make. The food was homemade and breakfast was served throughout the morning to suit the preferences of the residents, who wished to have a lie in. The menu was displayed in the corridor, so residents were aware of the forthcoming meal. Residents were asked their opinion of the food on an ongoing basis and they could make suggestions for future meals. The meal served on the day of inspection was plentiful and well presented. Residents were given sensitive and appropriate support to eat their meals. Drinks and snacks were served throughout the day and at other times on request. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to express their views and had access to a clear complaints procedure. Policies and procedures were in place to respond effectively to any allegations or suspicions of abuse. EVIDENCE: Arrangements were in place to ensure the registered person and staff listened to and acted on the views and concerns of residents. This was achieved during daily conversation, one to one discussion, residents meetings and satisfaction questionnaires. The residents spoken to said they felt comfortable about expressing their views and were aware of whom to speak to in the event of a concern. Staff who completed a questionnaire also indicated that they were aware of what to do if the residents or their families had a concern. This meant that systems were in place to ensure any problems could be promptly and readily rectified. The complaints procedure was included in the statement of purpose and service users guide and was also displayed around the home. The residents had been issued a personal copy of the complaints procedure as part of the service users guide. The procedure contained the necessary information and Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 17 included the relevant telephone numbers should a resident wish to raise a concern. According to information in the AQAA, the registered person had not received any complaints during the last twelve months. An appropriate recording system was in place in the event of a complaint being made. The policies and procedures for safeguarding vulnerable adults were available and provided guidance for staff should they suspect or witness any harmful practice. These issues were incorporated into the induction training and staff received specific tuition as part of their NVQ training. The staff also had access to a whistle blowing procedure. The procedures associated with the protection of vulnerable adults had been fully discussed at staff supervisions, to ensure staff were aware of how and where to direct any concerns. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were provided with a clean, pleasant and well-maintained environment, which promoted their comfort, independence and safety. EVIDENCE: Abiden Rest Home is a mature property with its own garden. The home is located approximately a mile from Burnley town centre and within easy access of main public transport routes. Accommodation is provided in 18 single rooms, 8 of which have an ensuite facility and 2 double rooms, both of which have an ensuite. Communal space is provided in three living rooms and one dining room. A chair lift eased access to the first floor. The residents had free movement around the home and could choose where they wished to spend their time. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 19 Since the last inspection, various improvements had been made to the premises. For example, the office had been completed, six bedrooms had been redecorated, new carpets had been fitted and new washbasins had been installed. Some communal area had been redecorated, including a lounge and a new fire alarm system had been installed. Established arrangements were in place to report repairs and routine maintenance and appropriate records were maintained of the work completed. A person was employed to carry out day to day maintenance. This meant that any problems with the building were promptly rectified. It was evident from a partial tour of the building that the residents had personalised their rooms with their own belongings and decoration was a good standard throughout. The residents said they liked their bedrooms. One person said, I have a very nice room, I like helping to keep it clean and tidy. The bedroom doors were fitted with appropriate locks and keys were distributed according to the needs and wishes of the residents. The home was clean and odour free at the time of the inspection. The residents and relatives spoken to said that a good level of hygiene was maintained at all times. All the residents who completed a questionnaire indicated that the home was always fresh and clean. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the 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 residents benefited from experienced, competent and well-trained staff. EVIDENCE: A staff duty roster was drawn up in advance and provided a record of the number of hours worked by the staff in the home. All staff who provided personal care were aged over 18 and all staff left in charge of the building were aged over 21. Many of the staff had worked at the home for several years, which meant they had a good knowledge of the needs of the residents. A recruitment and selection procedure was available in the policy and procedure file. Since the last inspection, improvements had been made to the recruitment of new staff, which ensured that staff were fully checked before they started work in the home. The files of two members of staff were looked at in detail. It was evident that both applicants had completed an application form, provided a full working history and had attended the home for an interview. CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks had been obtained prior to the applicants commencing work in the home, along with two written references. This meant that the registered Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 21 person had collated all records and checks in accordance with regulatory requirements. Arrangements were in place for all new employees to undertake induction training, which incorporated the Skills for Care standards. The latter provided underpinning knowledge for NVQ level 2. According to information supplied by the care manager 12 out of 13 care staff had achieved NVQ level 2, which equated to 92 of the overall staff team. In addition one member of staff was working towards this qualification. This meant the vast majority of the staff team had achieved the necessary qualifications to enable them to carry out their role effectively. All staff who completed a questionnaire confirmed they received training relevant to their role and all commented that they were well supported by the management team with any training needs. Since the last inspection, the care manager had completed the Registered Manager’s Award and the team leaders had completed NVQ level 4. This meant the management team had achieved appropriate qualifications to ensure the smooth running of the home. Staff attended both internal and external training courses and had at least three paid days training a year. It was noted staff discussed their individual training needs during their supervision sessions and staff meetings. The home was linked via a computer to the LWDP (Lancashire Workforce Development Plan), which is an internet database. The system displayed a training record for each member of staff and highlighted when mandatory training was due. This enabled the registered person to plan future staff training effectively, in line with the needs of residents. Further to this, the registered person had recently purchased three training DVDs on understanding the impact of dementia. The registered person explained that he planned to roll this training out to the staff team in due course. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration practices were effective in ensuring the home was run in the best interests of the residents. EVIDENCE: The registered person had the overall responsibility for the management of the home and had completed NVQ 4 in Management and the Registered Manager’s Award. The registered person had also undertaken periodic training, which included fire safety and an Investors in People workshop. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 23 The management approach was consultative and there were established ways of working to consult the staff and residents on an ongoing basis. Relationships within the home were positive and staff spoke to and about the residents with respect. Further to this, a member of staff wrote in a questionnaire, “The home gives good care to all service users” and another member of staff commented, “The home provides a good all round service for its service users. Abiden is a home from home with a friendly atmosphere”. There was a programme in place for staff supervision and the topics discussed during supervision were recorded on a suitable format. Staff received formal supervision six times a year with a designated line manager. This enabled the staff to identify any future training needs and discuss the care of the residents. In addition to supervision, staff were given the opportunity to attend regular staff meetings and handovers. This meant that the staff were able to share experiences and discuss future developments. The service was reaccredited with an Investors in People Award in 2009. This is a professionally recognised quality assurance award. Satisfaction questionnaires had been distributed to residents and their residents and their families in January and February 2009. At the time of the inspection, the results had not been collated. However, the registered person had produced an annual development plan based on the outcomes of the 2008 survey and other quality assurance monitoring processes. This document linked with the AQAA questionnaire submitted to the Commission. All sections of the AQAA were completed and the information provided gave a clear picture of the current situation within the service and the planned areas for development. At the time of the visit, the registered person was not managing any money on behalf of residents. Privately funded residents were sent an invoice every four weeks for their fees. There was a set of health and safety policies and procedures, which included the safe storage of hazardous substances and infection control. Staff received health and safety training, which included moving and handling, food hygiene, first aid, fire safety and infection control. Documentation seen during the inspection and information supplied in the AQAA indicated the electrical; gas and fire systems were serviced at regular intervals. However, it was noted that remedial work had been identified on the electrical certificate. The fire log demonstrated that the staff had received instructions about the fire procedures during their induction. Appropriate arrangements were in place to record accidents and incidents in the home. This ensured that the residents condition was closely monitored following an accident or incident. Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 24 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 X X 3 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 25 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 OP38 Regulation 13 (4) Requirement Remedial work, as identified on the electrical safety certificate, must be carried out on the electrical installations. This is to ensure the installations meet the necessary standards. Timescale for action 11/06/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abiden Rest Home DS0000009469.V375202.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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