Care Home: Abington Park View

What the care home does well People have moved to Abington Park View and continue to have their needs met that promotes their well-being, independence and choice of lifestyle. The pre-admission assessment, care planning and risk assessment are comprehensive and reflective of individual needs, including health and social aspects of people`s daily lives. We found examples of good practice where care plans provided clear guidance for staff to follow with reference to promoting their health and choice of lifestyle. Assessments of risk were in place to ensure people were able to continuity daily tasks safely. We found that some people who live at the home were familiar with each other and some staff, as they moved together from another care home. People live in a clean, bright and homely environment. Individual en-suite shower and toilet facilities promotes their privacy and independence. People said the quality of meals provided was `excellent`. The cook talks with people who uses the service to find out what they like and don`t like. There is a new menu developed after speaking with the people who use the service. The comments we received from the people who use the service and the visiting relatives that we spoke with included: "It was the best thing that happened after we were told .... was closing and everyone had to leave" "She has settled in really well and helped moving here with other residents and some of the staff" "She`s a very good cook" "The meals here are excellent, you can have what you want" "She had her sister and family visit over Christmas and the staff brought in a tray with a pot of tea, cups, saucers and a plate of biscuits - it was lovely" What the care home could do better: We found that people who use the service would benefit from better and timely access to health support, specifically the Chiropodist. Two people who use the service and visiting relatives told us since the appointment on 18th December 2009 was cancelled, they donot know whether another appointment had been made. The storage of controlled medication must be improved and advice must be sought from the Pharmacist to ensure the storage of controlled medication is in line with the British Pharmaceutical Regulations. People who wish to continue to manage their own medication must be better supported and provided with safe storage for medication. There should be evidence of the agreement in place for people to manage their own medication, an assessment of risk carried out and reflected in the care plan. This would ensure people continue to manage their medication safely and have safe storage in place within their own bedrooms, which is reviewed at regular intervals. People who use the service would benefit from having activities and social events available to them that is arranged by the home. People expressed to us that there are no activities arranged that they can take part in or look forward to. A number of activities were expressed to us and consistent with the social interests recorded in the care plans. This would promote people`s well-being and stimulation. There were some minor areas that require improving with regards to the environment. This includes the storage of staff lockers and cleaning equipment kept between the dining room and lounge and may pose a risk to people moving around independently. The `noisy radiator`, which has already been reported still requires addressing. The communal bathrooms and toilets have both liquid soaps in dispensers and bars of soaps. The use of bars of soaps in communal areas increases the risk of cross infection and places people`s health and well-being at risk. We found from speaking with the staff that they have since starting employment at the home have not received supervision. Staff must receive timely supervision with the person in charge, at regular intervals. There should be a programme of staff training to ensure staff skills and competency is in line with the home`s policy, procedure and best practice. This includes training in safeguarding adults. This would ensure staff have the right skills, knowledge and experience to support the people who use the service that promotes their health, safety and well-being. The `Regulation 26` reports must be kept at the home or made available to demonstrate the home`s monitoring of the quality of the service. The most significant improvement Abington Park View must make is the appointment of an `Acting Manager` for the service. The Acting Manager must also apply to become the `Registered Manager` for the service. This is important as all health and social care services must meet the registration requirements for the new `Health and Social Care Act 2008` coming into force this year. Random inspection report Care homes for older people Name: Address: Abington Park View 475 - 479 Wellingborough Road Northampton NN3 3HN one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rajshree Mistry Date: 0 7 0 1 2 0 1 0 Information about the care home Name of care home: Address: Abington Park View 475 - 479 Wellingborough Road Northampton NN3 3HN 01604719888 01604472892 greenpark@msaada.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Msaada Care Limited care home 22 Number of places (if applicable): Under 65 Over 65 22 10 old age, not falling within any other category physical disability Conditions of registration: 0 5 The maximum number of service users who can be accommodated is: 22 The registered person may provide the following categories 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 within any other category - Code OP, maximum number of places: 22 Physical Disability - Code PD, maximum number of places: 15 Date of last inspection Brief description of the care home Abington Park View is a registered care home providing care to people of the age of 65 years and up to 10 people who have a physical disbility. Abington Park View was previously known as Green Park Nursing home and is part of Msaada Care Ltd, which has a number of care services in the area. Care Homes for Older People Page 2 of 14 Brief description of the care home Abington Park View is situated in a residential area and is opposite a large park. It is on a main road approximately two miles from the town centre. There is good public transport and local facilities. The accommodation consists of single bedrooms over 3 floors: ground, first and second floor, accessible via the stairs or the passenger lift. All the bedrooms are single with en-suite shower and toilet facilities. There are a number of communal areas including two lounges and dining room on the ground floor and a lounge on the first floor. There is a patio to the rear, with seating for people to use on warmer days. The range of fees charged for 2010/2011 are not known. People who are interested in using Abington Park View should contact the home directly. Further information about Abington Park View and any specific requirements can be obtained in the form of the Statement of Purpose and the Service User Guide. The findings of the most recent inspection carried out by the Care Quality Commission (CQC) can be found in their Inspection Report, which is available at the home or accessible via our website: www.cqc.org.uk Care Homes for Older People Page 3 of 14 What we found: We as it appears throughout this Random Inspection Report refers to the Care Quality Commission (CQC). This Random Inspection took place as a number of people have now moved to the home since the last Key Inspection of the service. The focus was on the quality of care and support people provided by staff to meet peoples needs, quality of life people experiences, staffing and the management of the home. We were assisted by senior representatives of Msaada Care Ltd and the Acting Manager from another home within Msaada Care Ltd. During the site visit we spoke with the people who use the service and visiting relatives to find out their views and experience of the service. We looked at records such as care plans, risk assessments, daily record, medication records and other records relating to health support. We spoke with staff, including the cook and viewed some staff recruitment and training records. We looked at the accommodation, both communal areas and some individual bedrooms. We also read records relating to the management of the service. We found that people who live at the home and their relatives had the opportunity to visit the home prior to moving in. People were involved in the assessment of needs process to find out what care and support they required. The assessment records completed by the person in charge were comprehensive, clearly identifying individual needs, preferences and choice of lifestyle. We looked at three care files of which the majority contained care plans, detailing the level of care and support people required. The majority had evidence of assessment of risks, identifying the measures in place to promote peoples safety and well-being. The daily records showed peoples well-being and confirmed their care and support needs were mets consistently with the care plan. We found that there was no care plan and respective assessment of risks for the newest person, who had been in the home over a week. There was no guidance for staff to follow as the person had some physical needs and may not always communicate well. When we brought this to the attention of the person in charge, highlighting that the persons needs may not be met. Following the site visit we were notified by the senior representative of Msaada Care Ltd that a care plan and risk assessments were completed. People who use the service and visiting relatives told us they were involved in the assessment of needs process and the care plans. People said they were satisfied with the quality of care and support they received, found staff respected their privacy and enabled to them to maintain their independence as far as practicable. We found out the people kept their own General Practitioner (GP) and had been seen by them when required. We found that people were provided with equipment such as pressure care cushions to manage and prevent skin break-down and pressure sores developing. The care files maintained records of visits, treatment and appointments with health care professionals. Care Homes for Older People Page 4 of 14 Two people who use the service and a relative said that they have not yet been seen by the Chiropodist. They told us that the appointment on 18th December 2009 was cancelled and had not been advised of a further visit. When we asked the member of staff on duty they told us they had only just contacted the Chiropodist. This raises issues as to whether people are having access to timely health care support, which may place people at risk. Staff demonstrated a good understanding of their responsibilities, with regards to providing care and support to the people who use the service. Staff gave examples of how they support people to maintain their independence and choice of lifestyle. We found the medication is prepared into dossett boxes and is stored securely. The medication is administered by trained staff. We checked the medication and the medication administration records for three people and found these to be accurate. Staff told us they do have controlled medication on the premises and administered by two staff. The controlled medication were not stored securely as the cabinet was not usable. The controlled medication and records checked were accurately maintained. Following the site visit we were notified by the senior representative from Msaada Care Ltd that a controlled medication cabinet has been ordered. We found out that where people are able to manage their own medication, this is promoted. We read the care file of the person that manages their own medication. We noted that there was no information or associated self-medication risk assessments carried out to show the agreed arrangement. When we asked the member of staff where the medication was stored, they were unable to tell us. We checked the medication in the bedroom with the member of staff and found a number of medication (liquids and tablets) were left on the bedside cabinet, next to an electric heater. This is an unsafe practice and places the person at risk. The medication was removed from the bedroom by the member of staff and the person was advised. We observed the lifestyle people have in the home, ranging from watching television, receiving visitors and completing a large jigsaw puzzle in the dining. We noted that people remained in the lounge watching television for the most part of our visit. People said there were no planned activities arranged by the home. People who use the service and the visiting relatives told us they would like to have a range of activities that they can take part in. Some of the comments we received included: We like to play Bingo and quizzes or exercise but nothing happens here The TV in my bedroom is much better than this one The staff we spoke with showed us the activity record sheet, that showed some of the activities people took part in, such as one-to-one, had visitors puzzles and watched TV. Staff told us people who use the service like watching television and dont want to do things. This was inconsistent with what the people who use the service and relatives told us. We found out that there is a new cook. They told us about the range of meals they prepare to meet ensure peoples dietary needs and preferences. All the meals are prepared at the home and currently cater for some people with diabetes. Care Homes for Older People Page 5 of 14 The people who use the service spoke positively about the choice and quality of meals provided. The people who use the service and the visiting relatives were aware of how to complain and who to speak with. People using the service were confident to express concerns to the staff or to their relative in the first instance. People said they felt safe and well-cared for. We found out that there is a complaints and compliments folder. However, the folder could not be located. We spoke with a member of staff with regards to their understanding of safeguarding issues and their responsibilities. Safeguarding means protecting and promoting the wellbeing of people from risk, harm and abuse. We found that the member of staff was unclear of the multi-agency procedure and their individual responsibility. We found that some staff had completed safeguarding training. We found the home to be clean and tidy. The communal areas were bright, welldecorated and created a homely atmosphere. We saw a few bedrooms, which had been personalised. People who use the service said they were happy with the accommodation. The bathrooms now have blinds, which improves privacy. We noted people appear to have a choice of using liquid soap in a dispenser or a bar of soap. This increases the risk of cross infection and brought it to the attention of staff. We noted that staff lockers and the vacuum cleaner was stored between the lounge and dining area, where previously, the library and games were stored. Staff told us that people who use the service had not been consulted about the changes and there is a greater risk of trips or falls occurring as people move in and out of the lounge and dining room. One person told us they had complained about the noisy radiator but felt this had not been addressed. We looked at three staff files, all contained evidence of pre-employment checks consisting of two satisfactory references and a criminal records bureau (crb) check. This is check to assess the suitability of the applicant to work with vulnerable people. The records showed the range of training and experience of the staff, including training certificates. We found out that staff are required to completed an induction workbook within 3 months of starting employment. Two staff we spoke with said they have attained National Vocational Qualification (NVQ) level 2 and 3 in care and one member of staff has started NVQ 4. We found out that whilst staff do have team meetings every month, staff have not had supervisions. We found out that there is no Acting Manager managing Abington Park View. The service currently is overseen by the Quality Assurance and Development Manager, with the support of two Acting Managers of other services within Msaada Care Limited. We found that the monthly visits, known as Regulation 26 visits are conducted by the representative of the Responsible Individual. This demonstrates the internal system of reviewing and monitoring the quality of the service and compliance with the regulations and standards. However, were were unable to view these as there were not accessible at Care Homes for Older People Page 6 of 14 the home. We discussed with the senior representative from Msaada Care Ltd the important for recruiting an Acting Manager. They must submit an application to the CQC to become the Registered Manager for the service, as the new Health and Social Care Act 2008 Registration and Regulation comes into force later this year. What the care home does well: What they could do better: We found that people who use the service would benefit from better and timely access to health support, specifically the Chiropodist. Two people who use the service and visiting relatives told us since the appointment on 18th December 2009 was cancelled, they do Care Homes for Older People Page 7 of 14 not know whether another appointment had been made. The storage of controlled medication must be improved and advice must be sought from the Pharmacist to ensure the storage of controlled medication is in line with the British Pharmaceutical Regulations. People who wish to continue to manage their own medication must be better supported and provided with safe storage for medication. There should be evidence of the agreement in place for people to manage their own medication, an assessment of risk carried out and reflected in the care plan. This would ensure people continue to manage their medication safely and have safe storage in place within their own bedrooms, which is reviewed at regular intervals. People who use the service would benefit from having activities and social events available to them that is arranged by the home. People expressed to us that there are no activities arranged that they can take part in or look forward to. A number of activities were expressed to us and consistent with the social interests recorded in the care plans. This would promote peoples well-being and stimulation. There were some minor areas that require improving with regards to the environment. This includes the storage of staff lockers and cleaning equipment kept between the dining room and lounge and may pose a risk to people moving around independently. The noisy radiator, which has already been reported still requires addressing. The communal bathrooms and toilets have both liquid soaps in dispensers and bars of soaps. The use of bars of soaps in communal areas increases the risk of cross infection and places peoples health and well-being at risk. We found from speaking with the staff that they have since starting employment at the home have not received supervision. Staff must receive timely supervision with the person in charge, at regular intervals. There should be a programme of staff training to ensure staff skills and competency is in line with the homes policy, procedure and best practice. This includes training in safeguarding adults. This would ensure staff have the right skills, knowledge and experience to support the people who use the service that promotes their health, safety and well-being. The Regulation 26 reports must be kept at the home or made available to demonstrate the homes monitoring of the quality of the service. The most significant improvement Abington Park View must make is the appointment of an Acting Manager for the service. The Acting Manager must also apply to become the Registered Manager for the service. This is important as all health and social care services must meet the registration requirements for the new Health and Social Care Act 2008 coming into force this year. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 14 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 14 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 13 The Registered Person must 30/01/2010 ensure people who use the service have access to health support, which includes Chiropodist or Podiatrist services. This promotes peoples health and well-being. 2 9 13 The Registered Person must carry out an assessment of risk for people to manage their own medication and provide them with suitable secure storage. This ensures peoples safety and independence with managing their own medication. 30/01/2010 3 9 13 The Registered Person must have the correct controlled drugs storage that complies with the British Pharmaceutical Regulations. The safe storage of controlled medication ensures health and safety 30/01/2010 Care Homes for Older People Page 10 of 14 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 18 13 The Registered Person must consult people about the programme of activities arranged by the home for them to take part. This would stimuate and enable people to continue pursing their social and leisure interests. 30/01/2010 5 18 13 The Registered Person must 30/01/2010 ensure all staff are trained in safeguarding adults procedures, awareness of the forms of abuse and their responsibilities. This would protect the people who use the service. 6 19 13 The Registered Person must have suitable hand washing facilities are provided in communal bathrooms and toilets to prevent the risk of cross infection. This would ensure peoples health and well-being. 30/01/2010 7 19 13 The Registered Person must 30/01/2010 ensure the home environment is safe and in good state of repair at all times. This includes repair to the nosiy radiator and the storage of staff lockers and cleaning equipment. This would ensure the health and safety within the home. 8 30 18 The Registered Person must 30/01/2010 Page 11 of 14 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action ensure all staff are trained and there is a training programme in place to maintain the staff skills, knowledge and practice. This would promote the health and safety of people using the service. 9 31 8 The Registered Person must 15/02/2010 appoint a suitably qualified and experienced person to the position of an Acting Manager for the service. The details of the appointed Acting Manager and start date must be provided to CQC. This would ensure the service is managed and protects the health, wellbeing and safety of the people who use the service. 10 36 18 The Registered Person must ensure staff receive regular supervision and support. This would ensure people who use the service are protect by supervised staff. 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 30/01/2010 1 2 26 31 The Regulation 26 reports must be available at the home. The Acting Manager must submit an application to the CQC Page 12 of 14 Care Homes for Older People 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 to become the Registered Manager for the service. Care Homes for Older People Page 13 of 14 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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). 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