Care Home: Abraham House

Similar services:

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

What the care home does well Abraham House provides excellent personal and health care support for the people who live there. The manager and staff have good relationships with a range of health and social care professionals and this contributes to the provision of care based on a good understanding of the needs of the people living at Abraham House. The comments received from people living at the home, their relatives and health and social care professionals included: `When I first entered Abraham House I was immediately struck by the friendliness, warmth and genuinely caring attitude of the staff towards the residents.` `I strongly feel that the care staff and management , including the owners, do care about the residents in the home. The staff raise concerns if appropriate, act on advice and recognise when they are unable to meet the residents needs.` `I have met the new owners on three occasions and each time he has greeted me with courtesy and advised of any up and coming changes, indicating that the owners intend to ensure that relatives are kept up to date. In addition a newsletter has been distributed which is informative and ensures that those relatives who live some distance away and are therefore unable to visit regularly are also informed.` `The chef provides delicious home cooked food and Mum is gaining weight.` `The standard of food and catering is `top notch``. `I wish to place on record that the on going programme of expenditure has contributed to a much improved home.` `It a good place, they look after us well.` `Staff are good to us.` `The staff at Abraham House are `true carers.`` `The staff care for the residents with warmth and affection, always mindful of their individual needs and manage challenging behaviour appropriately.` `Staff seem to be well trained. The care staff do seem caring and interested in the residents.` Staff have regular opportunities to up date their skills. They are employed in sufficient numbers to meet the needs of the people living at the home. The manager and staff are committed to operating the home in ways which include the people who live there. A director of Europe Care Holdings Limited is actively involved in the running of Abraham House and is keen to gather ideas and suggestions about how to improve the home and the services offered. What has improved since the last inspection? The involvement of people who live at the home and their relatives in the planning of the care and support needed has improved. The care plans give clear guidance and are regularly reviewed, this ensures that people are supported in line with their needs. Europe Care Holdings Limited have been active in involving people who live at Abraham House and their relatives in their plans for the home. There have been regular meetings and the introduction of a newsletter to give information and to encourage involvement. The complaints procedure at the home has been simplified and well publicised. This has been made available in a range of formats including audio. Suggestions and views are actively sought by the manager and by the Director of the company and are acted upon. The refurbishment and upgrading of Abraham House has begun and there is a prioritised plan for continuing improvements. The staff are keen to carry out improvements in line with current research and advice for providing good environments for people who have dementia. The manager has been able to devote her undivided time to Abraham House and this has enabled her to monitor and improve the quality of care and administration at Abraham House. Staff feel well supported. The systems in place for monitoring the quality of care at the home have been improved. These ensure that all aspects of the care provided, the operation and safety of the home are monitored. The company which has purchased the home have worked hard to establish an open management style where people feel valued and are confident that their views will be listened to. What the care home could do better: The home was found to be meeting or exceeding the National Minimum Standards, which are good practice guidelines which are underpinned by legal requirements, assessed during this key inspection. Europe Care Holdings Limited, the manager and staff of Abraham House have significantly improved the service and aspire to continually building on their achievements. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abraham House 515 Blackpool Road Ashton-on-Ribble Preston Lancashire PR2 1EQ     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Felicity Lacey     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Abraham House 515 Blackpool Road Ashton-on-Ribble Preston Lancashire PR2 1EQ 01772721102 01772721102 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Gillian Francesca Saint Type of registration: Number of places registered: Europe Care Holdings Limited care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of people who can be accommodated is: 30 Date of last inspection Brief description of the care home Abraham House is a care home for people with dementia. The home is situated in Ashton a residential area on the outskirts of Preston. It is easily accessible by public transport. The home is close to local ameneties, shops and health care facilities. The accommodation is over two floors and the home is served by a passenger lift. There are 26 single rooms and two double rooms that are used as single occupancy. The Care Homes for Older People Page 4 of 30 Over 65 0 30 30 0 Brief description of the care home communal areas are situated on the gound floor and comprises of two lounge areas and a dining room. There is an enclosed garden to the rear of the home and a paved patio area. The home is under new ownership. Europe Care Holdings Limited took over Abraham House in August of 2008. Information about the home and fee levels are available from the manager. Care Homes for Older People Page 5 of 30 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: three star excellent 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 inspection included an unannounced visit to Abraham House. Prior to the visit information was provided by the manager of the home in an Annual Quality Assurance Assessment (AQAA), this is a record of how the service provided at Abraham House meets the standards set out in law and good practice guidance. Surveys were sent out to people living at the home, staff and selected health professionals. Two letters of support were received from relatives of people living at the home. During the visit people who live at Abraham House, their relatives, visiting health professionals, staff, the manager and a Director of Europe Care Holdings Limited were spoken with. An Expert by Experience was involved in this inspection. This is a person who because of shared experience of using services and/or ways of communicating, visits with an inspector to help them get a picture of what it is like to live in a care home or use a Care Homes for Older People Page 6 of 30 service. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 30 The involvement of people who live at the home and their relatives in the planning of the care and support needed has improved. The care plans give clear guidance and are regularly reviewed, this ensures that people are supported in line with their needs. Europe Care Holdings Limited have been active in involving people who live at Abraham House and their relatives in their plans for the home. There have been regular meetings and the introduction of a newsletter to give information and to encourage involvement. The complaints procedure at the home has been simplified and well publicised. This has been made available in a range of formats including audio. Suggestions and views are actively sought by the manager and by the Director of the company and are acted upon. The refurbishment and upgrading of Abraham House has begun and there is a prioritised plan for continuing improvements. The staff are keen to carry out improvements in line with current research and advice for providing good environments for people who have dementia. The manager has been able to devote her undivided time to Abraham House and this has enabled her to monitor and improve the quality of care and administration at Abraham House. Staff feel well supported. The systems in place for monitoring the quality of care at the home have been improved. These ensure that all aspects of the care provided, the operation and safety of the home are monitored. The company which has purchased the home have worked hard to establish an open management style where people feel valued and are confident that their views will be listened to. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 10 of 30 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 systems in place to assess individual needs and to introduce people to Abraham House ensure that the care needs of people are understood and met. Evidence: The people who completed surveys and who gave their views felt that they had enough information prior to moving to Abraham House to enable them to make an informed decision. One person wrote Before deciding on a home for my relative I visited other homes in the area. When I first entered Abraham House I was immediately struck by the friendliness, warmth and genuinely caring attitude of the staff towards the residents. People who may come to live at Abraham House are encourage to visit and spend time at the home to get a feel for the place. They can have a meal and stay for a few hours, this helps to reduce anxiety and allows an opportunity to become familiar with people and surroundings. The relatives spoken with during the visit had found that they had been fully involved in the admission Care Homes for Older People Page 11 of 30 Evidence: process and offered reassurance and support by the manager and staff during what is a very difficult time. The statement of purpose has been written to reflect the change in ownership and to set out information about the home in a clear way. It includes comments from people who have experience of having relatives living at Abraham House. The principles of care are included in the Statement of Purpose and this helps people who are considering coming to live at the home or their relatives understand the standards they should experience whilst living at Abraham House. The Statement of Purpose is available in a range of languages, large print and has recently been produced in Audio format for people who may have sight or reading difficulties. The pre admission assessments seen on peoples files showed that information about all aspects of a persons health and personal care needs is gathered. The views of the person thinking of moving to the home are also sought and in this way people are encouraged to express their hopes and expectations. For some people with dementia their relatives have been a key source of information, and evidence was seen of their involvement in the admission process. The pre admission assessment could be improved by the introduction of a Mental Capacity Assessment, this would help identify the areas in which a person has capacity to act independently and those where support is needed. This type of assessment recognises that dementia and associated conditions effect people in different ways and emphasises the impact on the individual and promotes their continued independence in the areas of daily living where this is possible. There are occasions when a person may need to move to the home in an emergency, in all cases a senior member of staff would carry out an assessment and if the move was in the best interest of the person, all other information would be gathered without delay. During the visit an emergency admission was discussed with a visiting consultant psychiatrist, who felt that the staff of the home were very skilled in recognising and responding to the care needs of people and this helped reduce upheaval and anxiety when a person came in an emergency. His comments were also echoed by a placing social worker who felt that she would approach the home in the first instance should an emergency admission be needed, as she was confident in the skills of the staff team and their experience in supporting people with dementia and other associated conditions. Care Homes for Older People Page 12 of 30 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 excellent 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 that people receive is based on an understanding of their individual needs. The principles of respect, privacy and dignity are put into practice so people living at Abraham House can be confident that they will be well cared for. Evidence: Each person living at Abraham House has a care plan which sets out support and assistance needed in all aspects of personal and health care. The care plans include preferences about support during both day and night. The care plan builds on initial information gathered at the time of admission and includes advise and input from other professionals involved. The manager has been active in ensuring that care plans are agreed and signed by people who live at the home or by their representatives. She has written to relatives to request that they take time to read the care plan. In this way the manager is demonstrating the importance of working to an agreed plan of care, this provides consistency and ensures that a persons needs can be fully understood. The relatives spoken with during the visit confirmed that they had been involved and that they were kept fully informed of any changes to the health and Care Homes for Older People Page 13 of 30 Evidence: personal care needs of their relative. There are a number of other assessments which are completed when needed, such as nutritional assessments, with monitoring records and skin integrity. Some people have agreed to be involved in an initiative which is a called The Priorities of Care, this is a way in which people can be involved in planning their future care should their health deteriorate. Examples were seen of these plans being used, the plan gives the opportunity for people to think and talk about their preferences and priorities for care at the end of life, including peoples wishes about being admitted into hospital and where they would prefer to have treatment. These plans are reviewed regularly by the person and their relatives to make sure that their priorities and choices remain the same. The case files seen during the inspection demonstrated that the staff were active in identifying individual needs and working with people to identify their preferred ways of being supported. One person who has experienced a rapid loss of sight has been supported by staff to continue to live at the home. Specialist advise and equipment has been provided by the Royal National Institute for the Blind. Staff have undertaken sensory deprivation training, where they had the opportunity to experience the impact of loss of sight. The care plan gives good advice about how to communicate with the person asking people to speak clearly at all times, do not shout as he is visually impaired not deaf. The importance of appreciating a persons social history is also recognised and care plans include a section in which key events and life experiences are recorded. For some people information has been given by relatives and friends and this helps ensure that staff have a rounded picture of a person, in this way it is the person, rather than their diagnosis, that is central to the care provided. Staff appreciate and understand the impact of dementia and other associated conditions. There were example of observed practice which showed that staff understood a persons previous experiences and respected the importance of this, for example one person had worked in a local factory and had previous lived in another part of the country, he liked to talk about these things and staff were aware of these interests. The health and wellbeing of people living at the home is actively promoted. The manager is involved in a number of initiatives with local health services which provide excellent opportunities for health monitoring and person centred approaches to the health needs of individuals. The home benefits from being involved in a Primary Care Trust pilot scheme, Care Home Effective Support Scheme (CHESS) which provides Nurse Practitioner support for one day a week at Abraham House. During her time at the home peoples health needs are reviewed, she is able to give advice and Care Homes for Older People Page 14 of 30 Evidence: information to relatives and staff. The opportunity is taken to consider each persons health needs. The manager and staff are committed to reducing the use of sedative medication. The expert by experience who visited the home commented It is the staff policy to get as many residents as possible off sedation so they can have as full a life as possible. I did not see anyone lounging in a long deep sleep in either of the homes lounges. Comments from a health professional confirmed that staff seek advice when needed and work in partnership to provide for the health needs of people living at the home, she went on to state I strongly feel that the care staff and management , including the owners, do care about the residents in the home. The staff raise concerns if appropriate, act on advice and recognise when they are unable to meet the residents needs. Another example of excellent health care at Abraham House is the approach taken to obtaining blood samples from people who have dementia and confusion. The success rate for this was very low when visiting District Nurses or health practitioners tried to obtain blood samples, in response to this the manager has completed Phlebotomy training is authorised to take blood samples in the presence of a supervising nurse. This has proved very successful as people living at the home are not resistant to a familiar person taking the blood sample. This has enabled samples to be taken and appropriate treatments to be put in place. During the visit a GP came to the home and clearly had a good relationship with senior staff which enabled open and frank discussion about difficult topics around health care for people with dementia. A social worker who also commented felt that staff were committed to securing the best outcomes for people at Abraham House and at times this led to discussion with other involved health and social care professionals, she felt that in these instances she had seen the staff and manager actively promoting the best interests of people at the home. The manager and staff benefit from close links with the Primary Care Trust (PCT ) Pharmacy adviser who carries out regular audits of medication. There are sound systems in place to audit the receipt, administration and return of medication. All senior staff have completed advance medication training. The records seen were completed accurately. Staff spoken with confirmed they had received training in the safe administration of medication. The Expert by Experience spent time with people who live at Abraham House and she found that people were treated with respect and dignity. She commented Staff treat residents as one big family, and I heard it said more than once it is their home. Care Homes for Older People Page 15 of 30 Evidence: Residents were taken to the toilet at regular intervals to avoid accidents, but this was done so discretely I doubt if a visitor would notice. Relatives spoken with felt that privacy and dignity were respected, and this was also the view of health professionals spoken with during the visit to the home. Care Homes for Older People Page 16 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities programme is continuing to develop and this provides social opportunities for people living at the home. The dietary needs of people living at the home are understood and this promotes health and well being. Evidence: The people living at Abraham House or their relatives are encouraged to complete a comprehensive questionnaire which looks at wishes and abilities relating to social, cultural, religious and personal expectations. Examples of these lists were seen on peoples case records. There is a structured but flexible programme of activities, which has included visiting entertainers, visits out in the warmer weather to the local park and seasonal celebrations. A newsletter has been introduced and this actively encourages people to become involved in social events and helps keep people informed of up and coming events. The last newsletter contained reports of the Halloween Party and gave the Christmas Programme of events. There is an activities coordinator at the home who has attended training to help with ideas for activities for people who have dementia, she is enthusiastic and outgoing. The owners have plans to improve the way in which activities are approached and Care Homes for Older People Page 17 of 30 Evidence: organised, they plan to provide staff training on the importance of activities, gather views of people living at the home and relatives about what activities they would like and monitor satisfaction levels through the quality assurance questionnaires that are used. The people living at the home are being encouraged to become involved in planning and leading activities, for example one lady is being supported to arrange and hold a bingo session. Some people are also involved in every day chores around the home, this helps to maintain independence and feelings of self worth. The Expert by Experience spent time talking to people about activities and found that there was interest in more activities being held at the home. There are some activities that are enjoyed by some people, for example a small group of ladies were having their nails done, but not everyone could participate in this activity. The challenges of providing meaningful social activities for people living at the home are appreciated by the staff, and they are keen to continue to develop both one to one and group activities. The people living at Abraham House are supported to follow the religion of their choice. Currently the home has arrangements with ministers from three denominations, who visit the home regularly. People living at Abraham House are encouraged to maintain control over their own affairs for as long as they are able to do so. The manager can provide advice of the options available to people once this is no longer possible. The relatives who contributed to this inspection were very positive about the ways in which they were treated on visiting and kept informed of events at the home. Relatives have been involved by the new owners and there have been a number of relatives meetings. One relative wrote I have met the new owners on three occasions and each time he has greeted me with courtesy and advised of any up and coming changes, indicating that the owners intend to ensure that relatives are kept up to date. In addition a newsletter has been distributed which is informative and ensures that those relatives who live some distance away and are therefore unable to visit regularly are also informed. All the people spoken with and who sent comments considered the food to be very good. The comments included: The chef provides delicious home cooked food and Mum is gaining weight. The standard of food and catering is top notch. Care Homes for Older People Page 18 of 30 Evidence: Breakfast time is flexible depending on personal preferences. There is a choice of hot and cold foods. At lunch time there is a set menu, but an alternative would be provided if requested. The manager is currently finalising a four week menu. Tea is at 5 oclock which is a savoury snack and sweet. There is hot drinks and biscuits served in the evening. A number of people living at the home find it difficult to settle at night, and some enjoy to come down stairs and have a drink and snack with the night staff. The staff training programme includes training about Nutrition and Dementia. People on specialist diets are supported and records are maintained to monitor their food and fluid intake as required. Care Homes for Older People Page 19 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are complaints and adult protection policies in place, which are actively promoted by staff this means that the welfare of people at Abraham House is promoted and protected. Evidence: The people spoken with and who gave their views during this inspection, knew how to raise a concern or complaint. The complaints policy is well publisized throughout the home. The complaints policy is also available in audio format. It is also available in a variety of languages. The language used in the complaints procedure is simple and encouraging, inviting people to make any concerns known. Relatives spoken with felt confident that staff would listen to any concerns they may have. Staff are aware of how to deal with complaints. The Commission for Social Care Inspection have not received any complaints since the home changed ownership. The manager maintains a record of complaints and action taken in response to complaints raised directly with her. The Director of the company which owns Abraham House is very active in spending time with the people who live at the home and their relatives. He is keen to discuss any concerns and is active in seeking views of how the home may be improved, this was confirmed by relatives spoken with during the inspection. All staff have completed Abuse Awareness training and Protection of Vulnerable Adults. Staff have undertaken training about supporting people who have challenging Care Homes for Older People Page 20 of 30 Evidence: behaviours. The importance of adult protection is emphasised in the staff handbook which contains information about how to stop, report and deal with any suspected abuse. The manager and staff are aware of local safeguarding procedures and have demonstrated that they understand these by making appropriate referrals and working in partnership with social and health care services to ensure that people are protected. Care Homes for Older People Page 21 of 30 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. Abraham House is clean and comfortable providing a safe and pleasant place for people to live. Evidence: Abraham House is pleasant and clean. There is a planned programme of maintenance and refurbishment. The new owners have ensured that the building meets health and safety requirements. The home has been thoroughly cleaned, the fire doors have been replaced and there has been redecoration and refurbishment of some rooms. There have been a number of bedrooms which have been refurbished, using good quality decor and furniture. The refurbishment is being planned to cause the minimum of disruption and inconvenience for people living at the home. New bedding and curtains have been purchased. Table clothes, runners and napkins have also been ordered. The improvements made so far were commented on by people who gave their views during this inspection, one relative commented I wish to place on record that the on going programme of expenditure has contributed to a much improved home. There has been work undertaken to improve the garden areas and exterior of the home. There are plans to build a conservatory and make the garden area fully Care Homes for Older People Page 22 of 30 Evidence: accessible. Staff have received training in infection control. The building has been thoroughly cleaned and all surfaced have been disinfected. There are hand washing facilities, paper towels and pump dispensers located through out the building. Protective aprons and gloves are available to be used when needed. In this way a clean and hygienic environment is provided which protects the health of people living at Abraham House. Care Homes for Older People Page 23 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff at Abraham House are experienced and competent and this promotes the welfare and wellbeing of the people living at the home. Evidence: The people living at Abraham House and their relatives felt there were always enough staff on duty. The staff were regarded as kind, helpful and committed to the people living at the home. Comments received from people living at the home, relatives and professionals included: It a good place, they look after us well. Staff are good to us. The staff at Abraham House are true carers. The staff care for the residents with warmth and affection, always mindful of their individual needs and manage challenging behaviour appropriately. Staff seem to be well trained. The care staff do seem caring and interested in the residents. Care Homes for Older People Page 24 of 30 Evidence: The recruitment process of the home are being reviewed. The staff records seen contained the required checks and clearances. There are plans to involve people living at the home in the recruitment of new staff. The staff group is quite stable, with many staff having worked at Abraham House for a number of years. The staff spoken with feel that there is good morale among the staff and that the home is a good place to work. There are currently 13, out of 17, staff who have achieved a National Vocational Qualification in Care at level 2 or above, this is the recommended qualification for people working on social care. There is regular staff training, and staff spoken with felt encouraged and supported in the training they undertook. Recent training has included, Infection Control, Report Writing, Dementia Awareness, End of Life Care and Equality and Diversity. There are plans to install a new computer which will allow staff access to further training and development. Care Homes for Older People Page 25 of 30 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. Abraham House is managed in a open and inclusive way,involving the people who live at the home and their relatives and this creates an atmosphere in which people living at the home, relatives and staff feel valued and that their opinions matter. Evidence: The manager is experienced and has provided continuity during the change of ownership. She has completed the Registered Managers Award. At the previous inspection the manager was covering management duties at another home, this has now ceased, she is now at Abraham House full time and this arrangement has helped to improve the standards at the home. The people spoken with during this inspection considered the manager to be approachable and committed to continually improving standards at the home. She is assisted by the deputy manager, who has many years experience, and who is also considered by the people at Abraham House to be a dedicated and responsive senior Care Homes for Older People Page 26 of 30 Evidence: member of staff. There a four senior staff who have completed additional training, including First Aid at Work and Team Leader training. The people living at Abraham House and their relatives are very pleased with the active and personal approach taken by Europe Care Holdings Limited. A director of the company visits frequently and he has held regular relatives meetings, he has introduced a newsletter which encourages involvement and celebrates achievements and events that have occurred at the home. People spoken with during the inspection found his approach to be open and that he was responsive to any suggestions and comments made. Abraham House has retained Investors in People status, this is a quality assurance award which recognises the support and training provided for staff. The company has introduced quality audits, which are carried out on a regular basis these include checks that are carried out daily, weekly, monthly and quarterly. The records of visits made by the Director under Regulation 26 of the Care Homes Regulations were seen during the visit to Abraham House, these demonstrate that the company is aware of the standards of quality at the home. There have been regular surveys of the views of people living at the home and their relatives, there are plans to revamp these surveys to encourage people to be able to make suggestions and identify both areas where they are most satisfied and where they feel that improvements could be made. The people living at Abraham House are responsible for their own financial affairs. The manager does not act as a appointee for any person. Information is available to help people make arrangements if needed for the administration of their finances if they are no longer able to retain independent control. The required health and safety training has been completed by staff at the home. This included Moving and Handling, Fire Safety and Abuse Awareness. The information provided in the AQAA indicates that the regular health and safety checks have been completed and equipment serviced. The accident book was seen at the visit. this was completed correctly. the manager audits this record to identify any trends or hazards, and any action that is needed to prevent further accidents occurring. Care Homes for Older People Page 27 of 30 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 28 of 30 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 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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. 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