Care Home: Lifestyle (Abbey Care) Limited - Elizabeth-Swale

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What the care home does well People have their needs assessed and are encouraged to visit the home before they decide to move in. This helps to make sure it is the right place for them to live. People receive the care they need from caring and friendly staff. People told us that they were happy with the care being provided, with comments including `the caring staff at Elizabeth House are extremely kind to the residents. They show a lot of love and get to know and understand each resident personally`, `provides friendly care, with good and positive interaction between staff and residents`, `the residents are always clean, tidy and well dressed` and `staff appear to have a dignified approach when dealing with residents`. People have access to some activities and events, can have visitors when they want and are provided with regular drinks, meals and snacks. The home has recently started to prepare meals and snacks on the premises, rather than relying on pre-cooked meals supplied by a local hospital. People were very positive about this with comments including `the food is a lot better, it`s great and we have lots of clean plates now`. People have a clean and comfortable place to live in. The Swale unit has recently been refurbished and redecorated and improvements have also been made to Elizabeth House. People`s comments to us about the home`s environment included `there is a clear improvement recently in efficient cleaning of rooms and public areas` and `the very unpleasant smell that was always noticeable on entering the unit seems to have been sorted out as it is not there now`. Staff are recruited safely and provided with ongoing training to help them do their jobs. Staff we spoke to felt that they had the opportunity to attend appropriate training and people told us that the staff were friendly and caring. The home benefits from management who have a clear idea of its strengths and weaknesses and have plans in place to keep making it better for the people who live there. People`s comments included `the appointment of a new manager has greatly improved day-day services`, `the care home has a new manager and things seem to be looking up, like the smell of the home, seems to be more staff about`. What has improved since the last inspection? This was the first inspection of Lifestyle (Abbey Care) Limited`s Elizabeth and Swale units since they were registered under this company. What the care home could do better: The new management have implemented a new documentation system for care needs assessment and planning. The records we looked at were comprehensive and up to date, but they haven`t yet been put in place for everyone who lives at the home. Activities and social events were the main areas that people who returned surveys said they wanted the home to improve. Comments made to us in surveys included `there appear to be very limited activities organised or motivation for the residents` and `there is not much evidence of regular activities`. However, a new activities coordinator has started to work in the home since these comments were made.People told us that there were sometimes problems with the laundry service, but the management were already aware of this and were making changes to improve things. Key inspection report Care homes for older people Name: Address: Lifestyle (Abbey Care) Limited - Elizabeth-Swale Abbey Care Village Scorton Richmond North Yorkshire DL10 6EB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rachel Martin     Date: 2 1 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Lifestyle (Abbey Care) Limited - ElizabethSwale Abbey Care Village Scorton Richmond North Yorkshire DL10 6EB 01748818307 01748812345 info@abbeycarevillage.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Lifestyle (Abbey Care) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 54. 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. Dementis: Code DE. Date of last inspection Brief description of the care home This service consists of the Elizabeth House and Swale units at the Abbey Care Village site, located in Scorton. The service is owned and managed by Lifestyle (Abbey Care) Limited and is registered to provide residential care for up to fifty-four people who have dementia. The home is split into two seperate units, with the accommodation provided on three floors. Passenger lifts provided easy access to all floors and there Care Homes for Older People Page 4 of 25 Over 65 0 54 Brief description of the care home are gardens and parking available. Up to date information about the homes fees and terms and conditions should be sought from the homes management. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of Lifestyle (Abbey Care) Limited - Elizabeth Swale. The service was re-registered under this name on 10th February 2010, because of some legal changes to the company that owns the service. The service consists of the Elizabeth House and Swale units, which are part of the Abbey Care Village site in Scorton. Before our visit we looked at all of the information we had about the service. This included a self-assessment that we had asked the management to complete and surveys that had been completed by people who use the service and their relatives. This information was used to plan our site visit. The site visit took place on Friday 21st May 2010 and was completed by two inspectors. During our visit we looked around the service, observed the care being provided, talked to some of the people who use the service and some of the staff who Care Homes for Older People Page 6 of 25 work there. We also spent time with the management and looked at a selection of the services records. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: The new management have implemented a new documentation system for care needs assessment and planning. The records we looked at were comprehensive and up to date, but they havent yet been put in place for everyone who lives at the home. Activities and social events were the main areas that people who returned surveys said they wanted the home to improve. Comments made to us in surveys included there appear to be very limited activities organised or motivation for the residents and there is not much evidence of regular activities. However, a new activities coordinator has started to work in the home since these comments were made. Care Homes for Older People Page 8 of 25 People told us that there were sometimes problems with the laundry service, but the management were already aware of this and were making changes to improve things. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed and are encouraged to visit the home before they decide to move in. This helps to make sure it is the right place for them to live. Evidence: The homes management told us that people can come to look around and have their needs assessed before they move in, to make sure that the home can meet their needs and is the right place for them. The home hasnt had any new admissions since our last visit, but the care records we looked at during our visit included assessments that had been completed before people moved into the home. They also contained information that had been provided by other profesionals involved in the persons care. For example, the hospital or local authority. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care they need from caring and friendly staff. Evidence: Since our last visit the new operations manager for the Abbey Care Village has introduced a new format for peoples care records. Everyone at the home doesnt yet have the new care records fully in place, but the records we looked at provided a good picture of peoples care needs, using a comprehensive system of assessments, risk assessments and care plans. The records had been reviewed regularly and were being kept up to date. The records also showed that people had been involved with their doctor, nurse or other health professionals when needed. Staff we spoke to had been involved in setting up the new care records and staff felt that the new records made it easier to find information. During our visit we spent time on the Elizabeth and Swale units, observing the care and support that was being provided. Staff were making sure that the communal areas of the home were being supervised and we saw that staff spent time talking and interacting with people in a pleasant way. People told us that they were happy with Care Homes for Older People Page 12 of 25 Evidence: the care being provided, with comments including the caring staff at Elizabeth House are extremely kind to the residents. They show a lot of love and get to know and understand each resident personally, provides friendly care, with good and positive interaction between staff and residents, the residents are always clean, tidy and well dressed and staff appear to have a dignified approach when dealing with residents. During our visit we looked at the way medication was stored and administered on both units. We found that medication was being stored safely and found that the new air conditioning system was maintaining the treatment room at appropriate temperatures. The records we checked showed that people were receiving their medication when they needed it and systems were in place to make sure that any changes in medication dosages were carried out correctly. For example, changes to Warfarin doses. We also saw the records of the medication audits that management are completing regularly. These checks help to make sure that medication is being managed safely at the home. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to some activities and events, can have visitors when they want and are provided with regular drinks, meals and snacks. Evidence: The previous activities coordinator left suddenly, but there is now a new activities coordinator for the Elizabeth and Swale units, who helps to coordinate the activities and social events at the home. The homes management has recently increased their working hours and they are now employed for 37 hours a week, sharing these hours across the two units. However, activities and social events were the main areas that people who returned surveys wanted to improve. Comments made to us in surveys included there appear to be very limited activities organised or motivation for the residents, more activities to suit the needs of the residents, appropriate to individual needs are required, there is not much evidence of regular activities and provide more activities, Ive not seen the activities organiser for several weeks. When we discussed this with the management it became clear that the surveys had been completed around the time that the previous activities coordinator had suddenly left the home and before alternative arrangements had been made. During our visit the activities coordinator was working in the home, with activities including movies and craft. We also saw the care staff helping people to sit outside in the garden and Care Homes for Older People Page 14 of 25 Evidence: spending time talking to people individually and in groups. The home allows visitors to come and see their friends or relatives with out any unnecessary restrictions. Comments made to us by relatives included visitors are made to feel welcome and usually offered a drink, caring atmosphere when we visit, both to us and the residents and they make all visitors welcome. The homes meals are now freshly cooked in the Abbey Care Village kitchens. On the day of our visit we observed the lunchtime meal. The kitchen staff brought the meals over to the home in a hot trolley, so that they were kept hot until served. People had the choice of fish and chips with peas or chicken and vegetable pie with mashed potatoes for their main course. The food looked nice and there appeared to be plenty to go around. There was rice pudding for desert, which was served with jam. Comments made to us included the food is a lot better, its great and we have lots of clean plates now. Staff asked people if they wanted salt, pepper, tomato sauce or vinegar and sat next to people who needed help to eat. They encouraged people nicely and offered different foods to try and encourage people to eat more. Some people ate in the dining room, while others ate in their rooms. Staff we spoke to also confirmed that people get regular drinks and snacks during the day. We saw staff regularly offering people cold drinks and saw that people were given hot drinks mid morning and mid afternoon. The care records we looked at included nutritional risk assessments and showed that people had received help from a dietitian if this was needed. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the home procedures and staff training on handling complaints and allegations. Evidence: The home has a complaints procedure, telling people how to make a complaint. Copies of this were displayed in the home during our visit. There have been six complaints made to the home in the last twelve months and no complaints made directly to CQC. A complaints record is kept, showing how complaints have been addressed. Staff have received training on safeguarding adults and the management were able to tell us how any incidents or allegations would be reported. Since our last visit the home has informed us of incidents appropriately and has reported any safeguarding concerns to the local authority. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a clean and comfortable place to live in. Evidence: The Elizabeth and Swale units are run as two different units and are located in different parts of the Abbey Care Village. Elizabeth House is located on the ground floor and Swale Suite is located on the second floor. Since our last visit the Swale unit has been refurbished and redecorated and is now back in use. During our visit it was clean and tidy and provided people with a pleasant and homely place to live. However, it was a hot, sunny day when we visited and we noticed that the dining room had become very hot at lunch time, with staff and residents expressing discomfort during the meal. Elizabeth House has also had improvements carried out since our last visit. For example, all en-suite bathrooms now have hygienic floor coverings and the floor coverings in the corridors have been replaced. A new air extraction system has also been installed to improve the ventilation and air quality. During our visit we found that the unit was clean, tidy and smelled much fresher than on previous visits. Unpleasant odours were still apparent in three bedrooms, despite the carpets having been cleaned and sterilised since our last visit. However, the manager confirmed that replacement flooring is now being purchased for these rooms. Care Homes for Older People Page 17 of 25 Evidence: Peoples comments to us about the homes environment included there is a clear improvement recently in efficient cleaning of rooms and public areas and the very unpleasant smell that was always noticeable on entering the unit seems to have been sorted out as it is not there now. The bedrooms we looked at had been made personal and homely. They included peoples own possessions and had peoples names and pictures that they could recognise on their doors. The communal areas looked comfortable and there was an activities table in the lounge with puzzles and games, so that people could pick things up and benefit from a more stimulating environment. A sensory room, with moving and coloured lights, has also been provided for people to use. People told us that there are sometimes problems with the laundry service, with comments including the laundry service falls short of what is needed: Clothes are washed inappropriately - some are then unwearable and others go missing, despite labels. We spoke to the management about this and found that they were already aware of peoples concerns and were able to tell us about the steps being taken to improve the laundry service. The management have also introduced a new infection control audit, to make sure that people are being adequately protected from the spread of infection. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are recruited safely and provided with ongoing training to help them do their jobs. Evidence: We checked the recruitment records for two recently recruited staff members. We found that all of the appropriate checks and information had been obtained before the staff member started to work in the home. We talked to the management and other staff about the staffing levels that are provided at the home. We also looked at the staff rotas and observed staffing levels while we were visiting. More staff have been recruited, making it easier for the manager to cover shifts if people are on holiday or off sick. The rotas we looked at showed that staff were being provided in appropriate numbers, with one-to-one staffing arrangements being covered where this had been agreed. In their self-assessment the management told us that twenty-five out of the homes thirty-one permanent care staff had already achieved a National Vocational Qualification (NVQ) in care. Staff we spoke to felt that they had the opportunity to attend appropriate training. The homes training plan showed that training in a range of subjects, including important health and safety related topics, has taken place and is planned throughout the coming year. The home employs a specialist training Care Homes for Older People Page 19 of 25 Evidence: provider to deliver its training programme. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from management who have a clear idea of its strengths and weaknesses and have plans in place to keep making it better for the people who live there. Evidence: Since the last inspection an operations manager has been recruited, to oversee all of the services at the Abbey Care Village. This person has a lot of experience of managing care services and now provides managerial support to the manager of Elizabeth and Swale. The manager of Elizabeth and Swale had submitted an application for registration with us, but this had to be returned due to the cheque being out of date. The manager assured us that it would be re-submitted very soon. People we spoke to during our visit felt that the homes manager was approachable. They were also aware of who the new operations manager was and told us that they found him helpful, supportive and approachable. Peoples comments included the appointment of a new manager has greatly improved day-day services, the care home has a new manager and things seem to be looking up, like the smell of the Care Homes for Older People Page 21 of 25 Evidence: home, seems to be more staff about. It was evident that improvements had already been made and when we talked to the homes management during our visit they had a good understanding of the ongoing improvements they wanted to make. The home will help people to manage a small amount of personal money. Each person has their own records and money, which is stored securely. We checked the records for one person. There were appropriate receipts available and the records and balance of money available were correct. A new quality assurance system is currently being implemented at the home. The manager told us how a new system of checks and audits is now regularly completed. These include regular room checks, infection control checks, medication audits, care plan audits and seeking peoples views through regular surveys and meetings. Records also showed that there have been staff meetings, to discuss and inform staff about the changes and improvements that have been made at the home. We looked at a selection of maintenance and health and safety records. Records showed that the maintenance person carries out regular checks to make sure that the fire alarm and emergency lights are in good working order. The self-assessment told us that inspections and servicing had been completed on the homes lifting equipment in November 2009 and the homes fire alarm in April 2010. A specialist company had visited the home and completed a fire audit and risk assessment in March 2010. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 All of the people who live at the home should have the new care needs assessment and planning documentation fully in place. The management should continue to monitor and review the provision of activities and social stimuation in the home, making sure that any necessary improvements are made. Replacement flooring should be provided in the bedrooms where carpet cleaning and sterilisation has not been effective at removing the unpleasant odours. The management should continue to monitor and improve the laundry service, to ensure that people are receiving a reliable and quality laundry service. The homes manager should re-submitt her application for registration as soon as possible. 2 12 3 19 4 26 5 37 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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