Inspection on 09/05/06 for Aadams Residential Care Home

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Aadams Residential Care Home 01/10/08

Aadams Residential Care Home 20/11/07

Aadams Residential Care Home 11/05/07

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Aadams Residential Care Home Peel Hall Street Deepdale Preston PR1 6QN Lead Inspector Ms Susan Dale Unannounced Inspection 9th May 2006 10:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aadams Residential Care Home Address Peel Hall Street Deepdale Preston PR1 6QN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01772 258977 Mr Salim Adam Miss Sharon Jean Brooks Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 12 service users in the category OP (older persons 65 and over) N/A Date of last inspection Brief Description of the Service: Aadams Residential Care Home was first registered in November 2005 to provide personal care to 12 older persons. Formally a Local Authority Residential Home, the building is purpose built on 2 levels and is located close to the city centre of Preston. The building has been considerably improved and adapted in order to meet the environmental standards necessary for registration. All the bedrooms have en-suite bathrooms and there are several lounges including a smoking room, dining room and bathrooms. The owner/responsible individual has ensured that the décor, furniture and fittings are of a high standard. Currently only the ground floor is registered for service users and the owner hopes to complete the upper floor and increase the number of service users, subject to registration, in the near future. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 2 days. There is currently no registered manager and the inspector spoke to the acting manager and the registered owner as well as service users, staff, relatives and health professionals. A tour of the premises took place and various documents relating to both service users and staff were examined. Comment cards were provided to service users, relatives/visitors and health professionals prior to the inspection and their views were taken into account. What the service does well: What has improved since the last inspection? Not applicable Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, & 5 Quality in this outcome group was adequate. There are missing gaps in the documentation available which needs to be reviewed and put in some order. There was evidence of an initial assessment. EVIDENCE: The Statement of Purpose and Service User Guide have not been updated since registration and they need to be updated with the current staffing levels and qualifications of the staff. There was no evidence of a written contract apart from the contract issued by the local authority for services funded by Social Services. There was evidence of an initial assessment that leads to a plan of care which covers physical requirements but could do with some expansion on social interests, hobbies, religious and cultural needs and should be signed and dated. A form is included for activities but had not been completed. The assessment also examines any risks including falls. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 9 According to the Acting Manager, prospective service users are able to come into the home on trial before they make a decision to stay on a permanent basis and this was confirmed by the service users spoken with. A comment was made by a relative: “My Aunt after refusing to go into care for many years agreed to enter Aadams Residential Care Home on a trial basis and after 3 days decided to stay and is very happy there”. The home does not provide intermediate care. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome group was good. The service users’ health and care needs are being met appropriately and staff treat service users with respect and dignity. A record needs to be kept of any review of the care plan. EVIDENCE: Each service user has a plan of care that is well laid out and covers physical and health requirements; the documentation did not cover hobbies, interests, and cultural or religious requirements although there is a form for the purpose of recording the information. The documentation needs to include the preferred name of the service user and a signature should be obtained from the service user or their representative to show their approval of the care plan. There was no evidence that a review had been carried out although the acting manager stated that it was being done but had not been recorded. There is a need to make a record each time a review is carried out and of any changes to the care plan. A record is kept of visits from health professionals. A record of weight is maintained however the records seen had not been kept up to date. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 11 Service users spoken with confirmed that staff respect their privacy and dignity particularly with regard to personal care. The procedures within the home are relaxed and service users can get up and go to bed assisted by staff at any time they wish. Visitors to the home are welcome at any time. The medication procedures and storage were examined. Three senior staff are trained to provide medication and according to the acting manager are to attend further training. The medicines are stored in a dedicated room and any controlled drugs are stored in a separate drugs cupboard that has a double lock; the cupboard is to be changed for more secure metal cupboard and controlled drugs register is on order. The record of medication provided was examined and found to be up to date and in good order. A comment card returned from a General Practitioner was very positive and District Nurses spoken with confirmed that they are able to see service users in private and have good liaison with the home that work in partnership with them. A comment from a Community Nurse stated: “I visit many homes & residences, this is one of the cleanest and well run with happy staff and happy patients”. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome group was good. Service users are cared for appropriately and are able to exercise control over their lives and maintain contact with friends and relatives. The meals provided are wholesome and provided in attractive surroundings. EVIDENCE: All the service users spoken with expressed their pleasure over the care and attention they received even though, as one service user said, she was “rather fussy”. Visitors can come and go as they please and those spoken with also expressed their satisfaction over standards within the home. A comment was received from a relative “ Aadams Residential Care Home is kept very clean and the staff are helpful and caring, not just to residents but visitors also at any time, no matter how busy they are”. The routines of daily living are relaxed and choice is available for meals, mealtimes and whether the service users prefer to have a meal in their room. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 13 Currently there does not appear to be a programme of activities and service users spoke of board games and being taken out shopping. The owner of the home stated that a ‘singer’ had visited the home and a hairdresser attended on a weekly basis. Meals are provided in an attractive separate dining room and meals are provided according to dietary needs and offer choice. The chef is currently employed for 16 hours a week and care staff have to cover on certain days of the week. There is a need to increase the chef hours to 7 days a week particularly once the home has expanded. The main meal has been at teatime and according to the cook this is now being changed to mid-day as a more suitable time for both the service user and her hours of work. There are apparently no restrictions on the food budget and all the service users expressed their satisfaction with the food and snacks provided. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome group was good. There is a suitable complaints procedure and policies and procedures are in place to protect service users from abuse. EVIDENCE: There is a suitable complaints procedure that is made available to service users, staff and visitors to the home. Complaints and their outcomes are recorded. There has been one complaint since registration that was partially substantiated. The home has a copy of the policy document ‘No Secrets’ and Whistle blowing and Adult Abuse policies and procedures are in place. Staff spoken with had received some training on the subject of Adult Abuse prior to commencement at the home. There was no documentary evidence of any training on the subject of Adult Abuse and Whistle blowing; a recommendation was made that some training on the subject should be provided All prospective staff are checked to ensure that they are not on the Protection of Vulnerable Adults Register (POVA) before commencement. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24 25 & 26 Quality in this outcome group was good. Service users live in a safe, comfortable, clean environment with quality furniture fittings and décor that meets their physical needs in a homely way and provides secure accommodation. EVIDENCE: The home has recently opened and evidence was provided that the building complies with all the necessary standards required in order to be registered with the Commission for Social Care Inspection. Service users have access to a patio area that provides a safe environment to sit outside. The home does not employ a handyman and the owner currently oversees routine maintenance. There is a need to implement a record of routine maintenance in order to ensure that all necessary work is carried out. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 16 There are ample assisted bathing and toileting facilities; each service user’s bedroom has a toilet and hand basin. Specialist equipment is provided as required including a portable hoist and handrails etc. The home has ample communal rooms including a smoking room that can only be used by service users. The bedrooms are all over 12 square metres excluding the en-suite and are suitable for wheelchair users. Each room has quality furnishings and fittings and there is enough space for personal possessions. The doors are lockable and there is a secure facility for the safekeeping of any valuables or medication. The pipe work and radiators have been covered to provide safe surface temperatures and a record was seen to be kept of the temperature of the water when a service user is bathed. Policies and procedures are in place with regard to the control of infection and the home was found to be warm, clean and free from offensive odours. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome group was poor. There is a need to increase the staffing levels to ensure that the quality of care is maintained. The documentation relating to the recruitment and training of staff is poor and needs to be put in order for ease of reference. EVIDENCE: Comments from staff and service users indicate that staffing levels are not always sufficient. Currently some care staff are working very long hours in order to cover the staffing rota. There are 12 service users who all require help with washing and dressing, 5 service users are in a wheelchair, 4 of them permanently. One service user requires a lot of assistance at night. There are currently only 7 care staff plus the acting manager and this does not allow enough cover for sickness or holidays. The amount of care staff is dependant upon the needs of the service users and should not be based on the number of service users. Currently the needs of the service users is fairly demanding and there is a requirement for additional staff as follows: 3 care staff plus a manager/senior between 8.00 a.m. and 1.00 p.m.; 2 care staff plus a manager/senior up to 5.00 p.m. and 2 care staff up till 10.00 p.m.; 2 waking care staff over night. The level of staffing should be kept under review according to the needs of the service users. The staffing rota needs to clearly show the designation of each member of staff on duty including the domestic and chef hours. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 18 One of the care staff also does 3 hours cleaning a day in addition to her care hours. The care staff spoken with confirmed that they also do cleaning as it became necessary and that this did have an impact on their time when they should be caring for service users. The domestic hours will need to be increased when the home is registered for additional service users. The inspector did not see a record of staff training but, according to the acting manager, 6 out of the 7 care staff have an NVQ qualification. The documentation connected with the recruitment of staff was difficult to read, as they were not in any specific order. Some references had been taken up and all had been checked with the Criminal Records Bureau. There is a need to structure the documentation and create a matrix to show the progress of each application. There was no evidence to show that staff have been employed in accordance with the code of conduct set by the General Social Care Council. There was evidence of some training undertaken by staff, mainly from previous employment. A training programme that meets National Training Organisation specifications and a training matrix should also be devised that clearly shows when training has been completed including induction training. Staff spoken with confirmed that they had received induction training. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome group is poor. The home is being managed very well by an acting manager; once appointed in order to be effective, any new manager must be allowed time to review and strengthen the existing policies and procedures. EVIDENCE: When appointed the new manager will need to be registered with the Commission for Social Care Inspection. The home has not been open very long and the manager when appointed, needs to communicate a clear sense of direction and leadership to promote the aim and purpose of the home as well as ensure the policies and procedures, service user and staffing records are up to date and of an acceptable standard. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 20 The evidence from service users and relatives/visitors is that the home is run in their best interests and staff praise the support they have received from the owner and his wife and the acting manager. There has been one staff meeting since the home opened. There are no formal systems in place for checking the quality of care within the home; feedback should be actively sought from service users, relatives, staff and any visitors to the home. Service users should also have the opportunity to be more involved in decision making within the home. There did not appear to be any financial records on behalf of service users; 2 service users are provided with assistance with regard to their financial matters. There is a need to keep appropriate financial records and issue receipts. If the service user wishes, any valuables are kept in a locked box within a locked filing cabinet. There was no evidence that an inventory had been taken of service users’ possessions as they enter the home. Staff spoken with confirmed that the owner and acting manager are very approachable and there is documentation in readiness for the supervision of staff however, no formal supervisions had taken place. There is documentation ready for annual staff appraisals and supervision. Measures have been put in place with regard to the health, safety and welfare of service users and staff including risk assessments and policies and procedures such as fire safety; 2 staff are qualified in First Aid. Prior to the inspection a pre-inspection questionnaire was provided and when it was returned there were several gaps in the list of key policies and procedures, the inspector found some of the missing policies at inspection; there is a need for the policies to be indexed, sorted and reviewed to ensure that they are all in place and appropriate for the home. Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 1 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 1 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 1 X 1 1 2 2 Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 Requirement The Statement of Purpose and Service User Guide must be reviewed and up-dated now that the home is open and staffed. Each service user must be provided with a statement of terms & conditions in respect of the accommodation being offered. The service user’s care plan needs to be reviewed each month and a record kept. A suitable programme of activities must be devised following consultation with service users. All staff must be provided with training on Adult Abuse. The home must be staffed according to the number and needs of the service users. Domestic help and chef hours must be provided 7 days a week when the upper floor is completed and registered. The documents relating to the recruitment of staff need to be put in order and a matrix devised to show the progress of DS0000044266.V287091.R01.S.doc Timescale for action 30/06/06 2 OP2 5 30/06/06 3 4 OP7 OP12 15 16 30/06/06 30/06/06 5 6 7 OP18 OP27 OP27 13 18 18 30/06/06 30/06/06 30/06/06 8 OP29 19 30/06/06 Aadams Residential Care Home Version 5.1 Page 23 9 OP29 19 10 11 OP33 OP35 24 17 each application. Evidence must be provided to show that staff have been employed according to the code of conduct set by the General Social Care Council. A formal system for monitoring the quality of care within the home must be devised. A written record of all financial transactions on behalf of service users must be maintained. 30/06/06 30/06/06 30/06/06 RECOMMENDATIONS These recommendations relate to Nation9al Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations The initial assessment needs to be expanded with regard to social interests, religious and cultural needs, signed, dated and show that the service user has been involved in the process. All staff should be provided with training in Adult Abuse and Whistle Blowing. A recording should be made of any routine maintenance to the home including the fabric and decoration of the premises. A record should be made of any training staff have received and a programme set for future training that meets the National Training Organisation’s specifications. Any new manager must apply for registration with the Commission for Social Care Inspection. Any new manager must communicate a clear sense of direction and provide opportunities to involve the staff and service users in the process. A formal system of individual supervision for all staff should be set up that takes place at least 6 times a year. All service user records should be kept up to date. The polices and procedures connected with the health, safety and welfare of service users and staff need to be reviewed and checked for any gaps. 2 3 4 5 6 7 8 9 OP18 OP19 OP30 OP31 OP32 OP36 OP37 OP38 Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aadams Residential Care Home DS0000044266.V287091.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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