Inspection on 18/07/08 for Aarandale Lodge

This inspection was carried out on 18th July 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Aarandale Lodge 18/07/07

Aarandale Lodge 08/08/06

Aarandale Lodge 16/03/06

Aarandale Lodge 13/10/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Aarandale Lodge Aarandale Lodge 2-4 St Vincent`s Road Westcliff-on-sea Essex SS0 7PR Lead Inspector Carolyn Delaney Unannounced Inspection 18th July 2008 11.30 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 Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 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. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aarandale Lodge Address Aarandale Lodge 2-4 St Vincent`s Road Westcliff-on-sea Essex SS0 7PR 01702 352096 F/P 01702 352096 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) Mr Navneet Singh Johar Mrs Aunjali Johar Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Twenty older persons who may have dementia. To comply with the report of the fire brigade including the provision of a second fire escape. Work to be completed within six months of registration To relay the tarmac to the front entrance and car park area. Work to be completed within six months of registration. Thermostatic valves to be fitted to all hot water taps accessible by residents. Work to be completed within three months from registration. 18th July 2007 Date of last inspection Brief Description of the Service: Aarandale Lodge is situated in a residential area close to the town centre of Southend, the sea front and rail and bus links. It is registered for twenty older people who might additionally suffer with dementia. The accommodation is on two levels with a shaft lift to enable access to both floors. It has two lounges, one with a dining area, eighteen single bedrooms and one shared bedroom. It has a large enclosed garden and there is limited parking to the front of the property. The home has an updated Statement of Purpose, Service User Guide and a copy of the last inspection report in the entrance hall. The current scale of charges as at July 2008 is between £352.00 and £580.00 per week. Extras charged are for hairdressing, chiropody, newspapers, personal toiletries and attendance to appointments using local taxis. As part of the inspection process an Annual Quality Assurance Assessment was forwarded to the Commission prior to the inspection. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality Rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a routine unannounced inspection, which included a visit made to the home between the hours of 11.30 and 19.30 on 18th July 2008. As part of the inspection process we used the information provided by the manager / proprietor in the Annual Quality Assurance Assessment. In addition we reviewed information provided over the last twelve months including notifications sent to us by the manager of any event in the home, which affect residents such as injuries, deaths and any outbreak of infectious diseases. Some residents were spoken with but they could only give limited information about their experiences in the home due to memory impairment and dementia. The relatives of seven residents were contacted by telephone and their views about the home were obtained and used in this report. Observations of residents’ experiences during the day of the inspection were noted. Surveys were sent to the home for staff and relatives to complete, however these were not available at the time of writing this report. During the site visit, records including residents’ care plans and assessments, staff recruitment files and training information were examined. A brief tour of the premises was carried out and communal areas including lounge, dining room and bathrooms were viewed. In addition some residents’ bedrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the service does well: A detailed assessment of each person’s needs is carried out before the person moves into the home. This assessment is carried out with the involvement of the person’s family where appropriate. People are given information about the home and invited to visit to see if they feel it will be suitable. There is detailed information for each resident in terms of their needs and how staff should support the individual. Resident’s wishes and particular Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 6 preferences for daily routines are recorded so that staff can support the resident in a way they choose. Residents receive the medical treatment they need and staff help to minimise risks to resident’s health and safety by identifying these and taking measures to prevent falls, pressure sores etc. Relatives are involved in planning care where they choose to do so and are kept informed of any changes to the health of residents. Residents and relatives commented that food in the home is very good. Residents have a good choice of meals and are provided with nutritious meals, which suit their needs and tastes. The views of residents and their relatives are obtained as part of the process for improving services at the home. What has improved since the last inspection? What they could do better: Some relatives feel that more activities could be provided for residents to keep them stimulated. While there is a plan of activities these are not always offered and at times residents were observed to be left unsupported in one of the lounge areas, particularly in the afternoon. People feel that they can make concerns known to staff however they do not always feel that some issues are taken seriously such as when items of residents’ belongings such as clothing or glasses go missing. Some relatives feel that it takes a long time to have light bulbs replaced etc sometimes taking weeks to be resolved. The manager / owner need to ensure that essential repairs and replacement of any facilities used by residents is carried out promptly so as to minimise the impact on residents. For example one of the boilers needs to be replaced and there was no hot water in the bathroom on the first floor. Staff in the home have not had recent training and this may impact upon residents. Staff practices regarding the storage and recording of medicines in the home were poor and highlight the need for training in this area. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into Aarandale Lodge have sufficient information to help them decide whether they will be happy there and, can be assured that their needs will be met by the robust assessment process. EVIDENCE: The provider told us in the Annual Quality Assurance Assessment that each person’s needs are assessed before they are offered a place in the home. In addition wherever it is possible prospective residents and their families are invited to visit the home and have a meal ‘to get the feel of the home’. The provider encourages people to look at other homes in the area to make comparisons with the service offered at Aarandale Lodge. One relative who was spoken with said that when they first visited to see if it would be suitable ‘they found it to be very nice and there was a homely feel to the place.’ Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 10 The pre-admission assessments for two people who had moved into the home since the last inspection were examined. Both had been completed prior to the person moving into the home and both were written in a clear way which described the person’s needs for activities such as communication, mobility eating and drinking, maintaining safety and social contact. Information was recorded about any particular risks to the person, for example it was recorded for one person that they tend to wander and for another that they were at risk of falls. Information recorded about these risks included details of the most recent incidents so as to try and determine the level of risk to the person. Each person’s preferences and dislikes for foods, their preferred routines such as times for getting up and going to bed and any particular wishes they have in respect of personal care were recorded. In both instances resident’s families were present and involved in the assessment process. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well cared for and their health and personal care needs are met. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment of the improvements made since the last inspection including a new system for planning care and the introduction of a key worker system so that care staff are allocated to specific residents. The role of the key worker is to check that residents have supplies of clothing and toiletries etc. The manager plans to review the key worker system so as to ensure that residents are happy with the staff allocated to them. The manager acknowledges that more could be done so as to involve residents and / or relatives in care planning. This would ensure that care plans are more reflective of each person’s individual needs. It was noted that in care plans which were seen that residents and / or their family had not always been involved in the care planning and review. One the day of the inspection the care plans for three residents were examined. In all of these there were clear instructions for staff as to how to care for and Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 12 support residents. Information included details of how residents wished to spend their days, including their preferred times for getting up and going to bed, where they like to spend time during the day and take their meal and their preferences for bathing and managing personal care. There was evidence that care plans are generally reviewed regularly and amended if there are any changes to treatment or the resident’s condition. However it was noted for one person whose condition had deteriorated significantly over the past few months that care plans had not been amended to reflect how this affected the person’s abilities and their general well being. As part of care planning staff identify any specific risks to the health and safety to each individual. Risks such as falls, developing pressure sores, and poor nutrition were minimised so far as possible. This is evidenced through records of incidents of falls and pressure sores in the home. Records indicate that residents receive access to medical treatments and routine check ups as required. Relatives who were spoken with made positive comments about the care provided. One person said that ‘the care is very good’. Another said that they were ‘very happy with the home and how staff treat their relative’. All relatives said that staff keep them informed of any issues affecting the welfare of residents. The home has a policy and procedure for the safe receipt, administration, storage and disposal of medicines in the home. During the inspection staff were observed to administer medicines in a safe manner, ensuring that residents take medicines before completing Medication Administration Records. General medicines were noted to be stored safely and securely. However a number of residents were prescribed medicines, which are Controlled Drugs and require special storage, handling and recording as set out in the Misuse of Drugs Act Regulations 2001 (as amended). Storage of these medicines must be in a suitable locked metal cabinet, which is secured to a solid wall. It was of concern to note that the cabinet had no lock as it was broken, and was secured to a stud wall. It was also noted that recording and checking procedures had not been carried out consistently bys staff. It is also noted that seven of the fifteen staff working at the home have not had recent medication training. While these issues do not impact upon the outcomes for residents they highlight poor staff practices and management. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Aarandale Lodge generally enjoy a lifestyle experience, which reflects their wishes and capabilities, however residents would benefit from more opportunities for stimulation. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that there is now a plan for daily activities and that information is posted throughout the home. The manager acknowledges that more one to one activities and stimulation could be provided for residents and in particular for those people who have dementia. In a survey of relatives carried out by the home in March 65 of people said that they felt that residents are offered appropriate social stimulation and activities. Staff record residents’ wishes for how they like to spend their time and what activities they like to participate in and this is reflected in the activities plan. On the day of the inspection the plan for activities was available and this showed that residents are offered the opportunity to participate in armchair activities, audio books, puzzles, videos, walks and gardening etc. However it was not clear from the daily records that all of these opportunities are Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 14 regularly available. For example on the day of the inspection it was recorded that residents could participate in cards, puzzles or dominoes. However in one of the lounges where the inspector sat no residents were offered the opportunity to join in any activities and for the most of the afternoon residents were left unsupervised with staff only coming in to give afternoon drinks and take residents to the toilet. Three relatives who were spoken with commented that there could be more stimulation available for residents. One person said that there have been some outings to the Cliffs Pavillion and the seafront, which residents enjoy but that these do not occur as frequently as they used to. Two relatives said that the garden area could be improved for residents with the provision of suitable garden furniture. Staff record what activities that residents participate in and how they enjoyed the experience. On the day of the inspection staff provided party foods and a cake for the evening meal to celebrate one resident’s birthday. Relatives confirmed that they are always welcomed to the home when they visit and two said that they are always offered refreshments by staff. Some relatives take residents out for meals and walks and are invited to special celebrations such as fete days. The menu for the day was displayed on a white board in the dining room. Residents have a choice of cereals, toasts or English breakfast. On the day of the inspection residents had the choice of fish and chips served with peas and lemon or sausages and mashed potatoes. Both selections were available to residents. Food looked well prepared and palatable. A selection of sauces, condiments and vinegar was available and residents were offered a choice of juices. Staff were available to assist residents who need some help or prompting. All residents were offered extra food and asked if they were finished their meal before plates were removed. Residents appeared to enjoy their meal and those who were asked said that the food was good. Relatives spoke very highly about the food in the home. One person said that ‘residents are very well fed’ another person said that their ‘relatives’ appetite had improved and they had gained weight since admission to the home’. As part of regular health monitoring residents have their weight recorded so as to identify any issues. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People do not always feel that issues are dealt with in a timely fashion. Residents are safeguarded from harm. EVIDENCE: There have been three complaints made to the manager since the last inspection. One was regarding a resident’s monies allegedly going missing, this was investigated and the police were involved and the manager reimbursed the resident. The second complainant said that their relative did not like the food offered, this was fully investigated and it is now recorded what choice of meals are offered to the resident. The last complaint was referred to us and the complainant said that there was not enough stimulation or activities for residents and that staffing levels within the home did not ensure that resident’s needs were met. The complainant further said that residents were left in the lounge unsupported by staff. We asked the homes manager to investigate this and respond to the complainant and ourselves. Staff now keeps better records as to the activities provided by the home. In addition we received one complaint anonymously regarding insufficient staffing levels in the home for the needs of residents. Each of the complaints received by the home were been investigated and dealt with in a timely manner in accordance with the home’s policy and procedure. The majority of complaints are made by relatives on behalf of residents. The majority of relatives who were spoken with said that they had no cause to Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 16 complain and in a survey carried out by the manager in March 2008, 100 of relatives said that they feel able to discuss any issues with staff or manager. Two people who spoke with the inspector commented that when ‘small issues’ such as missing laundry and other resident’s personal items and some repairs needed are raised that these do seem to take a long time to get sorted. Relatives who were spoken with said that residents ‘look well’, ‘clean’ and ‘well cared for’. There have been no safeguarding alerts made in respect of the home since the last inspection and a review of notifications made to the us by the manager indicate that there are been only a few minor injuries sustained by residents through falls and that residents have been protected form harm. Two members of staff who were spoken with during the inspection said that they ‘would inform the manager’ if they saw anyone being unkind to, or mistreating residents. A review of staff training records shows that the with the exception of one person staff have not received training in respect of safeguarding vulnerable people from harm, neglect or abuse. This is recommended so as to ensure that all staff have up to date information in respect of safeguarding procedures. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from a safe, comfortable and clean environment. However essential repairs and some general maintenance are not carried out promptly and may detract from residents’ experience living there. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that staff try as far as possible to accommodate residents’ wishes in respect of the décor of their bedrooms. Rooms are usually redecorated once they become vacant so as to minimise disruption to residents. New carpets have been fitted throughout communal corridors and stairways and a number of residents’ bedrooms have been redecorated and fitted with new furniture. The manager acknowledges that putting a timescale on maintenance work for the home would be an improvement. The home employs a maintenance person to carry out checks and essential repairs. The manager told us that there are Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 18 improvements planned for the garden area according to the wishes of residents and this includes widened pathways and raised flowerbeds so as to allow better access. This was also said at the time of the last inspection but had not as yet been actioned. Some relatives who were spoken with said that ‘it takes a long time for things to get done’ One person said that ‘simple things such as replacing light bulbs, securing toilet roll and towel holders two weeks to be done despite numerous reminders’. Two people commented that the garden could be made more attractive for residents. One relative commented that the home is ‘brighter and more modern now that areas have been painted and there is some new furniture’. All of the relatives who were spoken with said that the home is clean and fresh. One person commented that ‘no matter what time I visit the home is always lovely and clean’. On the day of the inspection all areas of the home, which were viewed, were noted to be clean and free from unpleasant odours. Resident’s bedrooms, which were seen, were nicely decorated clean and bright. Some bedrooms had new carpets and bedroom furniture. Two relatives who spoke with the inspector said that they had been able to bring into the home some items of furniture including beds and small items of personal belongings. During the tour of the premises it was observed that in one toilet area and one bathroom (on the first floor) that there was no hot water and no taps fitted to the wash hand basin in the bathroom. This was brought to the owner’s attention who informed the inspector that there was a problem with one of the hot water boilers, which was to be replaced sometime the following week. This meant that for twenty residents that there was only one functioning bath located on the ground floor, which may be difficult for some residents to access especially those with impaired mobility. At the last fire officer’s inspection to the home in June a requirement was made to link the garden gate to the fire alarm system instead of being padlocked. The owner said that this would be addressed in the next week. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People in the home are generally supported by a team of staff who are recruited thoroughly. EVIDENCE: The staffing structure for the home is a manager supported by three senior care staff, eleven care staff, two cooks and two domestic staff. Staffing levels for the home at the time of the inspection were one senior and three care staff in the morning, one senior and two care staff in the afternoon and one senior and one carer at night. The manager works between eight am and approximately six pm and is supernumerary to allow her to carry out the management duties for the home. Staff rotas indicated that these staffing levels are maintained and that staff generally have appropriate off duty time. However one person is noted to have worked fifteen days without a break, which is not good practice and may impact on the support provided to residents. Staff working in the afternoon have the responsibility for preparing the evening meal and this takes them away from their responsibilities of supporting residents. Staff who were spoken with said that ‘they manage this ok’. However residents in one lounge area were left unsupported for most of the afternoon. Some residents needed assistance with drinks or to mobilise and Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 20 the area manager who was present at the inspection intervened on a number of occasions however she would not normally be at the home to do so. The owner said that staffing levels are determined using the residential forum, which is tool to help determine the number of staff hours needed based upon the assessed dependency levels of people living in the home. The home has a policy and procedure for the recruitment of staff. The files for the two people who have been employed at the home since the last inspection were assessed. Both people had been subjected to the checks as required to assess their fitness to work in the home. Checks were carried out in respect of each person’s previous employment and references were obtained from previous employers. In addition satisfactory PoVA First and Criminal Records Bureau (CRB) disclosures had been obtained. These are checks in respect of any convictions or cautions and any information in respect of the list of people deemed unfit to work with people who may be vulnerable. The manager told us in the home’s Annual Quality Assurance Assessment that there is now a plan for staff training and development and that all staff have the opportunity to attend training. The manager said that more could be done so as to ensure that staff attend training. A copy of the staff training and development plan was provided for inspection and it was noted from this that the majority of staff working in the home have not undertaken recent or regular training. Only one person had received medication training within the last twelve months. Six members of staff had attended a session with the local Primary Care Trust pharmacist who provides advice to care homes and were awaiting competency assessment before certificates were issued. However issues regarding storage and recording of medicines were identified during the inspection. The manager and owner have recently been successful in applying for a social care grant for staff training and development and more training is planned for staff. However issues were identified at the last inspection regarding staff training and staff had still not received training appropriate to their roles and the needs of people living in the home. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally resident’s benefit from a well managed service, however some issues are not managed promptly which may impact upon residents experiences in te home. EVIDENCE: There has been a change of manager since the last inspection. The manager while present during the inspection did not assist in the inspection once the area manager arrived at the home. Some relatives who were spoken with said that ‘they have not had much contact with the new manager’ or ‘have not seen the new manager about much’. It is of concern that the issues identified in respect of lack of hot water and bathing facilities, poor and unsafe storage and Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 22 recording practices for some medication had not been acted upon more promptly by the manager / owner. The views of Residents, relatives and healthcare professionals who visit the home are obtained by way of a questionnaire so as to see where the home meets and exceeds expectations and where improvements to the service can be made. The most recent survey was carried out in March 2008, the results of which were available to the inspector. Comments made were generally positive, as were those of the relatives and staff who spoke with inspector. 100 of relative’s surveys said that the home had a relaxed atmosphere. There is a policy in the home for safeguarding monies held by staff on behalf of residents. Monies are stored in a locked safe and regular checks are carried out so as to minimise the risk of error or mishandling. Records were assessed and noted to be in good order. As described throughout the report there were some issues identified which require the urgent attention of the manager/ owner. There was evidence that equipment in the home such as hoists, chair lift, and gas and electrical systems are regularly serviced, maintained, repaired and replaced as required. Certificates were available in respect of checks carried out by the homes maintenance personnel and external professionals. Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 2 17 X 18 2 2 X 1 X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(2),Sch edule 3(3)(i), 12(2)(3) Timescale for action Medicines received into the home 30/08/08 must be stored in accordance with current regulations and guidelines. This refers to the storage of Controlled Drugs, which must be stored and appropriate records kept in accordance with the Misuse of Drugs (Safe Custody) Regulations 1973 as amended. So as to prevent the mishandling of medicines in the home. Bathing and showering facilities must be provided to meet the needs of people living in the home. This is in respect of the lack of hot water and bathing facilities on the first floor. 3. OP27 18(1)(a) Staffing levels at the home must be appropriate to the needs of residents. This relates to staff preparing meals in the evening and residents left unsupported in lounge areas. 30/09/08 30/10/08 Requirement 2. OP21 23(2)(j) Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 25 3. OP30 18(1)(c) and(i) All staff working in the home 30/10/08 must receive training for the work they are to perform and the needs of residents, so as to ensure that staff practices are safe and consistent and residents are supported properly. This requirement is outstanding from the last inspection and the previous timescale of 01/01/08 has not been met. 4 OP38 24(4)(5) The arrangements for evacuation 30/08/08 of the premises in the event of a fire must be in line with current fire safety regulations so as to help ensure the safety of people living in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 4. Refer to Standard OP16 OP18 OP28 Good Practice Recommendations More could be done to deal with minor issues raised by relatives so that they feel assured that these issues are taken seriously All staff working in the home should receive training in respect of safeguarding residents to ensure consistency in staff practices. Staff working hours should be monitored so that they have appropriate off duty time. This refers specifically to some staff working excessive hours (50-66 hours). Aarandale Lodge DS0000065514.V368415.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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