Inspection on 16/02/06 for Aaron Crest Care Home

This inspection was carried out on 16th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Aaron Crest Care Home 22/04/10

Aaron Crest Care Home 22/01/09

Aaron Crest Care Home 05/02/07

Aaron Crest Care Home 13/01/05

Aaron Crest Care Home 10/06/04

Aaron Crest Care Home 11/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Aaroncrest Nursing Home Aaroncrest Tanhouse Road Skelmersdale Lancashire WN8 6AZ Lead Inspector Anne Taylor Unannounced Inspection 16th February 2006 09:15 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 Aaroncrest Nursing Home DS0000025549.V278862.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. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aaroncrest Nursing Home Address Aaroncrest Tanhouse Road Skelmersdale Lancashire WN8 6AZ 01695 558880 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) aaron.crest@virgin.net Aaroncare Plc Mrs Mandy Harris Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (5) of places Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of Service Users is 50 to include: No more that 50 Service Users needing nursing or personal care in the category `OP - Old Age, not falling within any other category` No more than 5 Service Users in the category `PD - Physical Disability aged 45 ` 20th September 2005 Date of last inspection Brief Description of the Service: Aaron crest is a purpose built care home with nursing. The home can accommodate fifty people of either sex over the age of sixty-five years. At the time of inspection forty-three residents were living at the home. Eleven required nursing care and thirty-two, personal care. Aaroncare, a public limited company, privately owns the home. Day to day running of the home is the responsibility of the registered manager, Mrs Mandy Harris. Managerial support is provided by Mrs C Jarvis who is registered as the responsible individual. Accommodation is on two floors served by a passenger lift. Ramps to the front of the home allow access for wheelchair users and a number of aids and equipment are available to assist residents with mobility problems. The majority of rooms are single although one companion room is available for residents who might wish to share. Some en-suite facilities are provided, and there are sufficient washing, bathing and toilet facilities. The home has four day/quiet rooms for residents to enjoy activities or receive visitors. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 9:15am and lasted six hours. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. What the service does well: What has improved since the last inspection? The home now has a higher percentage of staff with a nationally recognised care qualification. Additional training for staff, specific to the health care needs of the residents, has also been completed so that staff are encouraged and supported to develop new skills and knowledge that will help them do their job effectively. The grounds have been re-landscaped and new tress and plants put in to improve the outlook and make sure the external environment is suitable for residents to enjoy. The home has purchased some additional pressure relieving equipment to make sure that any resident at risk of developing pressure sores has immediate access to the correct equipment they need. Aaroncrest Nursing Home DS0000025549.V278862.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. Aaroncrest Nursing Home DS0000025549.V278862.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 Aaroncrest Nursing Home DS0000025549.V278862.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): EVIDENCE: Standard 3 was not assessed at this inspection. It was considered fully met at the last inspection. Standard 6 is not applicable to this service, as Aaron Crest does not provide intermediate care. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 9 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): 10 Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff spoken to were able to discuss how they put into place the home’s policies and procedures relating to maintaining the privacy and dignity of the people they cared for and how this helped to make sure that residents felt respected. Staff were observed knocking on bedroom doors before entering. They were seen to be providing care in a sensitive and caring manner, which promoted residents’ dignity. People living at the home say staff maintained their dignity and treated them respectfully. One resident said, “Staff are very kind and respectful”. One visitor said, “When staff are seeing to my mum, we are asked to leave the room and staff always close the curtains and make sure the door is closed”. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 10 Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 11 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, 15 The daily routines were flexible so that service users were able to exercise choice and the range of social activities available met the expectation of people living at the home. The importance of providing a well balanced diet was recognised by the home so that clients were able to eat healthily and given a choice about what they ate. EVIDENCE: Records and discussion with residents showed that appropriate attention was paid to helping them take part in valued and fulfilling activities that were already established or developed in and outside the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. Residents had a range of needs and ability; some were able to go out independently, whilst others were reliant on support from staff. Residents spoken to were generally satisfied with the activities available. One said, “There is enough to do if you want it”. At the time of inspection some residents were taking part in a group activity. Others were doing more solitary things like reading the newspaper, doing a crossword and listening to music. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 12 All were enjoying their chosen activity and spoke positively about the way in which activities were organised for them. Records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast and tea in my room and lunch in the dining room”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “I have no complaints about the food. I get a choice, whatever I want really”. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 13 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): 18 Management processes in relation to abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: The home had its own adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included a training pack about abuse with a multiple-choice test at the end to assess knowledge and understanding. Staff confirmed that they received regular updates so that they continued to be made aware of the need to protect the people they care for. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 14 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, 25, 26 The home was clean, comfortable, and homely. And provided an environment that was suitable for it’s stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside. Accommodation was provided over two floors, accessed by a passenger lift. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. Residents spoken to were happy with their private accommodation and most had personalised their rooms so that they felt more at home. One said, “My room is fine, I have enough space for some of my things”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 15 Standard 25 was not fully assessed. However, progress in meeting the requirement made at the last inspection was monitored. Work to make sure that exposed pipe work in bathrooms was properly covered was almost complete but one or two had been missed, so there was still some risk to residents. The manager was aware of this and whilst the inspector was present asked the maintenance person to make sure the work was completed. Standard 26 was not fully assessed. However, progress in taking action to address the recommendation made at the last inspection was monitored. The home had arranged for the facilities and services provided at the home to be assessed as to whether they complied with the Water Regulations 1999. An assessment had been carried out and work recommended completed. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 16 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): 28, 29, 30 Training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. The recruitment process was not thorough enough to ensure the continue protection of people living at the home. EVIDENCE: Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. Staff spoken to said that training opportunities were good and that regular training courses were held for fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. National vocational training (NVQ) was available to care staff. A significant number of care staff had already achieved level two or three and thirteen care staff were in the process of completing NVQ training. The home was aware of the need to have fifty percent of care staff trained to NVQ level 2 or above in order to meet the national minimum standard. Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be able to provide good care and the continuing need to protect people living at the home. However, the files of two new members of staff examined showed that some of the documentation relating to “fitness”, in particular a criminal record check and checks against Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 17 the protection of vulnerable adults register had been obtained after the start of employment so the home could not be assured of their suitability to work with vulnerable adults. Staff talked about how they had been recruited and confirmed that they had received a statement of terms and conditions of employment and a job description so that they knew what their responsibilities were and what was expected of them. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 18 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, 35, 38 Residents lived in a well run home, managed by a responsible person who was able to make sure the home met its stated purpose, aims and objectives. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. The systems in place for managing health and safety matters were thorough enough to ensure the continued safety and welfare of people living and working at the home. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has completed a relevant management course and kept up to date with Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 19 clinical areas of practice so that she can meet the professional registration requirements of the Nursing and Midwifery Council. Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was expected of them. Residents and visitors said that they saw the manager regularly and could tell her if they had any problems. One Visitor said, “ We (the family) see the manager regularly, we go to her if we want anything and she sorts it out”. The home handled few personal allowances for residents. Any personal allowances and money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. When asked about access to their money residents said, “my niece does everything and brings me money if I need it” and “I have a bit of money here in the safe, I ask if I want anything and my family look after everything else”. Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Residents felt safe living at the home one said, “I feel safe and well looked after here”. Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 20 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP29 Regulation 17(2) Schedule4 Requirement All checks relating to the fitness of prospective employees, including criminal record bureau checks and checks against the protection of vulnerable adults register must be obtained prior to the start of employment. Timescale for action 30/04/06 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. Refer to Standard OP25 OP26 Good Practice Recommendations The registered manager should ensure that the programme to cover exposed pipe work in bathrooms and toilets is completed as soon as possible. The home should ensure that they have written confirmation that the facilities and services provided comply with the Water Supply (Water Fittings) Regulations 1999. Fifty per cent of care staff should be trained to NVQ level 2 or above. 3. OP28 Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 22 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 Aaroncrest Nursing Home DS0000025549.V278862.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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