CARE HOMES FOR OLDER PEOPLE
Aaron House 255 Preston New Road Blackburn Lancs BB2 6PL Lead Inspector
Mr Jeff Pearson Key Unannounced Inspection 09:40 22 November 2006
nd 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 Aaron House DS0000005802.V314281.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. Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Aaron House Address 255 Preston New Road Blackburn Lancs BB2 6PL 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) 01254 56208 (01254) 56208 mics03@dsl.pipex.com Mr Ahmad Ahmadi Mrs Badrolmolouk Abbaszadi Mrs Alison Foster Care Home 23 Category(ies) of Dementia - over 65 years of age (23) registration, with number of places Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home must, at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 5th December 2005 Date of last inspection Brief Description of the Service: Aaron House is registered to provide personal care and accommodation for 23 older people with a dementia. The home is situated on the outskirts of Blackburn on the Blackburn to Preston main road. The main public park, shops and churches are nearby. The town centre is within walking distance. Aaron House is a detached property and the small front garden leads onto the busy main road. At the rear of the house is a small parking area leading to an enclosed grassed area. The interior of the home is on four levels. The dining room is situated at basement level and leads into the conservatory. The office and staff room and three bedrooms are also situated at basement level. The car park and rear garden are accessed via a ramp from the dining room. There are two lounges on the ground floor and residents are able to access the dining room only via a passenger lift. The upper floors are accessed via the staircase or the passenger lift. The majority of bedrooms have single occupancy but there are some double rooms available. One single bedroom has an en-suite facility. At the time of this inspection visit the fees charged were £375.00. There were additional optional charges for hairdressing and toiletries. Written information about Aaron House was available in the dining room entrance and on request. Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key unannounced inspection, which included a visit to the home, was conducted at Aaron House on the 22nd, 23rd and 28th of November 2006, the visit took 16½ hours and was carried out by one inspector. There were 18 residents accommodated. Prior to the inspection visit, survey forms were sent to the home for the residents and their relatives/representatives to complete. Two were received from residents, three from relatives/visitors. Information was gathered from a pre inspection questionnaire completed by Mrs Foster, registered manager. The files/records of 3 residents were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of residents. During the inspection, the residents, manager, assistant manager, staff and visitors were spoken with. Care practices and interactions were observed. The records of the most recently recruited staff were looked at. Some policies and procedures were seen. A tour of the home was carried out. What the service does well:
Aaron House had a welcoming and supportive atmosphere and was being managed by a competent, experienced person. The staff were friendly and enthusiastic. One resident said, “I have lived here a long time, I like it alright” There were some good care practices at Aaron House, including the arrangements for finding out about peoples’ needs, abilities, likes and dislikes before they moved into the home, so that there care could be considered and planned for. One relative explained “ We came to look around they showed us the room and gave us information about the home” The residents personal privacy needs were being dealt with sensitively and they were being treated with respect and as individuals. A relative wrote, “I am very happy with the care he is receiving” There were various activities on offer and entertainment was occasionally provided at the home. Routines in the home were fairly flexible, so people had some freedom in how they spent their time. The residents expressed an appreciation of the food one saying “we are well fed, the food is simple, but good ” another commented “the food is very nice” Choice menus were available and mealtimes were seen as a social occasion, people needing help were given sensitive support. Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 6 Visiting times were flexible so friends and relatives could call at different times, the residents could see people in private. Relatives indicated they were always made to feel welcome at the home, one said “they are fantastic here, we can call anytime and they always let me know about things” The home was clean, warm and generally in good order. The residents had been encouraged to personalise their rooms, by bringing with them their own belongings, such as pictures and ornaments this had help create a sense of home and belonging. There were enough staff on duty to care for the residents. The residents appreciated the staff team, one said; “the carers are very good, very pleasant, nice and kind. If I want anything I just ring the bell and they are there” What has improved since the last inspection? What they could do better:
The resident’s individual care plans needed to include full details of all their health and social needs and how they are to be met, to ensure staff know exactly what to do for each person. Medication management, policies, practices, training, recording systems needed further attention for the protection of residents and staff.
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 7 Better records needed to be kept of meals served to the residents to show they are getting a proper diet and choices. The protection procedures needed changing to provide clearer instructions for managers and staff, to make sure they do the right thing. Everyone then needed to be made aware of the updated procedures. The quality assurance system still needed more work to make sure everyone is consulted and to show plans are being made to make improvements at Aaron House for the benefit of the residents. So that the residents and staff can call for assistance when needed, a call point must be fitted in the conservatory area. To make sure the residents’ can have privacy of space and possessions, they must be provided with suitable bedroom door locks and lockable drawers. Some bathroom and toilet doors also needed fitting with suitable locks. Handrails could be fitted on the steps leading to the conservatory to assist people with mobility needs. The homeowners should reconsider the bathing facilities in Aaron House and make plans for improvements to better meet the needs of the residents. To ensure a safe environment the gas appliances, boilers and heating systems must be checked and serviced. 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. Aaron House DS0000005802.V314281.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 Aaron House DS0000005802.V314281.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 at least once during a 12 month period. 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. Systems for assessing peoples’ needs and abilities ensured needs are known and planned for. EVIDENCE: The records of the two most recently admitted residents showed assessment information had been obtained, as appropriate, from Social Services. The manager said the information was mostly obtained prior to residents being admitted. The document used by the home for assessing people covered various health and social care needs and abilities. The manager said potential residents were always visited in their own environment and/or invited to visit the home as part of the assessment process. New residents and their relatives spoken with; said they had previously visited Aaron House and made positive comments about the home and staff. The manager said, following assessment potential residents are written to confirming the outcome.
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 10 It was advised the service user guide be reviewed and updated, to include the requirements of the amended regulations. Intermediate care is not provided at Aaron House. Aaron House DS0000005802.V314281.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 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 area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans did not fully address all health, personal and social care needs. Medication management practices needed some attention for the protection of the residents and staff. Support with personal care was provided sensitively in a way which promoted the resident’s privacy and dignity. EVIDENCE: Care plans seen as part of ‘case tracking’ were well organised and sensitively written. Specific risk assessments had been completed in response to individual needs and circumstances, with a care plan being written for staff to follow. Records showed care plans were being reviewed and updated accordingly. One resident spoken with had an awareness of an individual plan. Good records were being kept of peoples’ daily living and circumstances and contact with families. Care plans did not sufficiently include social, spiritual and
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 12 emotional care needs, relationships and family involvement. This more informal approach to care planning means that continuity of care is largely dependant upon staff memory and good communication systems, with a potential for care needs not being properly met and care being reactively rather than proactively planned. Residents’ surveys indicated they ‘always’ get the medical support they need, this response was also reflected in discussion with residents, relatives and staff. Moving and handling assessments had been carried out as appropriate. There were records of residents receiving attention from health care professionals, such as District Nurses and GPs. Various health care policies and procedures were available. Staff responsible for administering medications, had received some training. Storage was good, secure clean and tidy. Medication management policies procedures were available, but were lacking in some details and specific matters. Records and stock checked as part of ‘case tracking’ were mostly satisfactory. There were some discrepancies, for example, unexplained gaps on the record sheets, also agreed medication changes had not been updated on printed instructions, which may be misleading. Residents spoken with felt they were “treated with respect”. Care practices observed, showed privacy needs were being promoted, for example residents were supported to see visitors in the privacy of their own rooms, or ‘quiet lounge’. Staff spoken with explained how they promote individuality and dignity within their daily work, they responded positively to peoples differing needs. It was apparent people were being supported to take care of their appearance. A system was in place which linked residents to a named member of staff, who was responsible for overseeing aspects of their care. Although screens were provided in shared rooms, privacy of space and possessions was compromised by the lack of appropriate facilities (see Environment standards 19 – 26) Aaron House DS0000005802.V314281.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 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 area is good. This judgement has been made using available evidence including a visit to this service. The residents had an amount of independence, opportunity to take part in activities, make choices and decisions and keep in touch with families and friends. The catering arrangements were sufficient in providing for the residents tastes, choices and diet. EVIDENCE: Routines in the home appeared flexible, for example, the residents were being enabled to get up and go to bed when it was best for them and staff were seen to support peoples individual choices in how and where they spent their time. The residents had been encouraged to bring their own personal possessions and furnishings with them; individual records had been kept of such items to help ensure belongings are accounted for. Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 14 The visiting arrangements were outlined in the homes guide. Residents spoken with said they could have visitors at anytime. Several relatives visited the home during the inspection visit, those spoken with said they were always felt welcome at the home and made very positive comments about the care and attention provided. Representatives from various Churches had visited the home and a carol service was being arranged. The residents spoken with said they were generally happy with the quality, quantity and choice of meals provided, this response was also reflected in the residents surveys. A four- week seasonal menu system was in place, a choice of meals was being offered at lunch and teatime, alternatives were also available. Fresh fruit was available. Specific diets, such as diabetic were being catered for. Drinks were being offered at various times during the day and evening, fruit squash was available in the lounge. The meal times observed were unhurried and relaxed, staff were seen to be very courteous and attentive when serving meals. Ways of involving residents with menu planning and promoting further choice and independence at meal times; were discussed with the manager. The activities on offer were displayed in the home and included bingo, dominoes and hand massage; any planned events such as visiting entertainers and parties were also displayed. Staff spoken with had an awareness of peoples’ backgrounds and their daily routines; they said they usually had time to spend with the residents, for chatting and activities. Most residents were satisfied with the activities on offer. The library service was visiting regularly and specific books could be requested. Records were seen of the residents’ participation in activities. The manager explained various games had been obtained, also a DVD of activities. Various possible activities were discussed with the manager, it was suggested a staff member be chosen to oversee activities each month. Individual care plans needed to effectively respond to peoples’ activities of daily living, relationships, social and spiritual needs; to ensure all needs are known and properly planned for, and to help promote a more positive, person centred approach to care (see Health and Personal Care, standards 7 - 11. Aaron House DS0000005802.V314281.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 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 area is adequate. This judgement has been made using available evidence including a visit to this service. Systems and procedures were in place to provide for the management of complaints. Safeguarding adults policies and procedures, were not robust enough to fully protect the residents. EVIDENCE: The complaints procedure was included in the home’s guide and was displayed in the home; it met with the National Minimum Standards and Care Home Regulations. The residents and relatives spoken with had an awareness of the complaints procedure. There had been no complaints made since the last inspection. Systems were in place to record and follow up any complaints made. Records of training and discussions with staff and the manager; showed most staff had attended a protection of vulnerable adults (POVA) course provided by the local Council. Blackburn with Darwen protocols and guidelines on protecting adults were available at the home. A previous investigation and referral under the POVA procedures had been appropriately dealt with and concluded with the involvement of the relevant agencies. An allegation made during the course of the inspection was adequately dealt with. Another specific incident notified to the Commission was discussed with the manager; this had not been referred as part of POVA procedures. The homes own written
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 16 procedures did not include the specific action to be taken in line with the Councils guidelines. A staff procedure for reporting bad practice (whistle blowing) was seen; this did not include how to make appropriate local referral details, should staff concerns not be properly dealt with at the home. The policy and procedures for managing restraint or physical intervention were not readily available, it was suggested action be taken to ensure these instructions are line with current Department of Health guidelines. Aaron House DS0000005802.V314281.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,24,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The accommodation was warm, clean and comfortable; some matters needed attention to ensure the residents have facilities, which adequately and safely meet their needs. EVIDENCE: The residents spoken with were generally satisfied with the accommodation provided including their bedrooms. The main lounge and dining area were pleasantly decorated. The manager explained that a number of bedrooms had been redecorated to provide more calming, subdued environments for the residents. It was suggested this approach be also applied to the quiet/visitors lounge, which included several patterns and colours and therefore may be unsettling for some people with a dementia. Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 18 It was noted there was no call point fitted in the conservatory area and it was suggested consideration be given to providing suitable hand rails on the steps, to assist with mobility. There were bedrooms in the basement area but no bathing facilities on this level. Some of the bathrooms were not easily accessible due their location and they did not sufficiently meet the mobility/assistance needs of the residents. Some of the bathroom/toilets door locks were not working and one had a lock which did not enable access to be gained in an emergency. Liquid soap and paper towels had not been provided in all bathroom/toilets, which would help promote good infection control practices. The residents’ bedrooms seen were pleasantly decorated and had been personalised with their own belongings to reflect their character and background. None of doors had suitable locks therefore privacy and protection of personal space could not be guaranteed. Not all residents had been provided with lock drawers or cupboards, which meant they could not be supported to keep any possessions safe and private. The home was found to be clean and mostly free from unpleasant odours, residents and relatives completing surveys, indicated the home was always clean and fresh. Appropriate laundry equipment was available. Alcohol based had rub was provided for staff. Aaron House DS0000005802.V314281.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 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 area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements were sufficient in aiming to ensure the resident’s needs are effectively and safely met. Staff recruitment practices, showed attention was being given to protecting the residents. Induction training and ongoing staff development; promoted effective care and support for the residents. EVIDENCE: Residents spoken with were complimentary about the staff team. Staff were seen to provide support and interact with the residents in a positive and sensitive manner. One of the residents’ surveys indicated staff were ‘always’ available when they needed them, one suggested staff were ‘usually’ available. All relative/visitor comment cards indicated that in their opinion, sufficient staff were always on duty. Staff spoken with considered, although some days were busier than others, they had enough time to care for the residents. Staff rotas and records showed that previously agreed staffing levels were in place. Arrangements were in place to cover catering and cleaning duties. The recruitment records of the two newest employed staff showed the required information had been obtained and initial clearance checks carried out. It was advised the application form be developed to ensure a full employment history is requested and dates of school/college attendance declared. It was advised the interview notes sheet be used to record the exploring of gaps in
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 20 employment. Staff had been provided with contracts of employment following a six week probationary period, it was suggested temporary contracts be agreed with new staff to strengthen initial expectations and responsibilities. Arrangements had been made for new staff to be supervised as required. Staff training and development was ongoing, such as dementia care, foot care and moving and handling. A training matrix was seen showing planned and undertaken training, staff records included copies of certificates and individual training records were being compiled. More than 90 of the carers had NVQ level 2 in care, some had also attained NVQ level 3, the assistant manager was undertaking NVQ level 4. Staff spoken with said training was encouraged at the Aaron House, they were enthusiastic about their work and expressed a good understanding of their role in supporting the residents. Aaron House DS0000005802.V314281.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration arrangements, promoted the smooth running of the home for the benefit of the residents, staff and visitors. EVIDENCE: The atmosphere at Aaron House was found to be relaxed, supportive and welcoming. The residents, visitors and staff spoken with expressed an appreciation of the management team; everyone seemed to get on well together. Lines of accountability were clearly defined within the homes organisational structure and reflected upon the staff rota. Records showed that staff meetings were ongoing.
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 22 The manager had more than two years experience in her role, she had previously attained NVQ level 4 in care management and had completed the Registered Managers Award. The manager considered the homeowners to be supportive. The homeowners were fulfilling their responsibilities to visit the home unannounced and had forwarded reports of their findings to the Commission. Most records seen were found to be satisfactory, however, the record of meals served did not include details of the food provided at breakfast and supper and therefore did provide a proper account of the diet taken. The homes’ guide included some information about financial matters. Records seen indicated accountable systems were in place to manage residents’ pensions, charges and payments. It was advised that and the maximum of personal monies kept for residents be reviewed to promote best practice. Secure storage was available. The manager said satisfaction surveys had been carried out with residents. A business plan was seen to be available. Blackburn with Darwen Social Services had undertaken a quality assurance evaluation at the home. Complementary cards and letters were seen from relatives and a GP. The homes performance in fulfilling its aims and objectives had not been specifically reviewed; there was no development action plan. The residents’ relatives and others had not been formally consulted about the services provided. The pre-inspection questionnaire showed equipment had been serviced and that installations and maintenance checks were ongoing. Records were seen of various checks. A fire drill had been carried out but not dated. Fire risk assessments were in the process of being completed. Health and Safety risk assessments had been completed and health and safety policies were available. Training in safe working practices was ongoing, or being arranged. The annual Gas Safety inspection was five months overdue; the manager said arrangements had been made for this to be carried out. One bedroom carpet was slightly rippled and presented as a possible tripping hazard. Aaron House DS0000005802.V314281.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X 2 X X 2 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Aaron House DS0000005802.V314281.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 OP7 Regulation 15 Requirement Care plans must identify all aspects of health; personal; psychological and social care needs for each person and detail the action to be taken to ensure that all these needs are met. The protection of vulnerable adults procedures must include clear details of the action to be taken on suspicion or allegations of abuse. The registered manager and staff must be made aware of this procedure. The registered manager and staff must be aware of the procedure and ensure that it is appropriately followed. The reporting bad practice (whistle blowing) procedure must include appropriate referral details and assurances for staff. Staff must be made aware of this revised procedure. A call point for residents must be fitted in the conservatory area. All bathroom and toilet doors must be fitted with suitable locks which enable access to be gained in an emergency. Residents bedroom doors must
DS0000005802.V314281.R01.S.doc Timescale for action 31/01/07 2. OP18 13 31/12/06 3. OP18 13 31/12/06 4. 5. OP19 OP21 23 12,13 31/01/07 31/01/07 6. OP24 12,23 31/03/07
Page 25 Aaron House Version 5.2 7. 8. OP24 OP33 12,23 24 9. 10. OP37 OP38 16 23 be fitted with suitable locks which are approved by the Fire Authority and which provide the occupant with the choice of whether or not to use this facility. All residents must be provided with a lockable storage cupboard or drawer. The registered person must ensure that an annual development plan for the home, based on a systematic cycle of planning - action - review, reflecting the aims and outcomes for residents, is produced. Previous timescales of 30.09.05 and 31/03/06 not met. Records of meals served must be in sufficient detail to show whether diet is satisfactory. Arrangements must be made for the gas appliances and heating systems to be checked and serviced accordingly. 31/03/07 31/03/07 15/12/06 31/12/06 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. Refer to Standard OP9 Good Practice Recommendations Staff authorised to administer medicines should all receive accredited medicines management training which includes an assessment of their competence to complete these tasks. Medication management procedures should provide detailed instructions for staff on administering, including checking labels, observing residents taking medication and completing records. Policies should be available providing guidance for staff on
Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 26 2. OP9 when necessary and variable dose medication, covert administration and medication leaving the home with residents and their families. Any individual responses in promoting residents independence with medication should be risk assessed and dealt with as a care plan matter. Action should be taken to ensure any changes in medication instruction are corrected on printed records as soon as possible. The policy on restraint and physical intervention should be in line with Department of Health guidance. He steps leading to the conservatory should be assessed for the provision of handrails. The suitability and location of the bathing facilities should be included within the registered providers long-term development plans. Risk assessments should continue to be completed where residents are unable to use keys to their bedroom doors or lockable facility. Liquid soap should be provided in all bathrooms, toilets and the laundry. Action should be taken to re-fit or replace the slightly rippled bedroom carpet. 3. 4. 5. 5. 6. 7. OP18 OP19 OP21 OP24 OP26 OP38 Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Aaron House DS0000005802.V314281.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
