Inspection on 14/11/08 for Aaron House Residential Home

This inspection was carried out on 14th November 2008.

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

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

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Aaron House Residential Home 20 Collegiate Crescent Broomhall Sheffield South Yorkshire S10 2BA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shelagh Murphy     Date: 1 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Aaron House Residential Home 20 Collegiate Crescent Broomhall Sheffield South Yorkshire S10 2BA 01142660310 01142660310 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ackroyd House Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 25 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Additional conditions: 25 0 The maximum number of service users who can be accommodated is: 25 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP Dementia - Code DE The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. Shelagh Murphy carried out this unannounced visit to the service over one day and the total time spent on site was 7.5 hours. In the report we make reference to us and we. When we do this we are referring to the inspector and the Commission for Social Care Inspection. We used a variety of information as well as our findings from the visit to assess the quality of service offered to people who live at this home. Care Homes for Older People Page 6 of 27 Some time was spent with the people who use the service. We also observed people who had communication difficulties to gauge, how staff at the home supported them. It gave us some insight into how staff interacted with people, how people are supported by the staff and also an indication of peoples well being. We spoke to three people who live at the home. Three staff attended interviews with us. Three relatives were asked to complete surveys to give us their views of the service. Comments and feedback from these stakeholders have been included in this report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home and check the homes policies and procedures. Time was spent observing and interacting with staff and people. We checked all key standards and the standards relating to the requirements outstanding from the homes last key inspection in February 2008. The progress made has been reported on under the relevant standard in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The scale of charges ranges from 327 to 404 pounds per week. The inspector wishes to thank the people living in the home, staff, managers and relatives for their time and co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 27 Peoples care plans need to be developed further, to ensure they contain adequate details to meet peoples diverse and individual needs. A system, which ensures that peoples medication records are completed appropriately, on each shift, should be introduced to protect peoples health and safety. The manager should complete the registration application forms and send them to CSCI as soon as possible to ensure they are registered appropriately to manage the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to them being offered a place at the home, this ensures staff can meet peoples assessed needs before they move in to the home. Evidence: Two of the people who live at the home told us they had been offered a needs assessment before moving in to the home. Three people case files were checked to ensure they had been offered full needs assessments prior to being offered a placement at the home. We found evidence that two of the three people had needs assessments carried out by Local Authority care managers and the previous homes manager had assessed one person. Two of the staff we interviewed confirmed that people must have assessments before they moved in to the home or were offered a placement. Care Homes for Older People Page 11 of 27 Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were treated with dignity and respect. People had individual plans, but these needed to be more detailed and reviewed on a more regular basis. Evidence: We checked four peoples care plans and found that although they contained the most important elements of the persons care needs, they lacked detail and we found some plans had been reviewed but one had not been reviewed since July 2008. The manager told us that this was because the home had recently been taken over by a new provider and the staff team were in the process of re-writing and reviewing new care plans for people. People we spoke to knew they had care plans and told us they were satisfied with their overall care and support offered by the staff. Peoples told us their, health care needs were met by staff. We observed one person who was in pain request a visit from their G.P. and this was done immediately and the GP visited before we completed our visit. The person told us that this was usual practice from the staff. We also saw evidence in peoples care plans that other health Care Homes for Older People Page 13 of 27 Evidence: needs had been supported by specialists including opticians, dentists and community nurses. We observed a medication round being carried out by the deputy manager. The medication was stored safely and appropriately in a clean and secure cabinet. The manager told us that all staff that are required to administer medication have received appropriate training earlier this year. The medication was in the monitored dosage system packs and most of the medication administration sheets checked were completed appropriately. One persons drug sheet had a gap in signing for a medication. This was brought to the attention of the deputy manager. This was rectified by the end of our visit. this. People told us and we observed staff treating people with dignity and respect. This is what people told us; Yes, staff treat me with respect, They knock on my door and call out before they come in my room. I feel very well looked after, the staff are pretty good and they work well together. Staff without exception are all helpful and pleasant. If I need anything they get it for me. We asked staff to give us examples of how they protected peoples dignity and treated people with respect. They were all very aware of the importance of treating people as individuals and with respect for example one young carer who had only worked at the home for a short time told us; I always ask people for permission to help people undress and tell them what I am doing to ensure they are comfortable with the support I am offering them. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to meet their social, cultural and recreational needs. People received wholesome and appealing diets in surroundings, which met their needs. Evidence: People told us that routines in the home were flexible to meet their needs. They said they spent time in their rooms and or within communal areas of the home, as they wished. Ffor example one person told us to they chose to spend the majority of their time in their own room and the staff supported this but also offered company and opportunities to mix with other people in the home. Other people said they enjoyed the community aspects of the home and enjoyed other peoples company for the majority of the time. This demonstrated peoples opportunity to maximise choice and control over the lifestyles they led within the home. The manager told us and people confirmed they had an activities co-ordinator who works in the home for nine hours per week. The activities organised in the home included, hand and foot massage, jewellery making, gentle chair exercises, bingo and dominoes games, baking, and craft making. There had also been clothing parties and plans were in place to have cosmetics parties in the home to enable people to Care Homes for Older People Page 15 of 27 Evidence: purchase Christmas gifts. People had opportunities to access the local community on some occasions and the off site activities had included outings for lunch at the local pub, luncheon clubs at a local church and there were plans to take people Christmas shopping at a local shopping mall. This ensured that people had opportunities to mix and to join in organised events. People told us and their relatives and friends confirmed that visitors are welcomed in to the home at any reasonable time. People said they were able to see visitors in private in their own rooms. The mealtime we observed was organised and was relaxed. The dining areas were divided between two lounges and some people had the opportunity to have their lunch on individual tables whilst sat watching T.V. This was good practice and respected peoples individual choices. However, the only concern we raised about the organisation of the mealtime was that there were times when staff were not always in the same room as people eating their meals. We also observed someone struggling to swallow some food and for this reason we advised that at all times there should be staff in the dining areas to support people in case they have swallowing problems. We checked that people had swallowing assessments and nutritional risk assessments and in all three cases they had. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make complaints and their rights are safeguarded. Evidence: The manager told us and we saw evidence that a new complaints procedure had been devised and circulated to all of the people who use the service and their relatives and friends. No complaints had been made at the home since the last inspection. We asked people if they knew how to make a complaint, five out of the seven people we surveyed told us they knew how to formally complain and this is what they told us; I have got a copy of the procedure in my room. (They then showed us the procedure). I would shout up if I was not happy. I would just tell the manager or the staff if I was unhappy. The three staff interviewed knew what to do if someone wished to make a complaint. One person told us and the manager confirmed that they had supported a person to make a complaint about their discharge care from a local hospital and this is being Care Homes for Older People Page 17 of 27 Evidence: investigated at present. This demonstrated that people are supported to protect their rights as citizens. Two of the three staff interviewed had completed safeguarding adults training. They were also aware of the actions to take should they suspect someone was at risk of abuse. The manager told us that the newly recruited member of staff had been booked on this training. We asked for and were given evidence of staff training records which showed that adult safeguarding training had been offered in March 2008.We also found a copy of the local safeguarding adults policy and procedures in the home, which all staff have access to. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a warm, homely, safe and comfortable environment. Evidence: We asked people who lived in the home about the environment in which they lived and this is what they told us; Seven people said the home was, Always, fresh and clean. Another person said, I like my bedroom, I have brought in my own furniture. We made a partial tour of the premises and found the environment to be warm, clean, homely and hygienic. There was evidence the home was being redecorated and refurbished throughout. The manager confirmed this was being done in stages; communal areas first and then priority was being given to peoples bedrooms, which needed redecorating. One lounge had been completed and was bright and clean. New furniture had been provided in the lounges including high seat lounge chairs and footstools. There were new fire doors fitted throughout the ground floor communal areas. The manager also confirmed that a new roof had been put on the building and that central heating boilers had been checked and repaired as required. The call system has been redesigned to ensure staff can be alerted to peoples calls more efficiently. The owner advised us that new carpets, curtains and bedding had been ordered for most areas of the home as required and this was an ongoing programme. Care Homes for Older People Page 19 of 27 Evidence: There is a lift and staircase to the first floor to enable people access to their bedrooms. The lift was in working order on the day of our visit The home provides adequate numbers of bathrooms for people to use. The bathrooms and toilets checked were clean and fit for purpose. There are four lounges in the home and there are areas in each room to be used as a dining area, which had adequate numbers of tables and chairs etc. We checked the laundry area. The staff working in there confirmed they had adequate machinery and supplies to launder clothing appropriately, They also said that a new clothes dryer had been purchased and there were further plans to improve the laundry area to ensure staff had sufficient room to hang peoples clothing etc. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are protected by the recruitment and selection policy and procedures in place. Adequate numbers of staff are on duty to ensure that peoples diverse needs can be met. People are in safe hands as the staff are trained in how to keep people safe from harm. Evidence: There is an adequate staff rota in place that identifies peoples roles. The manager said the staffing levels are based on the needs of people who live at the home. This rota ensures that as a minimum staffing level there are two carers and a senior carer on each day shift and two waking care staff on duty during the night. This staffing is supplemented by the fact that the manager said there is always a cook on duty as well as cleaning and laundry ancillary staff, each day. We observed that this enabled the staff on duty to concentrate on supporting people with social and personal care tasks. The training records we checked showed that staff had completed the following training sessions since February 2008, care planning, adult protection, depression, dementia, approaches to dementia, falls, COPD, (Chronic Obstructive Pulmonary Disease), infection control, food hygiene, fire safety, health and safety and manual handling. Four staff had also completed first aid courses. Care Homes for Older People Page 21 of 27 Evidence: We saw evidence that a newly recruited member of staff had completed some induction training and this was ongoing. They were also able to confirm the induction training they had completed so far. Records also confirmed that more than 50 of the staff were trained to NVQ level 2 care awards and three carers had completed the NVQ level 3 award. One newly recruited member of staff needed to be put forward for the NVQ2 award. The staff we interviewed were much happier about the support and training they had been offered since the new owners had taken over the service. They said they felt more confident in their roles and more able to meet people’s needs as a result of this. The recruitment and selection procedures in the home were checked and found to be robustly adhered to. We checked three files and found all had CRB/POVA first checks, application forms with details of previous employers, two references and I.D. and health statements. The manager informed us that a training and development plan needed to be devised for the staff team and this was going to be devised in the near future. All of the staff we interviewed confirmed they had been offered support and formal supervision since the new owners had taken over. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are living in a well-run service. They are receiving appropriate levels of care and support to meet their individual and diverse needs. People are confident in the management of the home and find the manager approachable and professional. People are safe because the home makes sure all of the proper checks are undertaken and staff receive adequate support and training. Evidence: The manager said she had completed the Registered managers award and NVQ4 care management award. She has previously been registered as a manager with CSCI. However, the manager needs to re-register with CSCI. She has got the application forms but not yet completed and sent them to CSCI. She confirmed she would do this in the near future. The deputy manager has also gained the NVQ 3 Care award and was working towards NVQ 4 care management award. Care Homes for Older People Page 23 of 27 Evidence: People who lived in the home told us they were happy with the new management of the home. One lady told us, They seem very professional and caring and have started to sort things out. Another person said, They are quick to sort out any of my problems. The staff echoed this and described the managers as supportive and said they would listen to their concerns etc. In some cases people who live at the home and/or their families continue to manage their financial arrangements. Some peoples personal monies are managed by the home. We checked three of these and found each persons accounts tallied, receipts were kept and staff and people were signing monies in and out of their accounts. The manager and the owner confirmed that the home has a fire safety procedure and risk assessments. They showed us evidence that the alarm is checked weekly and that tests on equipment are also regularly made. We asked for evidence to show us that all equipment in the home is tested at appropriate intervals and all those checked had appropriate and up to date certificates. These included, fire safety equipment including fire extinguishers, lift, electrical and gas safety checks. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 5 Peoples care plans must contain adequate information about their needs. To ensure that staff understand how to meet peoples needs 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 A system should be introduced to ensure all medication records are accurately completed at the end of each shift to ensure that peoples health and welfare is protected. The manager should send in their completed application form to become the registered manager of the service. 2 31 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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