Inspection on 24/05/05 for Aaron Lodge

This inspection was carried out on 24th May 2005.

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 Lodge 14/04/09

Aaron Lodge 09/10/08

Aaron Lodge 24/04/07

Aaron Lodge 25/10/06

Aaron Lodge 17/10/05

Aaron Lodge 05/01/05

Aaron Lodge 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Aaron Lodge Marmaduke Street Liverpool L7 1PA Lead Inspector Beate Roth Unannounced Friday 20 and Tuesday 24 May 2005 09.30 th th 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 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 Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aaron Lodge Address Marmaduke Street Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 261 0005 0151 236 0005 Aaroncare Plc Care Home with Nursing 48 Category(ies) of DE (E) Dementia - over 65 registration, with number of places Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 24 DE(E) Personal Care and 24 DE(E) Nursing in the overall number of 48 One named person under 65 years old may be accommodated. Date of last inspection 5th January 2005 Brief Description of the Service: Aaron Lodge is registered to provide personal and nursing care to 48 elderly people who have an age related mental health condition. Aaron Lodge is a purpose built home. There are two units within the home on two floors. The ground floor unit provides nursing care and the first floor unit provides personal care. Each resident has a single bedroom. Bathrooms and toilets are situated on both floors. Each floor has a dining area and a lounge. There is a private enclosed garden to the rear of the home with patio furniture. Parking is also available at the rear of the building. A lift and bathing aids are provided. There is access to a bus service from the home. The home is close to local shops and amenities. The city centre is approximately 10 minutes away by public transport. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a day and a half. During the inspection time was spent in the office examining records and policies and procedures and talking to the acting manager, proprietor and support manager. A tour of the home was undertaken. Staff were observed delivering care to residents. The inspector spoke to residents and to staff. What the service does well: What has improved since the last inspection? 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. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 2 and 3 New residents are provided with contracts and are fully assessed before they are admitted to the home in order to ensure their needs are met. EVIDENCE: The sample of residents files viewed contained contracts. Each service user is provided with a contract after a period of settling in, usually within 4 weeks of admission. The contract contains all the required information. Sample copies of the contract used are available in the statement of purpose and service user guide. A sample of new residents files were examined. There was evidence of appropriate assessments being carried out before new residents move to the home. There was also evidence that information is gathered from social workers and health professionals to inform the assessment. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7 and 8 The health, personal and social care needs of residents are set out in an individual’s plan of care to ensure their needs are met. EVIDENCE: A sample of residents care plans were seen. These contained sufficient information to enable staff to meet the health, personal and social needs of the residents. The care plans seen had been reviewed monthly. Staff spoken to were aware of how to access a residents records. The acting manager reported that she endeavours to obtain the views of residents and their relatives regarding the care plan. Records showed that some signatures of relatives had been obtained. The records at the home and a discussion with the acting manager indicated that referrals are made to health professionals in accordance with the needs of residents. A record is made of visits by health professionals and the outcome is documented. The accident book was examined. Care needs to be taken when making these records. One entry could not be clearly read. A further entry did not indicate if an injury did or did not occur as the result of an accident. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 9 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 standard(s) 12 and 14. The routines of daily living are flexible and activities are available that reflect needs and preferences. Residents receive appealing well-balanced meals in pleasant surroundings. EVIDENCE: Observations and a discussion with staff indicated that the routines of daily living are flexible. There is a list of weekly activities available at the home. The acting manager reported that this is drawn up following consultation with service users. A record is made of activities that residents take part in. This includes gardening, board games, outings to the local park, pubs and shops, karaoke. The acting manager and a member of staff reported that when the staffing levels at the home are at a minimum due to absence this can affect the activities provided. This is being addressed as the staffing arrangements at the home are currently being reviewed. Observations of the dining areas at meal times indicated that a pleasant environment is provided for service users to have their meals, meals are unhurried and appropriate assistance to eat is given. It was observed that the independence of residents at mealtimes is promoted. The records of menus indicated that a variety of meals that would provide a balanced diet are available. Any special dietary needs are written in to a residents care plan. The cook reported that she is informed about any dietary needs and ensures Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 10 these are taken into account when meal planning. It was observed that residents appeared to be enjoying their meals. A resident said that they like the food provided. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 and 18 Staff training and policies and procedures are in place to ensure that service users views are heard and appropriate action taken. Improvements need to be made to the procedures at the home to ensure residents are protected from abuse. EVIDENCE: The home has an up to date complaint procedure that includes the name and contact details of CSCI. Staff spoken to are aware of the complaint procedure and are able to advise residents and their relatives of the steps to take to make a complaint. There have been two complaints made to CSCI about the home since the last inspection. One was founded, the second is being concluded. An adult protection and a whistle blowing policy and procedure are available. Staff are provided with training in these procedures. The adult protection procedure refers to staff investigating an allegation of abuse. This would not be the appropriate course of action to take. Allegations of abuse are to be referred to social services. This was brought to the attention of the proprietor who amended the procedure during the inspection. A recent incident of a resident making a possible allegation had not been referred to social services and had been investigated by a senior manager employed by Aaroncare Plc. The records relating to this were not available at the home. There was no documented evidence available to indicate that it was appropriate for a member of staff to return to work following suspension. The Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 12 acting manager reported that she had been advised that this was appropriate by the agency who investigated the matter. However, this information was not recorded. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19 and 26. The home is well maintained and there is a good standard of cleanliness and hygiene, providing residents with a pleasant environment to live in. EVIDENCE: A tour of the home showed that the home is well maintained and decorated to a high standard. There is a rolling programme of re-decoration and refurbishment. The home was clean and fresh smelling. The home employs a full time housekeeper and a team of domestics. The private garden area of the home is well tended and provides a patio area and patio furniture. There is a small balcony on the first floor leading from the lounge. The acting manager reported that this is seldom used. The acting manager was advised to carry out a risk assessment of this area. Following the inspection the proprietor reported that she had contacted the fire service and it was agreed that the balcony doors can be kept locked. The proprietor reported that the balcony area is only to be used if residents are accompanied by a staff member. This risk assessment is to be documented. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 There are sufficient numbers of staff with complementary skills to meet the needs of residents. Residents would benefit from improvements being made to the recruitment practices at the home. EVIDENCE: The rota and a discussion with the staff and the acting manager indicated that there are sufficient numbers of staff to meet the needs of the residents. There is a mix of trained and experienced care staff employed. There are currently vacancies for day care and night care staff. These vacancies have been advertised. The acting manager and proprietor reported on –going difficulties in recruiting registered mental health nurses. Bank and agency staff are deployed to cover staff shortfalls. The home endeavours to use the same staff in order to ensure continuity of care. A sample of staff recruitment files were looked at. In general, the required information was available. There was no evidence of a work permit for one member of staff. An examination of further staff files indicated that evidence of work permits was not available on all recruitment files where needed. Action has been taken to address. The inspector was concerned that a former member of staff who had a criminal record had been employed without undertaking a full risk assessment of the circumstances and implications for their working with vulnerable people. There was also no reference from a previous employer available for this former member of staff. These matters were discussed with the acting manager, support manager and proprietor. Appropriate action was taken to address the issues identified. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 15 Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38. There are quality monitoring systems in place and the policies and procedures of the organisation ensure that the health and safety of service users is promoted. EVIDENCE: The acting manager has been in post for 2 weeks. The competence of the acting manager cannot therefore, at this stage be assessed. The acting manager reported that she has worked at the home for 10 years and has in the last 18 months ran the residential side of the home. She has an NVQ 3 in care of the elderly and has completed an NVQ 4 in management and is awaiting verification of her portfolio. A discussion with the acting manager and records show that the acting manager has undertaken training to keep her skills and knowledge up to date. An application has been made to CSCI to register the acting manager. Records indicated that visits are made by the registered provider on a monthly Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 17 basis. These visits include discussion with residents and staff, a check of the standard of the premises and an examination of records. In addition an audit is carried out every 6 months, which focuses on a particular aspect of the running of the home. Questionnaires are sent to residents, their relatives and professionals who have contact with the home such as psychiatrists and doctors. There was evidence that when needed, action is taken to address findings. The records of fire safety checks, electricity and gas were in order. Training records showed that staff are given appropriate training in safe working practices. The timescales recommended by the fire service for fire safety training (day staff every 6 months and night staff every three months) was not being followed. There was a record to show that the home is insured. Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x x x 2 Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 19 No Are there any outstanding requirements from the last inspection? 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 18 Regulation 13 Requirement Timescale for action 24/05/05 2. 19 13 3. 29 17 The registered person must ensure that allegations of abuse are reported to social services without delay. All documentation relating to an allegation of abuse and the outcome must be held at the home. The registered person must 31/05/05 ensure that a risk assessment of the hazard presented by the first floor patio doors and the steps to be taken to minimise these risks is documented. The registered person must 24/05/05 ensure that staff who require work permits have them prior to commencing their employment at the home. The registered person must not employ a person to work at the care home unless the person is fit to work at the care home. A risk assessment of an adverse criminal records bureau check must be undertaken before a member of staff is employed. The registered person must ensure that fire training is provided to day staff on a 6 monthly basis and night staff on F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc 4. 29 19 24/05/05 5. 38 24 24/05/05 Aaron Lodge Version 1.30 Page 20 a 3 monthly basis. 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 Good Practice Recommendations Aaron Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Liverpool Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 Lodge F52 F02 S25077 Aaron Lodge V230059 200505 Stage 4.doc Version 1.30 Page 22 - 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. 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