Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Aaron Lodge Marmaduke Street Liverpool Merseyside L7 1PA The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Paul Kenyon Date: 0 9 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Aaron Lodge Marmaduke Street Liverpool Merseyside L7 1PA 01512610005 F/P01512610005 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Aaroncare Limited care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 0 Over 65 48 Conditions of registration: The home may accommodate up to 48 DE(E) Personal Care. The home may admit two persons DE Personal Care between the ages of 55 and 65 within the total of 48 beds. The Service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home may admit 5 persons under the age of 65 years. Date of last inspection Brief description of the care home Aaron Lodge is registered to provide personal care to 48 elderly people who have an age related mental health condition. Aaron Lodge is a purpose built home. 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 Care Homes for Older People
Page 2 of 10 home is close to local shops and amenities. The city centre is approximately 10 minutes away by public transport. The range of fees for residing at the home are between #385.00 and #415 per week. Care Homes for Older People Page 3 of 10 What we found:
Five assessments were examined relating to individuals who had come to live at Aaron Lodge since the last inspection. Four are funded by the Local Authority and one privately funded. The individual who is privately funded has been assessed by the service. In all other cases, the service had assessed their needs and had obtained an assessment fro the Local Authority. One Local Authority assessment had not included a health need that had been developed by the person once admitted into Aaron Lodge. The needs of this person are being reviewed. The services own assessment includes reference to the social needs of individuals as well as any other significant health need. In all cases, the assessments had been completed or obtained prior the individual coming to live at Aaron Lodge. Care plans were examined for five individuals. One person did not have a care plan and this is raised as a requirement in this report. In the remanding four care plans, all had been reviewed at least on a monthly basis. All care plans are accompanied by daily records. In some cases, daily records were not clear and referred to the fact that all care had been given. It is recommended that reporting writing is more detailed and outlines the care provided to each person. Staff interviews confirmed that staff were aware of care plans and in some cases had been given the responsibility to review them monthly. Health records for five individuals were examined. These contained details of when individuals had been involved with health care professionals. These ranged from regular District Nurse visits to other visits such as Doctors visits and visits by the skin specialist team. There have been some issues in respect of communication between the District Nurse services and the service. The Manager is currently reviewing all District Nurse notes. It is recommended that the Manager continues to liaise with the Community Matron on a regular basis. Other health records were examined. In some cases, individuals had had their susceptibility to pressure sores assessed but this had not been done in all cases. This is raised as a requirement in this report. In addition to this, risk assessments relating to those activities pursued by individuals were examined yet only in some cases could a manual handling assessment be produced. This again is raised as a requirement. Nutritional assessments had been carried out for all those sampled during the visit yet weight monitoring was not done monthly as a minimum. This is raised as a recommendation in this report. Staff interviews were held with three staff. In all cases, staff considered that they had enough aids and adaptations to meet the needs of those who needed help with transferring or those with pressure sores. Complaints records were examined. In some instances, incidents had been included on the form which are not complaints. As a result, complaints records were not coherent Care Homes for Older People Page 4 of 10 and could not be followed. It is understood that a new complaints form was to be introduced once it was approved by the organisation that operates the service. In some cases, complaints had not been included on records or no conclusion had been made. It is required that complaints are recorded to ensure that any complaints are investigated systematically. There have been a number of safeguarding referrals from the service in the last twelve months. The recording of safeguarding issues was not complete. It is required that there is continued liaison between the service and the Funding Authorities in respect of safeguarding referrals and outcomes of these referrals. There was evidence that staff had been issued with the main parts of the Local Authority safeguarding procedure and staff had signed to confirm that they had received this. Information in respect of safeguarding issues is also on prominent display in staff areas. Interviews with staff confirmed that some had had safeguarding training but some had received this a while ago Training records confirmed that the provision of this training had been inconsistent. It is required that all staff receive this training. The Manager confirmed that she had training materials available for staff training on this subject. Staff interviews confirmed that they were aware of whistle blowing procedure. Staff interviews suggested that some staff did not consider that current staff levels were sufficient. In addition to this, the auditing of accident records concluded that there was a need for more observation. This conclusion was made over several months in 2008 and as a result it is required that staffing levels are reviewed to ensure that they meet the needs of those who use the service. Training records for fourteen members of staff were examined. This suggested that while mandatory training had been received, there was inconsistent provision of training in safeguarding adults, pressure sore care and dementia awareness. It is required that this training is provided to all to assist in meeting the needs of individuals. Interviews with staff confirmed that they had received mandatory training. Other training received included medication training. Staff confirmed that they had either attained or had commenced a National Vocational Qualification. The Manager has been working in the service for a number of years and is registered with the Commission For Social Care Inspection. Currently she is receiving support from the Training Manager of the company who is looking at the service and providing with support at present. The training manager outlined a number of developments that she is undertaking in the home and has identified the need for some support. She is seeking to recruit a senior member of staff to provide a link between the Manager and the shop floor who is specialised in clinical issues and can liaise with District Nurses. Recruitment for this post has commenced. She has identified that there is a need to review the management structure to ensure that needs of individuals are met and that staff are developed. Accident records were viewed and these have been audited for the past few months. There was a conclusion in some cases that more observation needed. As a result of this, it has been raised as a requirement previously in this report that staffing levels Care Homes for Older People Page 5 of 10 are reviewed What the care home does well: What they could do better: 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 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 13 (4) (c) Risk assessments and daily records must be completed and kept up to date to ensure the safety of residents 25/10/2007 Care Homes for Older People Page 7 of 10 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 15 All individuals who use the service should have a care plan So that their needs can be met 28/11/2008 2 8 12 Manual Handling assessments must be devised for all So that their health and safety is promoted 28/11/2008 3 16 22 The recording of complaints must be coherent So that those who use the service and their families can be confident that their concerns are investigated approriately 28/11/2008 4 18 13 The service must ensure that 28/11/2008 there is continued liaison with the Social Services Department in respect of safeguarding issues So that those who use the service are protected form abuse 5 18 13 The service must ensure that 31/12/2008
Page 8 of 10 Care Homes for Older People staff receive abuse awareness training So that those who use the service are protected form abuse 6 27 18 Staffing levels must be reviewed To ensure that the needs of individuals are met and that their health and safety are promoted 7 30 18 Staff must receive consistent 30/01/2009 training To ensure the needs of all individuals who use the service are met 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 31/12/2008 1 7 Report writing should be as detailed as possible to enhance care plans in order to meet the needs of those who use the service. Weights should be monitored at least monthly so that the health of all is promoted The service should continue to liaise with the Community Matron in order to ensure that the needs of those with pressure sores are met 2 3 8 8 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. Copyright © (2008) 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. Care Homes for Older People Page 10 of 10 - 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!
