Inspection on 30/11/06 for Aaron Park Care Home

This inspection was carried out on 30th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Aaron Park Care Home 10/01/06

Aaron Park Care Home 14/07/05

Aaron Park Care Home 11/03/05

Aaron Park Care Home 01/07/04

Aaron Park Care Home 10/02/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Aaron Park Care Home 115 Poplar Road Cleethorpes North East Lincs DN35 8BD Lead Inspector Eileen Engelmann Key Unannounced Inspection 30th November 2006 09:30 Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 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 Park Care Home DS0000002818.V322316.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 Adults 18-65. 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 Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aaron Park Care Home Address 115 Poplar Road Cleethorpes North East Lincs DN35 8BD 01472 605685 F/P 01472 605685 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) info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Miss Vanya Louise Briggs Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (21) of places Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user, CM, who is over the age of 65 with a mental health problem to be accommodated in the home until discharge or in the event of death. 10th January 2006 Date of last inspection Brief Description of the Service: Aaron Park is a 21 bedded home for younger adults who experience mental health problems. The home is a converted two-storey property situated in the seaside town of Cleethorpes. The home is not registered to provide nursing care, however the home has developed good working relationships with local health care professionals and agencies. The home has 14 single rooms and 3 double rooms, privacy screens are provided. In addition the home has a range of communal facilities, which residents and visitors can access. The home has a good-sized courtyard garden complete with barbeque, flowerbed and a grassed area. The home maintains its staffing levels in accordance with levels set as at the 31.3.02. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home is available in the reception area. Information given by Louise Hayward (compliance officer) on 09/10/06 within the Pre-Inspection Questionnaire indicates the home charges a range of fees depending on the specific needs of the residents. Current fee scales are from £272.00 to £1200 per week and that there are no additional charges other that those for transport, hairdressing, private chiropody treatment, toiletries and newspapers/magazines (all of these are optional). Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was carried out with the manager, staff and residents of Aaron Park. Input from the compliance officer and provider was obtained by telephone, to clarify some issues discussed in the report. The visit took place over one day and included a tour of the premises, examination of staff and resident files and records relating to the service. Three of the staff on duty and seven of the residents were spoken to; their comments have been included in this report. Information was gathered from a number of different sources before the inspector visited the home. Questionnaires were sent out to relatives, residents and staff and their written response to these was good. The inspector received 2 back from relatives (100 ), 8 from staff (80 ) and 9 from residents (90 ). The provider completed a pre-inspection questionnaire and returned this to the Commission within the given timescale. Since the last inspection there has been a change of manager at the home, and feedback from the residents, relatives and staff is positive about the new person in-charge. What the service does well: The home offers residents the opportunity to make choices and decisions around their daily lives. Seven individuals said that ‘the staff are great, they offer help and support when you need it and respect your wishes when you need to be alone’. Staff support and encourage the residents to be as independent as possible. Risk assessments are used to enable residents to take responsible risks in their daily lives whilst making sure each individual’s safety and wellbeing is protected. Seven residents spoken to said how important their freedom to come and go from the home was to them and that staff understood this need. Contact with family and friends is encouraged and staff assist individual’s to maintain these relationships. The home is welcoming and has a relaxed atmosphere. Residents said they are happy with their bedrooms and can bring in their own possessions, making it feel more like home. Residents are provided with a warm, safe and comfortable environment that is homely and welcoming. The home is clean and staff work hard to make sure the building is odour free. Residents are able to have their comments and feelings about their care written into their individual care plan. Their viewpoint is valued and forms part of the monthly update of the care that is being given. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 6 How staff work and look after the residents is observed and checked by the manager on a regular basis. Staff are able to talk about any problems they may have and they receive information about how well they are doing from the manager. This makes sure that residents receive good care from staff who know how to do their jobs. 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. The summary of this inspection report can be made available in other formats on request. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is good. All residents have a full needs assessment carried out and are given enough information about the home and its facilities before admission, for them to be confident that their needs can be met by the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Aaron Park is essentially a home for younger adults, those within the age range of 18-65. Information gathered from the pre-inspection questionnaire indicates that six of the existing residents are now over the age of 65 and this number will increase over the next two years if the current residents remain in the home. Discussion with the manager and provider indicated that the home is aware of the changes within the structure of the residents group and this is being monitored on a regular basis. Discussion with the residents themselves and observation of the home showed that the needs of the older residents are being met by the service and facilities, and they are satisfied with the care and support they receive. The primary needs of all the residents are those linked to Mental Health problems and this means the residents continue to have similar goals and expectations that are not defined by age or physical needs, and they continue to ‘gel’ as a community. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 9 Since the last inspection the home has made adjustments to the statement of purpose and service user guide to document the change in managers. These documents are made available to residents on admission, are on display within the home and can be given out to anyone making a request for these. Information from the surveys showed that four of the nine residents who responded had been provided with written information about the service before they came into the home, and others had received verbal information prior to accepting placement. One individual said ‘ the hospital put me in here, I was given information about the home and my family came to look around and said it was nice. I met the manager and she was lovely’. Another resident said ‘ the manager came out to visit me and gave me information about the home so I could decide if I wanted to stay there’. Discussion with seven residents indicated that they are satisfied with the care at the home and those who spoke to the inspector all said the staff are caring and attentive to their needs. All of the current residents in the home are from a white, British culture although the service can and has in the past catered for others from different backgrounds. Information in the individual care plans includes specific wishes regarding spiritual needs, diets and activities of daily living. The care plans include risk management strategies that are reviewed and updated regularly for each individual. Staff members on duty were knowledgeable about the needs of each resident and had a good understanding of their specific problems/abilities and the care given on a daily basis. Discussion with the residents showed that they have a good relationship with the staff. Residents are able to make a limited choice of staff gender when deciding who they would like to deliver their care, as the home has two male staff who work night and day shifts, as well as the female members. Each resident has their own individual file and four of those looked had a need assessment completed by the funding authority and the home has also completed its own needs assessment before a placement was offered to the resident. The home develops a comprehensive care plan from the assessments, identifying the individual’s problems, needs and abilities using the information gathered from the resident, family (where applicable) and health care professionals involved in their care. The manager told the inspector that no changes to standard 5 have taken place since the last inspection (January 2006). The home has produced a statement of terms and conditions for private paying residents, which meets the required standard, but this document has not been given to funded individuals. Previous discussion with Louise Hayward from Prime Life Limited indicated that the company is currently working on the development of a suitable format that can be given to all residents on admission. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 10 This is an outstanding requirement from previous reports and their timescales (31/7/04, 31/5/05, 01/11/05 and 10/04/06) have not been met. The manager must ensure this is given priority in the home’s action plan for this inspection report. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Quality in this outcome area is good. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. Residents are encouraged to be independent within their daily lives using a risk assessment approach to care This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to produce and keep clear and well-written care plans for the residents. Individual care plans are in place for all residents and set out the health, personal and social care needs identified for each person. Risk management strategies are in place for certain individuals where a need is identified; these cover aspects of daily living as well as specific behaviours. All the plans looked at have been evaluated on a monthly basis and any changes to the care being given are documented and monitored by the staff. Risk assessments were seen to cover nutrition, moving/handling and activities of daily living and Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 12 residents have signed their own care plan. Information about the resident’s social interests, likes and dislikes, spiritual needs and wishes regarding death and dying are all included within the individuals care plan. The funding authorities are carrying out yearly reviews of the care plans and the minutes of these meetings show that residents have input to this process (where possible), and family/representatives are also invited to the reviews with the resident’s permission. Discussion with the staff and manager indicates that an important aspect of reviewing the care plans is the input from the residents. Individuals spoken to said they can discuss their care and write their viewpoints into their own plans and where residents struggled with this, the staff would record it for them. Information in the plans clearly shows this two-way discussion and the outcomes reached and agreed on. Information from the surveys indicates that the majority of the residents feel they are able to make their own decisions about life in the home, although two individuals said they felt some restrictions because they had been assessed as needing support when going outside of the home. One person commented that ‘ I like to get on the bus and go into town, I enjoy life in the home and can do what I want within reason and I like going in the home’s car for a drive’. Two other residents said ‘ I get up in the morning, have a shower and my medication and enjoy sitting in the smoke lounge talking to other people from the home’. One resident told the inspector that ‘ I visit the local shops, have a cup of tea and I especially like the second-hand shops for clothes shopping’. Discussion with the seven residents indicated that they have access to group meetings and can express their feelings and ideas about the home and its service, and these are listened to and acted on where appropriate. The manager said she uses the meetings to discuss subjects such as vulnerability in the community, keeping safe in public places and deciding group strategies as to how they can be confident and safe whilst outside of the home. Staff enable residents to take responsible risks in their every day lives and information within the care plans includes a number of risk assessments covering activities of daily living and individual ones linked to residents choices and wishes regarding their care. Where necessary risk management plans have been decided and agreed with the residents and these are reviewed and updated on a regular basis. The manager said that on admission the resident is taken into the local town and assessed for their knowledge of road safety. Escorts from the home are available for those lacking confidence or ability to go out on their own. Individuals are offered support to use public transport and a number of residents spoken to have bus passes or use the local rail network. Each care plan looked at has a missing persons information page within it, which would be used by the staff to aid police or others looking for the individual. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 13 In the last inspection report (January 2006) the inspector raised concerns over the confidentiality of complaints and accidents given that these are recorded in bound books, and do not have removable pages. Discussion with the manager and examination of the files indicates that no action has been taken since the last visit to address these issues. See comments in standard 22 and 42. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Residents are provided with choice and diversity in the meals and activities provided by the home. Relatives and visitors are made welcome at the home and good links to the community enrich the residents social and leisure opportunities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two of the residents do voluntary gardening work through the TUKES project, which is set up by the psychiatric hospital service. It involves individuals going out into the community to do voluntary work and receive training with a view to moving into paid work/training. Individuals have access to educational courses and TUKES will also help residents with computer courses if wished or needed. One individual is accessing help with numeracy skills from ‘Addaction’, which is a group helping people with addiction problems Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 15 Residents feel part of the local community and are comfortable and familiar with the transport systems and amenities in the area. One person said ‘ I like to get out and go to the shops and have a cup of tea. I especially like the second hand shops for clothes shopping’. Another resident commented that ‘ I like to get on the bus and go into town and I enjoy life in the home. I can do what I want within reason and I like going in the home’s car for a drive’. Contact arrangements between residents and friends/family are clearly documented in the individual care plans and have been made using a risk assessment process that looks at vulnerability and risk of harm. The residents, and the people they wish to visit, make decisions around the contact process with some input from the home or other healthcare professionals were needed. Some individuals see their families on a regular basis, whilst others choose to visit less often or not at all. One individual said they enjoyed visits by their family to the home and also kept in touch by telephone. ‘I like to go home to see my relatives and the staff support me to do this’. Another person told the inspector that ‘ I visit my brother regularly and have visits from my niece’. Seven residents spoken to said that they all have their own keys to their bedrooms and staff respected their privacy at all times. Mail is given to them unopened and there is a pay phone for their private use. Individuals feel that they are given choice and freedom within their daily lives and staff support them to be as independent as possible. One person said ‘ I am happy with how the home is run and I enjoy sitting in smoke lounge talking to the other service users’, another commented that the routine of the home was comfortable and they felt able to mix with others or be on their own when they needed time alone. Observation of the staff and residents together indicated that they have respect for each other and feel relaxed and at ease in the home. Comments made between individuals were friendly and showed there is a good relationship between all parties. Residents are able to take part in the menu planning, as Wednesdays are ‘Clients day’, when each resident takes their turn to plan the day’s meals. Recent choices have been as diverse as Quail (not everyone agreed with this), and the local speciality of fish and chips. Those people who do not like or want the choices made by the individual can access an alternative meal. Residents are very positive about the food and meal choices available at the home, comments made included ‘the foods great’, ‘plenty of grub given to you’ and ‘there is always something else if you don’t like what is on the menu’. The cook is aware of individual’s likes and dislikes and said that she caters for four diabetics within the home. Information on dietary needs and choices is clearly recorded in the care plans and input from dieticians is available if needed. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. The medication at the home is well managed promoting good health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information within the care plans clearly record the wishes and preferences of each resident regarding their personal care, and staff displayed a good understanding of the needs and support required for each individual. Individual residents are able to discuss and comment on their care in their own records and the comments seen indicate that they feel in control of their own lives. The majority of the residents at Aaron Park are independent care wise, with staff offering prompts and encouragement to maintain their hygiene and personal grooming. Individuals have a limited choice of staff gender when deciding who they wish to give their care, as there are only two male staff employed at the home. The daily routine is flexible and residents are able to exercise their independence in all aspects of their daily lives. One individual said ‘I get up in a morning, have my shower and medication and then the day is my own’. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 17 All the individual care plans seen during this visit document the visits and input each resident has received from various outside professionals, including local GPs, chiropody, dentist, optician and hospital outpatient clinics. Staff spoken to, said that they would accompany the resident’s to any appointment or support them to attend independently if wished. Discussion with seven residents indicated that they have insight into their illnesses and care needs, and can make decisions about their own healthcare/medical treatment. Recent notification reports sent to the Commission have shown that staff do not always agree with or understand the resident’s decision around medical care, but never the less they respect and support the individual’s decisions and ensure they have received full information and assessment from a medical professional to help them make their choices. A recommendation was made in the last report (January 2006) for staff to be provided with suitable facilities for storing valuables and personal items, as the current arrangement of using the medication cupboard is not acceptable. Discussion with the manager indicates that this has not been acted on and therefore it remains a recommendation in this report. The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. Checks of the medication records and the system used showed that these are up to date, accurate and well managed. Repairs have been made to the medication trolley since the last report and a new one is now in use. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Improvements to the recording aspect of the complaint system must be made to ensure issues raised by individuals are kept confidential; however, residents are satisfied that their views are listened to and acted on. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information from the complaints record and the pre-inspection questionnaire indicate that no complaints have been received since the last inspection. Comments from the residents survey indicates that the majority of the people living at the home are aware of the complaints procedure and know how it works. One person said ‘ I would speak to the staff, manager or my social worker if I had any problems’ and another commented that ‘ there is no need to make any complaints because staff are always looking after us and there is nothing wrong with the home’. Two other residents said ‘you can go knock on the manager’s door if you have a problem’, and ‘I would make a complaint in writing and give it to the manager to deal with’. No changes to the way in which complaints are recorded have been made since the last inspection (January 2006). This is not acceptable practice and the company must look at how it can change the type of documents it is supplying to the home for complaint record keeping, to ensure individuals can be assured that their right to confidentiality is upheld. Complaints are currently recorded in a book, but this does not offer individuals confidentiality because the format means that anyone writing in the book can Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 19 see previous complaints that have been made by different people. Discussion with the staff indicated that the book is accessible to all employees, and is kept in the manager’s office. The inspector recommended that a separate complaints form should be developed that can be filled in by the complainant and filed away by the manager once an issue has been investigated and resolved. The policies and procedures on Protection of Vulnerable Adults from Abuse (POVA) have been up dated and ‘No Secrets’ documentation has been produced in a booklet form by the company, and is available for staff. Three staff spoken to displayed a good understanding of their role and responsibilities regarding this aspect of care. They said that POVA was discussed during staff meetings and supervision, and that they had received training on POVA issues through their National Vocational Qualifications and training on handling challenging behaviour (NAPPI). Seven residents said that they felt safe and secure at the home and that staff spoke to them about being careful and alert regarding their personal safety when away from the home. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The standard of the environment within this home is good providing residents with a comfortable and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an ongoing programme of maintenance and renewal at the home and a property audit carried out by the company in February 2006 identified areas for redecoration, new floor coverings, furniture, furnishings and general repair and action. The manager said that most of the issues in the audit have been completed and she is waiting for a new kitchen to be fitted. Discussion with the provider indicates that he is aware that the layout of the home is not suitable for disabled individuals and given the aging population of residents this may cause some problems in the future. Planning is underway to look at how this can be monitored and addressed as needed. The residents spoken to are satisfied with the facilities at the home and feel that it is homely, welcoming and comfortable. Comments made include ‘Staff do a good job looking after the home and keeping it tidy’, ‘residents bedrooms Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 21 are always nice and clean’ and ‘it is nice to walk from room to room and find it all smells lovely’. The manager said that the home had a visit from the Environmental Health officer in October 2006, but she had not yet received their report. ‘A number of small issues were raised during the visit and many of these have been addressed and the staff are working towards completing any outstanding areas’. The recommendation for a fly screen to the back door of the kitchen, made in the last report (January 2006) has been actioned. Discussion with the manager and the staff indicate that the current office facilities in the home are too small and cramped for individuals to carry out the administration tasks of the home efficiently. The limited space makes it difficult to maintain confidentiality and privacy during handovers and meetings. The provider should consider what other arrangements could be made to provide a more spacious office area for the home. The home is clean, warm and comfortable and no malodours were present. Discussion with the care staff indicated that they are responsible for carrying out all domestic cleaning and laundry tasks. Policies and procedures are available for the control of infection. The laundry room is accessed from the outside of the home and discussion with the manager indicates that it is due to be altered and updated within the next year. Information from the residents indicates that they are satisfied with the laundry service provided by the home. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. The standards of staff supervision and training are good, ensuring the workforce is knowledgeable/skilled and competent to meet the needs and expectations of the residents, whilst maintaining their health, safety and wellbeing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff team at Aaron Park has a mix of experienced and new care workers. All individuals have access to the Prime Life Limited training department and can take part in a range of different learning sessions. Information from the staff files and that given by the manager indicates that 23 of staff have achieved a National Vocational Qualification at level 2 or 3, four more individuals are in the process of completing this training and five others are enrolling. Discussion with the staff indicated that they have a good understanding of the disabilities and specific conditions of the residents, but they would like more indepth training around specialist subjects linked to Mental Health and information about diversity and equality. These issues were discussed with the manager and will be entered as a recommendation in this report. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 23 Residents said that ‘ staff listen to us and act on issues raised as required’, ‘staff are kind and are always there for you if you need to talk or have any problems’. The home has an equal opportunities policy and procedure. Information from the staff personnel and training records and discussion with the manager, shows that that this is promoted when employing new staff and throughout the working practices of the home. The manager said that the home has tried to recruit more male carers in the past as the management team is aware that the majority of staff are female, but this has proved difficult as there have been few suitable applicants. She is aware that this may affect resident’s wishes regarding gender choice for giving of personal care, and this is discussed before an individual is offered a placement at the home. Comments from the manager indicate that all of the residents are from a white British background, but the home is able to offer a range of services when they are approached from someone of another culture or ethnic group. Checks of three staff personal files raised some concerns as these new starters had all been employed before a Protection of Vulnerable Adults register check had been obtained and before the police check came back. There was written evidence that the manager was acting on recent instructions (September 2006) from the Head Office of the company. A subsequent telephone conversation with the provider clarified that this was a misunderstanding and managers would be contacted immediately and asked to disregard the instructions as they had been written incorrectly and sent out in error. Staff files showed that new starters are supervised until their employment checks are completed and received by the manager, and references, health checks and past work history are all obtained and satisfactory before the person starts work. The home provides a mandatory staff-training programme and information in the staff training files and discussion with the staff indicates uptake of training has been good over the past 12 months and there is a staff training matrix in place to monitor this. Discussion with three members of staff indicated that they are motivated and enthusiastic about their work, and have a relaxed and confident approach to their care of the residents. Staff comments were positive about their access to training and the support they receive from the manager. Individuals receive regular supervision, both formal and informal and feel that this aspect of support is useful and offers them an opportunity to discuss their views and get feedback on their performance. Discussion with the manager and staff showed that employees are also receiving their annual appraisals. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The management of the home is satisfactory overall and the home regularly reviews aspects of its performance through a good programme of audits and consultations, which includes seeking the views of residents, staff and relatives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection there has been a change in manager at the home and Vanya Briggs is now registered with the Commission. She has completed her Registered Manager’s Award and attends regular training sessions and updates to maintain her knowledge and skills around Mental Health and Safe Working Practices. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 25 The home has Investors In People status and there is a Prime Life Limited Quality Assurance system in place. Audits of the service are carried out on a regular basis. Meetings for the staff and residents are taking place; minutes are kept and are available for any interested parties to read. Residents and staff agree that they are able to express ideas; criticisms and concerns without prejudice and the management team will take action where necessary to bring about positive change. Individuals said ‘ the manager listens to issues and acts quickly to resolve things’, ‘she deals with things professionally and confidentiality is maintained’. Policies and procedures are up dated and reviewed as an ongoing practice and action is being taken to ensure the requirements of the inspection reports are met. Feedback is sought from the residents and relatives through regular meetings and satisfaction questionnaires. A requirement made in the last inspection report of January 2006 was for information from the questionnaires to be analysed and put into an annual development plan. This documents the comments received and shows how the home has altered or developed its service as a result of this input from those using the service. Information shown to the inspector at this visit indicates that the manager is beginning to pull this information together to produce an annual development plan, although this still needs some minor amendments to include statistics gathered during the process. The inspector will look at this again at the next inspection. Maintenance certificates are in place and up to date for the utilities and equipment within the building and training records show that staff have attended safe working practice up dates. Discussion with the manager and observation by the inspector showed that changes to the accident books recommended in the last report (January 2006) have not been implemented, and therefore will remain on this report. Checks of the accident books found that incidents are accurately recorded, but the books do not promote confidentiality, as they do not have removable pages so information about different people is available to anyone using the book. Staff spoken to confirmed that all employees have access to the book within the manager’s office. The inspector recommended that the manager ask the company for the new ‘data protection’ type book where the pages detach from the book and can be filed away in the resident’s personal file or for access by the manager only. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 3 x Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 27 Yes. 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 YA5 Regulation 5 Requirement Timescale for action 01/04/07 2. YA10 17 The registered manager must develop and agree with each prospective resident a written and costed contract/statement of terms and conditions between the home and resident (given timescales of 31/7/04, 31/5/05, 01/11/05 and 10/04/06 were not met). Staff must ensure that 01/04/07 information (complaints and accidents) about the residents is kept confidential (given timescale of 10/04/06 was not met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA22 Good Practice Recommendations Staff should be provided with suitable facilities for storing valuables, as the current arrangement of using the medication cupboard is not acceptable. A separate complaints form should be developed that can DS0000002818.V322316.R01.S.doc Version 5.2 Page 28 Aaron Park Care Home 3. 4. 5. 6. YA24 YA32 YA35 YA42 be filled in by the complainant and filed away by the manager once an issue has been investigated and resolved. The provider should consider what other arrangements could be made to provide a more spacious office area for the home. The provider should ensure 50 of care staff have a NVQ 2 by the end of 2007. The manager should ensure staff have access to training in Specialist subjects linked to Mental Health conditions and Diversity and Equality. The home should introduce an accident book in line with ‘data protection’ guidance, with detachable pages so information about individual residents can be filed into their own personal files or kept where only the manager has access. Aaron Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 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 © 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 Park Care Home DS0000002818.V322316.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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