Inspection on 21/03/06 for Aarondale Residential Home

This inspection was carried out on 21st March 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 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

Aarondale Residential Home 30/10/07

Aarondale Residential Home 21/03/07

Aarondale Residential Home 18/07/05

Aarondale Residential Home 12/10/04

Aarondale Residential Home 05/05/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Aarondale Residential Home Sunny Brow, Off Chapel Lane Coppull Chorley Lancashire PR7 4PF Lead Inspector Pauline Randles Unannounced Inspection 21st March 2006 09:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Aarondale Residential Home Address Sunny Brow, Off Chapel Lane Coppull Chorley Lancashire PR7 4PF 01257 471571 01257 470220 aarondale@highfield-care.com 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) Southern Cross Care Homes Limited Mrs Ann Margaret Sheward Care Home 48 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (28) Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home is registered for a maximum of 48 service users to include: Up to 20 service users in the category of DE (E) (Dementia over 65 years of age). Up to 28 service users in the category of OP (Old Age not falling into any other category). 1 named female service user in the category MD (Mental Disorder, excluding Learning Disability and Dementia) may be accommodated within the overall number of registered places. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 18th July 2005 6. Date of last inspection Brief Description of the Service: Aarondale is a purpose built care home, situated in a residential area. It is registered to provide care for 48 older people, 28 of whom require personal care, and 20 who have a mental illness or cognitive impairment. The accommodation comprises of 5 communal areas, 24 en suite single bedrooms and 24 single bedrooms. There is an open sided garden to the premises and a large rear garden, which is landscaped and enclosed. The home is close to local shops, post office, public house and local churches, all of which may be accessed by residents with assistance from staff if required. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a period of seven hours. During the course of the inspection documents and records were examined and relevant aspects of the premises viewed. The Deputy Manager, Team Leader, Business Administrator, two care staff, a domestic assistant, cook, a visitor and eight residents were spoken to, four of whom were case tracked. What the service does well: What has improved since the last inspection? What they could do better: The result of a pre admission assessment must be confirmed in writing to the prospective resident to confirm whether the care home is suitable to meet their presenting needs or not. The wording, in the Service User Guide, that describes the arrangements for the safekeeping of residents’ finances should be reviewed to ensure Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 6 grammatical correctness and that the facilities offered follows good practice guidance. The teatime meal should be monitored to assess whether soup is served hot enough for residents and whether sandwiches are retaining their freshness, failing which suitable adjustments should be made. Reference to Matron on the manager’s door nameplate should be removed so that residents are not misled. At least 50 of care staff should achieve NVQ Level 2 in Care to demonstrate competence. Staff members should sign to confirm their understanding when policies and procedures have been read. The resident should sign accident reports wherever practicable to confirm the accuracy of the content of the report. Action taken, as a result of a fire risk assessment should be formally recorded to improve accountability. 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. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Some improvements to the Service User Guide would ensure that prospective residents and their representatives were suitably and fully informed about possible residency. The needs assessment process was incomplete as prospective residents were not being formally advised in writing whether a residential place could be provided. EVIDENCE: The Statement of Purpose and Service User Guide included all the required elements of service provision and facilities. The service provider kept both documents under review. The address of the Commission For Social Care Inspection (CSCI) local office had not been changed at this time. It was recommended that the wording of the paragraph relating to safekeeping of residents’ money be revised to ensure grammatical correctness and accord with good practice. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 9 It was suggested that the word “personnel” be amended to “personal” and “access” should read “excess”. Also, in accordance with good practice the text should reflect that, where money of individual service users is handled the manager ensures that the personal allowances are not pooled. In addition if the resident wishes to open an individual bank account they should be empowered to do so, irrespective of the amount of money involved. Pre admission assessment processes were in depth including for example dependency, nutrition, and moving and handling and pressure area risk assessments. It was required that, following assessment, the prospective resident be informed in writing whether the care home is able to meet their health and welfare needs. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Plans of care were detailed, reflecting assessed needs. The health needs of service users were well met with evidence of good multi disciplinary working and effective medication administration practices were in place. EVIDENCE: Care plan systems were detailed and included reference to physical, emotional and social needs building on the initial needs assessment information. The proprietors had introduced a new care plan format and senior staff members were in the process of transferring information across. There was evidence that residents and their relatives were being encouraged to participate more in the reviewing of care plans. One resident said that the deputy manager, “Comes and discusses when bringing up to date.” A relative spoken to had completed a life storybook with photographs for staff information and to better inform the care planning process. It was recommended that care plans be transferred fully to the new format as a priority, and that residents or their representatives should sign when care plans were completed and reviewed to evidence their involvement, and agreement to the plan. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 11 Personal records of residents that were examined indicated that appropriate health care had been accessed for individuals. This included optical, dental, chiropody, general practitioner and district nursing services. When asked about health care one resident commented that staff members were, “Very good if a doctor was needed.” Medication policies and procedures were in keeping with requirements and medication administration records had been effectively completed. Controlled drugs held for two residents were suitably recorded and safely stored. A spot check of drugs held, indicated an accurate amount. Only senior staff and those trained in medication procedures administered drugs. Examination of the home’s policy, discussion with residents and observation confirmed that residents were treated with courtesy and respect. Staff members were polite to residents and enabling to those who required support and guidance. One of the residents spoken to said “They’re grand here.” Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Residents were enabled to see their chosen visitors in a safe and private environment and to participate in a range of activities. The methods for serving teatime food were not adequate. EVIDENCE: There was evidence of a range of activities taking place. These included group activities and individual. It was observed at the time of inspection some residents were having their hair styled and fingernails polished. As one resident said, “There’s always something going on.” Notices of events were posted around the building and records were maintained of individual participation. Residents and a visitor spoken to confirmed that the visiting policy was upheld. Visitors were made welcome, offered refreshments and included, where appropriate in care planning. A visitor spoken to, said, “Made welcome, everyone knows me.” Menus indicated that balanced and nutritious meals were offered with alternatives. However several residents commented that at teatime, “Sandwiches a bit dry,” and “soup not always hot.” It was recommended, and agreed that the delivery of the teatime food would be monitored to ensure food Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 13 was served sufficiently hot and fresh otherwise adjustments to improve service should be made. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Policies and procedures of the home protect the residents from the potential of abuse and enable any issues or concerns to be addressed. EVIDENCE: Examination of procedures and complaints record indicated that complaints were addressed and investigated effectively. Discussion with residents and staff showed there was an understanding of the procedures and a willingness to raise concerns as they arose. One resident spoken to said she had raised issues and was confident they had been addressed. She went on the say that the registered manager was “very approachable.” Procedures for the protection of vulnerable adults included general information plus guidance on dealing with verbal or physical aggression and whistle blowing. These procedures were underpinned by Department of Health guidance No secrets in Lancashire. Some staff had undertaken specific training and further specialist training was planned. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 26 The premises provided a clean and homely environment that will be further enhanced when planned improvements are made to the designated smoking area. EVIDENCE: Communal spaces were generally comfortable and warm with suitable furnishings and lighting. Some progress had been made in addressing previous recommendations in relation to smoking arrangements. Staff members were no longer permitted to smoke within the home. A request for the installation of an extractor fan and a dividing door in relation to the residents smoking area had been put forward to the provider company. Permission had been given, at the time of inspection to proceed with seeking quotes for the door installation. The home was maintained hygienically and was odour free at the time of inspection. A resident spoken to confirmed that the premises were kept clean and said that was due to “very good cleaning ladies.” From discussion with one of the domestic assistants and examination of procedures it was clear that Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 16 there was an understanding of safe working practices in regard to cleaning and the effective control of infection. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 The arrangements for staffing the care home and training staff ensured that residents were suitably cared for by skilled and competent people. EVIDENCE: At the time of the unannounced inspection the home was suitably staffed in accordance with minimum requirements of the previous regulatory authority. Residents commented that staff members were readily available. One resident spoken to about the availability of staff said, “It’s wonderful and people join together.” The reference to “nurses” on nameplates and notice boards had been removed as previously recommended. However there remained a reference to “Matron” on the office door. It was recommended that this reference be removed to avoid any misconception about the nature of service provided. There was a strong commitment to training evidenced from discussion and training records. Two managers had undertaken training in care of older people with dementia that was to be extended to relevant members of the staff team. Catering staff had completed food hygiene training. Four staff members had undertaken abuse training. Further training was planned in relation to this topic. A number of care staff had completed National Vocational Qualification Level 2 and several spoken to were undertaking NVQ Level 3. The registered manager is aware that at least 50 of care staff should attain a minimum of NVQ Level 2. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Effective measures for quality self- assessment were in place. Systems for enabling individual residents to have control of their money and be protected from the risk of fire were in need of review. EVIDENCE: The registered manager has had many years experience in managing care services for older people and holds qualifications at NVQ Level 4 in both management and care. The registered manager has attended relevant professional training as evidenced from records and by her attendance on a dementia care course at the time of inspection. There were clear lines of accountability within the management structure. There were systems in place to ensure a quality service was maintained these included surveys of residents, and their relatives, as evidenced from records and discussion with a visitor. Policies and procedures were kept under review. A number of new policies had been established and others were in the process Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 19 of being introduced. It was recommended that staff members sign to confirm when policies and procedures have been read and understood. Requirements and recommendations from previous inspections had been effectively addressed. Money held on behalf of service users was held safely and individual records were maintained in an auditable format. However the money itself was kept as a “Pooled facility for residents.” It was recommended that the personal allowances of service users are not pooled and that the wording of the Service User Guide in this regard is reviewed. The procedure as described in the Service User Guide also stated that, “For amounts in access of £500 designated bank accounts can be opened.” It was recommended that residents be empowered to open bank accounts irrespective of the amount of money they wish to save to ensure they are maximising their investments. Health and safety policies and procedures were in effective use. Safety notices were appropriately posted throughout the building. Staff members had undertaken training in safe working practices. Risk assessments were in place and kept under review. Accident reports were examined. It was recommended that the report when completed by a member of staff be signed by the resident wherever practicable to agree the content. Certificates of compliance with water, gas and electrical safety were in place. Fire records were up to date and equipment had been tested at the required frequencies to ensure safety of residents. Individual risk assessments had been completed in relation to three residents and control measures identified. However the actions taken as a result had not been formally recorded. It was recommended that a recording system be established and the risk assessments be kept under review. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X 2 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP3 Regulation 14 (1) (d) Timescale for action The registered person must 15/04/06 confirm in writing whether the care home is suitable to meet the assessed needs of the prospective resident. Requirement 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. 3. 4. 5. 6. Refer to Standard OP35OP1 OP7 OP15 OP27 OP28 OP33 Good Practice Recommendations The Service User Guide should be reviewed to ensure grammatical correctness and that the facilities offered follow good practice guidance. Care plans should be signed by the resident or their representative, be fully completed and kept up to date at all times. The teatime meal should be monitored to ensure food is sufficiently hot and fresh when served. Reference to matron on the office nameplate should be removed. 50 of care staff should achieve NVQ level 2 Staff members should sign to state that policies and procedures have been read and understood. DS0000005948.V273996.R01.S.doc Version 5.1 Page 22 Aarondale Residential Home 7. 8. OP38 OP38 Where practicable residents should sign accident reports to agree the content. Actions taken as a result of a fire risk assessment should be formally recorded. Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Aarondale Residential Home DS0000005948.V273996.R01.S.doc Version 5.1 Page 24 - 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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