CARE HOMES FOR OLDER PEOPLE
Aarondale Residential Home Sunny Brow, Off Chapel Lane Coppull Chorley Lancashire PR7 4PF Lead Inspector
Mrs Marie Cordingley Unannounced Inspection 30th October 2007 09:00 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.V347227.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 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.V347227.R01.S.doc Version 5.2 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.V347227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 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. 21st March 2007 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 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, a post office, a public house and local churches, all of which may be accessed by residents with assistance from staff if required. The fees at the home range from £374 to £480 per week. Items not covered by the fees include hairdressing, incontinence products, chiropody, newspapers and toiletries. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection of Aarondale included a site visit to the home which was completed in one day, and unannounced, meaning that the manager, staff and residents did not know it was going to take place until we arrived. During our visit we spent time with residents talking to them about life at the home. We also spent time observing the day-to-day routines of the home and care staff, as they provided support. In addition, we held discussions with the registered manager and members of care staff and viewed a selection of documents such as residents’ care plans and staff personnel files. We also carried out a case tracking exercise which involved us looking closely at the care provided to selected residents from the point of their admission to the home. A tour of the home was undertaken and included bedrooms, lounges, dining areas, toilets and bathrooms. This was to assess whether the home provided a safe, comfortable and homely environment for residents. Prior to our visit we asked the manager to complete a very comprehensive questionnaire. This gave us a great deal of information about procedures within the home and also told us about the people who live and work there. We wrote to a selection of residents, their relatives and visiting health care professionals before we visited the home. We asked them to complete written surveys which asked their opinions about the standards of care at Aarondale. A number of completed surveys were returned to us. What the service does well:
We received a number of responses to our written survey and people who returned questionnaires spoke highly of carers and managers. We received some very positive comments which included; ‘The carers do a marvellous job.’
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 6 ‘Everyone is always so pleasant.’ ‘The home provides en excellent service in a genuinely warm and caring environment.’ Residents we talked to during our visit also expressed satisfaction with the approach of staff and managers. One resident said ‘’They can’t do enough for you, it is a very happy place to be.’’ The home has a very thorough approach to admitting new residents and the manager always ensures that enough information is gained about a prospective resident to confirm that their needs can be met. Even the care needs of residents who are admitted on an emergency basis are thoroughly assessed straight away, so that carers know the level of support they should provide. Each resident has a very comprehensive care plan in place which details their care needs and the support they require in each area of their life. Residents care plans are regularly reviewed to ensure that their changing needs are taken into account when planning their care. In addition, we were able to confirm that the residents and their families where appropriate, are fully involved in their reviews. The care plans we viewed contained very thorough risk assessments in relation to areas such as pressure care, falling and nutrition. Any risk to the individual had been clearly identified and detailed guidance was in place to help carers promote residents’ safety. Residents’ daily care records confirmed that they are supported to access health care whenever they need it. The manager told us that the home had very positive relationships with community health care professionals and this was confirmed by a visiting district nurse we consulted. She told us that the home were very good at identifying and acting upon any health related concerns in relation to residents and also said that staff always incorporated any advice she gave into residents’ care plans. Residents at Aarondale are provided with a nutritious and varied diet. The home has recently introduced a new system to ensure that people’s nutritional needs are met. When developing menus, the chef has access to software which provides a nutritional breakdown of every meal and assists him in creating the right balance for residents. The home also ensure that those residents who are unable to read or understand menus, are given the opportunity to make food choices. Residents who live in the unit for people with dementia are shown the plated up options available each day and encouraged to indicate a preference. Aarondale is a spacious home and all accommodation is offered on a single room basis. The manager has clearly put a great deal of thought into improving the environment and has made some very positive changes in the unit for people with dementia.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 7 Each bedroom door on this unit has been updated to look like a front door of a house with panels and brass furniture, so that residents have a sense of ownership of their room. The doors have been painted different colours to make it easier for people to recognise their rooms. A number of seating areas have been developed around the unit so that people who choose to move about, can take rests. Some themes have been introduced on the unit, for example one of the seating areas has been decorated to look like a park. All around the unit there are pictures of residents and pieces of artwork they have created. There are memory boxes arranged around the unit for people to look at and pictures and posters from various eras. Aarondale has the benefit of a suitably experienced and qualified manager who demonstrates a genuine commitment to providing a good quality service. Throughout our visit we noted that residents were very relaxed in the manager’s presence and clearly enjoyed a positive relationship with her. Staff we consulted throughout the inspection were also very complimentary about the manager of the home describing her as very supportive. One staff member said ‘’She is 100 dedicated to the residents, they are her first priority no matter what.’’ What has improved since the last inspection?
Some recommendations were made following the home’s last inspection. We were able to confirm during this inspection that these had been addressed. Procedures in relation to the administration of residents’ medication have been improved and the home now ensure that carers are provided with detailed guidance about any medication that is prescribed on a ‘PRN’ basis. This means that the individual resident may only need to take the medication from time to time for example, as pain relief. It is important that carers have all the information available to make a decision as to whether a PRN medication should be administered. The home have increased their number of qualified carers and during this inspection it was confirmed that over 50 of carers now hold National
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 8 Vocational Qualifications in care at level 2 or above. This ratio is in line with National Minimum Standards. The manager advised us that a number of environmental improvements had been made within the home. These included, the refurbishment of two bathrooms and the provision of new flooring in one area. As earlier stated, a number of improvements have also been made on the unit for people with dementia, including the provision of a number of seating areas and the updating of all residents’ bedroom doors, to resemble front doors of houses. What they could do better:
No requirements were made as a result of this inspection. However, we did make some good practice recommendations in relation to a number of areas. We viewed a number of residents’ care plans and these were found to be very comprehensive. However, none of the plans contained social histories. We discussed this with the manager who had already started to address this and advised us that life storybooks were currently being developed for residents who have dementia. We recommended that this process continue and that social histories be developed for all residents who want them. Information gathered in social histories is important because it assists staff in recognising each resident’s uniqueness and in planning their care in a person centred manner. All staff who have responsibility for administering residents’ medication are provided with training in this area. In addition, the manager carries out periodic observations of staff administering medicines to ensure that they are competent. We recommend that records of these observations be maintained. In viewing staff training records we noted that there are no carers at the home who have received any kind of training in working with people with dementia. The manager is addressing this and some senior members of staff have recently completed training in this area and this is to be rolled out to all carers. We recommend that this be done as a matter of priority. All carers working with people with dementia should receive specific training. We viewed records of residents’ meetings and found that these had taken place less frequently than we would recommend over the last year. We advised the manager to resume these meeting as soon as possible and ensure that they are held on a regular basis. We also advised the manager to consider resuming relatives’ meetings.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 9 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. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 10 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.V347227.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable to this home). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers have a good understanding of people’s needs as soon as they move into the home. This means that people can be assured they will receive the help they need straight away. EVIDENCE: We viewed a number of residents’ care needs assessments and found them to be very comprehensive. Assessments covered all areas of daily life such as personal care, mobility and nutritional needs. Where a resident’s assessment had identified they had needs or preferences in a certain area, this has been addressed in their care plan.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 12 Dates of assessments confirmed that this process is generally carried out prior to the resident’s move to the home, unless they are admitted on an emergency basis. For the people we case tracked who had been admitted on an emergency basis, a thorough assessment had been carried out on their arrival. Whilst we found assessments to be very comprehensive, none of those we viewed contained social histories. Social histories contain information about a person’s past, such as previous employment and family history. They are important as they assist carers in valuing each resident’s uniqueness and to plan their care in a person centred manner. We discussed this with the manager who had already identified that social histories should be added to the assessment process and was planning to make this addition. In discussion we were told that staff are sensitive when dealing with residents who are new to the home and make attempts to help people settle into their new surroundings. One resident who had moved to the home a few days earlier told us that staff had spent time with her putting up her pictures and arranging personal items such as ornaments in her room. She said this made her feel at home. Another resident told us that she had visited the home prior to her move and had a meal. She had found this helpful and said that this had helped her get a feel for the home. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care is planned in line with their personal needs and wishes. People’s medication is handled safely. EVIDENCE: We viewed a number of care plans which were of very good quality, providing a detailed picture of residents’ care needs and guidance to staff in how to meet them. Areas covered in care plans included personal care, mobility, nutrition and social activities. In addition, where a resident had complex behavioural needs, these were addressed and there was guidance on how staff should approach challenging situations. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 14 A number of staff members we spoke to commented on the quality of residents’ care plans. One carer said, ‘’When you read someone’s plan, it tells you exactly what help they need so you can be confident that you are caring for them the right way.’’ All the care plans we viewed had been reviewed on a regular basis so that staff were aware of residents’ changing needs. We also found evidence that residents and where appropriate, their families had been involved in the review process and had been given the opportunity to have their say about the care provided. There were very thorough risk assessments in place for all the residents we case tracked, in areas such as pressure care, falling and moving and handling. Where appropriate, any risks had been clearly identified and there was guidance to staff on how to maintain residents’ safety. Residents’ daily care records confirmed that they are supported to access health care whenever they need it. The manager told us that the home had very positive relationships with community health care professionals and this was confirmed by a visiting district nurse we consulted. She told us that the home were very good at identifying and acting upon any health related concerns in relation to residents and also said that staff always incorporate any advice she gives into residents’ care plans. We viewed the home’s medication stores and records relating to the administration of medicines. These were all found to be well maintained and in good order. In particular, the information provided to staff in relation to PRN medicines (as and when required) was very thorough and would enable them to make the correct decision as to whether they should administer it. We were able to confirm that all staff members who are responsible for administering medication are observed doing so by the manager on a regular basis. This is to ensure that they are competent and work safely when managing people’s medicines. However, these observations are not recorded at the present time. We advised the manager to ensure that all such observations are recorded in the future. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at this home are encouraged to take part in valued and fulfilling activities. Residents are provided with a nutritious, varied and appealing diet. EVIDENCE: In the entrance of the home, there is a pictorial notice board advertising residents’ activities such as bingo, tapestry, painting and quizzes. In discussion we learned that these activities were available on a regular basis. We were also advised that as a result of listening to residents, managers have arranged more visiting entertainers such as musicians. Some of the residents we talked to were looking forward to a musician who was due to visit the next day. We also found that residents have the opportunity to take part in trips out of the home quite regularly. The home has access to a minibus which is shared
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 16 with other homes in the area, and residents are offered trips out to places such as garden centres or local pubs. There is an activities coordinator employed at the home who has training in working with people with dementia. At the time of our inspection the activities coordinator was working on providing one to one activities for people which met their individual preferences. For example, one gentleman who was a keen walker, was being supported to follow his hobby on a regular basis. The environment in the dementia unit has been carefully developed to stimulate residents. As we carried out our tour we noticed a number of items of interest, such as memory boxes and items from the past such as a nineteen forties sewing machine. In talking to residents we were able to confirm that they have the opportunity to exercise choice in their daily lives. One resident we spoke to told us how he chose to spend his time in the garden area of the home. He said he spent time in the garden every day. Residents at Aarondale are provided with a varied and nutritious diet. The home has recently introduced a new system to ensure that people’s nutritional needs are met. When developing menus the chef has access to software which provides a nutritional breakdown of every meal and assists him in creating the right balance for residents. The home also ensure that those residents who are unable to read or understand menus are given the opportunity to make food choices. Residents who live on the unit for people with dementia are shown the plated up options available each day and encouraged to indicate a preference. We observed a meal time on the unit for people with dementia and noted that residents were eating a variety of different meals We viewed menus which showed that a good variety of meals are offered and that there is also a number of different choices available every day. As well as meals at breakfast, lunch and evening, residents are offered snacks and drinks mid morning, mid afternoon and in the evening. We spoke to the cook who told us that he was provided with an ample budget to provide good quality meals and also to cater for special occasions such as birthdays. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are enabled to voice their concerns and these are acted upon appropriately. EVIDENCE: The home has a complaints procedure in place which tells the reader how to go about making a complaint and what will happen if they do so. The procedure is included in the Service User Guide which is provided to all new residents at the point of their admission to the home. In addition, it is posted on the home’s notice board. People who responded to our written survey told us that they knew how to go about making a complaint. One person wrote ’ I am sure that if I had any worries Anne (the manager) would want to get it sorted out straight away.’ There is a record maintained within the home of any complaint made. We examined this record and found that the home had received one complaint since their last inspection. We found that this complaint had been thoroughly investigated and the appropriate action taken.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 18 The home has in depth ‘Safeguarding Adults’ procedures in place which outline the action that will be taken in the event that an incident of abuse is reported or suspected. During their induction, staff are also familiarised with the home’s whistleblowing procedures which encourage them to report any such concerns immediately. Staff we spoke to had a good understanding of whistleblowing procedures and were confident that the manager would deal with any such concerns effectively. One staff member said ‘’If anything like that happened here Anne would leave no stone unturned to get to the bottom of it.’’ Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Aarondale is a well maintained, clean and comfortable home. EVIDENCE: Aarondale is a spacious home and all accommodation is offered on a single room basis. We carried out a tour of the home and found all areas to be clean, warm and comfortable. The home is generally well maintained and the manager has a rolling programme in place to ensure that any area in need of improvement is dealt with straight away. In addition, the manager has access to a 24 hour helpline for cases of emergency such as plumbing or heating.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 20 There are a number of staff employed to ensure the home is well maintained including a housekeeper, several domestic staff and a full time maintenance worker. In discussion, the housekeeper confirmed that she had been provided with training in a number of areas including health and safety, infection control and COSHH (control of substances hazardous to health). The manager has clearly put a great deal of thought into improving the environment and has made some very positive changes in the unit for people with dementia. Each bedroom door on this unit has been updated to look like a front door of a house, with panels and brass furniture, so that residents have a sense of ownership of their room. The doors have been painted different colours to make it easier for people to recognise their rooms. A number of seating areas have been developed around the unit so that people who choose to move about can take rests. Some themes have been introduced on the unit, for example one of the seating areas has been decorated to look like a park. All around the unit there are pictures of residents and pieces of artwork they have created. There are memory boxes arranged around the unit for people to look at and pictures and posters from various eras. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager works carefully to ensure that only suitable people are employed at the home. Staff receive training in a number of areas but would benefit further from training in working with people with dementia. EVIDENCE: A number of people we consulted both in writing and in person, talked about the staffing levels at the home and raised concerns that they were not adequate. We discussed this with the manager who advised us that the home had recently experienced a short term problem in respect of staffing levels, due to the sudden departure of two staff members and a high level of leave. The manager advised us that this issue had since been rectified and that a number of new staff members had been employed. We viewed rotas which indicated that there were now a sufficient number of staff members on duty at any time to meet residents’ needs. The manager also advised us that she had taken measures to ensure that staffing levels did not become a problem in the future, for instance by increasing the number of bank staff that could be called upon.
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 22 We advised the manager to keep staffing levels under constant review in line with residents’ needs. We examined a number of staff files and found the home follow thorough procedures to ensure only suitable people are employed. On applying for employment, a candidate is required to give a full employment history. We saw evidence that where any gaps are present in a candidate’s employment history, they are investigated by the manager. In addition, all new starters must provide two written references, one being from the last employer wherever possible. New staff members can only start work after providing a Criminal Records Bureau disclosure. There is a good approach to training at the home which begins with the induction of all new staff members. We viewed records of staff members’ induction and were able to confirm that this training is in line with Skills for Care Standards. Ongoing training includes all the mandatory health and safety areas such as moving and handling and fire safety. Carers are also provided with training in other areas such as pressure care and continence. In addition, we were able to confirm that over 50 of carers at the home now hold National Vocational Qualifications in care at level 2 or above. However, we found that none of the carers within the home had been provided with training in caring for people with dementia. We discussed this with the manager who advised us that this programme was due to begin shortly. We also recommended that the core training for senior care staff be reviewed to include additional courses such as providing supervision. Staff we talked to told us that they felt well supported and in viewing records, we were able to confirm that all carers are provided with one to one supervision sessions with their manager on a regular basis. This is an opportunity to discuss areas such as training, general work performance and any concerns that either party may have. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well managed home which is run in the best interests of residents. EVIDENCE: Aarondale has the benefit of a suitably experienced and qualified manager who demonstrates a genuine commitment to providing a good quality service. Throughout our visit we noted that residents were very relaxed in the manager’s presence and clearly enjoyed a positive relationship with her. Staff we consulted throughout the inspection were also very complimentary about the manager of the home describing her as very supportive. One staff member
Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 24 said ‘’She is 100 dedicated to the residents, they are her first priority no matter what.’’ There are a number of systems in place to help managers monitor quality and constantly make improvements (quality assurance systems) and we saw evidence that residents and their representatives are routinely involved in these processes. Regular satisfaction surveys are sent to residents and their families and the results of these are carefully analysed and displayed on the home’s notice board. As a result of information from these questionnaires, the home have made a number of changes such as increasing the number of visits from professional entertainers. We viewed records of residents’ meetings and found that these had been less frequent than we would recommend over the last year. We advised the manager to resume these meeting as soon as possible and ensure that they are held on a regular basis. We also advised the manager to consider resuming relatives’ meetings. The home keeps very thorough records in respect of financial transactions made on behalf of residents and any valuables held on their behalf. We viewed the records and found them to be in very good order. In addition, the records are regularly audited to ensure their accuracy and further safeguard residents The home has a health and safety policy in place which is supported by a number of procedures including fire safety. Staff training records confirm that all carers are provided with training in the mandatory health and safety areas at the start of their employment. We viewed a selection of health and safety records, for example fire safety records, and found them to be in order and up to date. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 25 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 x x 3 x x x 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 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 OP3 OP9 Good Practice Recommendations Where a resident is in agreement, a social history should be developed so that staff can plan care in a more person centred manner. Staff who are responsible for administrating medication should be observed doing so on a regular basis. Records should be kept of these observations so that the manager can demonstrate that she has confirmed that staff who handle residents’ medicines are competent in this area. Staffing levels should be constantly monitored to ensure they are adequate for the number of residents and their level of dependency. All carers supporting people with dementia should have training in this area. The core training programme for seniors should be reviewed to include courses such as supervision. Residents’ meetings should be held on a regular basis. Consideration should be given to resuming relatives’
DS0000005948.V347227.R01.S.doc Version 5.2 Page 27 3. 4. 5 6 7. OP27 OP30 OP30 OP33 OP33 Aarondale Residential Home meetings. Aarondale Residential Home DS0000005948.V347227.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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