Inspection on 18/05/05 for Aden House Nursing Home

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Aden House Nursing Home 31/07/07

Aden House Nursing Home 06/03/07

Aden House Nursing Home 22/06/06

Aden House Nursing Home 08/09/05

Aden House Nursing Home 14/12/04

Aden House Nursing Home 14/04/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Aden House Nursing Home Long Lane Clayton West Huddersfield HD8 9PR Lead Inspector Sally McSharry Unannounced 18 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aden House Nursing Home Address Long Lane Clayton West Huddersfield HD8 9PR 01484 866486 01484 861928 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Aden House Ltd Mrs Carol Ellis Care home with nursing 60 Category(ies) of Older People over 65 60 (including Physical registration, with number Disability 4) of places Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 14 December 2004 Brief Description of the Service: Aden House is a purpose built home situated in Clayton West close to the main Wakefield road. The home offers personal and nursing care for up to 60 older people; it is also registered to accommodate up to 4 adults with physical disabilities. Aden House is situated on the same site as its sister home Aden Lodge, and is within a short walking distance of the main bus route on the Wakefield Road. Aden House offers single, en-suite bedrooms facilities on the ground and first floor. Communal sitting and dinning areas are located on the ground floor. The first floor is accessed by a passenger lift. The home also offers a day care service for up to 15 service users, however at this visit it was reported that this service is being run down with a view to stopping the service once current attendees have left. There are garden areas to the front and rear of the building and there is a patio area where service users can sit out if they so wish. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit carried out on 18 May 2005. The inspector looked at a selection of the core National Minimum Standards. During the visit the inspector spoke to some service users and staff, read some care plans and checked medication systems. Staff training and recruitment records were also audited. What the service does well: What has improved since the last inspection? What they could do better: Service users feel there are insufficient activities and social events in the home. Some service users feel staff talk too much among themselves and not enough to the service users. The management of medication is poor and the registered manager is not carrying out the necessary checks required on staff before they start work at the home. Further staff training is required to ensure staff are trained in adult protection and to ensure all staff move and handle service users safely. Service users said they liked living in the home, however they said that a small minority of care staff sometimes seem to run the home for their own convenience rather than for the service users. When asked if they had raised these issues with the manager, some service users felt this would be pointless and that if they did things would not change. Issues raised by the service users must be acted upon by the manager. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 6 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. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 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 standard(s) EVIDENCE: These standards were not assessed during this visit. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, and 10. Service users’ needs are identified in individual care plans. Service users health care needs are being met. The home is failing to manage medications correctly. Some medications could not be accounted for. Not all service users feel they are respected. EVIDENCE: The inspector read a sample of service users’ plans. The information provided was generally clear and gave sufficient information to enable staff to care for service users safely. Care records are generally reviewed monthly, however some risk assessments such as nutritional assessments and an assessment to ensure a service user is able to safely self medicate were not being reviewed monthly. All care plans and all assessments should be reviewed monthly to ensure that the planned actions remain safe. Daily records remain brief and still do not reflect how service users’ psychological and social wellbeing have been met. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 10 At the time of this visit one of the Primary Care Trust’s practitioner nurses was visiting the home to review some of the service users. The inspector was able to speak with her. The nurse said that she had been visiting the home weekly for the last 18 months. In that time she had noticed an improvement at the home. It was her opinion that service users were cared for in the home and that the staff at the home managed one particular service user with a multitude of ailments well. The nurse also felt that care was provided in a manner which respected individuality and choice. Medications audited could not be accounted for. Medications in the monitored dosage system could be checked and balanced against records, but those in individual boxes and bottles could not, as no stock balance had been carried over from one month to the next. The home has a policy for homely remedies however it was clear that the staff on duty did not know of the policy and were not working to the policy. In one case it was not clear where staff had obtained one dose of paracetamol from, to administer to a service user. Most of the service users said that staff were kind, caring and respected their privacy. Two service users said the male carers in the home were particularly caring. Two service users said it would be nice if staff spent more time talking to them, rather than to one another. Staff should be encouraged to spend time talking to service users. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. There are insufficient activities offered in the home. Service users are able to maintain contact with their families and the community. Some service users are not always able to exercise choice or control over their lives. Service users have choice of a varied, balanced menu. EVIDENCE: Most service users felt that the activities offered in the home had decreased and that insufficient social activities were being offered. Service users confirmed that they are able to maintain contact with their relatives and the local community. Members of local churches visit the home on a rotational basis. Service users said they have choices in the home such as a choice of meals, where they spend their time, what time they go to bed and get up in the morning. Two service users expressed some frustrations when asking for assistance; staff often tell them they have to wait, this is difficult particularly when service users want assistance to use the toilet. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 12 All service users were clear in their view that the meals provided in the home are varied, balanced and appetising. The meal being served at the time of the visit was very appetising. There was a choice of beef or fish; service users said the beef was beautifully cooked. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Service users were aware who to complain to, however not all were confident that their concerns would be dealt with. Systems are in place to protect service users from abuse. EVIDENCE: Service users were aware how to raise concerns and were very complimentary about senior staff, their kindness and professionalism; however not all service users were confident that if they raised concerns with the manager they would be addressed. There are systems in place to protect vulnerable adults. Some, but not all staff have received training in abuse awareness and the protection of vulnerable adults. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, and 26. The home provides a safe and comfortable environment for service users. There are adequate facilities and equipment to met the needs of service users. Service users are able to personalise their rooms. The home is clean and tidy. EVIDENCE: Some alterations are being carried out in the home at present; however the home was generally clean and tidy. Communal and bedrooms areas are pleasantly furnished and decorated. Some of the bedrooms are showing signs of wear and tear, however there is a redecoration programme ongoing in the home. The manager has addressed the issues identified in the last inspection report. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. There are sufficient staff to meet the needs of the service users accommodated in the home. Service users are not being protected by the home’s recruitment procedure. Staff receive some training to enable them to do their jobs. EVIDENCE: Current staffing levels are sufficient to meet the needs of the current numbers of service users accommodated at the home. Ancillary staff are also provided seven days a week. Some service users raised concerns that during the evening there were few staff around the lounge areas and that sometimes staff take breaks at the same time, leaving service users unattended in some areas of the home. This needs to be addressed by the manager and monitored by senior staff. Recruitment procedures are not being followed. Recent employees have not had the necessary Protection of Vulnerable Adult or Criminal Records Bureau checks taken up by the home. The manager must not allow staff to start work in the home until the necessary checks and references have been returned and found satisfactory. Some staff have had training but there was not evidence that all staff have had mandatory training such as movement and handling, fire and abuse awareness training. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 16 Approximately ten staff are working through a distance-learning course in positive dementia care, to help them understand and care for service users. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Some service users are not being moved and handled safely. EVIDENCE: During the visit staff were seen to transfer a service user manually, without the aid of lifting equipment. The service user was unable to assist and staff used an under arm lift. This lift was potentially dangerous to the service user and the two members of staff involved. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 x 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 x x x x x x x 1 Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. Standard 9 12 16 18 29 Regulation 13 16 22 13 7, 9, 19 & schedule 2 18 23 Requirement Timescale for action 31.08.05 There must be safe systems for the recording storage and administration of mediactions More activities must be provided. 31.08.05 The registered manager must ensure concerns raised by service users are addressed. All staff must receive training about abuse awareness and the protection of vulnerable adults. The registered provider and registered manager must ensure full recruitment procedures are carried out and records maintained. All staff must receive fire and movement and handling training. There must be safe systems for the movement and handling of service users. Staff must be trained and supervised to ensure they move and handle service users safely. 31.08.05 31.08.05 30.06.05 6. 7. 30 & 38 38 31.08.05 30.06.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 20 No. 1. 2. Refer to Standard 7 7 Good Practice Recommendations The daily entries should reflect how service users psychological and social well being have been met. All care plans and risk assessments should be reveiwed at least monthly, including nutritional assessments and any assessment carried out to ensure a service user is safe to self medicate. Staff should be trained and encouraged to spend more time talking to service users. Staff should be trained to ensure they priortise work and meet service users expectations. The registered manager and senior staff should ensure service users are attended and supervised at all times. 3. 4. 5. 10 14 27 Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Aden House Nursing Home J51J01_s1105_AdenHouse_v226890_180505.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!