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Inspection on 08/09/05 for Aden House Nursing Home

Also see our care home review for Aden House Nursing Home for more information

This inspection was carried out on 8th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Aden House provides a pleasant, clean and tidy environment for service users. Service users said they were made to feel welcome at the home. Staff assist service users to access NHS services and advice from other health care professionals if needed. Service users said staff were kind and respectful and that choice is offered in the home; some service users spoke of being able to maintain their independence and control over their own lives. Clear records are maintained regarding any money left at the home for individual service users.

What has improved since the last inspection?

During this visit service users` comments about the home and the staff were all positive. The new Butterfly unit provides a small nine bedded area for service users with dementia and it was positive to see staff sat spending time with service users. Movement and handling training and techniques were seen to have improved. During this visit service users said they were confident about how to raise any concerns they had and that these would be addressed.

What the care home could do better:

The registered provider must ensure there are safe systems for the storage, recording, administration and disposal of medications in the home. The amount and variety of activities offered in the home must be increased. Although some fire and movement and handling training has been provided, work is still required to ensure all staff have been trained in these areas. Staff must also be trained to recognise and report any potential abuse and to protect vulnerable adults. Fire checks and tests must be carried out weekly in the home. Quality assurance systems should be introduced to audit the services provided at Aden House.

CARE HOMES FOR OLDER PEOPLE Aden House Long Lane Clayton West Huddersfield HD8 9PR Lead Inspector Sally McSharry Unannounced 8 September 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 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Aden House 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 Position vacant. Care Home with Nursing 60 Category(ies) of Older People 51 registration, with number Physical Disability 4 of places Dementia - (over 65) 9 Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 18 May 2005 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 a maximum of 60 older people; it is also registered to accommodate up to 4 adults with physical disabilities and has a relatively new 9 bedded unit caring for eldery service users with dementia. This Unit is known within the home as The Butterfly Unit. 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 bedroom 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 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out by one inspector on 8 September 2005. Since the last inspection the manager from the sister home Aden Lodge has transferred to Aden House. The Commission for Social Care Inspection (CSCI) is awaiting an application from the new manager Mrs Karen Smith to formally register this change of management. The following inspection methods were used during this visit: discussion with service users, staff and management. Inspections of a sample of records including care plans and risk assessments, staff training records, staff recruitment records, health and safety documentation, some policies and procedures. A limited tour of the building was also made. Some improvements have been made since the last inspection, although some areas require further attention. Feedback from residents and staff was positive. What the service does well: What has improved since the last inspection? During this visit service users’ comments about the home and the staff were all positive. The new Butterfly unit provides a small nine bedded area for service users with dementia and it was positive to see staff sat spending time with service users. Movement and handling training and techniques were seen to have improved. During this visit service users said they were confident about how to raise any concerns they had and that these would be addressed. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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) 3 and 6. Most Service users’ have their needs assessed before they move into the home. EVIDENCE: A sample of service user records were examined, these showed that service users are assessed in relation to their health and welfare needs before being admitted to the home. The new manager advised that no referrals have been made since she took up post at Aden House but that she will endeavour to assess service users prior to their admission to the home. The home does not have an intermediate care contract but does provide shortterm respite care. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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’ health and welfare needs are identified in individual care plans and there is evidence that health care needs are being met. Medications are not being managed safely. Staff treat service users with respect and uphold their right to privacy. EVIDENCE: The new manager is currently reviewing care plans. The inspector audited a sample of four care plans. These showed that service users’ health and welfare needs are identified and a plan of care advises staff how to meet those needs whilst in the home. Following recommendations made in the last report the standard of daily records has improved and there is evidence that service users’ psychological needs are reported upon. There is also evidence that care plans and risk assessments are now being reviewed monthly. Risk assessment are used, however not all service users have an assessment in relation to nutrition. It is recommended all service users are assessed against the risk of poor nutrition and the assessment be reviewed monthly. Care documentation shows that where needed other health care professionals and NHS services are accessed for service users. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 10 At the last inspection issues were identified regarding the management of medications. Issues were again identified. An audit of medications showed that the amount of tablets held at the home does not correspond with records. A full review of the medications policy and procedures must be carried out including the policy relating to homely remedies and the disposal of medications. Comments made by service users during this visit were very complimentary particularly about the staff. Service users were well presented and staff were seen to talk to service users and assist them with activities of daily living in a kind and sensitive manner. Service users said they felt safe and that staff respected and maintained their privacy. One service user commented that she has never heard any member of staff speaking unkindly to any service user. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 and 14 Service users’ lifestyles experienced in the home do not fully meet their expectations, as limited activities are offered. Service users are assisted to exercise choice and control over their lives. EVIDENCE: Despite efforts to recruit an activities co-ordinator the manager has been unsuccessful in employing a member of staff specifically to organise activities in the home. Therefore activities offered are still limited. The requirement made in the last report to provide more social activities has been carried forward to this report. Due to mental or physical frailty some service users are limited in the choices they are able to make about their lives. However choice is offered, for example, during the daily living in the home, such as menu choices, where service users spend their time and whether they take part in activities. More able service users confirmed that they are able to determine and control their own lives. Service users are able to maintain their independence, manage their own finances and self-medicate. One service user said, “I live my life as I want to and make my own choices”. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 12 Menus remain varied and all service users were complimentary about the meals provided. One service user said that they were a “faddy eater” but that the kitchen staff always managed to provide suitable meals. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 confidant in raising concerns or complaints and that they would be addressed. Service users said they felt safe; however by ensuring all staff are trained to recognise and report any potential abuse appropriately could further protect them. EVIDENCE: One complaint has been investigated by the CSCI since the last inspection. The complaint related to nursing care and was upheld following an investigation. At the last inspection some service users lacked confidence that issues they raised would be dealt with. At this inspection all the service users who spoke with the inspector were both confident to raise any concerns to the manager or her deputy and that appropriate action would be taken. Although service users when asked, said they felt safe at the home the requirement made in the last report to ensure all staff receive abuse awareness and adult protection training has not yet been met, therefore the requirement remains in this report. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 and 26 The home provides a safe and comfortable environment for service users. There are adequate facilities and equipment to meet the needs of service users. Service users are able to personalise their rooms. The home is clean and tidy. EVIDENCE: The home was clean and tidy during this visit and there were no unpleasant odours. Service users are able to personalise their rooms and one service user’s family is currently redecorating the service user’s bedroom to the individual’s specifications. Accommodation is appropriately equipped and furnished. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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 current service users. Staff recruitment procedures have improved and this helps protect service users. Staff training is helping to ensure staff are competent to do their jobs. EVIDENCE: The manager and deputy manager of the home are usually supernumerary to staff numbers. Over all staffing levels in the home are currently: two nurses and nine carers during the morning, two nurses and seven carers during the evening, one nurse and four carers at night. Currently there are six service users in the Butterfly Unit and two carers work in the unit during the day and one at night. As service user numbers in this unit increase a second carer will be provided at night. Since the last inspection the standard of recruitment records have improved. A sample of staff records were audited and showed that appropriate checks and references had been obtained for all new staff before they commenced work at the home. Staff training has also improved. Some new members of staff confirmed they had recently had fire and movement and handling training. Some training records were available and showed that several training sessions have taken place, covering fire safety and movement and handling techniques. Records now clearly show which members of staff have had training, which members of Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 16 staff have yet to receive training and which members of staff require training updates. The general supervision of staff has improved since the last inspection and staff were seen spending more time with service users and checking lounge areas to ensure service users were alright. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 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) 33, 35 and 38. Some steps are taken to monitor the service the home provides, this is carried out to ensure the home is run in the best interests of the service users, however quality assurance could be developed further. Service users’ financial interests are safeguarded. Systems are in place to promote the health, safety and welfare of service users and staff. EVIDENCE: A representative of the company produces a monthly management visit report, however more could be done to monitor the services provided by the home. The new manager in her previous post circulated customer questionnaires to service users and relatives, it is suggested similar customer surveys be carried out at Aden House. Some service users are able to manage their own finances independently or with the help of their relatives. Facilities are provided to enable service users to store valuables securely in their rooms. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 18 The manager does hold small amounts of spending money for some service users. These monies were audited and found to be correct. Records clearly showed the amounts of money deposited and how this had been used, receipts were also available as proof of purchases. At the last inspection the inspector witnessed some unsafe movement and handling practices. During this visit staff were seen to move and handle service users appropriately, using appropriate equipment. There is evidence that some staff have had movement and handling training and some staff have had updated training. There is a regular maintenance programme and evidence of regular tests and servicing of equipment was seen. However the weekly tests and checks of the fire alarm and emergency lighting systems had lapsed during the summer. These must be carried out weekly as required. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 19 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x 2 x 3 x x 1 Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13 Requirement Timescale for action 31.10.05 2. 3. 12 18 16 13 4. 38 23 There must be safe systems for the recording storage and administration of medications. Time scale of 31.08.05 not met. More activities must be provided. 31.10.05 Timescale of 31.08.05 not met All staff must receive training in 31.12.05 relation to abuse awareness and the protection of vulnerable adults. Timescale of 31.08.05 not met. Tests and checks of the fire and 30.09.05 emergency lighting system must be carried out weekly and a record made of the test or check. 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. Refer to Standard 7 Good Practice Recommendations It is recommended all service users are assessed against the risk of poor nutrition and the assessment be reviewed monthly. Where a risk is identified a care plan should be produced to minimise or manage the risk. Further work is reqired to ensure all staff have received mandatory training and updates. 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 21 2. 30 Aden House 3. 33 Customer questionaires should be circulated to service users and relatives to audit the services provided at the home. Action should be taken to address any issues identified. Aden House 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 22 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 20050908 Aden House 1105 report OP v248220s1105.doc Version 1.40 Page 23 - 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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