Inspection on 01/08/06 for Aden Lodge Nursing Home

This inspection was carried out on 1st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

Aden Lodge Nursing Home 23/01/08

Aden Lodge Nursing Home 21/02/07

Aden Lodge Nursing Home 05/10/05

Aden Lodge Nursing Home 08/12/04

Aden Lodge Nursing Home 06/05/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Aden Lodge Nursing Home Long Lane Clayton West Huddersfield West Yorkshire HD8 9PR Lead Inspector Sally McSharry Key Unannounced Inspection 1st August 2006 09:30 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 Aden Lodge Nursing Home DS0000001106.V302159.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. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aden Lodge Nursing Home Address Long Lane Clayton West Huddersfield West Yorkshire HD8 9PR 01484 866602 01484 863749 kazsmith@gmaiol.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) Aden House Ltd Mrs Carol Ellis Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Aden Lodge provides nursing care and accommodation for up to forty elderly people. It is a purpose built brick home adjacent to its larger sister home Aden House. The home provides single room accommodation with en-suite facilities. It is situated on the corner of the main Wakefield Road in Clayton West. Aden Lodge is owned by Aden House Limited, a local company. The home is centrally located for Barnsley, Huddersfield and Wakefield with the villages of Clayton West and Scissett providing all local amenities within a few minutes walk. There is a bus stop outside the home. There is a garden area for service user’s use. The provider informed the Commission for Social Care Inspection on 01/08/06 that fees range from £344.71 to £521.00 per week. Additional charges include hairdressing, personal newspapers and charges made to escort service users to out patient appointments. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit carried out to the home by two inspectors on 1st of August. We arrived at the home at 09:30 am and left the home at 4:00pm. Since the last main inspection carried out on 5th October 2005, a further additional visit has been carried out by the Commission for Social Care Inspection, as there were some concerns about the standard of care and cleanliness in the home. When this matter was looked into the concerns were upheld. During this visit the inspectors spoke to some of the service users, a visiting relative, some of the staff and the home’s management. The inspectors read care records, audited a sample of medications, reviewed staff recruitment and training records, carried out a brief tour of the building and observed lunch being served to the service users. Prior to the inspection, ten service user questionnaires were sent to Aden Lodge to obtain service users’ views about living at the home. Three completed questionnaires were returned. Some service users in the home are very frail and may have difficulty completing a questionnaire. There were thirty seven service users resident in the home on the day of this visit. Relative surveys were sent out to ten of the service users’ relatives or friends. Three GPs attend the home and questionnaires were sent to them. Five health and social care professionals that have contact with the home and service users were also sent a questionnaire. When writing this report eight of the relatives had responded. Two responses had been received from GPs and two from health and social care professionals. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and a pre inspection questionnaire completed by the provider and manager. The inspectors would like to take this opportunity to thank everyone who participated in the inspection process. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Information obtained in pre admission assessments should be clearly documented and care must be taken to ensure service users admitted to the home are within the home’s registration category. Before admitting service users the registered provider must also ensure there are sufficient staff on duty to be able to meet the service users needs and that staff have the necessary skills to care for the service users appropriately. Care plans must be improved. Care plans must identify all the service users’ health, welfare and social care needs. The plan must give detailed and specific advice to staff as to how each service user’s needs are to be met in the home. The care plan must be in such detail as to enable any member of staff to care for the service user safely. Daily care records should refer to the identified needs and reflect the actual care provided each day. Routine risk assessments must be in place and all care records should be reviewed at least monthly. There must be safe systems in the home for the storage, recording, administration and management of medications. Suitable activities should be provided for all service users and staff must ensure that all service users are helped and supported to make choices in the home. Training must be provided to all staff to ensure that they know how to deal with complaints and how to report any suspicion of abuse or neglect. An up to Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 7 date protection of vulnerable adults procedure must be developed to support staff in this. There must be sufficient equipment available in the home to meet the needs of the service users accommodated and inappropriate storage of equipment in toilet facilities must stop. The registered provider must ensure that at all times there are sufficient numbers of staff on duty to meet the needs of the service users. The registered provider must also ensure that the staff on duty are skilled and experienced to meet service users needs and provide training to staff to maintain and update their knowledge and skills. The management and quality assurance processes in the home must be developed and expanded to identify issues and resolve poor care practice, particularly as three out of the ten service users relatives surveyed before this inspection felt that they were not satisfied with the overall care in the home. 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 Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 8 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 Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 9 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. Information provided in the statement of purpose is not up to date and is incomplete. No service user moves into the home without having had their needs assessed, however written assessments are not clear and do not evidence that the service users needs correspond to the home’s registration category. There are not always sufficient numbers of staff in the home with the skills required to meet the service users needs. Quality in the outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The three service users who responded by returning questionnaires were unsure if the information provided about the home before admission was sufficient. It has been a requirement of the last two inspection reports that the home’s statement of purpose be updated and checked to ensure it includes the Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 10 required information. This has not been carried out. This does not affect the outcome of care for service users already living in the home. However detailed and complete information is required to help prospective service users make an informed decision as to whether to stay at the home or not. This must be addressed. Before service users are admitted to the home a trained member of staff visits the prospective service user to carry out a pre admission assessment. This is documented on several different forms and information is difficult to access. It is recommended that a new form be developed covering all the areas recommended in Standard 3 of the national minimum standards. When auditing care records it was noted that recent service users admitted to the home were recorded to have dementia type illnesses as their primary diagnosis. The home is not registered to care for service users with mental health needs and have had at least three service users reassessed because they are unable to manage challenging behaviour. The home must not admit service users who they are not registered to care for. Whilst the home welcomes service users from differing cultural backgrounds at the moment the majority of service users are white British in origin. Service users and relatives provided written and verbal feedback indicating there are insufficient members of staff on duty in the home with the skills and experience to meet the needs of some of the service users. This is a serious matter and is addressed in the Staffing section of this report. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 11 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. Not all service users health, personal and social care needs are set out in the individual plan of care. Some risk assessments are carried out but greater care is required in their monitoring and further routine risk assessing is required. The service users are not protected by the homes medication policy and procedure. Service users are treated with dignity, respect and privacy. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The care records of four service users were examined during this visit. All were found to have gaps in the information recorded. Care plans do not identify all service users’ health, welfare and social needs. Not all care plans and risk assessments are reviewed monthly. Some risk assessments such as nutritional assessment and weight have not been completed. Some bath/shower charts have not been completed or indicate service users have only had one bath/shower in over six months. Advice in care plans is basic and is not specific. Some entries in care records contradict information found elsewhere Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 12 in the care records. Care plans do not provide sufficient information to enable someone reading the plan to provide care to individual service users safely. Feedback from three of the relative questionnaires confirms that not all service users needs are being addressed by staff and that some relatives are not satisfied with the overall care being provided. This was observed on the day of the visit and confirmed by speaking to staff and service users. Two members of staff said they felt that at times the care of service users is compromised. Some pressure relieving equipment is in place, and service users have access to GP’s, specialist nurses and to chiropody, optical and dental services. However it was concerning to find that specific advice given by specialist health care professionals has not been included in the care plan and is not being implemented by staff. This is a very serious matter and must be addressed. Daily records are of a poor standard. Some daily records refer to health care issues which are not identified in the care plan and do not appear to be followed up by staff. Daily records should reflect the identified needs in the care plan and record the actual care provided each day. Care plans do not reflect the diversity of individual service users. No attempt has been made to explore any cultural differences with service users from different backgrounds and cultures. All the issues about care planning must be addressed. Staff need help and training to develop and maintain care plans to ensure these shortfalls are corrected. The medication of five service users was checked. The medication of two of the service users tallied with the records held. A serious issue was identified in that some staff are signing to say they are administering medications when they are not. When the medication in individual packets and bottles was checked, too many tablets remained in the container. Some medicines are not being recorded when entering the home. Staff are not using recognised codes on drug administration sheets. Controlled drugs are kept as required and records were clear and accurate. The poor management of medications was identified on the last report. At this visit an immediate action requirement letter was issued to the registered provider. Action must be taken to improve the system. Service users were seen to be treated with dignity and their privacy maintained on the day of the inspection. Service users spoken to said that they are usually treated well by the staff. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 13 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, 14 and 15. Service users’ social, cultural, religious and recreational needs are not being fully met; they are helped to maintain contact with their families and the local community. Service users are able to exercise some choice and control over their lives but some staff could promote this further. Meals provided are varied. Meals are served in a pleasant environment and service users who need support receive the assistance they require. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Some activities are offered and service users discussed preparations for the forthcoming autumn fayre. Service users reported that other activities do take place such as crafts and quizzes. One relative commented in the questionnaire that there is, “ Not enough interaction from staff to residents. They do not give them enough stimulation i.e. Board games”. It is recommended a review of activities provided be carried out to ensure they meet the needs and expectations of all the service users. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 14 Service users and relatives confirmed both verbally and in questionnaires that they are able to visit the home. Six out of eight relatives who returned questionnaires said they were made to feel welcome, two however felt they were not welcome. During the visit one of the inspectors saw a member of staff welcome a visitor by offering them a seat and hospitality. Discussions were held regarding meeting the needs of service users from different cultural backgrounds. The home does little to meet service users differing cultural or background needs and this must be addressed. Contact with the local community is maintained and service users talked about visits to relatives and regular multi denominational services held at the home. During the visit there was conflicting evidence regarding service users being able to exercise choice and exercise personal autonomy. More able service users clearly advised of the choices they made in the home and spoke of being able to maintain their independence and autonomy. However staff may not enable less able service users as well. A member of staff was seen giving out biscuits at afternoon teatime. Service users were not given any choice in what biscuits they may like and service users who were unable to drink independently were not offered a drink. Feedback from one relative confirmed that less able service users are not always offered a drink in the afternoon. Staff must be trained to offer choice to all service and to ensure that less able service users are given opportunity to have a drink. Generally service users stated in questionnaires and verbally that the meals provided were good and that there was a variety offered. The meal served at the time of the visit looked and smelt appetising. Service users said they had enjoyed it. Following a random visit carried out by the Commission for Social Care Inspection on 7th July 2006, to follow up concerns about the standard of care and cleanliness of the home, some concerns were raised about the standard of food preparation, food presentation and the nutritious balance provided in evening meals. Mrs Ellis the manager advised this has been addressed and service users said they were satisfied with the meals. This should continue to be monitored by the registered provider. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 15 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. Not all service users or their relatives and friends are confident to make complaints and that these will be listened to and taken seriously. Service users are not fully protected from abuse. Quality in the outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has a complaints procedure which is available to service users and relatives. The majority of service users and relatives felt able to raise concerns and that these would be dealt with. However a recent complaint highlighted that not all staff are familiar with the complaints procedure and that not all staff are confident or competent to deal with complaints. It remains a requirement of this report that staff receive training in relation to the complaints procedure. Following the recent complaint the Commission for Social Care Inspection has some concerns about the content of the written complaint response sent on behalf of the registered provider. This is to be discussed in a forthcoming meeting arranged by the commission with the registered provider and local authority. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 16 Some staff have received adult protection training, however not all staff have had this training. It will remain a requirement of this report that all staff receive this training. The home’s adult protection procedure fails to provide clear step by step advice to staff about who to contact or how to report any concerns they may have regarding abuse and the protection of vulnerable adults. A clear guide must be produced with up to date information and contact details for reporting concerns to the local authority. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 17 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): 19, 23 and 26. Service users live in a safe, well-maintained environment. The home is generally clean pleasant and hygienic. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There is a redecoration programme in place and some rooms were being redecorated during the visit. During discussion with the manager about why a service user was being nursed in bed Mrs Ellis advised that on some occasions there was not a recliner chair available for the service user to sit in. The registered manager and registered provider must ensure that at all times there are suitable adaptations and equipment available in the home to meet the needs of the service users. At the random visit carried out on 07/07/06 wheelchairs were being stored in a toilet. The toilet door was unlocked and there was a danger that service users Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 18 might try to enter and injure themselves. The door is now locked, however the wheelchairs are still inappropriately stored in a toilet and must be removed. During the visit the home was found to be generally clean and well maintained. However this has not always been the case. Following concerns raised the Commission for Social Care Inspection carried out a random unannounced visit to the home on 7th of July 2006. At that time the home was not clean and clinical waste stored in service users rooms was causing unhygienic conditions and unpleasant odours. These matters were brought to the attention of the registered provider and action has been taken to address these issues. Clinical waste is now removed from service users rooms promptly and the standard of cleanliness in the home has improved. The registered provider should continue to monitor this closely. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 19 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, 29 and 30. There are insufficient staff on duty to meet the identified needs of the service users. The staff receive induction and foundation training and but not all staff are competent to meet the needs of the service users accommodated in the home. Staff recruitment policies and records protect service users. Quality in the outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Significant feedback was received from service users, relative questionnaires and from staff on the day of this visit regarding staffing levels. Three of the eight relative responses to the questionnaire stated that there were not enough staff on duty in the home. Service users who spoke to the inspector stated that staff are always very busy and that they have to wait to receive care. One service user said, “ The route to any problems in this home is the shortage of staff.” A relative commented “ Staff are very good but there just aren’t enough of them” Two other service users specifically mentioned staff shortages and one said, “Staff are really busy and not all of them are competent.” Two relatives in their feedback, advised of care that has been identified as needed, but is not being given on a daily basis. This was confirmed when reading care records in that treatment and management identified in care records is not being delivered. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 20 Two relatives and one service user also raised concerns about the competency of staff. There is only 4 of care staff employed at the home with national vocational training level 2. The recommended level is 50 of staff with this qualification. The registered provider must ensure at all times sufficiently skilled and experienced staff are on duty to meet the needs of the service users. Care must also be taken when admitting service users to the home. The inspectors have concerns that some of the service users admitted to the home have dementia type illnesses as their primary care need. The home is not registered to care for service users with mental health needs and there is evidence that the home is failing to meet some of the services users’ needs either due to insufficiently numbers of skilled and experienced staff being on duty or because staff in the home do not have the skills and experience to manage service users with mental health needs. Copies of staff rotas were provided during the visit, however these are unclear and future information has been requested to enable the Commission for Social Care Inspection to assess staffing levels. However it is the registered providers responsibility to ensure that at any time there are sufficient numbers of skilled and experienced staff on duty to meet the needs of the service users. Staff training and recruitment records showed appropriate references and checks are now being carried out in the home. Induction and further training is being provided however feedback from some service users and relatives indicates not all staff are competent. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 21 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 and 38. Service users live in a home with a manager of good character, however her experience is limited in some areas of management. Further quality assurance measures need to be introduced to ensure the home is run in the best interest of service users. Service users’ financial interests are safe guarded. The health, safety and welfare of service users and staff are promoted and protected. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Mrs Ellis has managed the home for approximately 12 months. She is a registered qualified nurse however she has struggled with some aspects of managing the home. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 22 Some quality assurance work has been carried out. Very basic questionnaires were circulated to service users and relatives about the service the home provides. The content of the questionnaires is limited. Quality assurance monitoring must be developed and progressed, to fully enable service users and their representatives to provide feedback about the service provided. This feedback should help to guide the management of the home and ensure the service is run in the best interests of the service users. Resident meetings have been held on two occasions in the last 12 months. The company has reviewed its own monthly management monitoring reports. Reports are now more detailed. However the issues identified in this inspection show that a more detailed management review and audit of the home must be carried out to identify how the service is being provided and issues that are occurring. This should help the company identify problems and take action to resolve them. The home holds some finances on behalf of some of the service users. A sample of these finances were audited and found to be correct. Appropriate receipts were also available for items and services purchased on the service users behalf. Regular fire safety checks are carried out and recorded. Members of staff confirmed that they have had or are booked to attend fire and movement and handling training. No specific health and safety risks were observed during this visit. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 23 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 1 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 3 X X 1 X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4&5 Requirement Staff experience and training must be updated in the statement of purpose. Information about emergency procedures must be added. Timescale for action 31/10/06 2 OP1 OP3 3 OP7 Time scales of 30/08/05 and 30/11/05 made in the previous reports have not been met. Section 24 The responsible individual must ensure that the home does not of the accept service users who do not Care fall within the homes categories Standards of registration. Act 2000 Care plans must give clear and 15 specific information to staff about service users’ needs and how they are to be met in the home. Time scales of 30/08/05 and 31/12/05 made in the previous reports have not been met. Care plans must be kept under 15 review. Reviews should take place at least monthly. Routine risk assessments such 12,13,14 Regulation as falls risk assessments, nutritional assessments and DS0000001106.V302159.R01.S.doc 31/08/06 31/10/06 4 5 OP7 OP8 31/10/06 31/10/06 Aden Lodge Nursing Home Version 5.2 Page 25 6 OP8 17(1)(a) schedule 3 12 weights must be carried out and reviewed monthly. The registered person shall ensure that the care home is conducted so as(a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and where appropriate, treatment, education and supervision of service users. When a specialist health care professional has given advice about the care and management of a service user, the registered person must ensure this health care management or treatment is provided. Staff must be trained and competent to develop and maintain care plans and manage record and administer medications. All medications entering the home must be accounted for. There must be safe systems for the recording, administration, storage and disposal of medication in the home. 31/08/06 7 OP9 OP8 13 & 18 31/08/06 8 OP9 13 31/10/06 9 OP7 OP12 12 (4) Time scale of 31/12/05 made in the previous report has not been met. The registered person shall make 31/08/06 suitable arrangements to ensure that the care home is conducted(b) with due regard to the sex, religious persuasion, racial origin, and cultural and linguistic background and any disability of service users. DS0000001106.V302159.R01.S.doc Version 5.2 Page 26 Aden Lodge Nursing Home 10 OP14 12 & 18 11 OP16 22 & 18 12 OP18 13 Staff must be trained to offer choice to all service and to ensure that less able service users are given opportunity to have a drink. Staff must be trained and aware of the complaints procedure. Verbal complaints and concerns must be addressed via the homes complaints procedure. Time scale of the 17/07/06 not met. Work must continue until all staff have completed this training in relation to abuse and the protection of vulnerable adults. 31/08/06 31/10/06 30/11/06 13 OP18 13 14 OP22 23 (1) (n) 15 OP22 23(2) (l) Time scale of 30/11/05 made in the previous report has not been met. 30/09/06 The home’s adult protection procedure fails to provide clear step by step advice to staff who to contact or how to report any concerns they may have regarding abuse and the protection of vulnerable adults. A clear guide must be produced with up to date information and contact details for reporting concerns to the local authority. The registered manager and 30/09/06 registered provider must ensure that at all times there are suitable adaptations and equipment available in the home to meet the needs of the service users. Wheelchairs must be stored 31/08/06 appropriately. Not in a toilet area. Time scale of 17/07/06 made following random visit carried out on 07/07/06 has not been met. DS0000001106.V302159.R01.S.doc Version 5.2 Page 27 Aden Lodge Nursing Home 16 OP27 OP30 18(1) 17 OP31 10 (3) 18 OP33 24 (1) & 26 The registered person shall, 31/08/06 having regard to the care home, the statement of purpose and the number and needs of service users (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users; This requirement relates to the number of staff and the level of competency of staff. The manager must be supported 31/12/06 to obtain further training to improve her management skills. Effective quality assurance 30/10/06 monitoring must take place. Service users and their representatives must be consulted about the service the home provides. Systems and practice in the care home must be observed and audited to ensure it is of an adequate standard. 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 OP3 Good Practice Recommendations It is recommended that a new pre admission assessment DS0000001106.V302159.R01.S.doc Version 5.2 Page 28 Aden Lodge Nursing Home 2 3 4 5 6 OP7 OP7 OP7 OP12 OP15 7 OP26 8 OP28 form be developed covering all the area recommended in Standard 3 of the national minimum standards. Daily records should reflect the identified needs in the care plan and record that actual care provided each day. All care plans and risk assessments should be signed, dated and reviewed monthly. It remains a recommendation of this report that sit on scales be purchased specifically for Aden Lodge. It is recommended a review of activities provided be carried out to ensure they meet the needs and expectations of all the service users. The registered provider should continue to monitor the standard of evening meals served in the home taking into account food preparation, presentation and nutritional content. Clinical waste is now removed from service users’ rooms promptly and the standard of cleanliness in the home has improved. The registered provider should continue to monitor this closely. Work must continue to ensure 50 of care staff have NVQ level 2 or equivalent. Aden Lodge Nursing Home DS0000001106.V302159.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Brighouse Area Office 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. 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