Inspection on 15/04/08 for Aden Mount

This inspection was carried out on 15th April 2008.

CSCI found this care home to be providing an Adequate service.

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 Mount 20/04/07

Aden Mount 15/11/05

Aden Mount 16/06/05

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Aden Mount Perseverance Street Primrose Hill Huddersfield West Yorkshire HD4 6AP Lead Inspector Karen Summers Key Unannounced Inspection 08:30 15th & 16th April 2008 X10029.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 Mount DS0000061700.V362219.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 and Care Homes for Adults 18 – 65*. 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 Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aden Mount Address Perseverance Street Primrose Hill Huddersfield West Yorkshire HD4 6AP 01484 515019 01484 533985 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 Position Vacant Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (18) of places Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The OP category of registration includes both residential and nursing care, with a maximum of 10 beds being used for nursing care. 20th April 2007 Date of last inspection Brief Description of the Service: Aden Mount is a purpose-built spacious home situated in Primrose Hill, a residential area of Huddersfield. It is situated on the same site as its sister home, Aden View. It offers personal and nursing care and accommodation for up to 27 older people and care for up to 18 people aged between 18 and 65 years with a physical disability. All bedrooms, which are over three floors, are single en-suite. All floors are accessed via a passenger lift or stairs. There is access to the home via a ramp for people in wheel chairs and there is a car park to the front of the home. There is a small garden area to the side of the home where people can sit out, weather permitting. The Commission was informed that as at 15/04/08 fees ranged from £368.12 to £1,028.80 per week. There are additional charges for hairdressing, chiropody and aromatherapy. Information about the home in the form of a Statement of Purpose and Service User’s Guide and the latest inspection report can be obtained from the home. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. There have been a number of changes since the last inspection in April 2007; and also since then the standards of care have fluctuated. In September 2007, Aden Mount Ltd was sold to New Century Care, and in February 2008 the manager resigned. The manager of Aden View, which is located in the grounds and next door to the home, has been managing the day to day running of this home with support from the Care Director of the company, with a view to increasing the standards at the home. This report refers to an inspection, which included unannounced visits to the home on the 15th & 16th April 2008. On the first day one inspector visited the home between 8.30am and 3.30pm, and on the second day the inspector visited between 10am and 5.30pm, and was joined by a second inspector between 12md and 5.30pm. There were 42 people living at Aden Mount on the days of the visit. As part of the inspection in order to provide information to help us form judgments about how the service is run, the acting manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with information about the way the home is run, and what they hope to achieve in the future. During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent fifteen surveys to people living at the home and their relatives. None of the surveys were returned at the time of writing the report. Ten surveys were sent out to staff and one was returned. The comments received from the member of staff were generally positive. We would like to thank all the people who gave there comments on the day of inspection, and would like to thank the acting manager and staff for their cooperation throughout the inspection process. Aden Mount DS0000061700.V362219.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: Senior staff could ensure that people are properly assessed both prior to and following admission to ensure that their needs can be met. And ensure that records are dated and signed to give an accurate account of when people have received treatment and care. Staff could treat people with more dignity and respect; they could record people’s needs and review them regularly so nothing is missed. The ordering of medication could be better managed to ensure that people do not run out of their drugs. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 7 Staff could give more consideration to the environment for people who use wheelchairs for example, ensuring that mirrors and electrical switches are at the correct height. Staff could receive regular formal supervision and be monitored to make sure that they are competent at their job. This will ensure that everyone living in the home receives the care that they want, including a stimulating social environment. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 3 Adults 18-65 years – 2 People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People moving into the home cannot be sure their health, personal and social care needs will be met. EVIDENCE: This home does not provide intermediate care. The information received from the home prior to inspection said that a senior member of staff assesses all people before admission wherever possible. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 10 Three peoples care records were looked at, two people who live on the Thompson unit and one from the residential unit. There was evidence that each person had a pre admission assessment however, the information recorded was minimal. In one of the records completed for a male resident the maiden name section had been completed, information relating to mobility was not written in sufficient detail, and nowhere was there information relating to the person being in employment. (The purpose of the assessment is to make sure that the home will be able to meet the person’s needs before they are admitted.) The records were not dated or signed. The records should be dated and signed to give an accurate account of when the assessment was done and by whom. The acting manager said that since she has been managing the home, all new people have had a pre admission assessment. We were shown a completed assessment, where the information was basic and the questions on it were open to interpretation. The information needs to be recorded in greater detail to be of value when assessing whether the home can meet people’s needs. A community care assessment (an assessment carried out usually by a social worker identifying the person’s care needs before admission to the home) was not seen in any of the care records inspected. The home provides some short stays and this can sometimes help people to gain an understanding of what it is like to live there before committing to live there on a permanent basis. Two of the surveys sent out by the home had been returned from people who had received short-term care, and people had commented on how they had chosen the room that they stayed in. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 7 – 10. Adults 18-65 years - 6, 9, 16, 18 and 20. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health, personal, social and dignity needs are not always being met. EVIDENCE: Surveys were sent out to fifteen people who use the service and their relatives, unfortunately none of the surveys were returned at the time of writing this Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 12 report. People who were spoken with who live in the residential part of the home, said that the staff were very kind, and also said that the staff were always there when they needed them. The atmosphere was relaxed and staff were seen to respond to people in a dignified and sensitive manner. Two people who were booked to go to hospital appointments that day, said that staff were going with them, and said that they were pleased that someone accompanied them on their visits. Five people who live on the Thompson unit (for physically disabled people,) were spoken with during the visit, and people expressed varying views about the care they receive. One person said that they lived the way they chose within the home, and they were very happy with the staff and the care they receive. The same person said that they went out of the home when they wished, and lived as independently as they could. Another person also said that they were as happy as they could be living in a home, and spoke affectionately about the staff that provided their care. Other people who were spoken with said that they had not been happy with some of the staff, as those staff had not always followed their wishes, which had been recorded in their care plan. Two people said that they had not seen their care records, and one of those people said that they had been refused access to look at them. They said that a meeting had recently taken place and arrangements were in place for people to look at their care plans. The acting manager also confirmed this, and said that all the care plans would be updated with the involvement of the individual people. Three people’s care records were looked at, and included one care plan for a person living in the residential unit. The documentation was very basic, and when the people were spoken with whose care plans were looked at, the information did not always reflect the care that the person was receiving. In one person’s care plan there was reference to them using the toilet independently, but a conflicting plan stating that they needed assistance. The same records showed that there were no issues regarding their nutritional assessment however, there was another assessment to show that the person had problems in relation to eating and drinking. Care plans had not always been written when problems/ needs had been identified in relation to the person’s physical, or psychological needs. Wound care was not always clearly recorded. The records had been evaluated monthly. Movement and handling assessments had been recorded however; movement and handling plans were not seen for all the records inspected. On two occasions it was noticed that staff have made reference, one in a bathing record and one in a daily record, to the person complaining of a sore bottom. On one of these occasions it was recorded that a treatment spray had been applied but neither files contained any information to show that staff had monitored the problem. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 13 The survey received from the member of staff said that they were always given up to date information about the needs of the people they support or cared for. People having choice about their wishes on resuscitation was also discussed with the acting manager, and that should the situation arise, the correct procedures should be followed. The privacy and dignity of people living in the home is not being maintained. During the visit we saw a person who had been incontinent of urine, and despite being informed by another person living in the home of this, staff proceeded to take the person for a walk, and then take them back to the lounge afterward without changing their clothing. The member of staff also had to be reminded to clean the chair where the person had been sitting. The Chiropodist who was visiting, was escorted by a member of staff into the lounge where she attended two people. Neither person was given the option of going somewhere more private. Throughout the treatments the chiropodist and the carer spoke to each about their personal lives with very little regard to the person receiving the treatment. The manager was made aware of the incident and spoke with the Chiropodist prior to her leaving the home, and said that she would ensure that future treatments were carried out in people’s own rooms. Four people’s medications were audited. Medications held at the home corresponded with records and were found to be stored safely. However, when one or two tablets had been prescribed, staff were not always recording how many had been given. The Clinical Nurse said that she had identified this when carrying out her monthly checks of the medication, and records confirmed this. There was also a printed sheet the home plans to use for the future, where the nurse will record the number of tablets given. On the medication recording sheet there was a signature omission, and evidence showed that this was when an agency nurse had been on duty. Should the nurse work at the home again, she should be reminded to sign for medication that she has given. People are able to self-administer their own medication, and there are procedures to ensure that this takes place in a safe way. In one of the care records inspected, a record had been made that medication had been borrowed from another resident on two occasions, and the dose varied to that what had been recorded on the medication record. The staff at the home investigated this, and found that the same medication and dose had been given on the two days, and also that the nurse had not recorded the correct amount in the care records. Medication must not be borrowed from other people within the home. With reference to the “Standards for medicines management” for nurses, the guidelines state that, “If a supply is not available medicines belonging to another patient must not be used.” If a supply of Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 14 medicines belonging to a person is given to another person, it is classed as theft. Discussion took place with the acting manager following the inspection and appropriate action is being taken. The room where the medication was stored was warm. The temperature where medication is stored should not be more that 25˚C; therefore you are advised to monitor and record daily, the temperature of the room. The daily drugs refrigerator temperature had not been recorded between the 9th to the 11th April 2008, and discussions were held regarding the need for the daily recording, to ensure that the desired temperature is maintained. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 12 – 15. Adults 18-65 years - 12 – 15 and 17. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s social and recreational needs on the residential unit are not being met. Meals provided vary in quality but are served in a pleasant environment. EVIDENCE: An activities person is employed to work on the Thompson unit, twenty hours a week, and she said that she works extra hours when needed for outings, or Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 16 activities taking place at the weekend. The person has been in post since January 2008 and therefore said that she was in the process of putting together information about people to ensure that their social and recreational needs are being met. Separate files were seen for each person, with photos of activities that they had taken part in and dates of the events. The information was informative and also included the person’s enjoyment of the activities. The activities person explained how she plans to improve on the documentation that she has already started. She also said that some of the people from the residential side of the home have started to join in on the activities that take place on the Thompson unit and this was confirmed by one of the people living there. At the time of the visit people were seen to be involved and enjoying themselves in the activities taking place. Activities that take place include pampering day, where people who wish, have their hands and arms massaged, wheelchair yoga, shopping trips, baking, flower arranging, and many more. The list of the activities on offer each day is written on a calendar and is located in the activities lounge. One of the people who were spoken with on the Thompson unit, said that they did not always wish to join in the activities at the home, but there was usually something going on most days. Another person said that they enjoyed the activities and joined in when they wished. A separate activities person is also employed on the residential side of the home, and she works twenty-seven and a half hours a week. The activities person said that sometimes she covers the care duties if people phone in sick, as she has been a carer in the past. The activities person also said that she has recently attended a course in physical activities, and was provided with activity equipment to use in the home. The book that the activities person uses to record what activities have place on a daily basis, had not been written in since the 5th February 2008. She said that she has been doing some activities but not recording them. People were seen sat in their rooms reading books, and watching the television, and a number of people were sat in the lounge. When asked what activities take place on a daily basis, a number of people said that not a lot went on, and the acting manager also confirmed this. Some people had their own telephone in their rooms and said that they kept in touch with relatives and friends. There was also evidence in the visitor’s book that people visit on a regular basis at various times of the day. Two people in the Thompson unit said that batteries for the remote controls for the televisions were not always changed as necessary, which made it difficult for people in wheelchairs to change channels. The same people also commented about the lack of clocks in certain areas of the home. Daily newspapers are delivered to the home and people said that they had their own delivered if they so wished. The library also visits and brings large print books, and the activities person arranges for specialised talking books to be delivered regularly. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 17 People also confirmed that they were able to go to church if they wished, and staff said that ministers visit on a regular basis. There have been problems with the cooker over the past few months and a replacement was purchased. People said that there had been inconsistencies in the quality of the food been served. There are two cooks and two kitchen assistants that cover duties over a seven-day period. (A total of 20 hours per day. One of the cooks has decided to step down from the role as cook to work as a domestic, and the home will be advertising for a replacement. The menus offered a variety of food, and the food preferences and diets of people were also taken into consideration. The cook said that no one presently requires a specific diet because of his or her culture, however; she also said that should this arise then one would be provided. One of the inspectors joined the residents in the residential dining room for lunch, and the food was of a good quality, plentiful and hot. People said that the food is usually very nice, on occasions could have been warmer, and a number of people said that they were over faced by the large portions. This was discussed with the acting manager and cook, and the ways that things could be improved. In the second dining room another inspector joined people for lunch. One of the people living there was given an omelette that was burned and was sent back to the kitchen. The omelette received in its place was of a good quality and enjoyed by the person. The inspector and people said that the food could have been hotter. One of the saltcellars on the table was empty and people also said that on two occasions salt had been put in the sugar bowl. When asked, people said that they would also like to have teapots and juice on the tables so that those who are able can serve themselves. Evidence was seen that the acting manager has arranged for a sample of different people to be asked each day about the quality of food they receive. The acting manager also said that she has asked the staff to ensure that someone other than the cooks carries out the monitoring. The sample of records showed that people were generally satisfied with the food, but some people said that the quality and temperature varied, however some of the people spoken with who were not always happy with the food said that they had not been included in these surveys for over two weeks. The Care Director of the company said that the home had one heated trolley, but that she would look at purchasing a second trolley to help ensure that the food was served hot. Discussions also took place about people saying that fresh fruit and vegetables were not always available everyday of the week due to the supplier. The director said that there had been an occasion when a person thought that they could not have a certain type of fruit, but that she ensured that the home purchased the fruit for the person. The acting manager also said that there was an occasion when the day before the delivery was due the home had run Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 18 out of fresh fruit, but that she would try to ensure that this did not occur again. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 19 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 16 and 18. Adults 18-65 years - 22 and 23. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are protected by the procedures relating to the recruitment of staff and management of complaints. EVIDENCE: People living at Aden Mount are given clear information about how to complain and this system is used effectively. Complaints are responded to within the given timescale of 28 days. The training manager said that all staff had recently received training on how to handle complaints. People spoken with said that they knew how to complain and who to speak with if they had any concerns. The acting manager said that since the last inspection she has had the complaints about the food not been sufficiently hot. There was evidence that this has been responded to. Where people who live on the Thompson unit have had concerns, they have voiced them in their regular monthly meetings, and minutes were seen to confirm that the action has been followed up at the subsequent meetings. There had also been a complaint earlier in the year Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 20 relating to a medication error, and which was found to be an error on the part of the nurse. Appropriate action was taken. Safeguarding investigations have also taken place, and identified areas relating to care practice and the recording of information, and which the management of the home have been working with the social workers, and contract managers to address. There was no record of anyone making a complaint on the residential part of the home. There is presently a safeguarding investigation taking place about the care a person received whilst living at the home. Records seen showed that staff commencing employment have a CRB (Criminal Records Bureau) and a POVA (Protection of Vulnerable Adults) check before starting work in the home. All staff have received safeguarding (adult protection) training which provides information on how to protect people from abuse. Those staff spoken with during this visit spoke with confidence about how they would report poor care practice and abuse. The member of staff who returned the survey said that she knew what to do if someone had conserns about the home, and that she would go to the manager. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 19 and 26. Adults 18-65 years - 24 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers people a homely, comfortable and clean environment. EVIDENCE: As part of the inspection a tour of the home was conducted which included the communal areas, a number of people’s bedrooms, (of which people gave their Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 22 consent for inspecting their bedrooms,) and the laundry. Bedrooms had been personalised, the standard of cleanliness was good and there were no unpleasant odours noted in any part of the home. The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. One of the rooms was showing signs of wear and a number of skirting boards had been damaged by wheel chairs. The home was generally in a good state of repair. The Care Director said that the handyman employed by the home would repair these areas and that the company have assessed the home with a view to it been redecorated in the near future. The smoking room was also discussed and there are plans to replace the existing door with a fire door that allows observation of people who are smoking to ensure that they are kept safe. Staff were also advised that all people who go into the smoke room, should have a risk assessment to also ensure that they are safe to be left in that area. One person spoken with said that the manager had arranged for handrails to be fitted in the toilet to assist him, and also had the light sockets lowered to enable him to reach them from his wheel chair. Whilst another person who uses a wheelchair, said that they could not see their face in the mirror in their room as it was at the height for a person standing up. Similarly the same person said that the electrical sockets and switches are placed at a height for people who have full range of movement. The acting manager should ensure that the environment meets the assessed needs of people living at the home. Bacterial soap and paper towels are provided in bathrooms and toilets to minimise the spread of infection. People said that the home is always fresh and clean. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 27 – 30. Adults 18-65 years - 32, 34 and 35. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by qualified, and experienced staff and in sufficient numbers. Staff have had all the necessary checks before working with people so that they are kept safe. EVIDENCE: On the day of inspection there were forty-two people in residence. The staff duty rotas were looked at and staff were spoken with. There was evidence to suggest that staffing levels and skill mix were sufficient to meet the number and needs of people living there. The member of staff who responded to the survey said that the staffing levels have got better and continue to do so, and that there are sometimes enough staff to meet individuals needs. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 24 Evidence was seen to suggest that care staff are encouraged to have an NVQ level 2 in care, and the manager confirmed that forty one percent of care staff have the qualification, and a further ten staff are enrolled to do the training. Staff recruitment files of four members of staff were looked at in detail and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. New staff undertake induction training in accordance with Skills for Care, the National Training Organisation for care staff, and the Care Director confirmed this. The member of staff who returned the survey said that their induction mostly covered everything they needed to know to do the job when they started, and it helped them understand and meet the individual needs of people. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Older People - 31, 33, 35 and 38. Adults 18-65 years - 37, 39 and 42. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 26 The management of the home has improved but further improvements need to be made in the management of staff supervision. The health and safety of people living and working there is protected. EVIDENCE: Denise McKenna is the manager of the Aden View, which is located in the grounds of Aden Mount. Denise is the acting manager and the company plan to register Denise as manager over the two homes. She has a number of year’s experience of working with older people, and also has a NVQ level 4 in Care and the Registered Managers Award. People spoke positively about Denise saying she was approachable. For those people who wish, small amounts of personal money are held safely at the home. The financial records of three people were examined and with the exception of one account that had a minor discrepancy, satisfactory records were maintained. Receipts are kept of all transactions made, and audits of the records take place. The person who is responsible for the management of the finances was checking why there was a discrepancy in the account held. The manager said that meetings involving people who live at the home have recently commenced on the Thompson unit, and had taken place monthly for the past four months. The people living there also confirmed this. The activities person is responsible for holding the meetings and the minutes were seen. The things that are discussed at the meetings include the quality of care, the quality of food and the menus, choice, staffing issues, management of the home, likes and dislikes etc. On the residential unit meeting do not presently take place. The acting manager said that she would ensure that meetings commenced. Staff meetings take place every two months and minutes were seen for January and March 2008. The company is sending out satisfaction surveys to people in the near future, and once they have been returned, the Care Director confirmed that said that the results would be displayed in the home for people to see. Two surveys had been received from people who had respite care at the home, and comments from one person said that the care was good, the staff were kind, and that they were able to choose their room. Other comments include, that the care was adequate, staff were helpful, and that there was a choice of food at meal times. Staff training records showed that some staff had not had supervision since January 2007, and the acting manager and staff confirmed this. The acting Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 27 manager said that she plans to ensure that all staff receive regular supervision and has booked and commenced supervision sessions. All care staff must receive supervision to ensure that they are supported to do their job. The member of staff who returned the survey said that they were kept up to date with new ways of working and that they met with their manager who gave them support and discussed how they were working regularly. Satisfactory checks were recorded for the fire alarm tests and emergency lighting. Fire drills are carried out at regular intervals and the acting manager said that this included the night staff taking part. The new proprietor has shown a commitment and willingness to make improvements in the running of the home in the introduction of the proposed management structure, and support from senior staff in the company. Since the acting manager has been appointed, there was evidence to suggest that improvements have already been made. Regular meetings are being held for people who live on the Thompson unit, and there are also plans to hold meeting for people who live in the residential part of the home. Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 28 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 X 2 X 3 2 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 2 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 2 37 X 38 3 Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 OP9 Regulation 13(2) Requirement Medication must not be borrowed from another person, as this is unsafe practice and theft. Timescale for action 16/04/08 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 YA2 Good Practice Recommendations People should not be admitted to the home unless a suitably qualified or trained person has assessed them, and their needs can be met. Staff should ensure that care records are up to date, factual, consistent, and dated and signed to give an accurate account of the care and treatment people have received. All people living in the home should have access to daily activities which meet their individual needs. The temperature of the room where medication is stored should not be more that 25˚C; therefore you are advised DS0000061700.V362219.R01.S.doc Version 5.2 Page 30 2. OP8 YA6 YA23 OP7 OP12 YA11 YA20 OP9 3. 4. Aden Mount to record and monitor, the daily temperature of the room. Nurses are accountable for their actions and should refer to the “Standards for medicines management” In relation to medication; if a supply is not available, medicines belonging to another person should not be used. 5. OP15 YA17 The manager should ensure that all food is of a good quality, and served to the required temperature to ensure that people enjoy it, and that the risk of food poisoning is reduced. The manager should ensure that the environment meets the assessed needs of people living at the home, to ensure that they can live as independently as possible. 50 of staff should have a minimum of NVQ level 2 qualifications or equivalent. All care staff should receive staff supervision at least 6 times a year. 6. OP22 YA29 7. 8. YA32 OP28 OP36 YA36 Aden Mount DS0000061700.V362219.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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. 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