CARE HOMES FOR OLDER PEOPLE
ADEN VIEW Perseverance Street Primrose Hill Huddersfield HD4 6AP Lead Inspector
Stephen French Announced 28 June 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 VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Aden View Address Perseverance Street Primrose Hill Huddersfield HD4 6AP 01484 530821 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) Mr T Dryden 85 Towngate, Mapplewell Barnsley Mrs Alyson Shaw CRH - Care Home 46 - Old Age Category(ies) of OP registration, with number of places ADEN VIEW J51J01_s26262_Aden View_v232045_280605.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 9th November 2004 Brief Description of the Service: Aden View is a spacious purposed built care home situated in Primrose Hill, a residential area of Huddersfield. It offers personal care and accommodation for up to 46 older people. The accommodation is on two floors, the first floor being accessed by a passenger lift. All bedrooms have en suite facilities, and there are communal toilets and bathrooms situated around the home. There are a number of lounge areas and a dining room. The gardens are well maintained and there is ample seating to accommodate service users who wish to sit out when the weather permits. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 28th June 2005. Five service users and four staff were spoken to during the inspection. The following inspection methods were used, a tour of the building including a selection of service users bedrooms, inspection of records including preadmission assessments, care plans, complaints records, staff duty rotas, staff files and training records and health and safety documentation. What the service does well: What has improved since the last inspection?
The amount and variety of social activities the home has on offer has increased since the last inspection. Previously service users stated that they were often board with nothing much to do. During this inspection service users expressed their delight at the many social activities on offer. The supervision of staff by the manager has improved and staff now receive at least six formal supervisory sessions with the manager per year. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.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 VIEW J51J01_s26262_Aden View_v232045_280605.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 VIEW J51J01_s26262_Aden View_v232045_280605.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 Although the home has a pre-admission assessment document these are not always completed fully. Service users could be at risk of not having their health care needs met if the pre-admission assessment is not detailed enough. EVIDENCE: Service users are admitted to the home following a community care assessment, completed by a social worker. The home manager also visits the prospective service user and completes a pre-admission assessment. This assessment outlines what care and support the service user will require and enables the home to make a judgement as to whether the home is able to meet those needs. Pre-admission assessments were seen for three recently admitted service users. One assessment was not completed fully and was not dated or signed. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.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 Improvements should be made to the care plans to ensure the service users health care needs are met. Care staff administer medication appropriately to service users. EVIDENCE: Service users have a care plan, which has been compiled from information gathered from the pre-admission assessment. The care plan identifies areas in which the service user requires assistants or support to enable them to maintain their independence. Three service users care files were inspected and these contained assessments for moving and handling, skin integrity, continence and nutrition. There were risk assessments in place for such things as falls and the use of bed rails. Risk assessments had been signed by the service user or their relative. It was noted that some of the care plans inspected were very basic and did not contain enough information on the actions staff need to follow in relation to delivering care. Service users who had a completed skin assessment, which identified them as being at risk from developing a pressure sore, should have a care plan in place. There was no evidence in the care files inspected that the service user had been involved in the monthly reviews of their care.
ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 10 Senior care staff are responsible for administering medication and have received training in this. Three service users stocks of medication were seen and the balances tallied with the medication administration records kept within the home. A pharmacy visit on the 24/6/05 concluded that medication within the home was stored correctly. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.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) 12,15 Service users are able to participate in a variety of social activities if they wish. The majority of food is home cooked and meals are varied and nutritious. EVIDENCE: Service users spoken to on the day of the inspection said that they enjoyed living in the home and that they were able to exercise choice in most things they did, this included rising and retiring times and choices in what they ate. The variety and amount of social activities on offer within the home has improved since the last inspection. Service users said that there is always something to do and at the moment they were preparing for a summer fate by making crafts and fundraising. On the day of inspection service users were making rag mats, which they were hoping to sell at the fete. Service users are able to choose from a menu what they would like to eat. On the day of the inspection the lunch consisted of a roast chicken dinner or liver and onions the sweet was bakewell tart and custard or a selection from the sweet trolley. The dining room tables were set with napkins, placemats and condiments and there were flowers on each table. The kitchens appeared well stocked of fresh fruit and vegetables. Service users all commented on how nice the food was and that there was always plenty of choice. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 12 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) 16,18 Service users are confident that complaints will be handled appropriately. There are policies and procedures in place on the protection of vulnerable adults and staff have received training in this. EVIDENCE: The home has a complaints policy, which is displayed in the reception area of the home as well as in service users bedrooms. Evidence was seen that complaints are logged and the complainant is made aware of the outcome of any investigation. Service users spoken to said that they were aware of the complaints policy and felt confident that any complaint raised would be investigated by the manager. New staff employed by the home are given training in the protection of vulnerable adults. Training records checked for three new staff confirmed this. The manager stated that she was currently reviewing this training and had purchased a new training package, which all staff would complete. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 13 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) 19,23,26 The home provides safe comfortable surrounding in which the service users can live. EVIDENCE: The home is purpose built and the interior is well maintained. Service users are able to lock their doors and hold the key if they wish. Bedrooms are personalised with the service users belongings and are bright and airy. One service users spoken to said that she had brought small items of furniture with her and that her room was like a “little flat.” Service users’ personal laundry is washed within the home. There is a dedicated laundry staff team who also do minor repairs to service users clothes. The standard of cleanliness throughout the home was very good. There was an odour of urine in one service users bedroom but there were no unpleasant odours detected in any other part of the home. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 14 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) 27,29,30 There are adequate numbers of competent trained staff on duty to meet the needs of the service users. EVIDENCE: The staff duty rota was checked for the month of June and this confirmed that the home was working within the staffing guidelines set by the previous registering authority. Service users said that as far as they were aware there was plenty of staff on duty to help them should they need it. Aden View also employs care cadets. These are young people under the age of 18 years who would like a career in care once they are 18 years old. The care cadets do not get involved in the personal care of service users, and are not counted in the staffing numbers. Their duties involve making beds, giving out meals and drinks and socialising with service users. Three recently employed care staff files were inspected, Information within these files confirmed that the homes recruitment procedures are robust. Care staff complete induction and foundation training, as well as N.V.Q level 2 training and the records checked confirmed this. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 15 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) 31,33,36,38 Aden View is a well managed home. Systems are in place to ensure the health and safety of service users and staff. EVIDENCE: Since the last inspection the manager has been registered with the Commission for Social Care Inspection. She has many years of experience in working with older people. Service users spoken to said she was very nice and was always around to talk to. Staff stated that they felt supported by the manager and senior staff. The manager stated that she sees most of the residents each day for a chat and that she is currently trying to encourage them to form a residents’ committee. Staff receive formal supervision from the manager at regular intervals. During the supervision the manager discusses the home aims and objectives and philosophy. Staff training needs are also discussed and identified.
ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 16 The manager is aware of her responsibilities regarding the health and safety of service users and staff. Staff have received training in the prevention of fire and the fire alarm system is checked weekly. Electrical equipment such as hoists and the passenger lift are inspected at regular intervals. Certification in relation to gas, electricity and water were in place and up to date. Accidents to service users and staff are recorded. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 17 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x 2 x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 x 3 ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 18 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 3 Regulation 14 (1) Requirement The pre-admission assessment must be completed fully and include the information as outlined in standard 3.3 Information in care plans must be detailed. Service users must be involved in the review of their care if they so wish. keep the home free from offensive odours( The carpet in the room identified should be replaced or a more suitable floor covering used) Timescale for action 31/8/05 2. 7 15 (1) 31/8/05 3. 26 16 (2)k 30/9/05 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 Where a service user has been identified as being at risk of developing a pressure sore a care plan should be devised.A more detailed nutrition assessment should be used. ADEN VIEW J51J01_s26262_Aden View_v232045_280605.doc Version 1.40 Page 19 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
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