Random inspection report
Care homes for older people
Name: Address: Ar-lyn Vicarage Lane Lelant St Ives Cornwall TR26 3JZ one star adequate service 19/05/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Ian Wright Date: 0 9 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Ar-lyn Vicarage Lane Lelant St Ives Cornwall TR26 3JZ 01736753330 01736759223 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Peter Hubert Oxley care home 13 Number of places (if applicable): Under 65 Over 65 13 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 1 9 0 5 2 0 0 9 Ar-lyn is a large detached property set in its own grounds in the village of Lelant near St Ives. The registered provider is Mr P H Oxley. The home provides personal care for up to 13 elderly people. There are nine single and two shared bedrooms situated on both the ground and first floors. There is a step at the main door; a ramped entrance is provided at a side door. A stair lift provides access to the first floor. The communal rooms are situated on the ground floor. Toilets and bathrooms are located on each floor. There are extensive secluded gardens around the home which house a range of aviaries and small caged animal enclosures. The garden provides seating areas for service users. A copy of the inspection report is available from the homes management or from the Care Quality Commission website. The range of fees at the time of the key inspection in May 2009 was £314.25- £375 per week. There are
Care Homes for Older People Page 2 of 10 Brief description of the care home additional charges e.g. for hairdressing, chiropody, and newspapers etc. Care Homes for Older People Page 3 of 10 What we found:
This unannounced random inspection was completed to: * Look at any regulatory breaches arising from concerns raised in an adult safeguarding investigation. * Check requirements issued at the key inspection on 19th May 2009. The methodology to complete this inspection was as follows: * We met privately with some people using the service to ask them their views about the home. * We had conversations with other people using the service in the lounge to ask their views of the service. * We inspected the building. * We met with the registered provider. * We inspected relevant documentation held in the home for example care plans and employment records. Apart from the judgements made as part of the safeguarding investigation (See What they could do better-below), we did not have any significant concerns regarding care in the home. In regard to the requirements issued on 19th May 2010 we found there has been some progress, although we note that the registered provider does still need to take further action to ensure full compliance with the regulations. Where this is the case we have renotified the statutory requirements within the report. What the care home does well:
All the people, who use the service, who we spoke to are happy with the service provided. People said the food provided was very good, appetising and wholesome. People said they could get up and go to bed when they liked. They said staff support was to a good standard, staff were pleasant, kind and caring. The registered provider and his wife were seen as supportive and caring. The building is homely, warm and welcoming. There is a large through lounge and diner where people can spend their time. The lounge has pleasant views of the garden. The garden can be accessed by people who use the service via a patio door. There is a paved area where people can sit. People using the service said they could use the garden at any time, although most people at this time of year, chose not to due to the weather. The registered provider has separate accommodation at the home. This has a separate staircase, from the main part of the home, with a separate exit. The separate facilities
Care Homes for Older People Page 4 of 10 and access should always be used by the registered persons family or visitors, if the people living in the care home do not wish to share space with them. We inspected one of the bedrooms and this was clean and furnished appropriately. Bedding was clean. Prior to the inspection, a concern had been raised about lack of equipment to help someone get on and off the toilet. On the day of the inspection there was appropriate equipment for this purpose; for example a toilet frame. We advised the registered provider to check all rooms had appropriate equipment, and grab rails where this is necessary. The registered provider said this equipment is in place. It is important that at the pre admission assessment stage, the registered provider always checks what equipment people may require, this is obtained and in place before the person moves to the home. We looked at requirements set at the last key inspection. The following areas, where there were regulatory requirements set, now meet the national minimum standards and associated regulations: * Staff employed since the last key inspection have a Protection of Vulnerable Adults first check (POVA first) / Independent Safeguarding Authority (ISA) check and a Criminal Record Bureau (CRB) check. * Terms and Conditions of residency or a contract (as appropriate) have been issued to all people using the service. * The hot water temperature control valve has been fixed, and there is a system of checking this is working. The registered provider said he would ensure a record is kept of temperature checks. The registered provider said even though there is a hot water temperature control valve on the baths; staff check the temperature of the water before people bathe. We will inspect the records of these checks at the next inspection. * A review of staffing levels at night has been completed by the registered provider. The registered provider has made the judgement that to have sleep in staffing at the home is sufficient. The registered provider states people are not admitted to the home who require waking night staff. The registered provider says staffing levels are kept under review. The commission has stated that it is advisable that waking night staff are employed, but based on the evidence presented to us we do not currently have evidence to enforce this. * The registered provider has completed the AQAA (Annual Quality Assurance Assessment)(for 2009) required by the commission. This is an annual self assessment and data set required by the commission. * The registered provider has supplied us with some notifications of deaths or untoward incidents, as are required by the regulations. * A quality assurance policy for the service is now in place, and the registered provider has stated this has been implemented. We will inspect the evidence of implementation at the next inspection. * The registered provider has carried out a risk assessment regarding legionnaires disease, and introduced a system for decreasing this risk. What they could do better:
A safeguarding investigation took place following a concern raised by a person who used the service. It appears the person had a fall, which may have been prevented if there had been better equipment to assist the person on and off the toilet. We understand that a member of staff raised their voice to the person on at least one occasion. The staff member has however apologised to the person concerned, and will try not to repeat this
Care Homes for Older People Page 5 of 10 behaviour to other people using the service. No other complaints have been received regarding this member of staff. In regard to other allegations about the cleanliness and routines at the home, we cannot find any evidence to substantiate these. We also looked at evidence regarding requirements issued at the last inspection. Further improvement needs to occur in the following areas: * Recruitment Procedures of staff. We assessed three staff files of staff employed since the last inspection. Some improvement is required to the services application form so there is a declaration regarding the applicants fitness in regard to physical and mental health. People also must provide a comprehensive work history. Two written references should be provided-preferably from the persons previous employer and if the person has recently worked in a caring capacity. If verbal references are provided, this should be recorded and every effort made to obtain the reference in writing. * Staff Training. The registered provider said some training had been completed for example regarding the administration of medication. However, further training required by law for example regarding infection control, first aid, fire awareness, moving and handling, and food hygiene needs to be provided. We have said the provider needs to take prompt action regarding these matters and we are concerned regarding the number of renotifications regarding this requirement. Enforcement action could occur if satisfactory action does not take place regarding improving training. * Records regarding some medical input (e.g. GP, district nurses, chiropody) appears satisfactory. However improvement is still required regarding detailing, in individual care plans, who medical practitioners are and when the last medical interventions occurred (e.g. dentist, audiology, CPN, Optician etc). If people do not use these services because they do not require them, refuse to use them or services are not available, this should be recorded in the care plan. This information will assist staff and external professionals to ascertain people are having regular input from external medical professionals. Other than these matters which require improvement, we believe the service meets the national minimum standards and associated regulations. People were happy with the service provided and the home seems a comfortable and pleasant place to live. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 8 12 Record keeping regarding 01/03/2010 when people last saw a medical professional (e.g. dentist, chiropodist, optician) needs improvement. It should be possible to track when some one had an appointment with each professional. (Previous timescale of 01/09/2009 not met. Second Notification) This should help to give people more assurance their medical needs are being monitored and they will receive frequent appointments from these services as required. 2 21 23 There must be a lock on each 01/03/2010 bathroom and toilet door. (Previous timescale of 01/09/2009 not met-Second Notification) This will ensure there is more privacy for people using these facilities 3 29 18, 19 The registered provider must 01/03/2010 ensure that the home adheres to a robust
Page 7 of 10 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action employment procedure in all instances to protect residents. (Timescale of 01/06/2008 not met-Second Notification) 4 30 18 Staff must receive training required by regulation, as outlined in the body of the report. (Timescale 01/09/09 not met, Third Notification) This will help ensure staff are equipped with the skills and knowledge to carry out their roles. 01/05/2010 Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
