Inspection on 19/12/05 for Arbor House

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Arbor House 02/10/07

Arbor House 04/05/06

Arbor House 19/05/05

Arbor House 04/02/05

Arbor House 18/08/04

Similar services:

Applegarth

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Arbor House High Street Evington Leicester Leicestershire LE5 6FH Lead Inspector Rajshree Mistry Unannounced Inspection 19th December 2005 9:25 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 Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arbor House Address High Street Evington Leicester Leicestershire LE5 6FH 0116 2739033 0116 2739033 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) Leicester City Council Mr Julian Citroni Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20), Old age, not falling within any other category (40), Physical disability over 65 years of age (4), Sensory Impairment over 65 years of age (10) Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Numbers DE(E) & MD(E) No one falling within category DE(E) or MD(E) may be admitted into the home when 20 persons who fall within categories/combined categories DE(E) or MD(E) are already accommodated within the home Service User Numbers PD(E) No one falling within category PD(E) may be admitted into the home where there are 4 persons of category PD(E) already accommodated within the home Service User Numbers SI(E) No one falling within category SI(E) may be admitted into the home where there are 10 persons of category SI(E) already accommodated within the home 19th May 2005 2. 3. Date of last inspection Brief Description of the Service: Arbor House is a care home providing care for up to forty older people. The home is owned and managed by Social Services, Leicester City Council. Arbor House is a large purpose built property located in Evington Village, with shops and other local amenities close by. The home is within walking distance to public transport and fifteen minutes by car to the city centre. Communal areas and residents bedrooms are located on the ground and first floor accessed by stairs or the passenger lift. Bedrooms are on both floors with sufficient numbers of bathrooms/shower and toilet facilities. All areas of the home are accessible for people using wheelchairs and other walking aids. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the service, which took place on the morning of 19th December 2005 and lasted 4½ hours. This is the second regulatory inspection of the service addressing the remaining core standards. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for the resident and their views of the service provided. The primary method of inspection used was ‘case tracking’. Three residents were identified for case tracking and the quality of the care received was examined through reviewing their care records, discussion with the residents, their relative, the staff, social worker and observation of the care practices. The Inspector had the opportunity to speak with the visiting Social Worker, to seek their view of the home from placing and reviewing residents at the home. The inspection included discussion and action plans following the changes in the temporary changes in the home’s management team. The inspection also addressed several issues brought to the attention of the Commission by a relative of a resident. What the service does well: What has improved since the last inspection? Since the last inspection, the requirements and recommendations identified have been addressed. Additionally the following improvements have taken place: • A stand-aid for the benefit of the residents. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 6 • • Appointment of a part-time Activities Organiser. Residents Meetings are taking place monthly. What they could do better: All the standards examined and the feedback received by the Inspector from the residents and staff were positive. This was a positive inspection as there was evidence demonstrating the implementation of procedures, practices and consultation for the benefit of the residents. The home’s management team must ensure residents are offered the option of having a key to their bedroom, as stated in home’s brochure. Some areas identified during the inspection were discussed with the Acting Manager and assurance was that these would be addressed, as follows: • Care plans and risk assessment to be developed in consultation with the resident reflecting the residents’ needs and choice of lifestyle. Evidence of needs being met and significant events to be accurately detailed in the daily notes; Prescribed course of medication completed and medication administered as required should be dated and detailed. Staff training matrix could be developed to show the staff skill mix and prompt training and refresher courses. • • 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. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 the following standard(s): 6. EVIDENCE: Arbor House is not registered to provided intermediate care. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 the following standard(s): 7, 9. Staff could meet the residents’ health and social care needs more appropriately by using more up to date care plans developed with the resident. EVIDENCE: Residents tracked who spoke with the Inspector were able to describe how staff were assisting and supporting them. Their individual plans of care examined were brief, did not consistently reflect the residents’ interests and instructions to staff how their needs can be met and did not show how the risks have been minimised or removed. Daily care notes were brief and did not reflect the care provided or any significant event. This was discussed with the Acting Manager who was also aware of the lack of key information on these documents. Assurance was given that risk assessments and care plans would be updated in consultation with the residents to ensure care is provided as identified respecting the residents’ choices. The visiting social worker indicated that staff had good knowledge of the residents’ wellbeing and valued their contribution at the review meetings. Visiting relatives also indicated their relatives have been well cared for and are satisfied with the homely surroundings. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 10 Medication is stored securely in a locked room and administered by trained staff. The system for ordering, storing, recording and returning medication is good. Medication and records were examined for residents were generally in good order. Recording of prescribed course of medication could be improved by accurate and timely recording on completion of the course. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 the following standard(s): 13. Residents experience a homely lifestyle and are supported to maintain contact with family and friends. EVIDENCE: Residents Meetings’ are held to consult and inform the residents of changes within the home and ensure the facilities and services provided are appropriate. Residents spoken with felt they were more involved in the home, received visitors at anytime and can meet with them in private. Residents are supported to maintain their own contacts with family and friends in the community or going out i.e. to the local church. On the day of the inspection a member of staff was observed taking a resident to the local shops. Relatives of a new resident were seen to make them comfortable and staff were being supportive. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 the following standard(s): 16 Arrangements for receiving and responding to complaints are satisfactory, resulting in protection of residents’ rights. EVIDENCE: The ‘service users guide’, given to residents on or prior to admission sets out the complaints procedure and is also available in other formats. The contact details of the Advocacy Services are included and displayed on the notice board at the entrance to the home and communal areas such as the library and the dining room. Residents spoken with including the new resident indicated that they were aware of whom to contact in the home or would raise concerns with their family. All were confident that concerns and complaints made would be addressed promptly. Records showed no complaints had been received since the last inspection. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 the following standard(s): 19, 24 Residents live in a clean, homely and well-maintained home although would benefit from having the option of a lockable bedroom. EVIDENCE: On the day of the inspection the home was found to be clean, tidy and well maintained. The décor was homely and bedrooms viewed were personalised with pictures and ornaments. Residents spoken with indicated they were happy with the surroundings which were safe with handrails with throughout the corridors. The visiting social worker indicated that the home was always found to be clean and tidy. From the residents spoken with, only one resident confirmed that they had been offered and chose to have a key to their bedroom. This was discussed with the Acting Manager, who acknowledged that the keys were not offered to all the residents’ as locks were not fitted on all the bedroom doors. This was found to contradict the statement made in the home’s brochure, indicating residents are offered keys to their bedrooms. The Acting Manager indicated that this has been raised with the Senior Management for action. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 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, 30. Residents’ needs are met by sufficient numbers of trained staff promptly and safely. EVIDENCE: On the day of the inspection staff, the carers and ancillary staff were on duty as indicated on the staff rota viewed. Residents spoken with staff appeared competent in assisting the residents. The Inspector observed carers transporting residents safely, ensuring footplates were used. The Acting Manager stated that as a result of an issue relating to residents being transferred safely from a chair to bed, staff have received training in moving and handling. Staff training records were viewed and further discussion with the Acting Manager it was acknowledged that the staff skill mix and training levels were not easily identifiable. Assurance was given to ensure staff training records is easily accessible, current to ensure needs of residents are met be the appropriately trained staff and is in a format to prompt refresher training. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 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 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): 35. The residents’ finances are safeguarded with a robust system. EVIDENCE: Records of residents’ valuables are accurately recorded. Residents have access to a lockable drawer in their bedrooms to store personal valuable items and money. Also refer to the section “Environment” on page 14. Residents manage their own finances with either support from a relative or solicitors, as appropriate. The Inspector observed a resident requesting and receiving her money timely. Residents finance records examined were clearly showed good financial reconciliation and management of residents money, which is double signed and crosschecked against the sums of money kept on behalf of the resident. Residents have access to the Advocacy Service such as Fairdeal. The Acting Manager is currently looking to invite Fairdeal to a Residents Meeting to benefit the residents. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 16 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X 2 X X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 17 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 OP24 Regulation 23(1)(a) Requirement The Registered Person must ensure all residents are offered a key to their bedroom, as stipulated in the home’s brochure. Timescale for action 19/01/06 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 OP7 Good Practice Recommendations The home’s management team should consider • updating the risk assessment and; • developing detailed care plans in consultation with the resident that reflects the needs and choice of lifestyle; • daily notes accurately reflect the how needs are met and events affecting the resident. The home’s management team should ensure the prescribed course of medication and medication is dated and signed on completion. The home’s management team should look to develop a staff training and skills matrix that is easily accessible, DS0000037704.V273974.R01.S.doc Version 5.0 Page 18 2. 3. OP9 OP27 Arbor House current to ensure needs of residents are met be the appropriately trained staff and is in a format to prompt refresher training. Arbor House DS0000037704.V273974.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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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