Inspection on 19/05/05 for Arbor House

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 19/12/05

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 LE5 6FH Lead Inspector Rajshree Mistry Unannounced 19 May 2005 at 10.00am 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. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arbor House Address High Street Evington Leicester Leicestershire 0116 2739033 0116 2739033 socis209@leicester.gov.uk Leicester City Council 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 Julian Citroni Care Home 40 Category(ies) of DE(E) Dementia, over 65 years of age - 20 registration, with number PD(E) Physical Disability, over 65 yrs of age - 4 of places SI(E) Sensory Impair over 65 yrs of age - 10 OP Old Age -40 ME(E) Mental Disorder over 65 yrs of age - 20 Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within category DE(E) may be admitted to the home when 20 person who fall within category DE(E) are already accommodated within the hoome. No person falling within category PD(E) may be admitted to the home when 4 persons who fall within category PD(E) are already accommodated within the home. No person falling within category SI(E) may be admitted to the home when 10 persons who fall within category SI(E) are already accommodated within the home. Date of last inspection 4th February 2005 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. Accommodation is on the ground and first floor accessed by stairs or the passenger lift. Bedrooms are on both floors with sufficent numbers of bathrooms/shower and toilet facilities. All areas of the home are accessible for people using wheelchairs and other walking aids. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 10am on 19th May 2005 and lasted for 6 hours. The method of inspection consisted of a tour of the premises, examination of the health and safety records for the home, three service users were spoken with and observed, specifically to look at their lifestyle at the home and how their care needs were met. Individual plans of care and relevant care records were examined. Key workers for service users talked about care provisions, how the identified needs were met and their training and management support. Visiting health and social care professionals and service users’ visitors shared their views about the home, which were very positive, and complimentary about the care provided in the home for the service users. Towards the latter part of the inspection visit, time was spent with the home’s manager discussing some of the findings, information received and observations made. What the service does well: What has improved since the last inspection? Since the last inspection new electric beds have been installed and new dining furniture. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 6 New care plans and risk assessments for service users have been introduced and now contain more detail for staff to follow to promote independence. Risk assessments have been undertaken for service users who manage their own finances. Record keeping has improved and systems are in place to regularly monitor to ensure compliance. The home is in the process of recruiting new permanent staff. 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. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 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 Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 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) 1, 2, 3, 4, 5 Information about the home and the facilities is made available at the earliest opportunity. The whole admission process is well managed and service users are given clear and detailed information about the provision of care. The robust assessment process ensures that care needs are met and individually tailored. EVIDENCE: There is a comprehensive Statement of Purpose and Service User’s Guide for service users accessing long and short-term care. Information is clear and made available at the first meeting. The admission procedure is good in that the assessments of individuals are carried out by the health and/or social care professionals, as part of the referral process. Three service users’ care files viewed contained the evidence of the placement agreement that forms the contract, detailing the terms of the stay. The files contained information to promote service users independence, as far as practically possible. The management team encourages service users’ and their relatives to visit the home and discuss the provision of care tailored to individual needs. Service users spoken with confirmed they were offered a trial period of stay. One service user was on a month’s trial period of stay with the option of making the stay permanent and described her stay as “safe and enjoyable”. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 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, 10 Service users well looked after having their health and social care needs met. Care provided is holistic and personalised. Management of medication in the home is good. Service users receive their medication in a timely manner. Recording is accurate and clear. Service users’ privacy is upheld and they are treated with respect. EVIDENCE: Since the last inspection the new care plans have been developed to contain detailed information to instruct staff providing the care without compromising service users independence, choice and rights. Three service users care files examined contained risk assessments and care plans reflecting the specific care needs. Service users spoken with confirmed they were consulted about the agreed provision of care. Records showed that care plans were revised periodically in consultation with the service users and other health and social care professionals. Medication is stored in a locked Treatment Room and administered by staff who are trained. Receipt, storage, administration of medication, returns and recording was seen and is considered to be safe. There is a robust system in place for auditing medication regularly. Management of controlled medication Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 10 is robust. Service users spoken with said that they receive their medication on time. An Assistant Manager has delegated responsibility to ensure the management of medication is remains robust. Staff were observed speaking with service users in a respectful and friendly manner. The home operates a key working system, whereby service users each have a nominated team of carers. Service users spoken with said they were treated with care and the privacy and dignity was respected in the way the care was provided. Other comments were received from the visiting Chiropodist that were very positive and complimentary about the care provided to the service users at the home. The Chiropodist gave a specific example relating to ‘foot care’ for service users with diabetes, where, “staff have followed the instructions and made accurate recordings”, and “being received by friendly staff in a homely environment”. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 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, 14, 15 Service users have a varied life at the home and are provided with a good social and recreational programme which meets their needs. Service users are supported well in exercising choice and control in their lives. There are good choices of meals that are nutritionally balanced, good quality and meet special dietary needs. EVIDENCE: The service users’ lifestyle within the home is tailored to meet the cultural, social and recreational expectations. Details of any planned events are displayed on the notice board and shared at the ‘Residents Meeting’. A delegated senior carer is responsible for arranging activities and events ranging from bingo, video and music nights and craft sessions and trips out in consultation with the service users. Service users can choose to participate in activities. One service user said that previously her key worker took her out to the local shops although this no longer happens. When raised with the service users’ key worker the response was of some concern as the key-worker indicated, “the service user would be taken out dependent on the availability of time and jobs” The library room stores a selection of books, which is replenished regularly by the Library Service. Service users are supported to practice their faith and have access to the local church. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 12 Visitors were seen on the day of the Inspection visiting relatives. The menu on the day of inspection was viewed and showed a choice of nutritionally balanced meals accommodating special dietary requirements. Meals are served in the large dining room. The home provides a small lounge and kitchenette for service users wishing to entertain family. Service users confirmed that they were offered choices at all meals, and that snacks were served throughout the day. Staff were seen serving drinks and biscuits to residents in the afternoon. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 13 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 The complaints system is robust, clear and accessible to all. Adult protection procedures are in place and staff in general are aware of the procedures to respond to any suspicion or allegation of abuse. EVIDENCE: There is a robust complaints procedure is displayed at the entrance of the home and in communal areas. Service users and visitors comments indicated that people are very comfortable discussing any concerns with the home’s Manager and the Assistant Managers. Service users spoken with felt they were safe and protected. The new adult protection procedure has been introduced. Two out of three staff spoken with had a good understanding the procedure to follow in accordance with adult protection issues and whistle blowing. One member of staff demonstrated little awareness the protection of vulnerable adults and the whistle-blowing policy and the procedure to follow. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 14 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, 20, 23, 24, 25, 26 A comfortable, well-maintained, personalised and safe standard of accommodation is provided individually and collectively for the service users. Specialist equipment is available to promote service users’ independence. EVIDENCE: Entry to the home and to the garden is wheelchair friendly. The home is well maintained and suited to residents needs. There is ample natural light throughout the home. There are several lounges on the ground and first floor including a designated smoking lounge. There is a large dining room with new furniture, attached to the kitchen. The dining room has a scenic view over the green surroundings and the balcony adjacent. All communal areas and hallways were observed to be in a good, clean condition. Four bedrooms viewed were individually decorated, with personal possessions, furniture and fittings suited to their needs. Respite/ emergency accommodation are located to one area of the home. There are handrails throughout the home and a passenger lift located to the centre of the home. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 15 Service users spoken with appeared to be happy with the home environment, “you get more than what you expect”. Bath/shower and toilet facilities are located throughout the home and were in hygienic condition. The home has a range of specialist equipment such as electric hospital beds and hoists, to promote service users’ independence, operated by trained staff. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 16 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 Service users’ needs are well met by the number and skill mix of staff. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the resident needs. EVIDENCE: Staffing levels were sufficient to meet the service user’s needs at the time of the inspection. The senior management at the home consists of the Registered Manager, two Assistant Managers, senior carers, carers and domestic staff. The home has a qualified trained National Vocational Qualification (NVQ) Assessor. Over fifty percent of staff have completed NVQ level 2, 3 or 4 with a further group of staff commencing NVQ level 2. The Local Authority has in place a departmental training plan, the document details general areas of training and training specific to needs of the service users. Staff training records reflected a variety of topics of training accessed which included health and safety, adult protection, care practice and specifically training in dementia care and challenging behaviour. A sample of staff files examined contained evidence of training undertaken in a staff training matrix used to match key workers for new service users. The management team is in the process of recruiting new staff and systems are in place to ensure that all the appropriate checks have been carried out. The service users and relatives spoken to, all felt that staff were ‘very good’, and that they listened to their needs and acted upon them. Staff were observed responding to the nurse call bell system promptly. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 17 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, 32, 33, 36, 38 The leadership and management approach of the home is good, and has a beneficial effect on the service users at the home. The health, safety and welfare of service users and staff are well promoted and protected. EVIDENCE: The management team were observed to work well together, and have a good understanding of each other’s roles and responsibilities. The Registered Manager offers a clear sense of leadership and openness in the management of the home, which is reflected on the day-to-day basis. The care plans and care records are in good order, and the key working system works well to provide service users with continuity of care. Residents Meetings are held regularly to discuss issues or concerns relating to the provision of care at Arbor House, which residents can choose to attend. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 18 Two members of care staff spoken to stated that they receive formal one to one supervision session with a member of the management team, these take place on a regular basis and are used to discuss training needs, changing needs of service users and any areas of concern. During the tour of the home fire exits were clearly marked and were not obstructed. Records of tests to fire safety equipment were in good order and health and safety issues were well documented. The Fire Risk Assessment was available and had been reviewed; generic risk assessments are in place, along with individual risk assessments for residents. The home has a Handy Person who is responsible for minor repairs and checks. There is a programme of maintenance and testing of all equipment in the home. Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 19 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 3 3 x x 3 x 3 Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 20 NO 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 18 Regulation 18 Requirement The Registered Manager must ensure that all staff receive appropriate training in relation to: (a) the protection of vulnerable adults, and (b) whistle-blowing. Timescale for action By 19th June 2005 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 OP1 Good Practice Recommendations It is strongly recommended that the Registered Manager undertakes an audit of documentations to ensure that the regulating authority is stated as the Commission for Social Care Inspection and not the National Care Standards Commission. It is strongly recommended that the Registered Manager ensures, that staff keep the service user informed as to when they would be ablet o respond to requests such as being taken out to the local shops. 2. OP14 Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 21 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire 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. Extracts may not be used or reproduced without the express permission of CSCI Arbor House C51 S37704 Arbor House V227523 190505.doc Version 1.30 Page 22 - 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. 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