Inspection on 05/02/08 for Archers Point

This inspection was carried out on 5th February 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Archers Point 25/04/06

Archers Point 19/01/06

Archers Point 21/04/05

Archers Point 07/10/04

Archers Point 16/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Archers Point 21 Bickley Road Bromley Kent BR1 2ND Lead Inspector Mohammad Peerbux Key Unannounced Inspection 09:15 5th February 2008 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 Archers Point DS0000006884.V351596.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. 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. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Archers Point Address 21 Bickley Road Bromley Kent BR1 2ND 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) 020 8468 7440 020 8467 3478 info@archerspoint.co.uk Mr Om Parkash Grover Mrs Nirmal Kanta Grover Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2006 Brief Description of the Service: Archers Point is a large detached three-storey purpose built residential home for the care of the elderly. The home is set back from a busy main road, with some off street parking to the front of the building. The home is within easy reach of Bickleys main line station, local shops and public transport. The resident’s accommodation is on the two lower floors accessed by a lift. The owners occupy the third floor. Residents have access to a large garden at the rear of the home. The accommodation offers two lounge areas one with a TV, a dining area and various sitting areas around the home. There are 17 single bedrooms, three double bedrooms and seven rooms that have en-suite facilities. There are grab and hand rails on stairs, in passageways, toilets, showers and bathrooms. Specialised bathing and toilet equipment and lifting aids are available. Central heating is provided to all areas of the home and residents can control the temperature of their own rooms. The radiators and hot pipes are guarded to lessen the risk of accidents. On the day of the inspection the range of fees for the home was between £350.00 and £485.00 per week. Archers Point DS0000006884.V351596.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. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2007/2008. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. This is the first key unannounced inspection for the year 2007/2008.This inspection was facilitated by the registered provider and registered manager and lasted seven hours. All registered adult services are now required to fill in an annual quality assurance assessment (AQAA) .It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from this AQAA is included in the report. Some times were spent looking at records, talking to some residents, staff and manager. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. Residents who were spoken to stated that they are happy with the way that the staff deliver their care and respect their dignity. One resident stated, “I am happy here and the staff are very good”. What the service does well: Comments from residents were generally positive, with indication that staff are kind and helpful in meeting their care needs. They were observed to be treated with respect by staff and to have their privacy and dignity respected. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet residents’ needs. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. The home is pleasantly designed and furnished, providing communal living, recreational and dining space that meets individual and collective needs. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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 Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home undertakes an assessment of the healthcare needs of residents prior to their admission to ensure that their needs would be met. EVIDENCE: The service considers the needs assessment for each prospective resident before agreeing admission to the home. Three residents’ files were sampled at random and they all had a pre-admission assessment carried out. However the manager must ensure that a date is included on the assessments. Intermediate care for rehabilitation and return to the community is not provided by this home. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally residents’ personal, physical and emotional health needs are being met. However the system for receipt, storage and disposal of medications is not always consistent and could potentially place residents at risk. EVIDENCE: Three residents’ care plans were sampled at random and it was noted they included basic information necessary to deliver the resident’s care however the manager is reminded that residents’ care plans need to be reviewed and updated to reflect changing needs and current objectives for health and personal care, at least once a month. Presently the care plans are being reviewed on a six monthly basis. The home actively promotes the residents’ right of access to the health and remedial services that they need, both within the home and in the community. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 10 Records show that the home arranges for health professionals to visit residents in the home and provides facilities to carry out treatment. The home has a medication policy, which is accessible to staff, medication records are generally up to date for each resident. However the policy must be updated to include procedures for the receipt, storage and handling of medicines. During the inspection it was noted that prescribed medications (creams) were left unattended and unlocked in residents’ bedrooms and also in communal bathrooms. This potentially places residents at risk. All prescribed medication in the custody of the home must be locked according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971,for the health and safety of residents. With regards to records for receipt of medicines, no records were available on the day of inspection. The manager stated that as they only receive 14 days supply of medication each time, they are not able to sign for 28 days. This was discussed with the manager and she stated that she would ask the chemist to supply 28 days stock of medication so that they could sign on the MAR sheet itself. Records must be kept of all medicines received by the home to ensure that there is no mishandling. A number of prescribed medications were out of date. All item of medication must be within their use by date so that residents are not put at risk. It was also noted that there was a large amount of medication in the stock. The manager was advised to return them to the chemist for disposal. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. The home arranges for residents to enjoy the privacy of their own rooms. Residents who were spoken to stated that they are happy with the way that the staff deliver their care and respect their dignity. One resident stated, “I am happy here and the staff are very good”. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being provided with a range of opportunities for recreational and social activity that is in accord with their social and cultural needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Staff are aware of the need to plan the routines and activities of the home in a way, which meets the choice, and wishes of residents. The home tries to be flexible and attempts to provide a service, which is as individual as possible by using its staff and resources effectively. As far as possible the residents are consulted on how the home can work to provide them with a flexible lifestyle, and to achieve their wishes. The home has open visiting arrangements and residents know they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 12 Maintaining independence and enabling residents to make their own decisions about how they wish to live is a key objective of the home. Residents have the choice to bring personal possessions with them on admission to the home and are encouraged to keep personal items, which are important to them in their own room. The manager stated that a wide variety of different food options are available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. Hot and cold drinks are available at all times and at regular intervals. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. EVIDENCE: The home has a complaints procedure that is conspicuously displayed in the home for all to view. The procedure explains how to make a complaint and that the complainant can expect a response about the outcome of any investigation to a complaint within 28 days. The current complaints procedure is good and gives a clear step-by-step guide of how to make a complaint. The home’s aims and objectives include the rights of residents. Residents are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. The home is clear when an incident needs to be referred to the Local Authority as part of the local Safeguarding procedures in place. The manager stated that most of the staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the residents’ health and emotional wellbeing. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet residents’ individual and collective needs in a comfortable and homely way. Residents’ bedroom are personalised to reflect their individual needs, and personalities. Overall the home was decorated to a good standard throughout and appeared to be very comfortable, bright and warm. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 15 The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are of sufficient quantity to meet the residents’ needs and provide consistency and to ensure their safety. However recruitment policies are not been consistently followed resulting in residents receiving care from staff members who have not been properly vetted. This potentially leaves people who use the service at risk. EVIDENCE: The staff rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. The manager stated that 9 staff have NVQ level 2 qualifications and one staff has NVQ level 3 qualification. It was previously required that the Registered Person must ensure that current CRB checks are obtained for all staff before they commence work at the home. During this inspection three staff files were sampled and they did not have all the documents as per schedule 2 of the National Minimum Standard. However they all had a CRB on file. Staff files must contain all relevant documentations Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 17 as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. The home ensures that all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. The manager is aware that there are some gaps in the training programme. These are being addressed and further training sessions have been arranged. The staff individual training programme was sent to the Commission following the inspection. As the record was not available on the day of the inspection, this would check in more depth at the next inspection. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally managed well however the health, safety and welfare of residents and staff are not being promoted/protected and this potentially places them at risk. One-to-one supervision sessions are still not being held with staff on a regular basis, this could affect the staff’s ability to consistently meet the residents’ needs. EVIDENCE: The registered manager has the required experience and is competent to run the home. She works to continuously improve services and provide an Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 19 increased quality of life for residents. She has the Registered Manager’s Award and NVQ level 4. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are now in place to measure success in meeting the aims, objectives and statement of purpose of the home. The manager stated that the home does not handle residents’ monies. Three staff supervision records were sampled and it was noted that progress still need to be made regarding this issue. The manager is reminded that formal supervision sessions must be held with all care staff at least six times a year for the delivery of good quality services. This was a requirement at the last inspection and would therefore be repeated. A number of health and safety issues arose during this inspection and they are as follows: - A high number of doors including the kitchen door were wedged open. Fire doors must not be wedged open unless held open by a magnetic door holder that responds to the fire warning system. The local fire brigade was contacted on the following day of the inspection and they have visited the home and advised the provider and manager accordingly. -Fire records were also checked and it was identified that there was no record of fire alarms test being carried since 30/12/07. The registered manager stated that the test has been carried out but not recorded. Fire alarms test must be carried out and recorded on a weekly basis for the safety of staff and residents. -The hot water temperatures in some areas which residents have access to were well above the recommended level of 43 degrees centigrade. Some of the readings were between 55 and 66 degrees centigrade. The Commission was very concerned and asked the registered provider to take immediate action to rectify this issue. A plumber was contacted on the day of the inspection and visited the home that same afternoon. The hot water temperature must always be within the recommended level of 43 degrees centigrade so that residents and staff are not at risk of being scalded. Certificates relating to health and safety were up to date servicing certificates. Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 1 Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(2) Requirement Residents’ care plans must be reviewed and updated to reflect changing needs and current objectives for health and personal care, at least once a month. The medication policy must be updated to include procedures for the receipt, storage and handling of medicines. All prescribed medication in the custody of the home must be locked according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971,for the health and safety of residents. Records must be kept of all medicines received by the home to ensure that there is no mishandling. All item of medication must be within their use by date so that DS0000006884.V351596.R01.S.doc Timescale for action 05/04/08 2. OP9 13(2) 05/04/08 3. OP9 13(2) 12/02/08 4. OP9 13(2) 12/02/08 5. OP9 13(2) 12/02/08 Archers Point Version 5.2 Page 22 residents are not put at risk. 6. OP29 19 Staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the delivery of good quality services and for the protection of residents. Formal supervision sessions must be held with all care staff at least six times a year for the delivery of good quality services. (Previous timescale of 15/04/07 not met). Fire doors must not be wedged open unless held open by a magnetic door holder that responds to the fire warning system. Fire alarms test must be carried out and recorded on a weekly basis for the safety of staff and residents. 05/04/08 7. OP36 18 (2) 05/05/08 8. OP38 13(4) 12/02/08 9. OP38 13(4) 12/02/08 10. OP38 13(4) The hot water temperature must 12/02/08 always be within the recommended level of 43 degrees centigrade so that residents and staff are not at risk of being scalded. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Archers Point DS0000006884.V351596.R01.S.doc Version 5.2 Page 24 - 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!