CARE HOMES FOR OLDER PEOPLE
Ardath 27 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ Lead Inspector
Michele Etherton Unannounced Inspection 22nd July 2008 09:50 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 Ardath DS0000021027.V368687.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. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Ardath Address 27 Hastings Road Bexhill-on-sea East Sussex TN40 2HJ 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) 01424 210538 01424 810486 ardath1@btconnect.com www.sxhousing.org.uk Sussex Housing and Care Miss Jane Ann Narborough Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of service users to be accommodated is thirtytwo (32) Service users must be older people aged sixty five (65) years or older on admission. 28th September 2006 Date of last inspection Brief Description of the Service: Ardath is a part adapted, part purpose built care home situated on the outskirts of Bexhill on Sea. The home is situated approximately one mile from Bexhill town centre with its shops and access to bus and rail routes. The home is registered to accommodate thirty-two older people and the registered owners are Sussex Housing and Care (SHC). The home comprises of 22 single occupancy en suite bedrooms and 9 double occupancy en suite bedrooms. There are additional toilet and bathroom facilities throughout the home. Rooms are located over two floors, accessible by a passenger shaft lift. There are extensive well-maintained gardens to the rear of the property that are accessible to service users. There are car-parking facilities to the front of the premises. Potential new service users can obtain information relating to the home via the internet, CSCI Inspection Reports, Care Managers, Placing Authorities, by word of mouth and by contacting the home direct. The range of fees charged (at the time of this report) were £358 - £508 per week, with additional charges made for hairdressing, newspapers/magazines, transport and chiropody. Ardath DS0000021027.V368687.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 2 stars. This means the people who use this service experience good quality outcomes.
A key unannounced inspection of this service has been undertaken, this has taken account of information received from the service and about the service by CSCI since the last inspection, including an Annual quality assurance assessment (AQAA) completed by the manager. The AQAA has been completed to a reasonable standard and provides us with most of the information we need, there are some areas where more supporting evidence would have been useful to illustrate what actions the home has taken to address previously identified shortfalls, the activities of the service and future planning. The inspection includes an unannounced site visit to the home on 22/7/08 between the hours of 9:40 am and 17:10. During this visit a tour of the premises was undertaken, care and ancillary staff consulted with in addition to residents, their views and comments have been influential in the compilation of this report. Survey responses have also been sought from residents and other stakeholders these will be analysed, and incorporated into the report if returned before the final report is issued. All key standards have been inspected some in more depth than others; Standards where outstanding requirements have been issued previously or outcomes became apparent during the site visit have also been included. A range of documentation has also been examined including care plans, risk assessments, menus, Medication administration records, staff recruitment, training and supervision records, complaints and accident information. What the service does well:
Residents we spoke with told us that they like the home environment which is clean and well kept, comfortably furnished and provides a homely comfortable atmosphere. Residents like being able to furnish their bedrooms with their own possessions as this makes them feel more at home. “Its so important to have your own things around you, I felt right at home straight away”. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 6 “Yes its nice here, the girls are very nice and the food is good all of that’s all right but its not home is it? And it will take a long time to adjust” Residents like the large well-kept grounds and enjoy making use of the outside patio space. Resident’s benefit from having enough staff on duty to support them, staff turnover is low and continuity for residents good. The staff team are well trained, and demonstrate commitment to their role. Staff feedback indicates that relationships and communication within the staff team is good. The management team operate an open door style of management valued by staff and residents alike who find the manager and deputy approachable. Staff’ report they are able to express ideas and influence service development. The home listens to residents and keeps them informed of changes Systems are in place to ensure prospective residents are assessed before moving in and needs are kept under review to ensure residents can continue to receive the support they need. The home routines promote and encourage independence amongst residents and the opportunities to make choices and decisions for themselves on a dayto-day basis. Residents who are able to continue to manage their own medication and finances, residents kitchens are provided on each floor to enable those residents assessed as able to do so the facility to make drinks and snacks for themselves and their visitors. The home is welcoming to visitors, and provides a guest room. Residents enjoy a varied diet and are able to choose what they eat, they particularly enjoy the flexibility of choosing to eat in their room or the dining room and greatly appreciate the special birthday teas produced by the chef and kitchen staff to celebrate their individual birthdays. There is evidence that some residents have done so well whilst at the home that they are awaiting a move back into sheltered accommodation in the community. “Ardath made me well again” The home has a history of co-operation and compliance with regulation to ensure that standards are maintained for service users. What has improved since the last inspection?
The home has addressed previous outstanding inspection requirements. The AQAA tells us that since the last inspection the home has increased staffing levels in the afternoon to better support residents who wish to go out. A rolling
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 7 programme of staff training has been established to ensure mandatory and more specialist training is provided to staff. The main lounge and dining area has been re-carpeted, and new curtains have been fitted in the dining area and TV lounge. Laundry hours have been increased, a phased purchase of more chairs with arms is underway, and external redecoration of the home is ongoing. A flat used formerly for staff accommodation in the basement has been refurbished and will provide a new staff changing area, staff room, and training suite. New Patio furniture has been purchased and residents were observed making good use of this area in fine weather. Residents also benefit from the purchase of a new sovereign bath this enables disabled residents improved access to bathing facilities. What they could do better:
The home has identified within AQAA information areas where they consider further improvement is still needed. During the site visit we found a number of areas where the service provides positive outcomes for service users as well as a small number of areas, where Standards are either not being sustained or would benefit from improvements to current practice. An examination of staff records indicated an absence of important information about staff that is used to determine their fitness and supports the homes decision to employ them as suitable. The Home is unable to evidence that recruitment is sufficiently robust to safeguard service users and are required to make improvements discussed at the site visit and to ensure they can produce documentation for each staff member in keeping with current legislation under the Care Homes regulations 2001. The home is also required to ensure staff induction is in keeping with skills for care common induction standards. The home is also recommended to: Make clear actions taken in response to falls monitoring and liaison with other agencies, that changes to medication records are dated as well as signed and that easier access is provided to staff for PRN medication guidelines for individual residents, all liquid medications should also be dated upon opening. Residents told us that they would like more frequent staff supported outings and the home is recommended to review this. Additionally, it is recommended that the Home manager ensure that complaints are recorded separate from each other to afford greater confidentiality. The frequency of formal staff supervisions should be improved to evidence practice is suitably monitored, and individual staff training files maintained. Improvements to the consistency and content of accident reporting has also been recommended as it is not always clear what actions have been taken by staff following a resident accident.
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 8 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. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 9 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 Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 10 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, 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents to the home can be confident that there needs will be assessed prior to admission to ensure these can be met, and that changes in needs will be kept under review. An Intermediate care service is not provided and this standard has therefore not been assessed. EVIDENCE: We consulted with people recently admitted to the home who told us about their experiences, they told us that in the majority of cases they had been involved in the decision to come to the home and had been given information about what the home was like, this was mostly anecdotal through relatives and
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 11 significant others who had visited on their behalf, they confirmed they were visited by someone from the home prior to their admission, they were all happy with the decision they had made and felt the home lived up to their expectations. The AQAA states that all prospective residents or their representatives are issued with a brochure that contains the statement of Purpose and user guide, senior staff consulted confirmed that an assessment’ of need is carried out by the manager or deputy of all prospective residents prior to admission, examples of assessment information was noted on resident files examined including those only admitted for a period of respite. The home does not offer an intermediate care service although it can as vacancies arise provide opportunities for respite. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Health care and personal support for residents is well managed by the home and takes account of privacy and dignity issues. Independence of residents is actively promoted within a framework of responsible risk taking. Satisfactory procedures are in place for the management of medication and these will be enhanced by suggested improvements EVIDENCE: We looked at three care plans for current residents in addition to assessment information for someone admitted at the time of the site visit. Care plans files are more person centred and identify short and long term goals for the individual residents, there is a range of documentation to ensure that the health and personal care of each resident is well managed either by the resident themselves or with staff support.
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 13 Residents consulted told us that they can where possible retain their own opticians and dentists and make arrangements to attend appointments for this outside the home, a resident commented that “ I understand the ones they provide for you are very good too” Resident files contained evidence of falls risk assessment and falls monitoring where there is an high risk of falling this is clearly recorded in care plan information and related risk assessments, there is a lack of clarity about what the home does with information about individual falls monitoring e.g. involvement of falls assessment team and it is recommended that this is made clear within documentation. Two of the residents spoken with whose files were examined spoke positively of their experiences of living at the home one commented that “its so important to have your own things around you, I felt right at home straight away”. Another resident reported that they had come in when they were particularly unwell but since being in the home they had regained their confidence and independence and were now looking to move back out into the community “Ardath made me well again”. Another resident commented:”yes its nice here, the girls are very nice and the food is good all of that’s all right but its not home is it? And it will take a long time to adjust” Examination of residents files and accident reports highlighted that residents are empowered to make decisions about their own welfare even where this goes against the advice of staff e.g. not wishing to go to hospital after a fall. We found from consultation with residents and staff’ that those that are able to are encouraged to maintain control of their own medication and secure facilities are available in their rooms for this. We examined medication administration records and these are generally completed to a satisfactory standard, handwritten entries are being signed for but would benefit in accuracy from the addition of dates, the home has implemented medication profiles and individualised PRN guidelines, staff would be better informed of medication needs if PRN guidelines are more readily accessible to those administering and these are recommendations for improvement in practice. Medication storage is good with temperatures recorded. It is further recommended that, as with prescribed drops and creams liquid medications are dated upon opening to aid medication audits. Routines and staff practice ensure residents privacy and dignity is maintained the home actively promotes independence in its residents, and this is clearly evidenced in those residents who are now awaiting rehousing into sheltered accommodation in the community. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents lead the lifestyle they choose and can access activities offered, increased opportunities for staff supported trips out would enhance this. Guests and visitors are made welcome, independence is promoted and residents empowered to exercise choice and control in their daily routines. A varied and nutritious diet is provided in pleasing surroundings convenient to the individual resident. EVIDENCE: We consulted residents who told us that they enjoy maintaining some of their own interests, make good use of the mobile library and participate in some of the organised activities in the home and occasional trips out. We spoke with other residents two of whom commented that they would like more opportunities to go out on staff supported trips as once per week is not often enough and consideration should be given as to how this may be achieved and this is a recommendation. Some residents we spoke with said they enjoyed the flexibility of choosing to opt in and out of activities. The
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 15 home has a drinks bar that is open during the day at 12 noon and at other times throughout the week. Residents we spoke with all commented positively on the spacious and well kept grounds and clearly enjoy walking around this and making use of a secluded patio area, residents are asked to wear a call pendant when out in the grounds to alert staff if necessary. Residents we spoke with maintain good contacts with their families and a guest room facility exists, visitors are made welcome and are offered refreshments. We joined residents for lunch in the dining area; tables are laid for dinner with tablecloths and napkins, and cutlery for all courses. Residents told us that they select their menu choices for the next day and can have alternatives if they do not like what’s on offer, some residents were observed having different options that they had requested, a vegetarian option is also made available in addition to any specialist diets e.g. reducing, diabetic. Residents told us that they liked having the choice to have meals in their room, and spoke very positively about the fact that birthday’s teas are provided for them and that there birthdays are made special. A small kitchen is provided on each floor of the home for use by those residents assessed as able to safely make drinks and snacks for themselves and their guests, they have use of a small fridge and a microwave. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 16 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): 16,18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents feel listened to by staff and that any concerns they have will be acted upon. Staff’ are trained and have an awareness of adult safeguarding issues, staff practice and home procedures should generally safeguard residents from harm or abuse. EVIDENCE: Residents we spoke to during our visit said they found staff friendly and approachable and they would feel confident about approaching them with their concerns, a number of residents particularly indicated they would approach the deputy manager who they thought was someone who would act immediately to address any concerns they might have. Staff indicated that the management team are open and approachable and that they would feel confident about raising issues with them. The complaints record was examined and highlighted two complaints received by the home this year, both have been resolved with details of the complaints, investigations and outcomes recorded. Whilst access to the complaints record book is restricted to that of the manager and deputy, it is recommended that
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 17 the present recording system is reviewed to ensure that confidentiality is not infringed by the recording of complaints on the same page. We consulted staff’ they told us that they receive training in adult safeguarding and that this is updated regularly. Systems are in place to ensure that generally residents are safeguarded from abuse and harm but identified shortfalls in recruitment and staff induction practice must be addressed. Satisfactory systems are in placing for managing residents monies. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 18 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): 19,20,21,22,24,26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in comfortable, homely, and well-maintained accommodation. They are encouraged to personalise their own space and have access to specialist aids and adaptations to support their care needs. The home is well kept, clean and odour free. EVIDENCE: A tour of the premises and partly of the gardens was undertaken during the site visit. This allowed us to see a mix of communal and personal bedroom areas with resident consent. Residents commented that having their own things around them made them feel at home quicker and aided their settling in, bedrooms are decorated for new residents and takes into consideration their personal taste and wishes.
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 19 Communal rooms and corridors are a mix of newer and older furniture and fittings that create a pleasant and homely environment throughout. Smoking arrangements for residents are outside under a roofed area with seating, compliant with present smoking legislation, consideration should be given to how residents who smoke will continue to be supported to do so when colder weather comes. There are ancillary staff to undertake domestic duties including cleaning, maintenance, laundry and kitchen duties, this frees up care staff to make more time available for residents. The fire log has not been checked on this occasion although a servicing invoice has been noted for the fire alarm system, the AQAA states that the handyman is an appointed fire warden and holds a level 2 health and safety certificate there are plans to train additional senior staff as fire wardens. The AQAA tells us about the improvements already made this year to carpeting in the small lounge and the replacement of some chair’s, the home has purchased a sovereign bath with grant money. The manager advised that equipment, which needs upgrading, has been identified and will be replaced as part of a plan for improvement in the next 12 months. There are plans to renew curtains throughout the home and a training and staff facility is being developed in a former flat in the basement, the maintenance man ensures that all minor repairs etc are addressed. Residents who are able to and want one have a key to their bedroom, No unpleasant odours or smells were noted within the premises’, which are maintained to a high standard of cleanliness and generally well kept. A member of the cleaning staff confirmed working to set cleaning schedules but these can be overridden by priority cleaning duties as they arise. There is a sluice room on each floor and staff confirmed to us that these are used for the management of commodes. The laundry area is well equipped and a laundry staff member is employed. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 20 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): 27,28,29,30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is enough staff on duty; residents generally benefit from the continuity of a well-trained and committed staff team, however, shortfalls have occurred in the quality of staff induction, recruitment, EVIDENCE: We consulted with staff about staffing levels within the home which they reported as being satisfactory, staffing has been increased on afternoon shifts to enable outside trips to be supported by staff, residents indicated that staff are always available and at no time expressed concerns about staff numbers. Resident’s benefit from staff continuity, with many staff employed for some years. Consultation with staff indicated that they felt they got on well with each other, felt well supported by the management team and each other, and that communication was effective. Ancillary staff are very much inclusive into the staff team and are provided with mandatory training in addition to specialist training linked to their role. Comprehensive handovers are implemented for each shift change to ensure staff’ commencing duty are fully apprised of the welfare of residents.
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 21 The manager has implemented a rolling programme of both mandatory and specialist training courses and demonstrates commitment to training for care and ancillary staff in the home. Staff spoke positively of the amount and range of training they have received, one staff member told us that since coming to work at the home they had received so much training that they felt this had maximised their potential and boosted their confidence to take on more responsible roles within the home. The home has achieved in excess of 50 staff trained to NVQ2 and is encouraging staff to pursue further NVQ qualifications. Staff files examined indicated that Individualised training profiles have not been maintained and it is recommended these are re-instated. We examined a sample of three staff recruitment files these indicated that the content of staff files is not compliant with the care Homes regulations in that copies of ID although noted by senior home staff have not been retained, two references were noted in only two out of three files viewed, interview records are not in place and therefore no evidence as to whether interviewers are exploring gaps in employment histories verification of reasons for leaving previous care roles has been established. One file viewed was without a CRB or Pova 1st check although a disclosure has been sent. The Home has been asked to ensure that no care worker works unsupervised with residents at any time with out a CRB and two good references being in place, a requirement has been issued in this respect. An examination of newer staff files indicates that an orientation induction is provided to new staff that includes some shadowing over a two-week period. Induction information viewed would suggest that induction is signed off in one day, and not over the timescales expected within nationally agreed common induction standards, it is also unclear how and in what depth staff competencies are assessed, the home is therefore required to review the present induction process for care staff with reference to the Skills for care common induction standards. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 22 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): 31,33,35,38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is generally well managed and in the best interests of residents, a culture of openness and respect is promoted and residents living in the home feel listened to. EVIDENCE: On the day of the site visit the manager was absent as also was the deputy, a senior carer was in charge for each shift. We found both senior carers demonstrated a good understanding of the home routines, policies and procedures, they understood the needs of the residents and maintained a calm
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 23 and professional approach to the inspection visit. They were able to answer all of the questions or could direct us to where these could be found. Four care staff’ including two seniors were spoken to in total, in addition to the chef, laundress and one of the domestics. Care staff reported that they felt well supported by the management team, who they found encouraging, interested and whom they felt valued by. Domestic and kitchen staff in addition to laundry staff are included in all training and are perceived as playing and equal and important role in the running of the home. The staff team is stable and settled, staff consulted reported that communication and team working are good. The AQAA states that the home undertakes quality audits and seniors commented that medication audits are being implemented shortly, an organisational and home development plan are in place and residents consulted with told us that they are surveyed by the home for their views, residents have access to the outcomes of quality audits, this was not explored in detail on this occasion, residents confirmed that resident meetings are held one commenting “I missed the last one but I would certainly speak up if I needed to” Systems are in place to ensure that any monies’ held on behalf of residents’ are safeguarded by satisfactory recording, including the use of second signatures and also those of the individual residents’. Cash balances held for two case tracked residents have been checked and were found to be accurate. Staff confirmed that supervisions are held and that appraisals are also provided, the national minimum standards expects staff to receive a minimum of six formal supervisions annually, examination of staff files indicates that frequency of formal staff supervisions has slipped and it is recommended that the frequency of these is reviewed. Staff felt that the open-door policy of the manager enabled them to seek support at any time, but, there is a need to ensure that formal supervision frequencies are maintained and recorded to evidence that staff competencies and practice are being appropriately monitored and developed. AQAA information advises that all health and safety checks and tests have been completed, a sample of lift and hoist servicing certificates were examined to support this. Staff told us that there is a maintenance book for recording minor repairs or priority cleaning and both the maintenance person and cleaning staff refer to this record on a daily basis The home staff’ are actively recording all accidents minor trips and falls, these can be cross referenced with daily records, but do not consistently contain a level of detail to inform the reader what action has been taken as a result of the accident, it is recommended that staff are encouraged to record consistently and detail actions taken.
Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 24 Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 25 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 26 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 OP29 Regulation 19 Requirement The provider must ensure that all staff commence employment at the home only after the receipt of a satisfactory CRB check and that Staff recruitment files must also contain the range of information stated within schedule 2 of the care home regulations 2001, and there should be evidence that the employer has explored gaps in employment and verified reasons for leaving previous care roles The provider must ensure that staff induction is compliant with skills for care common induction standards. Timescale for action 22/08/09 2. OP30 18 22/10/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No.
Ardath Refer to Good Practice Recommendations
DS0000021027.V368687.R01.S.doc Version 5.2 Page 27 1. 2. Standard OP8 OP9 3. 4. 5. 6. 7. OP12 OP16 OP30 OP36 OP38 The home should make clear within falls monitoring information what action has been taken with regard to frequent falling and what other agencies may be involved The manager should ensure that handwritten changes to MAR sheets should be dated as well as signed, and that Administering staff have easier access to individual resident PRN guidelines. Liquid medications to be dated upon opening. The manager should review the frequency of opportunities for residents to access staff supported trips outside the home each week. The manager should ensure that complaints are recorded separately within the current complaint record book to improve confidentiality. The manager should evidence that the individual training and development needs of staff has been assessed and this is recorded The manager should ensure that staff receive formal supervision a minimum of six times within a twelve month period The manager should ensure that staff make clear within accident reporting what actions have been taken with regard to the residents welfare. Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Ardath DS0000021027.V368687.R01.S.doc Version 5.2 Page 29 - 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!
