Inspection on 22/09/06 for Arden Court Care Centre

This inspection was carried out on 22nd September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Arden Court Care Centre 07/07/08

Arden Court Care Centre 14/06/07

Arden Court Care Centre 07/08/06

Arden Court Care Centre 08/03/06

Arden Court Care Centre 23/11/05

Arden Court Care Centre 14/03/05

Arden Court Care Centre 14/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Arden Court Care Centre 76 Half Edge Lane Eccles Manchester M30 9BA Lead Inspector Adele Berriman Unannounced Inspection 22 September 2006 10:45 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 Arden Court Care Centre DS0000006693.V313873.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. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arden Court Care Centre Address 76 Half Edge Lane Eccles Manchester M30 9BA 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) 0161 707 9330 0161 707 9698 ardencourt@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (3) of places Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 47 service users who require nursing or personal care may be accommodated. Three named service users are under 65 years of age and require care by reason of physical disability. If any of these service users leave or reach the age of 65 years the category will revert to OP. 7th August 2006 Date of last inspection Brief Description of the Service: Arden Court is a care home providing nursing and personal care for up to 47 older people. The registered owners are Ashbourne Eton Ltd. The single room accommodation is provided on two floors with communal day areas on both floors. Access to the first and second floors is by a passenger lift. Entry to the building is via steps or an access ramp and a manned reception is provided. The grounds include a large garden area with some car parking to the rear and side of the building. The home is on a main bus route, is close to the motorway network and a train station is five minutes away in Eccles town centre. Fees for the home are between £355.52 and £528.00 per week. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Friday 22 September 2006 starting at 10:45hrs. The inspection took place over a period of approximately 6 hours by two inspectors. A second visit was made to the service on Sunday 24 September 2006 by an inspector. The purpose of the second visit was to assess the outcome of three immediate requirements made on the visit dated 22 September 2006. There was no manager in post at the time of the visits and the care manager who would usually deputise was unavailable for duty. A manager from another of the company’s homes had been transferred to Arden Court to manage day to day issues in the home for an interim period. Requirements have been made in this report to improve some of the current standards within the home. Not all standards were assessed during this inspection and therefore it is strongly recommended that this report be read together with the previous report to see how the home is meeting the needs of the people who live at Arden Court. What the service does well: What has improved since the last inspection? The service had recruited an activities co-ordinator to provide social and recreational opportunities for residents. The home had made arrangements for an activities co-ordinator from another home to spend several hours a week providing activities for the residents of Arden Court while wating for the new person to start. The home had purchased a new hoist to meet the needs of residents. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 6 Records requiring personal information were stored appropriately. 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. Arden Court Care Centre DS0000006693.V313873.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 Arden Court Care Centre DS0000006693.V313873.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality outcome in this area is adequate. This judgment has been made using available evidence including a visit to the service. People’s needs were assessed prior to moving into the home. EVIDENCE: Residents needs were assessed before they moved into the home to ensure that the home were able to meet the persons needs. The assessment was documented on a set pro-forma that was completed by the person carrying out the assessment. Copies of the pre-admission assessments formed part of individuals’ care plans. Some assessments contained detailed information, however, some of the assessments were not signed or dated by the assessor. Arden Court does not provide does not provide intermediate care facilities. Arden Court Care Centre DS0000006693.V313873.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 9 Quality outcome in this area is poor. This judgment has been made using available evidence including a visit to this service. Failure to administer medication and maintain accurate records of medication may put people’s health and wellbeing at unnecessary risk. EVIDENCE: Each resident had a care plan and a sample of these were assessed. The documents contained details of what care and support people needed from the staff team and also included a social profile on the individual. Some care plans contained more detailed information than others. Care plans gave the opportunity for staff to record and monitor people’s pressure areas, fluid intake and weight when a need had been identified. Some but not all of these records were up to date. For example, one person’s care plan stated that weekly monitoring was required of the individual’s weight but the last recorded weight in the care plan was 24.07.06. Other documentation stated that the individual had been weighed in September 06, however this had not been recorded. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 10 Risk assessments were available on residents’ files that included pressure ulcers, moving and handling, dependency and nutrition. Care plans demonstrated that staff maintained daily records of what care and support had been offered/delivered to individuals. However, one record that was assessed contained inconsistent records. For example, one recording read ‘X was for a bath today but there was not time to do so please could you give him a bath tomorrow if time (permits)??’ An entry into a bath record book demonstrated that the person had had a bath around that time and therefore gave conflicting information. This issue was discussed with a representative of Southern Cross Healthcare Ltd, proprietors of the home, who visited the home during the visit. Personnel at the home were unable to identify the signature of the member of staff who had written the entry into the daily records. The representative from Southern Cross Healthcare informed the inspectors that only qualified nursing staff should be recording in people’s care plans and the procedure should be that carers inform the nursing staff what care and support they had delivered to a resident and the nurse should enter it into the records. There was documentation available that demonstrated that residents had access to healthcare professionals as and when required. One care plan contained information relating to a recent referral made by the home for a swallowing assessment for someone who was experiencing some health issues. The home had a policy for the administration of medication and had a contract for the disposal of unwanted medication. Medication was stored in an appropriate locked facility and taken around the building in medication trolleys. The inspectors arrived at the home at 10:45hrs. When entering the home the inspectors observed medication being administered. The inspectors were informed that it was the breakfast/morning round of medication had just started. The staff member stated that the delay was due to staff assisting with a visiting health professional. At 10:55hrs the inspectors found an open medication trolley with medication on the top of the cabinet and the keys in the door. The trolley had been left unattended on a corridor. After several minutes a member of staff returned to the trolley and explained that she had been called away to take a telephone call. Both people administering medication were wearing tabards stating not to disturb them as they were administering medication. The member of staff said that the breakfast/morning round of medication had just started as she had been helping the care staff to get residents up, washed and dressed as they were short staffed. The issue of the time when medication is being administered in the morning is a concern that has been raised on several occasions in previous reports. The acting manager of the home recognised that this was an issue and had already arranged a meeting with the staff who administer medication to take place within three days of the inspectors visit. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 11 An audit of two residents medication was undertaken. Both audits contained errors. In one audit the number of tablets in the blister pack did not match the number of tablets recorded as being administered on the Medication Administration Records (MAR’s). Half of a tablet (the prescribed dosage was a full tablet) had been administered two days in advance. In audit two the number of tablets contained in the blister pack did not match the number of tablets that had been signed for as being administered. Due to the concerns raised regarding the procedures for medication within the home immediate requirements were made of the home to ensure that medication was administered at the prescribed time, that medication needs to be stored appropriately at all times and a full audit of medication was to take place to ensure that people were receiving what medication was prescribed to them. Action was to be taken within 24hrs. A further visit was made to the home two days after the initial visit to the home. The purpose of the visit was to assess the outcome of the immediate requirement left at the home relating to medication. The inspector arrived at 10:30hrs and the breakfast/morning medication round was almost completed on both floors. A monitoring sheet had been implemented for staff to record what time they started and finished their medication rounds. Staff had been made aware that they needed to carry out a full audit of medication that day and medication was stored appropriately. Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Quality outcome in this area is adequate. This judgment has been made using available evidence including a visit to this service. More opportunity is required for residents to access social and recreational activities to ensure that people have access to stimulation. EVIDENCE: Since the previous inspection the acting manager had recruited an activities co-ordinator and was waiting for the appropriate references and Criminal Records Bureau check to be returned. A requirement was made following the previous inspection that residents had the opportunity to make choices and have access to social and recreational interests. In order to address this requirement whilst waiting for the newly recruited activities co-ordinator to start employment a co-ordinator from another home was being employed to provide some activities on a part time basis. A list of activities was displayed in the foyer of the building. During the inspection three residents were seen to be enjoying a game of bingo. Arden Court Care Centre DS0000006693.V313873.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are comfortable in using the home’s complaints procedure and the home’s policies would protect residents from abuse. EVIDENCE: The home had a complaints procedure that was displayed. The home had a system for recording any complaints received about the service. However, some of the complaints recorded did not contain information relating to the outcome of the complaint investigation. Residents said that they were comfortable in raising any concerns or complaints with staff members. A copy of Salford Social Services adult protection procedure was available in the home. Staff files demonstrated that some staff had attended awareness training in adult protection. Arden Court Care Centre DS0000006693.V313873.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. The home provides a comfortable environment for people to live, however improvements were needed in the management of malodours. EVIDENCE: Facilities were available to ensure that the building was accessible to all. These facilities included a ramped entrance and an internal passenger lift between each floor. The home has an ongoing programme of redecoration. Communal rooms were pleasantly decorated and were furnished comfortably to meet the needs of the residents. A requirement was made following the previous inspection that all residents have access to appropriate moving and handling equipment. This was a result of a resident raising concerns about a hoist that had been broken for some Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 15 time. During this inspection the resident confirmed that a new hoist had been purchased and was available to use. The home was clean and tidy. However, several areas of the home had a malodour. Arden Court Care Centre DS0000006693.V313873.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to this service. The number of staff on duty did not fully meet the needs of the residents. EVIDENCE: During the first visit to the home there were two registered general nurses, one being a bank member of staff, four carers and an agency carer on duty to meet the needs of the residents. The rota demonstrated that a further carer was meant to be on duty but they had not turned up. A newly recruited member of staff was also on duty carrying out their induction programme. During the second visit to the home there were two nurses and four carers, one nurse and three carers working on the first floor and one nurse and one carer working on the ground floor. Staff explained that a member of staff had telephoned in sick and a decision had been made by the staff team to “manage”, although the home did have a procedure to follow in the event of a staff member not arriving for the shift. During both visits staff were seen to be extremely busy meeting the needs of the resident. This was evident on several occasions when the inspectors observed call bells not being answered for a considerable amount of time. One carer commented to the inspectors that they were extremely busy and unfortunately there was a lack of time to speak to people and the only opportunity they had was when they were giving people drinks and supporting people with their meals. Residents confirmed this. Concerns regarding the number of staff on duty were raised in the previous inspection report and a requirement was made that the staffing levels must be reviewed in line with the needs of the residents accommodated to Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 17 ensure that people’s needs are met. This requirement is reiterated in this report. Positive interaction between staff and residents was observed. Staff were respectful of residents and demonstrated a thorough knowledge of the needs and wishes of individuals. Residents spoke highly of the staff team that worked throughout the day. Several staff files contained evidence of training that had taken place including food hygiene, health and safety, fire safety and protection of vulnerable adults. The administrator for the home stated that she was in the process of updating all training records onto a new recording system. This standard will be assessed in further detail during the next inspection. Arden Court Care Centre DS0000006693.V313873.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The service is in need of being managed consistently to ensure that the service is being delivered appropriately. EVIDENCE: At the time of this inspection there was no manager in post. However, information received from the responsible individual for the service after the visits stated that a new manager had been recruited. In the absence of a manager arrangements had been made for a care manager from another of the organisations homes to be based at Arden Court to deal with day to day issues. The organisation had a corporate procedure for improvement and monitoring of people’s views on the service. The acting manager of the service stated the Arden Court Care Centre DS0000006693.V313873.R01.S.doc Version 5.2 Page 19 home was in the process of arranging for each resident to receive a questionnaire. The home has a non-interest bearing savings account where all resident’s monies are banked. All transactions are documented and receipts kept on file. People are only able to access their monies by the administrator of the home who needs to be informed in advance if anybody requires any money. Residents have no access to monies over the weekend or at any other time the administrator is not on duty. A policy on health and safety was available in the home. A recording system is in place for the monitoring of hot water temperatures, fire detection equipment etc. The results of all monitoring and testing were documented in one file. Risk assessments relating to people’s health, safety and wellbeing were available. Arden Court Care Centre DS0000006693.V313873.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 2 10 x 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Arden Court Care Centre DS0000006693.V313873.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 Requirement Care plan records need to fully demonstrate that all identified needs are being met and health requirements monitored. Information needs to be recorded in an accurate and consistent manner. The registered person must ensure the appropriate management for the recording, storage and administration of medicines. Timescale for action 14/11/06 2. OP9 13 02/10/06 3. OP26 23 It is required that all areas of the 30/10/06 home are kept free from malodours. The staffing levels must be reviewed in line with the dependency needs of the residents accommodated to ensure that people’s needs are met and medication is administered at the prescribed time. DS0000006693.V313873.R01.S.doc 4. OP27 18 30/10/06 Arden Court Care Centre Version 5.2 Page 22 5. OP31 8 An application must be submitted to the Commission for the registration of a manager. 14/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP16 OP35 Good Practice Recommendations All pre-admission assessments are required to be signed and dated by the assessor. It is strongly recommended that all records of complaints investigated by the home contain information relating to the outcome of the investigation. It is strongly recommended that residents have access to money at all times. It is also strongly recommended that where possible residents are enabled to open an interest bearing account. 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