Inspection on 19/12/05 for Arden Lea Nursing Home

This inspection was carried out on 19th December 2005.

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

The inspector 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 Lea Nursing Home 21/04/09

Arden Lea Nursing Home 08/04/08

Arden Lea Nursing Home 12/04/07

Arden Lea Nursing Home 22/06/06

Arden Lea Nursing Home 24/02/05

Arden Lea Nursing Home 03/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Arden Lea Nursing Home 25 Mayo Road Sherwood Rise Nottingham NG5 1BL Lead Inspector Dee Shelvey Unannounced Inspection 19th December 2005 10:00 X10029.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 Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 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 and Care Homes for Adults 18 – 65*. 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 Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Arden Lea Nursing Home Address 25 Mayo Road Sherwood Rise Nottingham NG5 1BL 0115 9621100 0115 9113292 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) Mr Nimalendra Atheray Mrs Brigid Williams Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (4), Terminally ill (2) of places Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2005 Brief Description of the Service: Arden Lea is a 27-bed home situated close to the city centre with many local amenities and well served by local transport. All areas of the home are accessible to service users. The home provides 24-hour care with nursing for older people but 4 places may be used by people with a Physical disability between the ages of 18 and 65 years. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four and three quarter hours and included reading documents, examining records, speaking with service users and staff and a tour of the premises. The inspection focused on checking the progress made in meeting the requirements and recommendations set at the previous inspection. The new manager had taken up the position on 6th September 2005 but unfortunately was taken ill and was absent from 15th September to 28th November. She is therefore currently auditing the home, prioritising tasks and drawing up a plan for improving standards. What the service does well: What has improved since the last inspection? Appropriate medical waste disposal bags, gloves and medical hand-wash are now provided in rooms where service users have M.R.S.A. and al the linen from these rooms is placed in colour coded bags for separate washing. This has considerably improved infection control. The lobby areas around lifts had been cleared of clutter and the home was clean and tidy. Commodes and urine bottles were being cleaned in the sluice room. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 6 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 Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Prospective service users have their needs assessed. The standard of information on offer could be improved. EVIDENCE: There were outstanding requirements from the last inspections to include information in the statement of purpose that the home admits people aged form 18 to 65 yeas of age and to produce information in formats suitable for all service users. On the day of the inspection the elements to be included in the service user guide were discussed with the manager and a time extension was agreed to allow for her sickness absence. Prospective Service users and their families are able to have trial visits to the home and there was evidence on the most recent assessments of service user and family involvement. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): YA 6,9,16, OP 8 and 9. Service users health and personal care needs are met. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 10 EVIDENCE: The case files of 2 service users were examined and these contained details of service user and family involvement. Risk assessments were completed for all identified risks. The manager was in the process of transferring all records onto a new format as they were reviewed. The new formats will ensure that all details of involvement and support are recorded and that reviews for younger adults are reviewed with service users /significant professionals/relatives or representatives as stated in standard 6.10. Appropriate medical waste disposal bags, gloves and medical hand-wash are now provided in rooms where service users have M.R.S.A. and al the linen from these rooms is placed in colour coded bags for separate washing. This has considerably improved infection control. The home had satisfactory policies for the handling and administration of medication. All drugs were properly stored and records were up to date. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion having all been met at the previous inspection. EVIDENCE: Although not inspected in depth service users spoken with expressed satisfaction with activities on offer. On the afternoon of the inspection they were being entertained by a musical duo. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 The home had a satisfactory complaints policy. EVIDENCE: The complaints policy was seen and met the standard. Service users spoken with knew they could speak to any member of staff about their concerns and were confident they would be taken seriously. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA27, OP19, 22, 24 and 26. Service users have a safe and comfortable environment. There is some need for refurbishment and the wooden ramps in use constitute a safety hazard. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 14 EVIDENCE: Concerns about access via wooden ramps to two bedrooms for service users in wheelchairs, had been raised following previous inspections. As a result the areas had been assessed by an occupational therapist and she had recommended the purchase of new telescopic ramps to greatly reduce the safety hazards. Some corridors have only one grab rail in place and although this was not determined a hazard it was recommended that 2 rails be fitted where the corridors were wide enough. Window restrictors had been fitted where necessary. The provider had fitted locks on individual bedrooms where the service user had expressed a wish for one. When an assessment shows this is not safe due to service user capacity or the service user has refused a lock the result must be recorded on the care plan. There was sufficient communal space, toilets and bathrooms to meet minimum standards. Bedrooms were individualised and those service users spoken with expressed satisfaction with their rooms. Two areas of the home need urgent attention. The sluice rooms were very old with only basic washing facilities and the metal storage shelves were rusting. The laundry was sited in the cellar down very steep stone steps. The floor was in fair condition but the walls were showing signs of deterioration. There was either a growth or exudation from the walls showing that the surface had broken down. This would be impossible to keep clean and infection free. The area was cluttered, the lower handrail was very loose and the door opened inwards. This resulted in either leaving the door open or in walking backwards down the steps as it was opened, either being a safety hazard. The rest of the home was clean and tidy and it was clear that the owner had made considerable improvements since purchase. If refurbishment continues the home will offer a good standard of accommodation. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The number of staff on duty would meet the service users needs during the day. A dependency level audit is required to ascertain that sufficient numbers are on duty over night. EVIDENCE: Service users spoken with made positive comments about the staff. Observations during the inspection showed staff treating residents with respect. The roster showed sufficient numbers on duty during the day but at night there was one qualified nurse and one care assistant on duty. Based on the care plans seen and observations of assistance needed by residents this could be a cause for concern especially should an emergency such as a fire occur. The manager agreed to do a comprehensive audit of service user needs with special attention to those who require more than one to assist them to mobilise. The night staffing arrangements must then be arranged to meet service users requirements based on the audit report. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 36, 37 and 38. The manager acknowledges the need to improve the administrative systems of the home. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 17 EVIDENCE: The manager demonstrated a commitment to improve the quality of care and services for service users and a determination to meet the national minimum standards. The registered provider undertakes regular quality assurance visits to the home and had already made improvements to the comfort of service users by fitting new carpets in many areas. All safety equipment had been tested at regular intervals and fire drills had been re-instated by the manager. Checks need to be made on emergency lighting and exits. The manager also needs to approach the fire brigade for advice on compiling a fire safety assessment. The home had satisfactory policies and procedures for the protection of adults. When service users are not able to manage their financial affaire Nottingham City Council act as appointee for the management of benefits. Personal allowances are then paid into a bank account and managed with the assistance of the proprietor. The accounts were seen and were in good order but there are no separate accounts in case files for residents to access should they wish. When money is given to families for safe keeping the home should get a receipt. Staff supervision has been organised to commence in January 2006 and records will be kept. The manager was aware of the need for a minimum of six supervisions per calendar year. Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 18 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 2 2 3 X 4 X 5 X 6 X 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 X 13 X 14 X 15 X X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X ENVIRONMENT Standard No Score 19 3 20 X 21 3 22 2 23 X 24 3 25 X 26 2 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 X 34 3 35 X 36 3 37 2 38 2 Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 23(2) Requirement The registered person must include that the home admits service users aged 18 –65years and emergency admissions in the statement of purpose. The registered person needs to ensure that the service user guide and other information needs to be made available in other formats suitable for the service users accommodated at the home The registered person must liaise with the fire safety officer and record the outcome and action. The registered person needs to develop policies and procedures on service users access to their personal financial records, safe storage of valuables, consultation on finances in private, and advice on personal insurance; and preclude staff involvement in and making or benefiting from service user’s wills. The management must act upon the recommendations made by the occupational therapist and replace the wooden ramps. DS0000059465.V278360.R01.S.doc Timescale for action 28/02/06 2 YA2 4 Schedule 1 28/02/06 3 4 OP38 OP37 23 17 Schedule 4(9) 28/02/06 28/02/06 5 OP22 13, 14 31/03/06 Arden Lea Nursing Home Version 5.1 Page 20 6 OP27 18 (1)(a) 7 OP26 13(c) 16(2) The manager must do a comprehensive audit of service user needs with special attention to those who require more than one to assist them to mobilise. The night staffing arrangements must then be arranged to meet service users requirements based on the audit report. The laundry room wall must be made good, all the clutter must be removed and advice must be sought on providing a safe access to the cellar. Ideally the laundry room should be re-sited. 28/02/06 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Arden Lea Nursing Home DS0000059465.V278360.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. 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