Inspection on 08/04/08 for Arden Lea Nursing Home

This inspection was carried out on 8th April 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Arden Lea Nursing Home 21/04/09

Arden Lea Nursing Home 12/04/07

Arden Lea Nursing Home 22/06/06

Arden Lea Nursing Home 19/12/05

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 Karmon Hawley Unannounced Inspection 8th April 2008 09:30 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.V362105.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 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.V362105.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arden Lea Nursing Home Address 25 Mayo Road Sherwood Rise Nottingham NG5 1BL 0115 962 1100 0115 911 3292 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) Atheray Organisation Limited Mrs Lesley Ann Wright Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (5) of places Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2007 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 5 places may be used by people with a physical disability between the ages of 18 and 65 years. The manager provided information on weekly fees on 26/04/07, these are as follows: £323 - £350 this is dependent upon needs and the nursing determination. These fees do include the cost of chiropody but do not include the cost of hairdressing. This information is made available on the point of enquiry. A service users guide is available at the home in large print and a large print and audio version of the statement of purpose is also on display in the home to inform prospective service users of the services and facilities available. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service. We received this back from the manager in good time and the form was well completed and helped us to plan our visit and to decide what areas to look at. We also reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We did this inspection with one inspector; it was unannounced and took place over one day. The main method of inspection we use is called ‘case tracking’ which involves us choosing four residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We spoke to four members of staff and five people who use the service to form an opinion about the quality of the service being provided to people living at the home. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. What the service does well: A warm and welcoming atmosphere was evident on entering the home. Staff were observed to interact with both people living at the home and their relatives in a comfortable and relaxed manner. People using the service who were spoken with spoke highly of the staff, care received and standards maintained within the home. Comments such as, ‘I am very happy here, the staff are very good and help me when I need it,’ and ‘the Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 6 staff take me out shopping and come with me to appointments to offer me support,’ were received. The lifestyle experienced in the home by people living there matches their expectations and preferences, enabling them to live a life of their choosing. They stated that staff were respectful and that they felt confident that staff would listen to them if they had any concerns. A range of activites are on offer, which people using, the service said that they enjoyed. The menu on offer is wholesome and offers choices at each meal. All people spoken with stated that food was very good and plentiful; one person said it was good old-fashioned food, just as they liked it. Staff spoken with were able to discuss the individual needs of people living at the home and how they support them to meet these. They were knowledgeable in regard to ensuring that people who use the service remain safe and good practices are maintained. People living at the home are enabled to offer their views and opinions about the service and these are acted upon to ensure that the service is run in their best interest. What has improved since the last inspection? What they could do better: Plans of care in regard to people’s complex needs such as diabetes mellitus and behavioural issues need development to ensure that people’s needs are fully met. When changes occur or concerns arise plans of care must be updated to reflect this to ensure consistency of care and monitoring of peoples needs take place. Risk assessments in regard to entrapment and diabetes mellitus are required to ensure that people using the service are fully protected. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 7 The service’s recruitment policies and procedures need attention to ensure that people using the service are protected from unsuitable people being employed. 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. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 8 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.V362105.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are assured that their needs will be assessed and met before they make a decision to move into the home. The service does not offer intermediate care. EVIDENCE: The manager visits people who may wish to use the service in the community prior to admission and carries out a preadmission assessment. There was evidence of these assessments taking place within those files examined, ensure that the staff are able to meet their needs before they move into the home. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 10 Staff spoken with were able to discuss the preadmission procedure that takes place. One person using the service said that the staff had been very good to them when they first moved in and this helped them to feel more settled. The service does not offer intermediate care. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. As plans of care and risk assessments do not cover all people’s required needs these may not be fully met and people are not fully protected. People using the service are supported in accessing health services as required. EVIDENCE: Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 12 People using the service undergo various assessments such as manual handling, nutritional needs, pressure area care and the daily activites of living, information gained forms the plan of care. Plans of care reflected people’s personal preferences and outlined the remaining skills and the areas that they may need assistance with. However within one plan of care where the person experienced agitation it did not outline the triggers that may cause this, thus reducing the level of support staff may offer them in elevating this. Also within two plans of care in regard to diabetes mellitus, in regard to blood glucose monitoring, the plans did not outline what their normal levels were and there was no action to take in regard contacting the emergency services if needed. Also plans did not cover the specialist foot care that one with diabetes mellitus may require. Staff spoken with were able to discuss how they would act should they suspect that there were problems with a persons blood sugars. Within one plan of care where bedrails were in use there was no risk assessment in place in regard to entrapment, however staff spoken with were able to discuss the checks that take place when people use these to ensure that they are safe. Daily records were maintained, however in one plan where a concern had been raised, the plan of care had not been updated to reflect this and trigger monitoring of the concern. Where a person using the service had been diagnosed with MRSA (methacilline resistant staphylococcus areus) there was no plan of care in place in regard to the care of this or the prevention of cross infection. To ensure that people using the service receive relevant health care, access to services such as the district nurse, general practitioner, optician and hospital appointments are facilitated. One person spoken with said that they could see the doctor at any time they needed and also that staff went with them when they visited the hospital, which made them feel better. Equipment necessary for the maintenance of healthy skin was see to be available during the tour of the home and the manager said that the district nurses ensured that this was provided as necessary for residential clients and the service also had a good supply of equipment for people requiring nursing care. To ensure that people are protected by the service’s medication polices and procedures the medication of those people case tracked was observed. There were clear and accurate records of medication that had been administered. Handwritten entries on the medication record had been signed as correct by two members of staff to ensure that people received the correct medication. Fridge temperatures were available to show that medication is stored as required. The medication has now been moved from upstairs to a downstairs area to ensure that they remain at a more suitable temperature and thus the potency of medication is protected. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 13 To ensure that peoples privacy and dignity is maintained there is screening available within shared rooms. Staff spoken with were able to discuss the practices that they undertake to ensure that the privacy and dignity of people is upheld. All people using the service spoken with said that staff were very good and that they felt the staff treated them in the correct manner. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are enabled to live a life of their choosing, which matches their expectations. People using the service are enabled and supported to maintain contacts with people that are important to them. EVIDENCE: Care staff offer activites such as bingo, arts and crafts, cooking, and games to people who use the service on a daily basis. An outside entertainer called Mr Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 15 Motivator also visits the home when people carry out gentle exercise to music. People using the service said that they enjoyed the activites that were in offer and that they joined in these. One person said that they enjoyed going out shopping with staff. Staff stated that the routine of the home was flexible and people may choose how they spend their time. One person using the service confirmed this as they said it was a happy family atmosphere and they could do as they please with their time. People using the service were observed to move freely about the home and make choices as to how they spent their time. Two people using the service said that they had a good rapport with staff and they often had a laugh and a joke with them. Although at present no one wishes to attend church services, staff read from a big easy read bible for those people who wish to join in. One person accesses a local club where they carry out various activites, they stated that they enjoyed going and looked forward to doing different things. To ensure that people using the service are enabled to maintain contacts that are important to them, there are no restrictions on visiting and visitors may be received in private. Several visitors were seen to visit people throughout the day. Three people using the service spoken with all stated that their visitors were always made welcome and could visit whenever they were able. Staff spoken with were able to discuss issues in regard to equality and diversity, they stated that they felt confident that each person is treated as an individual and they knew their personal preferences. Two people spoken with said that they felt that staff listened to them and treated them, as they would want to be treated themselves. A wholesome and appealing menu is on offer and choices are available at each meal. The meal on the day of the visit looked appealing and was plentiful. All people spoken with said that food was very good; one person said that it was good old fashioned food, just as they liked. They confirmed that choices were available. Staff were able to discuss the special diets that are on offer such as diabetic diets to ensure that people’s dietary needs are met. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service feel confident that should they feel the need to complain that this will be taken seriously and acted upon. People using the service are protected from abuse. EVIDENCE: The service has received one complaint since the previous inspection in regard to the delivery of food and drink. As this complaint made an allegation about a member of staff this was referred to the safeguarding adults team who alongside the service carried out an investigation, no further action was taken following this. Staff spoken with were able to discuss how they would deal with a complaint should one be received. People using the service all stated that they had no complaints, that they were happy with the care received and that if they had any problems they felt they could approach a member of staff and these would be resolved. Staff have undertaken training in safeguarding adults to ensure that people using the service are protected from abuse. Staff spoken with were able to Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 17 discuss relevant issues and how they would deal with any untoward incidents should they occur. They were able to discuss how they would alert the relevant people such as the Commission for Social Care Inspection should they feel that bad practice were taking place. Two people using the service said that they felt safe living at the home and that staff were very good to them. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service live in a satisfactory maintained environment, attention is still required in some areas, however these have been acknowledged and work has been outlined to address these. EVIDENCE: To ensure that people live in a comfortable environment an ongoing redecoration and refurbishment programmed is in place. Redecoration has Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 19 taken place in the downstairs corridors, small lounge and dining room; new carpets have also been laid. Also a new PVC conservatory has been installed which offers access into the garden should people wish to go outside. The annual quality assurance assessment sent to the commission for social care inspection before the visit outlines the areas that have been addressed and those which will be addressed in the future. All areas of the home accessed during the tour were clean, tidy and satisfactorily maintained with the exception of the area in the main lounge where the conservatory had been installed. Decoration in this area has been affected due to the installation, thus detracting from the benefits of the new conservatory. People using the service spoke positively about the environment and one person said that it is the cleanest place they have been in. Another person spoken with said that they enjoyed the new conservatory which was nice to sit in. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People using the service are supported by sufficient numbers of staff. People using the service are not protected from unsuitable people being employed by the current recruitment practices. EVIDENCE: The staff duty rotas seen showed that sufficient staff were available to meet peoples needs. Staff were seen to be available to assist people throughout the visit. Staff spoken with confirmed that the staff team worked well together and that sufficient staff were available. All people spoken with said that staff were very kind and helpful and that they assisted them as needed. To ensure that all new staff are aware of their roles and responsibilities on joining the team they undertake an induction. Three new members of staff spoken with confirmed that they had undertaken an induction when they first Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 21 started work and also stated that they felt that the staff team supported them during this time. Staff personnel files observed confirmed that the induction process had taken place. All members of staff with the exception of two have attained the National Vocational Qualification (a nationally recognised work and theory based qualification) level 2 or 3 in care, which develops knowledge and skills in caring for the client group. There was evidence to confirm this on staff files observed; one member of staff spoken with also confirmed that they had undertaken this qualification. Staff personnel files were examined to see if they contained all the documentation required by law to ensure that people are protected from unsuitable people being employed. Two members of staff had been employed with no criminal record bureau check (a police check to see if an individual has a police caution or record) in place. The one on file had been undertaken by their previous employer and was no longer valid. Also there was no evidence of registered nurse’s profession identification numbers on file to show that they were in fact registered to practice. The remaining files contained all the required documentation such as two references and an application form. To ensure that staff have the required knowledge and skills to care for people using the service a compulsory training programme has been arranged. Staff files showed that there are currently a number of deficits in manual handling, first aid, health and safety and fire. A contract with a new training company was seen which showed that staff had been enrolled on further training in the near future to address these areas. Staff spoken with stated that they had attended training courses and that training offered was at a good standard. All people using the service spoken with said that they felt that staff were well trained to carry out their job. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The views and opinions of people using the service are listened to and taken into account in the running of the home. The finances of people using the service are protected. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has been in post since September 2005 and is registered with the Commission for Social Care Inspection. She remains up to date with attending study days and in house training. Staff spoken with spoke highly of the manager and said that she was always approachable. People using the service also spoke highly of the manager and the way in which the home is run. There are concerns in respect of the recruitment practices and record keeping, which are discussed further in the staffing section. Quality assurance surveys have been given to people who use the service and to their relatives. Those completed were observed and most offered positive feedback such as: the manager is always available, friendly and very pleasant, the rooms are big and bright and have been newly decorated you cannot fault it, good choice of food; staff are always cheerful, helpful and lovely. Staff meetings are held, during which various issues such as standards of care and training are discussed, minutes of these meetings were available and staff spoken with confirmed that they took place. Meetings also take place for people who use the service and their relatives; again minutes of meetings were available which demonstrated that issues such as the environment, redecoration and activites had been discussed. Four personal allowances of people using the service were examined. These were correct when corresponded with the accounting sheet. There were records of all transactions and receipts were available. People may access this money at any time should they wish. One person spoken with confirmed that they could access their money when they needed it. The annual quality assurance assessment sent to the commission confirmed that routine servicing and testing of equipment within the home had taken place to ensure that this was safe and serviceable, the gas, hoist and lift certificate examined confirmed this. Staff were able to discuss relevant issues in regard to health and safety. There were no obvious hazards seen during the tour of the home. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 24 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 X 2 X 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement Plans of care are required for people’s complex needs such as diabetes mellitus and behavioural issues to ensure that people’s needs are fully met. Plans of care must be updated when changes occur or concerns arise to ensure that consistency of care is offered and people’s needs are appropriately monitored. Risk assessments in regard to entrapment and diabetes mellitus must be in place to ensure that people are protected. All staff employed must have a satisfactory POVA 1st check in place prior to commencing employment. Whilst waiting for a criminal record bureau check to be completed supervisory practice must take place to ensure that people using the service are protected from unsuitable people being employed. Records of registered nurses professional identification numbers must be available to DS0000059465.V362105.R01.S.doc Timescale for action 20/05/08 2 OP7 15(1) 20/05/08 3 OP7 13(4c) 20/05/08 4 OP29 19(1,a) 18(2) 09/04/08 5 OP29 18(3,b) 06/05/08 Arden Lea Nursing Home Version 5.2 Page 26 demonstrate that they are registered to practice and thus people using the service are protected. 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 OP19 OP29 OP30 Good Practice Recommendations Provide a maintenance program that addresses the areas of redecoration that will be improved upon. Develop a system that enables registered nurses professional identification numbers to be checked on a regular basis. Update staff files once training has been completed to demonstrate that the compulsory training programme has been achieved. Arden Lea Nursing Home DS0000059465.V362105.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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