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Inspection on 26/04/05 for Arden Valley Christian Nursing Home

Also see our care home review for Arden Valley Christian Nursing Home for more information

This inspection was carried out on 26th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users say they are treated well by the staff who are kind and caring. There is a comprehensive computerised system in use in the home, which supports the staff in the delivery of care. The service users enjoy the meals in the home.

What has improved since the last inspection?

Progress has been made to make sure service users are less likely to suffer pressure sores, where they do the records and treatment of pressure sores has been improved and staff have attended training to be kept up to date in this. The manager is no longer acting as an appointee for any service users and an advocacy service has recently become involved with one service user. There has been a lot of redecoration going on in the home over recent months. Service users said they were pleased with the improvements made. There is also some new furniture on order to replace old items.

What the care home could do better:

Some specific work is needed to improve the care plans relating to mental health, so that staff know how to recognise any increasing problems and what to do about them. The manager and provider were required to do this as a matter of urgency. The manager should arrange for new service users to be weighed on admission or within 48 hours and for their dietary needs to be identified. The medicines in the home are not always stored safely. Creams were seen in service users` rooms and staff should be given clear instructions about when to give some medicines that are prescribed on an occasional basis. Staff work long hours, which has the potential to put service users at risk, and this must be kept under review. Systems are in place for recruitment to ensure service users are protected. On the whole staff are trained to meet service users needs. It is recommended that training in depression awareness be arranged for staff. More staff need to be trained in first aid. Comment was made by some service users about problems with communication on occasions, due to language issues, as most of the staff are from overseas. The inspector recommended that this be looked into as part of a satisfaction survey. The staff work frequent 12-hour shifts. This should be kept under review to ensure staff are not overworked and tired. Sometimes staff are not using equipment properly, such as wheelchair and aids to help with moving service users. This can put service users at risk. An official letter was left at the time of the inspection to tell the manager and the provider that this must be put right within a week or enforcement action would be taken.

CARE HOMES FOR OLDER PEOPLE Arden Valley Christian Nursing Home Bearley Cross Wootton Wawen Solihull, West Midlands B95 6DR Lead Inspector Tracy Regan Unannounced 26 April 2005 09:15 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 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 Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arden Valley Christian Nursing Home Address Bearley Cross Wootton Wawen Solihull West Midlands B95 6DR 01789 731168 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Southern Cross Healthcare Services Limited Jacqueline Huckvale N - Care home with nursing 48 Category(ies) of DE (E) DEMENTIA - OVER 65 NUMBER 24 registration, with number OP - OP OLD AGE NUMBER 24 of places Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08 September 2004 Brief Description of the Service: Arden Valley is a purpose built home providing accommodation for 24 people with dementia and 24 people who are frail elderly. Accommodation is provided on the ground and first floor of the property. Service users from both units have access to a secluded garden at the rear of the building. Each unit provides a variety of communal living space with a light and airy conservatory area. The home is located in a rural area, which is not easily accessible without a car. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the day over a period of six and a half hours. The inspection was one of the two statutory inspections to be carried out this year. A partial tour of the premises took place and records including care records were inspected. Six of the staff on duty and twelve of the service users were spoken to. What the service does well: What has improved since the last inspection? Progress has been made to make sure service users are less likely to suffer pressure sores, where they do the records and treatment of pressure sores has been improved and staff have attended training to be kept up to date in this. The manager is no longer acting as an appointee for any service users and an advocacy service has recently become involved with one service user. There has been a lot of redecoration going on in the home over recent months. Service users said they were pleased with the improvements made. There is also some new furniture on order to replace old items. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 standard(s) Service users are assessed prior to admission to the home to ensure the home can meet their needs. EVIDENCE: The computerised system supports the staff to ensure that service users’ needs are assessed and care associated with those needs identified. However there is a need to improve the recording of needs in some instances, in particular the depth and detail of needs identified. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Progress has been made to improve arrangements to ensure that health care needs are identified and met, further work is needed. Further work is also needed to ensure that the medicines are used properly. Service users feel they are treated with respect and dignity. EVIDENCE: Good progress has been made in addressing requirements to improve records relating to pressure area care. Staff have improved on the recording of pressure area care and treatment and assessments for the risk of pressure sores, including the use of body maps and photographs. There has also been improvement in recording of tissue viability shortly after admission to the home. Some staff have received training updates in pressure area management recently. There is a need to identify oral health care needs and assistance required in service users’ plans. Staff seek assistance and professional help from others outside the home, such as dietician, community nursing services, speech therapists, community psychiatric nurses. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 10 The home has been advised to make sure that anyone admitted has their weight checked prior to admission or within 48 hours of admission, the two most recently admitted service users had their weights noted one week after they were admitted, this needs to be improved. There has been improvement in identifying increasing risk in respect of nutrition and staff are making appropriate referrals for GP follow up. Service users identified as having nutritional needs have appropriate care plans drawn up. There are still some creams being kept in service users’ rooms, these need to be kept in a lockable space or with the other medicines in the home. Some psychotropic drugs are prescribed on an as needed basis. There needs to be a detailed plan relating to this. Staff were seen to be treating service users with respect and dignity and service users confirmed this to be the case. However, some service users commented about communication problems, as most of the staff are form overseas. This is a concern, especially as many of the service users have dementia. A recommendation is made about this. The home is now keeping transfer letters to hospital for reference purposes and in case of disputes or complaints. From discussions with staff it is apparent that not all are fully aware of the company policy and procedure regarding accident reporting. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Meals are appealing and balanced and enjoyed by the service users. The length of time some service users are spending in the dining room needs review. EVIDENCE: Several service users said they enjoy the food in the home. The staff deal with service users needing help with eating and drinking in a sensitive way. One of the service users said they did not like having to wait for long periods in the dining room. It is recommended that this is reviewed as part of a satisfaction survey. The manager said the home has recently been awarded a “Heartbeat Award” for the meals provided in the home. The meals are varied and appetising. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18 Systems are in place to protect service users from abuse. EVIDENCE: The manager is no longer acting as an appointee for any service users. An advocacy service has recently become involved with one service user. There have been no allegations of abuse made since the last inspection. Service users spoken to confirmed they felt able to speak to the manager about any concerns. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 20 Service users have access to safe and comfortable indoor and outdoor communal facilities, which are being redecorated and maintained for their benefit. EVIDENCE: There has been a lot of redecoration going on in the home over recent months, service users said they were pleased with the improvements made. There is also some new furniture on order to replace old items. There are wellmaintained enclosed gardens for service users to enjoy. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Staff work long hours, which has the potential to put service users at risk. Systems are in place for recruitment to ensure service users are protected. On the whole staff are trained to meet service users needs. EVIDENCE: The majority of the staff in the home are from overseas, many are qualified nurses in their own countries, but are working as carers in the home. Several of the staff are undertaking assessor/mentor training to support the conversion training of overseas staff. Comment was made by some service users about problems with communication on occasions, due to language issues. The staff work frequent 12-hour shifts, this should be kept under review to ensure staff are not overworked and tired. There are appropriate checks being made to ensure service users are protected, however it was not possible to see the actual Criminal Records Bureau checks as these are kept at the organisation’s head office. Arrangements need to be made so that these can be checked at the time of the next inspection. The training records show that staff are undergoing appropriate mandatory training, as well as other specific training to meet the needs of the service users in the home. It is recommended that training in depression awareness Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 15 be arranged for staff to increase their knowledge and understanding and enhance their ability to meet the needs of service users who have depression. There is still the need to ensure sufficient staff are trained in first aid. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 Work is being done to ensure that staff are appropriately supervised. A safe system for moving and handling requires further development to ensure the health, safety and welfare of service users is protected. EVIDENCE: Supervision records were seen and the requirement made at the last inspection is being worked on. There is still room for improvement in this area as care staff should be supervised at least six times a year. Some had only two supervision records for the last 12 months. Senior staff supervise others in their team and staff appraisals are carried out twice annually. Supervisory skills training is being considered. Staff were seen to be using a handling belt incorrectly and footplates were not always being used when wheelchairs were being pushed. Care plans regarding manual handling lacked detail such as the equipment and techniques to be used. Staff are not always putting into practice what they have been taught in relation to moving and handling. These practices have the potential to put Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 17 service users at risk. An immediate requirement notice was given to put this right. Fire drills are now being carried out at different times of the day, the last one being 17 March 2005 during the evening. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x x x x x x STAFFING Standard No Score 27 2 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x 2 x 2 Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 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 30 Regulation 13 (4) Requirement The registered person must ensure that staff are trained in first aid in sufficinet numbers so that there is always a first aider on duty. (previous timescale of 31 December 04 not met). The registered person must ensure that any service user with a history of suicide attempts and/or psychotic illness has a detailed care plan drawn up relating to their mental health needs, including the identificaton of any risks and plans for managing those risks. Liaise with other professionals to complete this as appropriate. The registered person must ensure that arrangments are made to provide a safe system for moving and handling (i.e. footplate use on wheelchairs, handling belt use, details on care plans such as equipment and techniques). Complete with immediate effect All serivce users must have a full nutritional assessment and basleine weight undetrtaken either at the assessment prior to admission or within 48 hours of Timescale for action 31 July 2005 2. 7 15 4 May 2005 3. 38 13 (5) Immediate 4. 7 14 30 June 2005 Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 20 5. 9 13 6. 27 18 7. 7 12(1) 8. 9 13 9. 36 18(2) being admitted to the home. (timescale of 31 October not met). The registered person must make suitable arrangements for the recording, handling, safe keeping and safe administraion of medicnes received in the home. (previous timescale of 13 October not met) The registered person must keep staffing levels and work patterns under review to ensure staff are fit for duty. The registered person must ensure that oral health care needs are identified in care plans. The registered person must ensure that detaield plans are in place for the admistration of as needed medicnes, including the maximum amount to be given in 24 hours, circumstances when the medicine should be administered. The registered person must ensure that all staff formal supervision at least six times a year (previous timescale of 30 November 2004 not met). 30 June 2005 30 June 2005 30 June 2005 30 June 2005 30 August 2005 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. Refer to Standard 8 Good Practice Recommendations The manager should ensure that all staff are aware of the policy and precedure regarding accident reporting (inclduing informing relatives/next of kin and noting any concerns or responses). The manager/provider should review satisfaction of service users in the home giving particular attention to communication issues and mealtimes. E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 21 2. 10 & 15 Arden Valley Christian Nursing Home 3. 30 Deperession awareness training should be arranged for staff to increase their knowledge and understanding and enhance their ability to meet needs where service users have depression. Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Arden Valley Christian Nursing Home E53 S4385 Arden Valley Christian NH V223481 260405 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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