Inspection on 05/06/07 for Ardenlea Court

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 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

Ardenlea Court 30/07/08

Ardenlea Court 05/07/06

Ardenlea Court 01/02/06

Ardenlea Court 20/09/05

Ardenlea Court 15/02/05

Ardenlea Court 05/10/04

Ardenlea Court 20/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ardenlea Court 39-41 Lode Lane Solihull West Midlands B91 2AF Lead Inspector Yvette Delaney Key Unannounced Inspection 1st August 2007 11:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ardenlea Court Address 39-41 Lode Lane Solihull West Midlands B91 2AF 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) 0121 711 7773 0121 711 2235 www.bupa.com BUPA Care Homes (BNH) Limited Mrs Kim Elizabeth Brown Care Home 63 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (34), of places Physical disability (34) Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May provide accommodation, nursing, and personal care for up to 5 people requiring palliative care over 65 years of age. May provide intermediate care for up to 18 people over 50 years of age, which may include care and nursing needs related to sickness, injury and infirmity. Intermediate care services must be provided from the dedicated accommodation identified for this purpose within the home and must be supported by equipment and staffing appropriate for its specific intermediate care function. Rehabilitation facilities and equipment must not impinge upon or reduce the communal space available to non-intermediate care service users. 5th July 2006 3. 4. Date of last inspection Brief Description of the Service: Ardenlea Court is a purpose built Care Home that is owned and managed by BUPA Care Homes Ltd. The home provides personal care and nursing for up to fifty-five residents over the age of 65, who are frail elderly and/or physically disabled. Of the fifty five beds available eighteen of them are under contract with the Solihull Primary Care Trust to provide Intermediate care to patients following transfer from hospital. These beds are used for patients of 50 years and older falling within the following categories: sickness, injury, infirmity, surgical or investigative care and are situated on the ground floor. In addition, up to 5 beds are registered to provide care to residents requiring palliative care. All bedrooms have en-suite facilities and there are assisted bathing facilities situated around the home. The home is situated within walking distance of the centre of Solihull. The M42 is about two miles away and the bus and rail services are easily accessible. The property is adjacent to private housing accommodation. There is a paved garden to the rear of the property providing a seating area and there is adequate car parking space at the front of the building. Access for wheelchair users is good. There are no steps to the front door. The home has a passenger lift situated in the main corridor, which provides access to all areas inside the building. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 5 Information provided at the inspection confirmed the fees for living in the home to range between £780 and £850. Additional costs are payable for items such as hairdressing, newspapers and some events. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by us is upon outcomes for the residents and their views of the service provided. This process considers the capacity of the service to meet the regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. This was a key unannounced inspection visit, which addresses the essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for residents (people living in the home). The inspection took place on Wednesday 1st August 2007 between the hours of 11:15 a.m. and 7:30 p.m. On the day of inspection there were 51 people living in the home. Since the last key inspection in July 2006, two further random visits were carried out in November 2006. The purpose of these visits were to look at compliance with requirements set at the key inspection. Evidence of improvement was found during the random inspections. This key inspection visit showed some improvement in a number of areas and it was evident that the manager is making good progress in ensuring Ardenlea Court is meeting regulations and national minimum standards recommending good practice. Before the inspection the manager of the home was asked to complete an Annual Quality Assurance Assessment (AQAA) detailing information about the services, care and management of the home. Following receipt of the AQAA a number of questionnaires were sent out to people who live in the home, people who had stayed in the home for a short stay and their families to ask their views about the home. Twelve questionnaires were sent out to residents and twelve to family members or their relatives. Six questionnaires were returned by residents, four of, which were completed by their relatives. Information contained within the AQAA and questionnaires is detailed in this report where appropriate. Four people living in the home were identified for close examination by reading their care plans, risk assessment, daily records and other relevant information. This is part of a process known as case tracking and where evidence of the care provided is matched to outcomes for the residents. Other records examined during this inspection, include staff recruitment records, training records, social activity records, staff duty rotas, health and safety records and medication records. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 7 The homes manager was present throughout the inspection and the inspector was able to tour the home, spend time speaking with residents, seven visitors and staff. The inspector would like to thank the people who live in the home and staff for their co-operation and hospitality. What the service does well: What has improved since the last inspection? The manager and staff have worked hard in addressing the requirements and recommendations made at the previous inspection. This demonstrates the motivation of staff in insuring that the services provided are for the benefit of those people who live at home. Care file documentation had been reviewed to ensure a comprehensive assessment of peoples needs is carried out before admission to the home. The ongoing development of activities the home ensures that residents have suitable opportunities for stimulation. This will ensure that residents enjoy appropriate mental and physical activities appropriate to their needs. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 6 Quality in the outcome area is good. The Statement of Purpose, Service User Guide and contract provides people with sufficient detail about the home to assist in making a decision about moving into the home. People considering moving into the home have a care needs assessed so that they can be sure the home can meet their needs. People admitted for intermediate care are helped to maximise their independence and return home. This judgment has been made from evidence gathered both during and before the visit to the service. EVIDENCE: The manager said that she visits people who are considering moving into the home to undertake an assessment of their needs and abilities. Staff from the Primary Care Trust (PCT) are involved in assessing the rehabilitation needs of people admitted to the home for intermediate care. Social services and staff Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 11 from the PCT complete assessments of individual care needs, which include assessing whether people require nursing care. The pre-admission assessments of two residents recently admitted to the home were examined. Assessments read showed that a thorough assessment had taken place in aspects of personal and health care needs. The outcome of this being that the manager was provided with sufficient information to confirm that the home could meet the care needs of individual people. Areas of risk related to the individual care of residents were also assessed. Information gathered about the needs and abilities of people living in the home is used to develop care plans to meet these needs. Documentation used to undertake assessments has been reviewed and changed to include specific details of the assessment information required. The Assessments seen and examined were clear and contained a good level of information, which covered areas identified by the National minimum Care Standards. These include diet and nutrition, mobility and falls history and personal care. Other care needs assessed were the mental state of potential residents that is memory, mood, orientation, anxiety and behaviour. Assessments in this area are particularly important for those people admitted to the dementia care unit. Relatives commented that they had been able to visit the home before their family member was admitted to the home. An updated Statement of Purpose and Service User Guide is given to all residents. These documents and the most recent inspection report is also available in the reception area of the home. Some residents were able to comment that they had received contracts to be. Information provided by residents and their families said that they had received welcome packs which provided them with information about the home. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome is adequate. Care plans are not consistently developed and reviewed to address the identified needs of people living in the home, which puts them at risk of not having their needs met. Medication records are not consistently maintained to demonstrate that all medicines are administered as prescribed. This judgement has been made from evidence gathered both during and before the visit to the service. EVIDENCE: Observation during the inspection found that most people living in the home are genuinely well cared for. It was noted however, that two residents showed that more attention could have been given to supporting them in being better presented. Attention was needed in respect of grooming. One visitor spoken to expressed their concerns about their relative always been poorly presented saying that: “Attention is not given to the little things. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 13 The lack of support in helping a person to attend to their personal needs in this instance grooming does not help them to maintain their dignity and well being. Other concerns expressed by another resident said that: “I felt that (the resident) was left alone for long periods of time and more effort could have been made to get (the resident) into the lounge and dining room.” Four people who live in the home were case tracked. This involved looking at their care plans, looking at their living accommodation, talking to staff, the residents themselves and some members of their families. Although people living in the home had care files containing care assessments, daily records, risk assessment and monitoring records not all residents had appropriate care plans written. Residents without appropriate care plans were two residents admitted to the dementia unit. The mental and psychological care needs of these residents had been assessed before admission to the home but individual care plans had not been developed to support staff to meet these care needs. Examples of this were for a resident who was assessed as being: Frequently disorientated, consistent memory loss, sometimes wonders to the front door and opens the door, and has been known to hit out. Care plans had not been developed to support staff in managing the residents care. Care files were recently reviewed to introduce new standardised documentation in May 2007. Concerns were raised by staff that the documentation is not entirely suitable for those residents admitted to their aided recovery unit on the ground floor of the home. The aided recovery unit provides intermediate care the people who need to be supported through rehabilitation back into the community. The care file documentation to be used in this unit is currently under review. Information regarding dietary requirements, peoples likes and dislikes are recorded and residents are weighed on a monthly basis. Monthly observation records are maintained to monitor weight gain or loss, blood pressure and pulse. This information supports staff when monitoring a resident’s well being and enables them to take appropriate action when needed. Risk assessments regarding nutrition, pressure areas and moving and handling were completed and available in files examined. Information received by the commission, examination of accident records and audit records show that some residents have many falls. Details of action taken are not clearly identified. It was not clear that as suggested at the last Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 14 key inspection that these residents are referred to a falls clinic. This referral will help staff to implement appropriate individual falls prevention plans, which may reduce the number of falls experienced by people living in the home. Entries in the residents’ health records and comments by staff confirmed that people are supported to get access to relevant health professionals where required, such as the GP, district nurse, dentist and optician. There is a close working relationship with health professionals, which include physiotherapists and occupational therapists from the PCT who provide a rehabilitation service for people admitted to the intermediate care unit. Systems for the management of medicines in the home were examined. A monitored daily (blister packed) system is used. Medication is safely stored in locked cupboards and trolleys specifically designed for the storage of medicines. A medication fridge is available with daily recordings of the temperature, which is within recommended limits. The medication administration records of the four residents reviewed through the case tracking process show that generally they were well maintained. Gaps were identified on two records where nursing staff had not signed for medication given. One of the deputy manager’s explained the procedure for the receipt of medicines into the home, which includes copying prescriptions and crossreferencing these with medication charts and medicines received into the home. This will ensure they match those requested on the prescriptions. There was some evidence of overstocking of some medicines, which staff are addressing. Throughout the inspection, staff were observed to be caring and supportive towards residents. The personal care needs of people living in the home are carried out behind closed doors, demonstrating that staff show a suitable regard to peoples privacy. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in the outcome area is good. People living in the home are supported to maintain their independence and enduring interests, which enhances their quality of life. People benefit from a varied and nutritious diet and enjoy their meals as a social occasion. This judgment has been made from evidence gathered both during and before the visit to the service. EVIDENCE: Plans continue to improve the level of activities available to people living in the home. Improvements made include the recruitment of an additional activity organiser, which will provide an increase in dedicated activity time. The increase in activities in the home is intended to also provide sufficient time to provide appropriate stimulation for residents living on the dementia care unit. There is an activity room on the second floor, which provides the opportunity for activities to take place in small groups. A notice of planned activities was displayed and forthcoming events are advertised. Activities planned include sing-along, artwork, one-to-one sessions, music and movement and trips to Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 16 garden centres. People are encouraged to make visits outside of the home on their own if they are able or with the support of their families or staff. Records are maintained detailing who has participated with activities, their level of interest and whether they enjoy the activity. Some care files contained information related to the life history of residence. Maintaining these, records are important to monitor if peoples personal preferences and interests are being met. The home has an open visiting policy. People are encouraged to maintain links with their family and friends. One visitor said: Residents living in the home that commented: “My friends and family visit every day.” “Sometimes my family take me out…it is no trouble.” Visitors were seen to visit their relatives throughout the day. The dining rooms in the home of well presented. Tables are laid at meal times and menus provided enable people living in the home to make choices in the food they eat. Menus examined demonstrated that meals offered are varied and appealing encouraging residents to eat nutritious and balanced diets. A cooked breakfast can be requested any morning. Lunch is the main meal of the day and a choice of a hot dish all like meal of the sea and selection of sandwiches is offered at teatime. Snacks are available between meals and special diets are catered for. Care staff were observed to provide discreet assistance to residents as and when required at mealtime to meet the needs of individual people. “I love my food.” Information received in the AQAA identifies that ‘Night bite’ boxes have been introduced, ensuring that there is food available 24 hours per day specifically during the evening and night when the kitchen is closed. Menus are reviewed and altered when residents make suggestions. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this area is good. Complaints are taken seriously by the home and there are appropriate policies and procedures to safeguard people living in the home. This judgment has been made from evidence gathered both during and before the visit to the service. EVIDENCE: Policies and procedures are in place to support staff in managing any complaint received by the home. Residents and visitors spoken with said they had no complaints about the home. Two people spoken with said that they are aware whom they should speak to if they have a complaint. Responses in questionnaires received said: “I have no complaints.” An adult protection policy is available in the home. Staff have attended training on how to recognise abuse and in conversation were able to say what they would do if they suspected or evidence of abuse. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in the outcome area is good. People live in a pleasant and comfortable environment, which is clean and well maintained, this ensures people living in the home are cared for in a safe environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A brief tour of the home demonstrates that a clean, fresh and homely environment is provided for people living in the home. Bedrooms are located on both floors of the home. Bedrooms of residents followed through the case tracking process were observed to contain personal possessions, making them individual, homely and comfortable. En suite facilities are provided in each room. Residents said they liked their room. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 19 Separate lounge and dining rooms are provided on both floors. These provide suitable and adequate space for all residents. There were few residents sitting in the lounges those that were sat in suitable chairs. Residents were socialising with other residents, family members or staff. Three residents were taking advantage of the warm weather sat in the garden with their relatives. A family member expressed concern that each time they visited their relative was always sitting in a wheelchair. This issue was discussed with the manager who explained that the resident concerned was transferred to a suitable chair and had a period of bed rest during the day. This issue highlights the importance of sharing the contents of the plan of care with appropriate relatives. The kitchen is clean and standards of hygiene maintained. Records in the kitchen indicate the cleaning procedures had been maintained. Temperature checks are maintained of the fridges and freezers, food received into the home and cooked meals served to residents. Standards in the laundry have been maintained. The area is clean, well organised and provides appropriate equipment to ensure that residents are confident that their clothes are treated with due care. Residents and their residents were happy with the laundering of their clothing by the home laundry staff. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome group is adequate. There are sufficient staff on duty and robust recruitment procedures to support meeting the health and personal care needs of people living in the home. Information available on the training of staff does not confirm that staff are appropriately skilled to meet all the care needs of people admitted to the home. This judgment has been made from evidence gathered both during and before the visit to the service. EVIDENCE: The home is divided into three units, each of which provides care for three client groups. The first floor of the home provides accommodation for twentynine people with varying stages of dementia. The ground floor provides a service of five long-term residents and up to eighteen people requiring intermediate care. The intermediate care service involves helping residents to maintain their independence through supported rehabilitation, with the intention of resuming their day-to-day life in the community. Staff at the home were observed to be friendly, caring and supportive to people who use the service. Resident and relative comments made about staff include: Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 21 “Staff are friendly and very kind, I feel that (the resident) is being well cared for. There were sufficient staff on duty on the day of inspection. The following numbers of staff are provided over a 24 hour period: Staff Nurses Early 07:30 am – 2:30 pm 2 07:30 am – 2:30 pm 5 Late 2:00 pm – 9:00 pm 2 2:00 pm – 9:00 pm 5 Night 8:45 pm – 07:45 am 1 8:45 pm – 07:45 am 2 Carers An additional nurse also works between the hours of 12 midday and 7:00 pm to provide additional support where is needed. The home is also supported by kitchen staff, housekeeping staff, laundry staff and a maintenance man. New staff have an induction period, which ensures a basic introduction to the home and is linked to the ‘Skills for Care Council’ induction programme. Three personnel files for the most recently recruited staff were examined. Staff files contained evidence that satisfactory checks, such as Criminal Record Bureau checks (CRB), Protection of Vulnerable Adults (PoVA) and references are obtained before staff commenced employment in the home. Staff files showed that good recruitment practices were followed, thereby safeguarding residents from unsuitable staff selection. Separate records are maintained to identify staff training completed, these were read but were not easy to follow. Training records available made it difficult to see if staff were up to date with mandatory training in health and safety, infection control, fire training, moving and handling, abuse awareness and food safety. The last key inspection identified that a training matrix was being completed to identify the training needs of nursing and care staff. The matrix was requested again but had not been received by us at the time of writing this report. The absence of a monitoring system such as the matrix, makes it difficult to identify staff who require updating their training so that training can be arranged. The manager has said in the AQAA that 39 of staff are trained to the National Vocational Qualification level 2 or 3 in care document. A further ten carers have started the course, which when completed will insure more than 50 are qualified in care. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is adequate. The manager is qualified and fit to run the home. Monitoring systems in the home need to be robust to ensure residents health and well being are maintained at all times. This judgment has been made from evidence gathered both during and before the visit to the service. EVIDENCE: The manager of the home has the necessary skills and experience required to undertake the role of managing the home. Qualifications include many years experience in the care industry and being a registered nurse. The manager is currently in the process of completing the Registered Managers Award. She has an adept knowledge of the care needs of those that live at the home and Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 23 was observed using an open, consistent and friendly approach to people living at the home, visitors and staff. Staff spoken with provided positive comments about the management style and the support they receive. There is a quality assurance and monitoring process, which is based on ensuring the home is meeting the needs of the people living in the home. This involves an internal audit against identified standards. Quality monitoring covers all areas of the service and includes, infection control, training and development of staff, food provision, staffing levels and complaints. Comments received from people who use the service do not confirm that the service has a commitment to involving people using the service, relatives and friends, health care professionals and staff through seeking their views. Monies are held by the home on behalf of a number of residents for safekeeping and are stored safely and securely. The records of residents followed during the case tracking process were examined. The system is robust and evidence of good practice was seen. Residents’ money is held separately in individual accounts. Computer and manual records are held of financial transactions. Residents and or relatives acting on their behalf are sent details to show the conduct of accounts. Accounts are audited and reconciliation of all accounts takes place. Individual receipts are held in respect of money spent on behalf of the resident. The manager confirmed that the majority of residents maintain or handle their own financial affairs either themselves, with the support of relatives or other advocate or representative from outside of the home. Staff are supervised at least six times per year this includes an annual appraisal. Staff files showed that the outcomes of supervision sessions are consistently recorded. Topics discussed and action or activity that staff would be undertaking before their next supervision to demonstrate any progress made were identified. Care plans and training are not appropriately reviewed to ensure good standards of care and health and safety practices are maintained. These areas are discussed within this report. The kitchen was seen to be clean and organised. Records of fridge, freezer and high risk cooked food temperatures are maintained. A cleaning schedule was in place and used to make sure all areas of the kitchen were regularly cleaned. Procedures followed in the laundry are maintained at high standards. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 24 Pre-inspection information received shows that maintenance of fire fighting equipment, electrical appliances and hoists takes place on a regular basis. Fire safety management includes regular testing of fire alarms, emergency lighting, and all records relating to fire safety management were up-to-date and in good order. A record is maintained in the home of any accident or incident that happens to a service user. On the day of the inspection, staff were attending a training session on fire safety. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 02/08/07 2 OP7 OP38 15 3 OP9 13(2) 5 OP28 18(1) All persons using the service must have an up to date detailed care plan this will ensure that they receive person centred support which meets their needs. The prescribed treatment and 31/10/07 care of people living in the home must be monitored and reviewed to ensure that the care is effective and appropriate. This will ensure that residents are not exposed to the risk of omission in care. All nurses must sign the MAR 02/08/07 chart following administering medication to people in their care. This will confirm to other professionals that the medication has been administered, provide information for audit and promote the well being of people living in the home. The Registered Manager must 31/12/07 ensure that at least 50 of care staff are trained to NVQ level 2. This will ensure that people living in the home are in safe hands at all times. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 27 6 OP30 OP38 18 Up to date records must be maintained to confirm and easily identify training attended by staff. This will ensure the safety of people who live in the care home and that staff are trained and competent in all areas related to safe practices, which meets residents. 31/10/07 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 OP10 Good Practice Recommendations Care should be taken when attending to the personal care needs of people living in the home, this should include ensuring that they are well groomed at all times. Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Ardenlea Court DS0000004566.V336801.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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