CARE HOME ADULTS 18-65
Ardgowan House 4 Middle Street Newsham Blyth Northumberland NE24 4AB Lead Inspector
Karena M Reed Unannounced Inspection 16th January 2006 2:00 Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 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 Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 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 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. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ardgowan House Address 4 Middle Street Newsham Blyth Northumberland NE24 4AB 01670-367072 01670 367072 deborah.jobson1@btinternet.com 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) Mrs A Jobson Mrs A Jobson Care Home 13 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (7), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (4) Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd July 2005 Brief Description of the Service: Ardgowan House is a home registered to provide personal care to thirteen adults, categories of registration include eleven places for adults with mental health problems, four of these places are for people over sixty five years of age and two places are for adults with learning disabilities . The home is situated in a residential area on the outskirts of Blyth. It is close to local facilities and is easily accessible to the town centre and nearby coast.The home does not provide nursing care. The home consists of a large detached house with a small front and very large rear garden. All bedrooms are for single occupancy. There is a diningroom/combined lounge, separate lounge and a quiet room . A passenger lift is not available but some bedrooms are located on the ground floor of the property. There are two bathrooms and sufficient lavatories for the needs of service users. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two and a quarter hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. Records included: 4 care plans, The Statement of Purpose, fire log record, the accident book, admission/discharge register, complaints record, staffing rotas, staff and service user meeting minutes, daily communication book and service users personal allowance records. The proprietor and two carers were spoken to during the inspection. Time was also spent with 4 service users during the inspection. What the service does well: What has improved since the last inspection?
The standard of record keeping continue to improve and service users’ plans of care demonstrate the care and support provided by staff. Physically the environment is becoming more comfortable and better maintained. It is becoming equipped with aids and adaptations to meet the needs of service users. A conservatory is in the process of being built to provide extra communal areas for the use of service users. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 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. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 There is not enough relevant information provided by the home to ensure that potential service users are supplied with details of all the services the home provides to help them make an informed decision about coming to stay in the home. Service users needs and aspirations are assessed before they are admitted to the home. Individual contracts are not available between the home and the service user. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 9 EVIDENCE: A Statement of Purpose was not available at the home at the time of inspection, it is still being prepared, and it should include all the information as required by the Care Standards Act 2000. The document should be made user friendly and easy to read to inform prospective service users of the services available within the Home. Service users records did not contain written contracts between the home and the service user stating the terms and condition of residency, but they did contain more general contracts between the home and County Council. Inspection of records for four service users showed that full assessments had been carried out prior to their admission. Service users have the opportunity to visit the home as many times as they like to decide if they wish to live there. This may involve tea- time visits, day and overnight stays and can be adjusted to the pace of the service user. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 There are good arrangements in place to ensure that residents’ health and social care needs are met. Health needs are clearly addressed to ensure the staff team are fully informed. Service users are supported by staff and care plans reflect the amount of care and support that staff are providing to service users. There was no regular review of service users changing care needs. Service users are encouraged to be involved in decision making and to communicate and make their views known. EVIDENCE: Inspection of the records for a recent admission showed that an assessment had been carried out prior to their admission. This was combined with information received from the care manager’s assessment of the service user’s care needs. The resulting care plan recorded detailed information about the health and medical needs of the service user and the amount of staff intervention required in order to provide support. A service user recently returned from hospital was delighted to be home and updated assessments from the relevant health professionals were on file in order to ensure his care needs were met.
Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 11 Daily recordings about the care provided to service users are contained in the service users’ care records. Other care plans looked at were not up to date and there was no evidence of recent evaluation of care plans by the home to ensure staff provided the appropriate levels of care to service users in case their care and support needs had changed. Meetings are held with service users about the running of the home. Service users spoken to stated that they were involved and consulted about decisions involving themselves. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users are supported and encouraged to have appropriate personal, family and sexual relationships. EVIDENCE: Service users care plans and case records detail any family involvement. Conversation with service users also provided evidence that they are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. Two of the service users in the home are married, they married after meeting at the home. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,21 There are arrangements in place to ensure that service users’ health care needs are met. Records reflect the changing needs of service users due to incapacity and old age. The home does respect the wishes of the individual when dealing with incapacity, and is preparing for the ageing of service users. EVIDENCE: Four care plans and case records were inspected. They contained relevant individual plans of care detailing care and support required for some complex needs. Records showed when service users had seen health professionals eg doctors, community nurses, etc. Records also showed when service users had seen opticians and dentists. The medication system was not examined at this inspection. Staff receive training before they can administer medication to residents. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 There is a complaints procedure. A procedure for responding to allegations of abuse is available. EVIDENCE: The home has a complaints procedure. There have been no complaints about the home since the last inspection. It was evident from records since the last complaint that complaints were viewed negatively by the staff and management team. A procedure for responding to allegations of abuse is available. Staff have not received training about Protection of Vulnerable Adults. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 The building is quite well maintained with better quality furnishings and décor in the communal areas, which creates a pleasant environment for those living there. A more homely environment would be created if a separate office was created. Systems are in place to provide a safe environment for service users and staff. Specialist equipment is being provided. There is a good standard of hygiene around the home. EVIDENCE: There is an ongoing programme of decoration and refurbishment around the home. A conservatory is currently being built in order to provide an extra living room for the use of service users. It was evident an office should be created in order to prevent office equipment and notices being placed in service users living areas: medication cupboard in the smoking room, filing cabinet and official records being kept in the lounge/dining room and staff notices on the kitchen door. A bathroom is being adapted to ensure the home can meet the needs of service users as they become older or incapacitated. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33 EVIDENCE: The home is staffed as follows: 8.00am- 4.00pm 3 4.00 pm- 10.00pm 2 10.00pm-8.00am 2 These numbers include the management team of manager and one assistant manager. The proprietor lives on the premises four nights of the week. Discussion took place about reviewing this arrangement. There is a senior staff member on each shift. Staff members carry out food preparation. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41,42 Record keeping showed that service users’ interests are safeguarded. Systems and procedures are in place to ensure the well running of the home and to ensure the safety of service users and staff as far as possible. EVIDENCE: There is a system in place to ensure that the staff are given training in moving and handling skills, fire safety, first aid and food hygiene. A thermometer was not available for testing hot water temperatures. No nurse call system is available for service users to summon staff assistance, this must be reviewed and a system set up so service users can summon staff assistance during the night if ill or incapacitated. The fire log book indicated that fire safety checks are carried out routinely. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 x x x 1 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 4 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Ardgowan House Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x 3 3 DS0000000521.V258862.R01.S.doc Version 5.0 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. 2 Standard YA5 YA24 Regulation 5(b)(c) 23(2)(g) Requirement A contract must be issued to all new service users. An office must be created and remove all notices and storage equipment from service users’ living areas. To ensure all staff receive POVA training To provide a nurse call system Timescale for action 01/04/06 01/07/06 3 4 5 6 6 YA23 YA42 YA42 YA3 YA1 13(6) 13(4)© 13(4)c 01/04/06 01/06/06 01/06/06 12/04/06 01/04/06 To provide certificates for electrics and gas. 15(2)(b) To update care plans at least 3 monthly. 4(1)(a)(b)c The Statement of Purpose must be expanded and made more user friendly. 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 Refer to Standard YA33 YA38 Good Practice Recommendations To review the current sleeping in arrangements. To hold more regular staff meetings. Ardgowan House DS0000000521.V258862.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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