Inspection on 09/07/07 for Argyle Park

This inspection was carried out on 9th July 2007.

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

The inspector 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

Argyle Park 24/08/06

Argyle Park 17/02/06

Argyle Park 21/12/04

Argyle Park 15/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Argyle Park 9 Park Road Southport Merseyside PR9 9JB Lead Inspector Mrs Claire Lee Unannounced Inspection 9th July 2007 08:45a 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 Argyle Park DS0000017219.V340513.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. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyle Park Address 9 Park Road Southport Merseyside PR9 9JB 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) 01704 539001 01704 539001 argylepark@argyleparkdevelopments.co.uk Mr Albert Marcel Zachariah Mrs Bernardine Sananes Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 31 OP Service users to include 2 named clients under pensionable age The service should employ a suitably qualified and experienced Manager who is registered with the NCSC. 23rd January 2007 (Random Inspection) Date of last inspection Brief Description of the Service: Argyle Park is a purpose built nursing home, which is situated close to Hesketh Park in Southport. The manager and staff provide nursing care to thirty one older people with varying needs. All bedrooms are single and have ensuite toilets. The bedrooms are spread over three floors with a passenger lift, which takes wheelchairs for those who are less able. Residents have the use of a large comfortable lounge with a designated dining area. There is also a hairdressing salon and well-equipped bathrooms with aids to assist those who require help to bathe. A new call system with an alarm facility was fitted last month for the residents. There is a small garden to the side of the premises and car parking space is also available. The weekly rate for accommodation is from £476.00 to £510.00. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit took place as part of the unannounced inspection over one day for a duration of approximately eight and half hours. Twenty nine residents were accommodated at this time. A partial tour of the premises took place and a number of the home’s care, staff and health and safety records were viewed. Discussion took place with twelve residents, four staff, the home’s maintenance person and registered manager. During the inspection four residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. Interviews also took place with three relatives. All the key standards were inspected and also previous requirements and recommendations from the last inspection in January 2007 were discussed. Satisfaction survey forms “Have Your Say About …” were distributed to a number of residents, relatives and health care professionals prior to the inspection. A number of comments included in the report are taken from the site visit and also the survey forms. Surveys were received from five residents, six relatives and one health care professional (GP). An annual quality assurance assessment (AQAA) was completed by the manager prior to the site visit and some of the information from the assessment is contained within the report. The AQAA provides details of the service and the current staff and resident group. What the service does well: Argyle Park presents with a very warm, caring and friendly environment and residents appeared relaxed and comfortable with the staff. There were a number of visitors either spending time with the residents in the lounge or in their own private room if preferred. Staff were observed to greet visitors warmly and offer them refreshments. A relative reported that the care home does the following well – “Meals. Cleanliness. Endeavours to respect the dignity of its clients and listens to relatives”. The manager and staff record care information in good detail and care plans seen are based on individual care needs with details regarding religion, preferred routines, wishes and expressing sexuality. All care documentation is subject to regular review to ensure it reflects relevant change to the care Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 6 provision. Residents can be involved as much as they want in this process and residents interviewed confirmed that the staff are quick to access GPs or other health professionals if their advice is needed. Two residents required hospital treatment at the time of the site visit and their transfer to hospital was dealt with in a professional and timely manner by the staff. Staff interviews confirmed their knowledge of the residents’ individual care needs and the level of support required. Care was seen to be given in a discreet, sensitive manner and feedback from residents was good regarding this. Staff were patient and gentle in their approach thus ensuring residents were treated respectfully and their dignity maintained. Comments from residents regarding the care include: “Good care” “Staff give the help I need” “The staff are kind when helping me” “We get good care all the time” Residents interviewed confirmed that the daily routine was flexible and based very much around their wishes. Residents interviewed said they could get up late or go to bed when they want. A relative reported that a shower would be good for the residents and as there is not one installed the owner is looking to provide this facility later this year. Residents were complimentary regarding the standard of the meals and referred to the ‘home baking’ as being good and tasty. The menu was on display for residents to see and this offered a good choice of foods for breakfast, lunch and tea. A resident reported, “Lovely food and always well presented”. The accommodation is maintained to a good standard and subject to a programme of redecoration. The halls and landings have recently been decorated and the bedrooms are receiving attention. The good standard of furnishings and fittings ensures the comfort of the residents. All areas seen were spotlessly clean and there are sufficient numbers of domestic staff on duty each day to maintain this. The manager uses a variety of methods to seek the views of the residents and recent survey forms report favourably regarding the service. All residents have the opportunity to communicate their views and help to complete the form is offered from staff, relatives or an advocate. Risk assessments are completed to protect the residents and to allow them to be as independent as their condition allows. Health and safety checks and maintenance contracts of equipment/ services ensure their ongoing protection. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 8 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 Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 9 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): Standards 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a contract, which advises them of the terms and conditions of the home and the pre admission health care assessment ensure the staff can meet their needs. EVIDENCE: Displayed in the main hall is a resident charter, which outlines the rights of the residents and the Statement of Purpose. The Statement of Purpose was not reviewed at this time however there was good information on display advising residents of the service and what they should expect when they take up residency. Contracts were viewed for one new and two existing residents. These detailed terms and conditions of residency and the rights and obligations of the owner and resident. The contracts ensure the resident is fully aware of the service provision. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 10 There have been five residents admitted since the last inspection however they are no longer resident due to a variety of reasons. An assessment was viewed for a resident who was admitted in June 2007 and is looking to take up placement on a long term basis. The resident visited the home to have a look round and assessment details were taken at this time by a registered nurse. A relative also confirmed that the matron visited them to obtain information regarding a family member. The assessment identifies key areas including mobility, skin care, diet, elimination, vision, social background, medicines, psychological state, safety, sleep and speech. The manager normally completes a more detailed needs’ assessment however there was no record of this available at this time. The resident has specific care needs in relation to mobility, speech and diet and although basic details were on file it would have been beneficial to have obtained a more thorough assessment to assist staff with writing up the plan of care. The resident’s relative reported that her family member was settling in gradually and that manager and staff had make them both welcome. Standard 6 was not assessed, as intermediate care is not provided at Argyle Park. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 11 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): Standards 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. Residents are placed at risk, as medicines are not administered safely to them. EVIDENCE: As part of the case tracking process four resident care files were viewed. This included a file of a resident who has been admitted since the last inspection. Staff and residents have access to the care files and the information seen was organised and easy to read. There was evidence of residents being involved with formulating the plan of care and also monthly reviews. The care plans detail the nursing intervention to enable staff to give the right level of care and support. Resident care plans are pre populated with basic information for key areas and this includes mobility, diet, sleep, socialising, medical conditions, communication, maintaining a safe environment, past medical history, personal hygiene, and pain management. Care plans record sexuality and this was noted in relation to general appearance and medical conditions that affects their health, well being or mental state. Further information had been recorded by the staff to make the care plans individual however two care plans lacked Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 12 detail regarding a resident’s psychological state and nutritional requirements. There was no evidence of a nutritional assessment or weight record for the resident who has been assessed as being at risk due to problems with swallowing. The resident is currently receiving hospital treatment and the manager confirmed that the documents would be updated on return. Weight records and nutritional assessments were evidenced in other files examined and staff had recorded the encouragement they give to one resident with regards to their poor intake. Staff complete a monthly health check as part of monitoring the residents’ general condition and supporting care documents include risk assessments for moving and handling, care of skin, falls (with use of bed rails) and administration of own medication. It was evident the different health care needs of the residents were being met and reviewed each month to ensure the information was accurate and relevant to them. Comments from residents and relatives included: “Mum is always dressed impeccably and her hair neat and tidy” (relative) “Very good care” “I get all the care and help I need” “Really good care by everyone” “Extremely good care” “A very caring environment and families are made to feel really welcome” “A very high level of care and personal attention is given” Care files evidenced visits by GPs, speech therapist and physiotherapist. A relative said, “The manager telephones the doctor immediately there is something wrong, I have no worries in that respect”. Two GPs were visiting at the time of the site visit and the subsequent treatment was recoded in the care files. Two residents required admission to hospital and their transfer was carried out in a professional and timely manner by the staff. Residents receive the medical attention required to maintain and promote their general well being. Daily records sheets had been completed by the staff to record the care they give and handovers at each shift enable staff to discuss residents’ daily care. Staff are therefore fully aware of the care provision and what is expected from them. Medicines are not administered safely to residents. Not all medicine administration sheets (MARs) evidenced staff signatures for medicines administered and there is therefore a risk that the residents did not receive them. A controlled medication was not checked in a safe manner and the medicine trolley was found to be left unlocked with the medicines dispensed on top of the trolley on two occasions. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 13 There was no evidence that checks were undertaken to ensure staff follow the procedure for safe handling, recording and administration of medicines. This meant that the manager could not guarantee the medicines were given out in a safe and appropriate manner at all times. Staff who administer medicines receive annual training however this has not been given for 2007 and there was no evidence of an assessment of competency for staff responsible for this task. Medicines are administered from blister packs and dispensed from two medicine trolleys. The manager provides support to residents who wish to keep their own medicines and a risk assessment is completed to ensure the resident is capable of undertaking this practice safely. A resident said, “I have a special drawer for my medicines and take them when I need to”. Through observation and discussions with residents and relatives it was evident that staff treat residents in a respectful manner. Staff addressed residents with their preferred name and also were seen knocking on private doors before entering. Residents were smartly dressed and a resident confirmed that they choose their own clothes each morning. Likewise a relative reported that her family member was “Always dressed impeccably and hair neat and tidy”. Staff receive guidance regarding privacy and dignity when they undertake their induction and a staff member gave examples of how this is respected when assisting residents with various aspects of personal care. Care was observed to be given in a sensitive manner to respect the residents’ wishes. Although Standard 11 (Dying and Death) was not assessed, three care files contained details of residents’ final wishes. These are obtained at the appropriate time and discussed in a sensitive manner with the resident and/or relative. Residents are therefore assured that the manager will act in accordance with their wishes and observe their spiritual needs. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 14 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): Standards 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can choose how they wish to spend their day and are given wholesome nutritious meals according to what they would like to eat. EVIDENCE: Argyle Park presents with a warm welcoming atmosphere and a resident reported, “Argyle Park is a very caring home, with cheerful staff and homely atmosphere. Could not ask for more” Residents interviewed stated that the routine was relaxed and that they could choose within reason how they would like to spend their day. A resident likes to go out alone with the use of an electric wheelchair and the staff respect this wish. The risks involved have been explained to the resident and are evidenced in a written format, which the resident has signed. A resident said they could stay in bed and be late rising if they wanted or could have a bath in the afternoon if preferred. Staff interviewed were knowledgeable regarding individual preferences thus ensuring the wishes of the residents were understood and respected. Visitors were seen popping in at various times of the day and made welcome by the staff. They were offered refreshments and a relative said that she is Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 15 able to stay and have a meal at any time. Relatives commented that they were made welcome at any time and reassured at difficult times. Bedrooms seen had ornaments, pictures and small pieces of furniture brought in by the residents to ensure their comfort. One resident had a special chair brought from her own home, which was essential for her safety and for maintaining her mobility. Residents can make private phone calls to enable them to keep in contact with people and they also have the use of the Internet on the office computer. An activities organiser visits twice a week and an activity record is maintained of the different social arrangements. There is however no record of resident attendance to evidence their participation and enjoyment. The activities board is updated each and activities include, bingo, quizzes, cinema showings, manicures, one to one therapy, hangman, aromatherapy and outings; a resident said how much they enjoyed the hangman games. Another resident reported there was little variety and the manager was informed of this comment. Staff accompany residents to the park however one relative reported that more outings could be arranged as residents benefit from the fresh air. Again this was passed to the manager for her attention. There is a hairdressing room and the hairdresser visits each week. Residents’ religion is noted on admission and Holy Communion is offered. A small number of residents also attend a local church. This helps residents to continue to practice their chosen faith and the manager makes sure care is provided in a way that meets residents’ beliefs. Details of a local advocacy service were displayed in the main hall, as there may be a resident or relative who wishes to seek independent advice from them. The meals remain of a good standard and the feedback regarding the quantity and the quality of the food was positive. Residents can have their meals in the dining areas or in their own room if preferred. The dining room tables were laid and lunch was seen as a social occasion where residents could get together for a chat. Some residents have individual trays and these were attractively laid. Staff were observed to assist a number of residents in a sensitive manner and residents were not hurried in anyway. The presentation of the meals was good and residents are offered a choice at breakfast, lunch and tea. The menu is based over four weeks and there was plenty of fresh fruit and vegetables in the kitchen. Dietary requirements are noted in the care files and the cooks advised of this information. This ensures residents receive the foods they like in accordance with any diet control needed. Comments regarding the food from residents and relatives include: “Lovely food and always well presented” “Good choice, the cooks are really good” “Sometimes too salty” Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 16 “Good standard of food” “Fantastic food” “The food is very good” (relative) Environmental health records seen were up to date and in line with the most recent guidance to ensure the ongoing safety of the residents. Argyle Park DS0000017219.V340513.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Polices and procedures are in place to listen and respond to complaints and to safeguard and protect vulnerable people from abuse. EVIDENCE: The complaint policy is displayed for residents and/or their relatives to view. Residents and relatives interviewed had no concerns at this time and reported that they would speak to the manager if they were at all unhappy. One relative said, “I have no complaints whatsoever about Argyle Park. The care offered more than meets my mother’s requirements”. All complaints received are logged and are audited by the manager. Two complaints raised in February 2007 had been dealt with in a timely and appropriate manner in accordance with the complaint policy and procedure. The Commission were advised of one of the complaints, the subsequent investigation and action taken. The complaint is now closed. Staff interviewed were aware of the correct procedure to be followed when a resident or relative reports a worry or concern. An abuse policy and Sefton and Liverpool’s Guide to the Protection of Vulnerable Adults was available. The Guide was on display in the main lounge for staff referral. Staff receive adult protection training as part of their training programme and dates of attendance were recorded on the training matrix and also staff training files viewed. The last course was arranged in April 2007. A staff member described the various forms of abuse and the whistle blowing Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 18 procedure for reporting an alleged incident. It was evident that the manager and staff are aware of the correct procedures to be followed to safeguard the residents. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 19 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): Standards 19,20,21,22,23,24,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in pleasant, safe, comfortable and well-maintained surroundings. EVIDENCE: Argyle Park is a purpose built home providing accommodation to residents over three floors. All rooms are single and have ensuite facilities. There is a garden to the side of the property however there is no garden at the rear. A maintenance person works part time and carries out day to day jobs. There was no record of rooms decorated however decorators are currently working on a number of bedrooms. One resident has requested that her bedrooms be decorated next and the manager was advised of this. A partial tour of the premises was conducted and areas seen were maintained to a good standard. The main hall and landings have been decorated recently Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 20 and the wallpaper is pleasing to the eye. Attention is paid to making the accommodation ‘homely’ for the residents to ensure maximum comfort. The lounge is bright and has comfortable armchairs and coffee tables. Part of the lounge is designated as the dining area and the tables are laid for lunch and tea. A number of residents were sitting in the lounge watching television and talking to the staff. Others had chosen to stay in their rooms. There is a hairdressing room on the ground floor and the bathrooms are fitted with bath hoists to assist residents with bathing. The manager stated that a walk in shower is going to be fitted. This is a good idea as several residents and their relatives have commented that they would like a choice of bathing facilities. The bathrooms were clean and smelled fresh. Staff stated that there is a good standard of equipment to support the residents. There are many residents with high dependency needs who require the use of manual handling equipment. This equipment was seen on all floors and residents were not kept waiting when they needed the use of a hoist. A new call bell system has been installed and residents reported that it was far more reliable than the old alarm. Staff were observed to answer call bells promptly however one relative reported that on occasions their family member has to wait. The manager was advised of this. Residents’ bedrooms were personalised and thought had been given to making sure they were bright, airy and warm. Attractive bed covers and matching curtains make the rooms pretty and residents can decide what furniture to have in their rooms. A resident said, “My room is fine and I have everything I need”. Likewise a relative reported, ““They are very good about the fact that my mother’s room is cluttered with her belongings”. The temperature of the hot water is tested to ensure it is delivered to a safe temperature and emergency lighting is provided throughout the premises. It is tested each week and subject to an annual safety maintenance contract. Records seen for the hot water and emergency lighting were in date to ensure the ongoing safety of the residents. The laundry room is situated in a separate building and new washing machines have been purchased. Personal items are washed at the home however the linen is sent out to an external contractor. A resident reported that the laundry service was fine. The home was clean and staff have access to policies and procedure regarding the control of infection. There was a good supply of gloves and aprons to reduce the risk of cross infection. Staff used these at the appropriate time. Several residents commented on the fact that their linen was changed when they wanted rather than once a week. With regard to cleanliness in the home a relative reported, “Exceptionally clean. It never smells and accidents are dealt with immediately”. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 21 Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 22 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): Standards 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment practices for new staff help ensure the protection of the residents. Sufficient numbers of trained and skilled staff are employed to care for the residents. EVIDENCE: The manager was present at the time of the site visit with a registered nurse and five care staff. A member of the care staff was off sick and extra covered had been arranged for later that day. Three domestic staff were on duty and a laundry assistant and cook. The manager takes charge of a number of shifts but also has supernumerary hours for the completion of managerial duties. The staffing rota for the week of the site visit evidenced sufficient numbers of staff on duty to provide the care and support to the residents. Staff were observed to assist residents with various aspects of their personal care. This help was given in a professional and sensitive manner to ensure a good standard of care. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 23 Comments from residents and relatives regarding the staff include: “They really do care about their residents often giving cuddles and have time to talk to them. Everyone tries to make the residents feel part of one big family” (relative) “Good care” “Some staff are exceptionally good” “The staff make the home very welcoming to everyone” (relative) “The senior care staff and carers chat to my husband” (relative) “Lovely people” “Very skilled” (relative) “Exceptionally kind caring staff” (resident) There are currently 50 of care staff with an NVQ (National Vocational Qualification) in care and records seen confirmed certificates obtained. Seven care staff are due to start NVQ Level 2; the manager is waiting for confirmation of start dates. Three new staff have been employed since the last inspection and their files were examined. Recruitment procedures are robust to protect the residents however one reference was obtained prior to a member of staff starting work. Two references are required for all new staff and these should be obtained prior to employment to help protect the residents. An equal opportunities policy ensures staff are given the same opportunities to undertake training and forward their development with in the organisation. Staff files evidenced completed job application forms with details of past employment. POVA (Protection of Vulnerable Adult) checks had also been obtained prior to staff commencing employment. There was evidence of CRB (Criminal Record Bureau) enhanced disclosures. Staff had been given contracts and also commenced on a full induction in line with Skills for Care Induction Standards. Induction records seen were completed in good detail to ensure staff were aware of their role, the organisation and the care needs of the residents. Staff are given details of a number of policies and procedures, for example, confidentiality, abuse, staff supervision, and fire precautions as part of the induction process. The manager has a training matrix and staff files have a record of training with certificates of course attended. Staff receive moving and handling, fire safety, food hygiene/safety, health and safety, infection control and the protection of vulnerable adults. First aid training has not been arranged as yet. The manager should complete a risk assessment to identify the training and qualification that will deliver the first aid provision as identified by the risk assessment. Some of the staff are currently undertaking a dementia care course and report writing and record keeping was attended by staff in April 2007. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 24 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): Standards 31,32,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a manager who is experienced and qualified to manage the service effectively and who seeks the views from the residents to provide a quality service. Policies, practices and procedures are in place to safeguard the health, welfare and safety of residents and staff. EVIDENCE: Ms Sananas is the registered manager and she is also a registered nurse with a current registration with the NMC (Nursing and Midwifery Council). Mrs Sananas has completed NVQ Level 4 in Management and attends training in Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 25 safe working areas. Mrs Sananas has also recently completed an equality and diversity course and this is being rolled out to all staff. This will promote staffs’ awareness or areas such as religion, culture and relationships/sexual needs. Residents, staff and relatives were very complimentary regarding Mrs Sananas’s management of the service and her willingness to take on board new ideas, which will benefit the residents. A resident said, “Berni (manager) is really good”. Likewise two relatives reported, “I think the home is generally well run” and “I would recommend Argyle Park to anyone. They are very kind as well as caring”. The manager uses a variety of methods to seek the views of the residents. This includes surveys, which the residents complete on their own or with the help of a relative or advocate. Comments received from two surveys had been dealt with by the manager to the satisfaction of the residents. A resident meeting was held in March 2007 however due to the frailty of the residents not many attended. New cutlery had been requested at the time of the meeting and a resident confirmed that this had been purchased immediately. A bedroom is also being decorated, in response to a resident’s request. Through these various methods residents are assured that their opinions and wishes are taken into account. The owner carries out a visit to the home to view the premises, meet with staff, residents and relatives. The visit also includes examination of a number of health and safety records to ensure residents are well taken care of. A report of his findings was seen for April and March 2007. Quality monitoring systems include an external star rating, which was achieved by the home earlier this year. As part of monitoring the staff the manager arranges staff meetings and dates of the meetings are displayed in the main hall. Meetings are also arranged for the registered nurses and key workers (a role assigned to senior care staff which gives them more responsibility for their residents). Staff reported that it is good to have meetings and staff supervision as Berni (manager) keeps them informed of developments within the home and planned training. Staff supervision records were seen for three staff. There is no annual development plan however the manager is looking to formulate one and this will evidence a review of the service and what the manage wishes to achieve this year. Residents are encouraged and supported to look after their own money, so enabling them to maintain their independence. In terms of environmental health and safety, current certificates were in place for the lift, gas, electrical installations, moving and handling equipment and portable electrical equipment. The manager on a regular basis completes a Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 26 safety inspection. This ensures the ongoing protection of the people in the home and helps maximise and maintain residents’ independence. Staff receive fire awareness training and fire prevention equipment is tested in house and subject to an annual safety inspection to ensure it is in working order. Staff and residents confirmed that they hear the fire alarm being tested each week. A fire risk assessment of the premises was available and a fire drill was conducted earlier this month. This ensures staff are aware of the procedure to follow in the event of a fire. Accidents that affect the welfare of the residents are recorded. Records seen were completed in sufficient detail regarding the incident and action taken. Care records seen evidenced this information also. Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 27 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 28 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 OP9 Regulation 13 (2) Timescale for action The registered person shall make 09/08/07 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines receive into the care home. The registered manager must ensure staff administer medication in accordance with the prescribers’ instructions so that people who use the service receive the correct amount of medication at all times. The registered person shall make 09/08/07 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines receive into the care home. The manager must ensure there is an effective system in place to audit medicines management within the service in order to ensure that people who use this service are receiving the correct medication. Requirement 1. OP9 24 (1) Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 29 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 OP3 OP9 Good Practice Recommendations A more detailed resident assessment should be completed in relation to specific care needs to assist staff with writing up the plan of care. Staff who administer medicines should receive medicine awareness training and there should be a record of an assessment of competency for staff responsible for this task. The activities record should evidence residents who attended as part of evaluating the participation and enjoyment. Two references for new staff should be obtained prior to a new member of staff commencing employment. This helps protect the residents. The manager should complete a risk assessment to identify the training and qualification that will deliver the first aid provision as identified by the risk assessment. 3. 4. 5. OP12 OP29 OP30 Argyle Park DS0000017219.V340513.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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