Inspection on 22/08/06 for Argyle (The)

This inspection was carried out on 22nd August 2006.

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 (The) 26/01/09

Argyle (The) 23/01/06

Argyle (The) 01/07/05

Argyle (The) 03/03/05

Argyle (The) 04/08/04

Argyle (The) 06/10/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Argyle (The) 24/25 Broad Walk Buxton Derbyshire SK17 6JR Lead Inspector Marie Bonynge Unannounced Inspection 22nd August 2006 10:20 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 Argyle (The) DS0000019921.V308819.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 (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyle (The) Address 24/25 Broad Walk Buxton Derbyshire SK17 6JR 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) (01298) 23059 Argyle Residential Home Ltd Mrs Ann Andrew Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Bedroom 5 and 6 cannot be occupied until they have been upgraded and meet with National Minimum Standards. Timescale: Within 2 years from the date of registration. The proposed 3 bedrooms on the second floor numbers 22, 23 and 24 cannot be occupied until they have been upgraded and meet with National Minimum Standards. Timescale: Within 2 years from the date of registration. 23rd January 2006 Date of last inspection Brief Description of the Service: The Argyle is a large period building, which was formally a hotel. The home overlooks The Pavilion Gardens in Buxton and has a small garden area to the front and side of the building, which provides a sitting area for service users. Accommodation is provided on three floors that are accessed via a passenger lift. Accommodation comprises of nineteen single rooms, 10 of which have ensuite facilities. The Proprietors plan to renovate a further 5 bedrooms over the next two years to meet with national minimum standards, these bedrooms cannot be occupied until then. Lounge / Dining facilities are provided on the ground floor. Support services are provided locally with residents having a choice of GP from three practices. Other support services are accessed on request. The fees for this home range from £340 to £400. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over one day in August 2006 over a period of 6 hours. During this time the Inspector spoke to 3 residents individually and a group of 3 residents. The Inspector also spoke with 3 members of staff and the Registered Manager (who is also one of the providers). 19 residents were accommodated on this visit who had low to medium dependency needs. Inspection methods used included a tour of the building, tracking the care of 3 residents where their care plans and associated records were examined. Training records, staff files, certificates of maintenance and medication systems were also examined. Many of the residents in this home were able to contribute directly to the inspection process, although a small number were not able to do this due to communication difficulties. However, they were directly observed during this visit to see how well their needs were being met by staff. The main focus of this visit was on previous requirements and recommendations from the last inspection and on the key inspection standards. The previous inspection took place on the 23rd January 2006. Most of the requirements made at the last inspection have been met and progress has been made towards meeting the remainder. What the service does well: Residents say that the Argyle provides a comfortable and homely environment for them, that is clean and generally well maintained. Residents spoke highly of the care provided and commented that staff were ‘kind’ and ‘well mannered’. The management endeavour to encourage residents to express their views and actively seek the views of residents and their representatives via questionnaires and meetings. There is a strong commitment to staff training and to encouraging a variety of skills amongst staff members. The training programme seeks to take into account the changing needs of the residents accommodated. A good standard of food is provided with residents’ individual needs being catered for. The activities and routines of daily living are flexible and are arranged around the expressed interests of residents. One resident commented that this was one of the best things about the home. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 6 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. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3, standard 6 was not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Assessment processes contribute to ensuring that residents needs are understood, recorded and met. EVIDENCE: Signed contracts were in place for residents that included the terms and conditions of residence of the home, thus giving residents an understanding of what they can expect. These had recently been reviewed and updated in accordance with recommended guidance. The care plans of three residents were examined as part of the case tracking process. Preadmission assessments had been obtained that covered health, social and personal care needs. The homes own assessment has been further developed and the practice in the home was to visit prospective residents prior to their admission. This assisted in staff being able to plan care so that assessed needs could be met more consistently. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 9 Staff said that they were actively encouraged to use the care plans in handovers and they were an everyday working document. A requirement made at the last inspection has therefore been met. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The homes care planning system assists in ensuring that residents assessed needs can be met. Systems are in place that contribute to the promotion and maintenance of residents health and ensures access to health care services. EVIDENCE: As part of the case tracking process, three residents care plans were examined. These indicated that the documentation was improving, with fuller details being provided of the care given and of the well being and health of residents. Sufficient detail was provided to enable staff to ascertain the action needed to be taken to ensure that all aspects of the health, personal and social care needs of the person could be met. Care staff were aware of the needs of residents and they had become increasingly involved in the formulation and development of the care plans. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 11 Daily records were detailed and illustrated that the changing needs of residents were being monitored and care plans were being updated accordingly. Good working relationships with the community health care team were said to be in place and residents said that they had prompt access to all aspects of health care. Risk assessments were present, although these had not all been consistently reviewed and did not always reflect the up to date needs of the resident. A recommendation has been made in respect of this and two requirements made at the last inspection have been met. Medication systems were generally in good order, all of the requirements made at the last inspection have been complied with and regular advice from the community pharmacist was being sought. The temperature of the medicines fridge was being recorded and monitiored, however the maximum and minimum temperatures were outside of the recommended range with no action being taken. A recommendation has been made in respect of this. The manager rectified this during the visit. Residents spoke highly of the quality of care that they received. Confirmation was given that staff always knocked on residents doors before entering and residents felt that staff respected their privacy. Comments included staff are polite and well mannered and staff do everything they can for you. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Activities and recreation are provided that generally meet with the expectations and preferences of residents. The meals are of a good standard and are taken in a pleasant dining area, this contributes to enhancing the good standard of overall care. EVIDENCE: Three residents who were spoken with said that the home met with their expectations and was run flexibly with residents needs in mind. A number of residents used community transport to access interests outside of the home, this included a luncheon group that was reported to be popular with residents. Care staff are involved in providing activities for residents, there is also an activities co ordinator who attends the home twice each week. A range of activties and recreational pursuits are offered. A recent trip and lunch on a river boat had been organised and residents had taken part in decorating the outside of the home for the Buxton carnival. Comments included there is Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 13 plenty for me to do if I want to. One resident has identified religious needs and is supported to continue with their religious observances. The building is adjacent to a park where care staff often accompany residents on a walk. A newsletter is produced to keep residents and visitors informed of events and activities. Visitors are welcomed and residents said that they are afforded privacy when seeing visitors. Meals are of a good standard and taken in a pleasant dining room. Residents looked forward to mealtimes and said that this was one of the best things about The Argyle. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Policies and procedures were in place that assisted in ensuring that the welfare of residents was safeguarded. Staff attitudes and awareness underpin these policies and procedures. Residents feel that their concerns are taken seriously and acted upon. EVIDENCE: The complaints procedure indicated that a swift response would be taken in the event of a complaint. Complaints are taken seriously, four minor complaints were recorded that had been responded to and resolved, the outcome of these was also recorded. Residents said that they felt any concerns they had would be listened to and action would be taken, although they had no complaints at this time. A requirement made at the last inspection has therefore been met. Information was available regarding Derbyshires’ safeguarding adults procdures and policy and staff were aware of what to do if they had concerns about a residents welfare. Abuse awareness training had been attended by staff although this was not the local authoritys’ own training. A recommendation has been made in respect of this. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 22 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is generally well decorated, comfortable and well maintained thus contributing to the well being of residents. EVIDENCE: Residents spoke highly of the general standard of accommodation provided. Some general redecoration of bedrooms has taken place, although the refurbishment of the remainder of the bedrooms and bathroom has not yet commenced. The building is clean and generally well maintained, being free from offensive odours throughout. Aids and equipment are provided to meet the care needs of residents including raised toilet seats and bath lifts. Residents said that the home is a pleasant place to live. Many of the bedrooms offer en suite facilities and are larger than the national minimum standards. Residents are encouraged to bring in personal effects such as pictures and photographs. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 16 Risk assessments had been completed regarding the use of electric radiators in bedrooms and risk assessments regarding radiators had been reviewed. The risk assessments had not however been updated to reflect the changing needs of residents. A recommendation has been made in respect of this. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Recruitment practices generally assisted in the safeguarding of residents, however these need to be thoroughly implemented to ensure that residents are fully protected. There is a committment to training that supports staff in the work they do. EVIDENCE: Nineteen residents were accommodated on this visit, having a variety of care needs including low and medium dependency needs. The manager and staff were well aware of the care needs of residents and were prompt in updating the daily records to ensure that communication systems were in good order. A senior care assistant is on duty with 2 care assistants during the day. The manager is generally supernumary, although she is available to cover any shortfalls. A housekeeper and cook were also on duty on this visit. The home is staffed according to the assessed needs of residents and consideration is given to the skill mix of staff and the dependency levels of residents. All of the residents spoken with said that staffing levels were generally satisfactory and there was always a member of staff around if they needed help with anything. Staff were observed to be respectful and friendly in their interactions with residents and they also spent time with those residents who could not participate in conversation. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 18 There is a strong commitment to training in the home both from the management and from staff, who are keen to extend their skills and experience. An induction programme is in place that staff complete within their first 6 weeks of employment. The programmme of training enables staff to fulfill the aims of the home and to meet with the changing needs of residents. Recruitment procedures are in place, however these are not always followed in respect of obtaining 2 written references for staff. 2 written references had not been obtained for 2 new members of staff, although completed CRB checks had been received. This practice could potentially place residents at risk and was discussed with the manager. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well run in the interests of residents with a strong and approachable management team. This assists in ensuring the health, safety and welfare of residents and staff. EVIDENCE: The registered manager (who is also one of the providers) has completed her NVQ level 4 in management and care and has a number of years of experience in managing this service. Residents and staff expressed confidence in the management of the home and reported that they felt their views were listened to and would be acted on. A system for quality assurance was in place that included resident questionnaires, the results of these had been collated and acted upon. Regular staff meetings were held that were said to be useful and the views of staff were sought and action taken. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 20 The management team demonstrated a strong commitment to improvement in the home and had made changes to the activities programme in accordance with the suggestions of staff. Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 21 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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation 19 Sch 2 Requirement Two written references must be obtained for new staff prior to the commencement of their employment. Timescale for action 01/11/06 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 OP7 OP9 Good Practice Recommendations Risk assessments should be reviewed more regularly and consistently in accordance with the changing needs of residents. The maximum and minimum temperature of the medicines fridge should be recorded and lie within the recommended range, appropriate action should be taken when the temperature is outside the recommended range. Staff should attend training regarding Derbyshire’s safeguarding vulnerable adult procedures. 3. OP18 Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Argyle (The) DS0000019921.V308819.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!