Inspection on 23/01/06 for Argyle (The)

This inspection was carried out on 23rd January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Argyle (The) 26/01/09

Argyle (The) 22/08/06

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 23rd January 2006 10:00 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.V273733.R01.S.doc Version 5.1 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.V273733.R01.S.doc Version 5.1 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.V273733.R01.S.doc Version 5.1 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 Minimun 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 form the date of registration. 1st July 2005 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 services user having a choice of GP from three practices. Other support services are accessed on request. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 and a half hours. The focus of this visit was to follow up the requirements and recommendations from the previous inspection report and to focus on the key standards and outcomes for residents. Inspection methods used included discussions with 8 residents, 1 relative, 1 visitor, 3 members of staff and the manager and proprietor. Records examined included residents care plans, accident records, staff rotas and training records. A brief tour of the building also took place. The home has increased its registered numbers since the last inspection to take account of expansion into what was formerly a hotel. The Proprietors have plans to completely refurbish the remainder of the bedrooms in the next two years to meet with minimum standards. In the meantime these bedrooms cannot be used. Progress has been made regarding the implementation of the requirements made at the last inspection. What the service does well: Residents said that they thought the environment was ‘homely’ and there was plenty to do if you wanted. Some residents said that they preferred to spend time in their rooms and they had been able to furnish them with personal possessions. Good reports were made about the food with residents saying that the food was to a good standard and there was plenty of it. Relatives and visitors to the home said that they found the staff welcoming and there was always a member of staff to speak to if they needed. The home was generally clean and well maintained with some of the bedrooms being decorated and furnished to a high standard. Staff said that they enjoyed working at the home and they found the proprietors approachable. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 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.V273733.R01.S.doc Version 5.1 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.V273733.R01.S.doc Version 5.1 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): 3 Deficits in the assessment process do not serve to assure residents that their needs will be fully met. EVIDENCE: Three residents care plans and associated records were examined as part of the case tracking process. These indicated that assessment information was generally obtained from the social services department via Care Management arrangements or from the health service / hospital. Assessment information was available for two of the residents but no assessment information was in place for a newly admitted resident. The Manager stated that she had been to assess the resident but there was no recorded assessment in the care plan. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Care plans were generally indicative of residents’ needs and their care, however these must be in place for all residents to ensure that care can be delivered consistently and in accordance with individual need. Regular reviewing of care plans is needed to ensure that residents changing needs are addressed and met. Generally good systems of medication administration were in operation. Residents’ privacy and dignity is generally promoted, upheld and maintained. EVIDENCE: Care plans were said to be in place for all of the residents accommodated. Three of these were examined. Two care plans were signed either by the resident or by a representative and a confidentiality statement was included. There was a detailed record of daily personal care and good records of GP and District Nurse visits and their outcome. Details of the residents’ personal Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 10 history, their likes and dislikes had been obtained. However, this was not the case for the third care plan where the personal profile was not completed, nor was the care plan. No information was available as to how to meet the persons’ health, personal and social care needs. Discussions with staff indicated that they were aware of the residents care needs and of how to meet these, this was based largely on verbal communication systems and the use of the daily records as opposed to being set out in an individual plan of care. Discussions with the resident supported this, who stated that they felt their needs were being met. Risk assessments had been introduced regarding nutrition and pressure area prevention and a falls risk assessment was also included. These had been reviewed recently, although they had not been reviewed consistently throughout the last year. Accident records had been completed and a requirement has been met in respect of this from the last inspection. There were a number of accidents recorded due to falls. Appropriate action had been taken to refer the residents for assessment regarding the reasons for falling, however there was no strategy in place for the prevention of falls or for monitoring the incidence of falls. Records showed that residents had access to health services such as the optician, dentist and chiropody. A new treatment room has been made, although the medicines were still being stored in the locked office. There was not enough room to store all of the stock in the locked medicine cupboard and there was no lock on the cupboard they were being stored in. The proprietor assured the Inspector that a lock would be placed on this by the next day and a new medicine trolley would be purchased. The systems for the administration of medication were generally in good order with the exception of the following: • • • • • Handwritten Medication Administration Charts (MAR charts) had not been signed by two people. The code for a resident not having medication ‘O’ did not indicate the reason. Controlled Drugs were not being recorded in a bound book with numbered pages. The storage of Controlled Drugs was in need of review in accordance with recommended guidelines. There was no lock on the cupboard door that creams and other topical medicines were being stored. Residents and relatives said that they felt their privacy was respected and promoted. Staff knocked on the bedroom door of residents’ rooms before entering and were felt to be appropriate in their manner. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The daily routines of the home and leisure activities provided generally met with the expectations of residents. A good standard of meals was provided. EVIDENCE: Residents said that they were offered a range of activities including cards, board games and plenty of books. Residents were also offered the opportunity to go out and one resident was supported to continue voluntary work in the community. Residents said that they felt their preferences were met and that the routines of the home were flexible and fitted in with the way they wanted to spend the day. Visitors to the home were welcomed and those spoken to said that they could visit at any time. Visitors to the home were observed to come and go throughout this visit. It was said that staff were ‘very kind’ and ‘nothing is too much trouble’. Residents told the Inspector that the standard of food was good. The kitchen staff were aware of the likes and dislikes of residents and an alternative was offered where residents preferred something else. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Policies and procedures were in place that served to protect the interests of residents, however further staff training is needed. EVIDENCE: A complaints procedure was in place that was displayed in the entrance hall of the home. Residents spoken to said that they knew who to speak to if they had any concerns and they felt their concerns would be acted upon. Relatives also stated that they thought any issues were addressed promptly. A complaints file was kept although minor complaints were not being recorded. The Manager had attended a 2 day course with Derbyshire Social Services regarding Protection of Vulnerable Adults. The home had information regarding Derbyshire’s protection of vulnerable adults procedures and also had a copy of the Department of Health ‘No Secrets’. Staff interviewed were aware of who to report any incidents of abuse to although they had not attended any formal training. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24 and 25 Generally well maintained and comfortable accommodation is provided that contributes to the enhancement of residents every day lives. The proposed refurbishment of the home will assist in increasing this further. EVIDENCE: Discussions with residents confirmed that they were generally pleased with the standard of accommodation provided. 3 of the homes bedrooms have been upgraded to provide a high standard of accommodation including en suite facilities. The home is now registered to provide 24 places in the category of (OP) Older People although 5 of the bedrooms cannot be occupied until they have been upgraded to meet with national minimum standards. The 6 bedrooms that were formerly part of the hotel have been included in the homes development plan and it is expected that these will be upgraded within the next two years. Upgrading of the downstairs bathroom, including the replacement of the assisted bath and floor has been included in the homes Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 14 development plan and is expected to be completed within the next two years. The ceiling in bedroom 4 has been re-plastered as required at the last inspection. Risk assessments on the radiators had been completed but had not been in reviewed to take account of the changing needs of residents. Some of the radiators were hot to the touch. Window restrictors had been fitted following the completion of risk assessments. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 15 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): 28 and 29 The home’s recruitment policy and practices did not always serve to fully protect and support residents and were in need of review to take account of updates to Criminal Record Bureau checks. EVIDENCE: A programme was in place for the achievement of NVQ level 2 and in excess of 50 of staff had completed this. Policies and procedures were in place regarding recruitment, however current Criminal Record Bureau (CRB) checks had not been obtained for new members of staff. Not all of the required records were in place for these members of staff such as a photograph and proof of identity. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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 and 38 Generally good management systems were in place to assist in the aims and objectives of the home to be implemented. The management and staff are considered to be open and approachable. EVIDENCE: The Registered Manager who is also one of the Proprietors has achieved level 4 NVQ in management and care. Discussions with residents, staff and relatives indicated that the Manager was approachable and led a dedicated staff team. Quality assurance systems were being developed in the home to include residents’ questionnaires. The Manager reported residents’ families assisted them in dealing with their finances and a system was in place for the administration of personal allowance monies. Records were generally in good order and well maintained with the exception of those identified in the main Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 17 body of the report. Risk assessments had been completed for the environment. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 17 X 18 2 2 X 2 X 3 2 2 X STAFFING Standard No Score 27 X 28 3 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14 1 a b d Requirement The registered person must ensure that full assessment information is obtained prior to the admission of a resident and recorded in the care plan. The registered person must keep the residents care plan under review according to recommended guidelines and update the care plan to reflect changes in needs. The registered person must ensure that each resident has a care plan that sets out how the residents needs in respect of their health and welfare are to be met. The registered person must ensure that a lock is installed on the cupboard door used for storing additional medication. The registered person must ensure that all of the matters in standard 9 detailed in the main body of the report are actioned. All complaints including minor ones must be recorded with details of the action taken and their outcome. DS0000019921.V273733.R01.S.doc Timescale for action 01/04/06 2. OP7 15 2 b 01/04/06 3. OP7 15 1 01/04/06 4. OP9 13 2 24/01/06 5. OP9 13 2 01/04/06 6. OP16 22 3 4 01/04/06 Argyle (The) Version 5.1 Page 20 7. 8. OP18 OP19 13 6 23 9. OP21 23 10. OP24 23 11. OP25 23 12. OP29 Sch 2 13. OP29 19 1 4 Sch 2 13 14. OP25 15. OP37 Sch 2 Staff must attend Derbyshire’s protection of vulnerable adults training. Arrangements must be made to ensure that the 6 bedrooms that were formerly part of the hotel are upgraded. Upgrading of the downstairs bathroom must include the replacement of the assisted bath and floor. Arrangements must be made to ensure that bedroom doors are fitted with locks suited to service users capabilities and accessible to staff in emergencies in consultation with the Fire Officer. From inspection report 01/07/05. Previous timescale 01/11/05. Risk assessments on radiators must be reviewed. The registered person must ensure that the surface temperature of radiators does not exceed 43C and cover radiators where necessary. From inspection report 01/07/05. Previous timescale 10/10/05. The registered person must ensure that all of the required records are kept in accordance with Schedule 2. Criminal Record Bureau checks and a POVA check must be obtained for all members of staff. Risk assessments must be completed regarding the use of electric radiators in residents bedrooms, regarding the large panes of glass in the first flor and second floor bedrooms. Records required by regulation must be maintained, up to date and accurate. 01/07/06 01/01/08 01/01/08 01/07/06 01/05/06 01/05/06 01/05/06 10/10/06 01/05/06 Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Further information should be sought regarding the prevention of falls. Argyle (The) DS0000019921.V273733.R01.S.doc Version 5.1 Page 22 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.V273733.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!