Inspection on 07/03/07 for Argyll House

This inspection was carried out on 7th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Argyll House 12/12/07

Similar services:

Chesham House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

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

CARE HOME ADULTS 18-65 Argyll House 201 Holt Road Cromer Norfolk NR27 9JN Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 7th March 2007 09:30 Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 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 Argyll House DS0000067522.V332710.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyll House Address 201 Holt Road Cromer Norfolk NR27 9JN 01263 838411 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) info@argyllhouse.org K T Health Limited Mrs Katherine Yarbo Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This is a new service. Brief Description of the Service: Argyll House is situated in an suburban location on the outskirts of Cromer. It is house that was built at the turn of the century and has been designed to accommodate people with mental health problems who need to develop a more independent lifestyle. The house itself comprises of eight flats and or studio flats and four rooms that have en suite facilities. The train and bus stations are within walking distance. Service users are encouraged to promote as much independence as possible and are facilitated to engage in work experience, further education and activities provided by the home. They are also encouraged to take part in the running of the home. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced first key inspection of this service has been carried out using information from the provider/manager, all of the residents and a vast majority of the staff. The care services of this home are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. This report gives an overview of the service and current judgements for each group. Opportunity was taken to tour the home. What the service does well: What has improved since the last inspection? This is a new service and has not been inspected before. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Persons who use the service have adequate information to make an informed decision about admission to the home and their individual aspirations and needs are assessed. EVIDENCE: All service users are given a most comprehensive guide to the facilities of the home, this includes accommodation, the qualification of all staff, a summary of the purpose of the home and a copy of the complaints procedure. Case tracking confirmed good practice, it also confirmed that the process for assessing the service user’s needs was carried out before admission and also during a settling in period to ensure that the home can meet the needs of those service users who have complex needs but who need to become more independent. Prospective service users are also assessed prior to admission over a period of time when they are invited to make short visits to the home before they eventually move in. The case tracking highlighted the involvement of other agencies before admission to the home. Newly admitted service users informed the Inspector that they felt that they were given sufficient information and time to make an informed choice before admission to the home. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 9 The admission records showed that the service user’s mental, physical, and social care needs were taken into consideration with the formulation of a therapeutic intervention for care. Contracts were seen for all the seven newly admitted service users. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service, discussion with service users, staff, and other professionals. Service users are encouraged to lead independent lifestyles and are involved in all aspects of life in the home. EVIDENCE: The Inspector examined seven care plans of the service users who were now resident in the home. The assessment process had been used to formulate a plan of care that also included therapeutic intervention. It was evident that the service users were involved in the care planning system; they chose what intervention they wanted to work on initially that will lead them on to the path of independence. This consisted of social inclusion, budgeting and catering, including all other aspects of care relating to their changing needs and their aspirations. The service users that the Inspector spoke with all indicated that they were very much involved in the care planning and they felt that their needs were being catered for in a positive way that they had not experienced before. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 11 It was noted that there had been continual evaluation of the care and intervention and that there were also records of multidisciplinary intervention and review. There were very detailed daily notes and some of this data was entered on the care plans where appropriate. Those service users spoken with indicated in their conversations with the Inspector that they were encouraged to take risks in their daily lives and towards more independence. They also indicated that they felt confident that all information about them was handled in a confidential manner. The service users discussed with the Inspector about their involvement in the running of the home. House meetings take place every two weeks and all aspects of the home are reviewed each time. It was evident that no service user was excluded from anything; they are involved in the interview process for new staff, menu planning and work in the kitchen on a one to one basis with the cook. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service, observation, and discussion with service users and staff. Activities and meals are managed extremely well. The service users are encouraged to be in control of their own lives and enhancing their social skills whilst also developing personally and meeting their educational objectives and their move towards independence. EVIDENCE: Discussion with service users revealed that they are given ample opportunities for personal development and this was also reflected in the care plans. The manager stated that a lot of the activities are geared around moving people on and facilitating their personal development; they engage in trying to gear an interest for a particular individual and the service users appear to engage in many projects. Discussion with the service users confirmed that opportunities were given to encourage them in their personal development and educational needs; various care plans indicated involvement in the service users learning opportunities and leisure activities. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 13 One service user explained that they were doing a degree; another stated they were engaged in voluntary work at the National Trust. There are other opportunities for the service users such as sailing instruction; the home owns a yacht, swimming lessons, song and dance sessions and other sports. One service user commented that it seemed like a whole new vista had been opened up since they arrived at the home and that there were so many opportunities put their way. Another commented that they felt that they had really moved on since they had been living at Argyll House. Yet another service user stated that the home was an amazing place, everyone works as a team to support the residents in their pursuit to independence and their personal development. The Inspector noted that at lunchtime, discussion took place amongst the service users and staff what they were all planning to do at the weekend and where they were going. The Inspector was able to observe lunch being served and this appeared to be quite a social activity, one of the service users had been working in the kitchen helping to prepare lunch. This activity was part of this individuals plan for becoming more independent. The lunch was buffet style with many options for the service users; it appeared both appetising and nutritious. Fresh fruit is always available at any time of the day. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service, after discussion with staff and service users. Service users are exceptionally well supported by staff and the arrangements for administration of medication is handled well. EVIDENCE: Discussion with service users confirmed that they were well supported by all levels of staff and made comments like…. “With the help of the staff I am much more focused;” “such a positive move to come here;” “all the staff are so passionate about the home and wanting to help us move on;” “they are so supportive I cannot put into words.” One service user commented that they felt that they were supported in every direction and that it was a privilege to be at the home. In fact the general consensus was that the staff were very, very supportive and that they were all working towards the same goal. The service users confirmed that they were supported to take control of their own health care needs and that the home worked very well with other agencies to facilitate this. All service users self medicate and are encouraged to do so; risk assessments are in place for this activity and the medication is stored appropriately and safely in the service users rooms and that which is not in use or for general use is stored safely in the clinical room and in the appropriate storage facilities. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 15 It is recommended that those service users who are prescribed Clozapine and go on leave have the amount recorded. It is also recommended that spot audits of medication take place. Staff are aware of the policies and procedures for the administration of medication and have all received training for this. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and discussion with staff and service users. Arrangements for dealing with complaints are satisfactory. EVIDENCE: The Inspector asked the manager if the home had received any complaints from service users or their relatives and none had been received. The Inspector went on to ask the service users about their understanding of the home’s complaint procedure and if they would feel happy airing any concerns that they might have. All those spoken to said that they were aware of the procedure and were given it on their arrival at the home; they also said that they would feel quite comfortable addressing any issues that they might have, in fact suggested that at this stage it was most unlikely. The staff that were spoken to were knowledgeable about issues relating to the protection of vulnerable adults and all but one new member had received training in this area, and the training records supported this. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, and made on observations made during the tour of the home and discussions with the service users. The home provides facilities to match the individual requirements of the service users. EVIDENCE: The home was found to be very clean and tidy and suitable to meet the needs of the service users. Independent living accommodation can be found within the home enabling those who are learning to live more independently to do so. A separate smoking area has been provided that does not infringe on those that have no wish to smoke. Overall the home appeared very homely and safe. The service users remarked in their conversations with the Inspector that they felt that the home was very homely and that they wanted for nothing. One service user who was living independently invited the Inspector to view the flat, this was found to be most suitable to enable an individual to learn to live as an independent person. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 18 Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and by examining records and discussion with staff and management. The service users are supported by competent, effective and qualified staff. The service users are protected by the homes recruitment procedure. EVIDENCE: Discussion with staff members confirmed that they felt that they were well supported by the management and that they were clear about their roles within the home. The staff also felt that the home was sufficiently staffed to facilitate all the assessed needs of the service users; examination of duty rosters confirmed this to be true. Records for all the staff members were examined and were seen to reflect a robust system for recruitment and all appropriate checks have been made prior to employment. The staff records also contained proof of staff identity. The staff spoken to state that they felt that the provision of training opportunities in the home was good and training records indicated this. New staff members confirmed that they had been given an induction and records were seen for this. Formal supervision has been initiated and this was confirmed after discussion with staff members. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and using information gained from the service users, staff, and a visiting professional. Records were also checked to gather further information. Service users and staff benefit from a well managed home and are safeguarded by its policies and procedures. EVIDENCE: The manager has had a wealth of experience running environments for those with mental health problems, she is enthusiastic and passionate about her role and this inevitably rubs off on those that work with her and then cascades down to the service users. Service users and staff have definitely benefited from the ethos and leadership of the manager who constantly strives to support the staff and service users. The staff and service users generally feel that they are well supported by the management. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 21 A system for monitoring the quality of the services offered by the home is in place and will be extended as the home moves forward. Service records for equipment were examined and found to be in order. Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 4 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 4 3 3 3 3 3 3 3 Argyll House DS0000067522.V332710.R01.S.doc Version 5.2 Page 23 New Service Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA20 Good Practice Recommendations It is recommended that a spot audit is carried out for medication and that Clozapine is recorded for those service users on home leave. 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