Inspection on 10/07/06 for Arkley Nursing Home, The

This inspection was carried out on 10th July 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

Arkley Nursing Home, The 12/01/09

Arkley Nursing Home, The 31/01/08

Arkley Nursing Home, The 04/01/06

Arkley Nursing Home, The 29/06/05

Arkley Nursing Home, The 28/10/04

Arkley Nursing Home, The 27/04/04

Arkley Nursing Home, The 24/02/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Arkley Nursing Home, The Barnet Road Arkley Barnet Hertfordshire EN5 3LJ Lead Inspector Brian Bowie Key Unannounced Inspection 08:30 10th-11th July 2006 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 Arkley Nursing Home, The DS0000010398.V298223.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. Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arkley Nursing Home, The Address Barnet Road Arkley Barnet Hertfordshire EN5 3LJ 020 8449 5454 020 8364 8087 woodallvebupa.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BUPA Care Homes (BNH) Limited Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0), Physical disability of places over 65 years of age (0) Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users under 65 years of age of with a physical disability must not exceed 10 (ten). 4th January 2006 Date of last inspection Brief Description of the Service: The Arkley Nursing Home is a purpose-built home, owned and managed by BUPA Care Homes Ltd. The home is registered to provide nursing care and support for older people and care for up to ten younger adults with a physical disability. The Arkley is located in a rural setting in Arkley near Barnet in Hertfordshire. The home is an attractive three-storey building, with a large car park, attractive shrubbery and landscaped gardens that are accessible to wheelchair users. There is a central atrium with a glass-domed roof. This provides a very attractive feature and a good source of natural light. Residents’ bedrooms are located in four corridors on each floor, which feed off the central area. There is a large dining room and lounge on the ground floor, a smaller dining room and lounge is situated on the first floor. The home’s large kitchen is located on the ground floor. The first floor is serviced by a passenger lift. On the second floor, there are some offices and a large area dedicated to staff training. The home’s stated aim is to provide high quality nursing care. Their vision is to take care of the lives in their hands and provide as individual a service as possible to all residents. In July 2006 the fees charged by the home averaged from £850-£1,000 per week. BUPA makes available to residents, families and prospective residents inspection reports and information detailing the service provided by The Arkley. Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 2 full days. The acting manager, Sister Beatrice Godfrey, and a number of nursing and care staff assisted the inspector. The inspector was able to speak to 6 relatives, and 15 residents. The inspector was also able to speak to four members of staff individually, as well as the chef manager and training coordinator. In addition the inspector spoke with the GP who provides a regular surgery at the home. Many of the residents were very able to communicate how they felt about living at the home. Throughout the inspection the way in which staff communicated with and supported residents was observed. The former manager of the home, Lucy Woodall, had moved on in June 2006 and BUPA were in the process of appointing a new manager for The Arkley. The home can currently accommodate up to 60 residents. At the time of the inspection there were 48 residents. The inspector completed a tour of the building and examined five care plans. Records relating to accidents and incidents, complaints, medication and staff files were looked at. The inspector would like to thank all the residents, their relatives, the acting manager and staff for their assistance during the inspection. Particular thanks go to those residents who were involved in the feedback session with the acting manager at the end of the inspection for their thoughts and comments on what it is like to live at The Arkley. The overall impression from this inspection is that The Arkley provides a very good standard of care to residents and has a relaxed and caring atmosphere. The quality of care at the home is improving, with the potential for it to be assessed as excellent once areas for improvement are dealt with and a new manager has got established. One resident commented: ‘This home is the tops.’ What the service does well: As well as being clean and well-maintained The Arkley has a homely and relaxed atmosphere. One resident said: ‘It feels homely. You can go to staff for advice- they’re easy to talk to.’ Members of staff have got to know the residents well and understand their individual needs and preferences. As a result many residents are able to communicate confidently with staff. Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 6 Each resident is seen and treated as an individual in their own right. This means each resident has a choice about how they spend their time and what they want to do. There is a committed and experienced team of staff at The Arkley who work well together. Staff feel well supported by the management team at the home. The staff have had a significant amount of training in working with older people, especially in meeting their health needs. Consequently the residents get the benefit of living in a home where they feel supported and their needs are met. The home has achieved a high standard in meeting the health needs of residents and has close and effective relationships with local health professionals. This is reflected in the care plans maintained for each resident. Residents were generally positive, or very positive, about the food served in the home, with residents having choices about what and when they ate. What has improved since the last inspection? What they could do better: At the previous inspection there had been 3 areas the home had to improve. These improvements had been made. From this inspection 6 new areas to be improved are identified. In order that the needs of residents are properly met at all times the home needs to achieve the following: • • • • • Care plans to have a person-centred focus Weekend staffing levels to be reviewed to identify improvements needed 2 satisfactory written references to be obtained before any new member of staff starts working at the home In the specific case highlighted the member of staff must work under supervision until a satisfactory 2nd reference has been obtained All staff to have a formal supervision meeting at least 6 times each year Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 7 • The checks of the fire safety equipment to be carried out weekly at all times These areas for improving the service were discussed and agreed with the acting manager. 3 recommendations are made to highlight ways in which practice can be further improved at the home: • • The best practice training in palliative care being used by BUPA to be available to all care staff The home to review its current activity programme in order to identify improvements needed and ways of increasing the level of activities on offer at weekends The acting manager to review current catering arrangements between supper and breakfast to ensure they are completely satisfactory for all residents. • 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. Arkley Nursing Home, The DS0000010398.V298223.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 Arkley Nursing Home, The DS0000010398.V298223.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 ( Standard 6 does not apply to this service) Residents and prospective residents can be confident that detailed assessments are carried out prior to admission to ensure the home is able to meet their needs. EVIDENCE: Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Records relating to 2 residents who had recently entered the home were looked at. Specialists had carried out assessments on these individuals before they had moved to The Arkley. An assessment had then been undertaken by the home. The assessments detail residents’ needs and abilities. New residents are seen quickly by the GP for the home and specific issues followed up. As a result new residents at The Arkley get a proper and thorough assessment of their needs and a detailed care plan drawn up which indicates how these needs are to be met. Arkley Nursing Home, The DS0000010398.V298223.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): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The home is to be congratulated on achieving an excellent standard of health care provided to residents. Residents are protected by the effective, safe and thorough arrangements in place in relation to the administration of medication. Staff treat residents with respect and residents can be sure that staff will respect their privacy. Staff support people who are terminally ill sensitively. The home is good at recording in detail the health and medical needs of residents, but needs to improve how it records people’s life histories, interests and wishes. EVIDENCE: The home pays close attention to meeting the physical emotional and psychological health needs of residents. Residents have access to a variety of specialist medical services, including physiotherapy and chiropody. Care plans record clearly and in detail each individual’s needs and how these are being met by staff. Each resident has a named nurse and keyworker who pay special attention to how each resident is getting on at the home. However care plans contained little information about the resident’s life history, interests and Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 11 wishes, having instead an emphasis on health and medical needs. BUPA is beginning to implement a more person-centred approach to care plans, but must ensure that all care plans have this focus. The GP who provides a twice-weekly surgery at The Arkley was interviewed. The GP confirmed that the home has built up good working relationships with local health professionals so that residents get good healthcare support, including Macmillan Nurses when needed and back up from the N. London Hospice. Staff are having training in working with people with palliative care needs, and it is recommended that the best practice training being used is available to all care staff. Staff interviews and records show that the home is achieving an excellent standard of health care in relation to residents, particularly in the area of pressure sores, which are monitored closely. Medication arrangement were checked during the inspection and staff who have a special responsibility in this area were interviewed. This indicated that The Arkley has comprehensive and effective procedures in relation to medication. New trolleys for dispensing medication had been purchased, and a new system for administering medication from blister packs was being introduced with appropriate staff training planned. A contract had been set up by BUPA to ensure there were proper arrangements in place for the disposal of medication. Throughout the inspection staff treated residents with respect and respected their privacy. Residents themselves made comments such as: ‘The staff treat us very well. I get on well with them.’ As previously required care plans now indicate the wishes of residents in the event of their death. Relatives of a resident who had recently died were interviewed. They were very positive about the support provided to their mother by staff in her final weeks. They said: ’Mum was very well cared for at The Arkley by very caring staff. Staff kept in touch with us and let us know if there were any problems. It was very nice that 5 staff came to mum’s funeral.’ The GP for the home commented that there was a commitment at The Arkley to looking after people and caring for people as long as possible so that people could die at the home if that was their wish. Arkley Nursing Home, The DS0000010398.V298223.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Residents benefit from a choice of activities in the home and are encouraged to pursue their interests. Staff are good at welcoming relatives and friends so that they also feel part of the home. Residents make their own decisions wherever possible about what they do when. Mealtimes are enjoyed by the residents who have a choice about what they eat, with cultural and religious preferences provided for. EVIDENCE: On the day of inspection residents were taking part in a craft activity which they were clearly enjoying. Residents had recently been on outings to Buckingham Palace and the Zoo, as well as going out with relatives. Activity organisers put together a varied weekly programme of activities, as well as trying to respond to the individual needs and wishes of residents. One resident said: ‘I’ve been on all the outings- more outings which can take more people are needed.’ Other feedback from residents showed that staffing and transport resources might limit the number of residents who could go on certain outings, and that there were fewer activities on offer at weekends. It is recommended that the home reviews its current activity programme to identify improvements needed and ways of increasing the level of activities on offer at weekends. Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 13 Cultural and religious needs are responded to. A significant proportion of residents are Jewish so arrangements have been made for appropriate services to be held in the home. Over the 2 days of the inspection a number of relatives were seen visiting residents or taking them out. Relatives spoken to were positive about visiting arrangements and the good communication by staff with them. Residents clearly valued and enjoyed the contact they had with their relatives which was adding considerably to their quality of life. A regular meeting of relatives is held at the home which enables them to feel part of the home as well as being better informed about what is going on at the home. Throughout the inspection staff offered choices to residents about how they spent their time, what food they wanted and if they wished to go out. Residents meet regularly as a group and make suggestions for activities and outings and raise any issues of general concern. ‘The chef is very kind. If you’re not happy with your food, he’ll make you something special like an omelette.’ This was the comment of one resident but reflected the general view of residents and relatives spoken to. The Chef Manager has undergone appropriate training and has achieved BUPA’s ‘Chef Best’ award. He was aware of the individual dietary needs and preferences of residents and responds to these as far as he can. Meals reflecting cultural needs, including Jewish dishes, are available. At the time of the inspection a heatwave alert was in place and suitable arrangements and practices were in place in the home. Feedback from residents indicated there is a long period between supper at 5pm and breakfast at 8pm when in some cases residents were not sure, or were not taking advantage, of the snacks available over this period. It is recommended that the acting manager reviews current catering arrangements between supper and breakfast to ensure they are completely satisfactory for all residents. Arkley Nursing Home, The DS0000010398.V298223.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): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Residents and relatives are able to sort out their concerns and complaints as they arise. Residents are protected by the arrangements The Arkley has in place in relation to adult protection. EVIDENCE: ‘It’s very nice here. Staff are mainly good. Some staff hurry me when going to bed. I spoke to the acting manager who spoke to the 2 staff, so that now things have improved- the carers do listen.’ This was the comment of one resident and indicates that when things go wrong then the home is able to put things right. Another resident said: ‘If I have a problem I talk to a nurse- they help.’ The feedback overall from both residents and relatives was very positive which had been typified in the card to the home from one family: ‘Thank you all for the great care and kindness you gave to my mum. Her time with you was short but we know she was happy and content.’ The complaints record showed that complaints are recorded and followed up appropriately. Staff have had training in both adult protection and whistle-blowing policies and procedures. Interviews with residents and relatives did not identify any concerns in this area. There had been no adult protection referrals made since the previous inspection. Arkley Nursing Home, The DS0000010398.V298223.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): 19,22,26 Quality in this outcome area is excellent. This judgement has been made from evidence gathered during the visit to this service. Residents benefit from a spacious and attractive home which is comfortable, clean and well maintained. Residents are helped to maintain their independence by the provision of specialist equipment throughout the home. EVIDENCE: ‘I’ve got a very nice room with a balcony, and a shower instead of a bath which is what I want.’ This was the comment of one resident. The home has an onsite maintenance person who ensures minor repairs are dealt with promptly. Residents spoken to were very happy with the living environment at The Arkley and this clearly adds to their quality of life, with a feeling of space and light created throughout by the central atrium area. The home has achieved a high standard in this area. ‘My bedroom’s very nice- I’ve got everything I want.’ This was the feedback from a resident who had significant communication difficulties. The individual Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 16 took great pride in pointing out personal items in their bedroom, which had a number of adaptations so that they could be as independent as possible despite their physical disabilities. Throughout the home residents were benefiting from having suitable aids and adaptations so that they could be as mobile as possible and could get out of their bedroom regularly. Throughout the inspection cleaning was going on with attention paid to infection control. Residents were positive about how clean the home is and that it does not have the offensive odours they had come across at other homes. Arkley Nursing Home, The DS0000010398.V298223.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Residents benefit from the support of a committed and experienced team of well trained staff. Residents are protected by the recruitment procedures in place at The Arkley, however in one specific case this procedure has not been sufficiently rigorous. Weekend staffing levels and arrangements need improvement. EVIDENCE: ‘They’re very considerate. The night staff are very good. There’s nothing I dislike here. I get the help I need.’ This comment reflected the general view of residents. The home employs 25 permanent staff, with 14 bank staff to provide back up. No agency staff are used which means residents get continuity of care from a regular team of carers. However feedback from residents and staff indicated that at times at weekends staffing levels were insufficient, especially if 1 or 2 staff had rung in sick on the day and extra staff had not been obtained. BUPA, with the acting manager, must review staffing levels at weekends to identify if additional staff are needed. The training coordinator was interviewed and went over the comprehensive training available to staff. New training needs, such as working with people with terminal illnesses and dying residents, have been identified and are being followed up, using best practice models. Staff interviews showed that staff have had a range of relevant training to enable them to do the job well, with a significant number doing NVQ Level 2 or 3 in caring for people. Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 18 Staff files were sampled and showed that BUPA has thorough and detailed recruitment procedures in place in relation to new staff. However in one specific case a proper 2nd written reference had not been obtained on an employee before appointing them. In order to safeguard residents it is essential that BUPA obtains 2 satisfactory references before a new member of staff starts working at the home. In the specific case highlighted the member of staff must work under supervision until a satisfactory 2nd reference has been obtained. As well as the training identified above staff are doing training in more specialised areas such as peg feeds, diabetes, Parkinson’s disease. Staff are also encouraged to take part in BUPA’s own ‘Personal Best’ scheme which trains staff to provide as good a service as possible to residents, families and all those involved with the home. BUPA is to be commended for its commitment to ensuring staff are trained well so that they can better care for residents and for the high standard it has achieved in this area. Arkley Nursing Home, The DS0000010398.V298223.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): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The Arkley is managed and run very well with an open and inclusive approach in the home which listens to and values the comments and views of residents and relatives. Residents are protected by the secure arrangements in place in relation to their monies. The home is good at supporting staff but needs to improve arrangement for staff to have 1-to-1 meetings to improve their practice. Health and safety standards in general are good, but residents need the protection of fire safety tests that always take place at the required frequency level. EVIDENCE: ‘It’s an excellent home. I’ve been here nearly ten years. Lucy was an excellent manager.’ This reflected the view of residents. A member of staff commented: ‘We’re doing our best- we’re working hard. Staffing levels are good. The home runs well as a team. The home’s ticked over and standards have been kept up since Lucy left.’ Throughout the inspection it was evident Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 20 that there are a range of effective management systems and procedures in place in the home. BUPA was appointing a new manager who would be put forward for registration by CSCI. There is an open and inclusive atmosphere in the home so that residents able to participate in how the home is run. When the inspector gave feedback to the acting manager on his findings from the inspection meeting also included 2 residents and a member of staff. In this way home welcomes and empowers residents and staff to have a say in how home is run. are his the the the Residents’ meetings are held regularly and give residents the opportunity to make suggestions and raise concerns which are listened to and responded to by staff at the home. BUPA has various formal procedures for reviewing and improving the service on offer at The Arkley. It is recommended that as part of its quality assurance process it considers the idea of a group which has a cross-section of residents, relatives, management and staff which comments on how the home is run and ways of making it even better. Residents explained the arrangements in place regarding monies in the home. Residents are able to pay on a private basis for additional services such as physiotherapy and chiropody. An account is kept and receipts given for such expenditure. ‘Some staff get regular supervision, but I haven’t.’ This was the comment of one member of staff. Staff files showed that not all staff have 1-to-1 meetings to develop and improve their practice. The acting manager must ensure that all staff have a formal supervision meeting at least 6 times each year. Health and safety and fire safety records were looked at. These records were up-to-date and accurate and confirmed that essential checks are being made and acted on. However there was a gap in the recording of the weekly fire safety checks. The acting manager must ensure that these checks are carried out weekly at all times. Arkley Nursing Home, The DS0000010398.V298223.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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 3 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 4 X X 3 X X x 3 STAFFING Standard No Score 27 2 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 2 X 2 Arkley Nursing Home, The DS0000010398.V298223.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. 2 Standard OP7 OP27 Regulation 12 (3) 18 (1) (a) Timescale for action The registered persons must 30/09/06 ensure that care plans have a person-centred focus. The registered persons must 31/08/06 ensure that weekend staffing levels are reviewed to identify improvements needed. The registered persons must 12/07/06 ensure that 2 satisfactory written references are obtained every time before a new member of staff starts working at the home. The registered persons must 12/07/06 ensure that in the specific case highlighted the member of staff must work under supervision until a satisfactory 2nd written reference is obtained. The registered persons must 31/08/06 ensure that all staff have 1-to-1 meetings to improve their practice at least 6 times/annum. The registered persons must 12/07/06 ensure that the weekly checks of the fire safety equipment are carried out weekly at all times. Requirement 3 OP29 19 (1) (b) Sch 2 4 OP29 19 (1) (b) Sch 2 5 OP36 18 (2) 6 OP38 23 (4) Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 23 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 OP8 OP12 Good Practice Recommendations The registered persons should ensure that the best practice training in palliative care being used by BUPA is available to all care staff. The registered persons should ensure that the home reviews its current activity programme to identify improvements needed and ways of increasing the level of activities on offer at weekends. The registered persons should ensure that current catering arrangements between supper and breakfast are reviewed to ensure they are completely satisfactory for all residents. 3 OP15 Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Arkley Nursing Home, The DS0000010398.V298223.R01.S.doc Version 5.2 Page 25 - 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. 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