Inspection on 13/12/06 for Arle House

This inspection was carried out on 13th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arle House 24/08/09

Arle House 05/09/07

Arle House 21/07/06

Arle House 04/10/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Arle House Village Road Arle Cheltenham Glos GL51 0BG Lead Inspector Mrs Eleanor Fox Key Unannounced Inspection 13th December 2006 09:30 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 Arle House DS0000064574.V318616.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. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arle House Address Village Road Arle Cheltenham Glos GL51 0BG 01242 514586 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) The Orders of St John Care Trust To be appointed Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate two (2) named Service Users under the age of 65 years. The home will revert to the original service user category when these service users reach the age of 65 or no longer reside at the home. 21st July 2006 Date of last inspection Brief Description of the Service: Arle House is a purpose built Care Home providing personal and nursing care; it is situated in a large housing estate close to local shops and other amenities. The Orders of St. John Care Trust is responsible for the management of the Home. The accommodation, consisting of forty-eight single rooms and one double room, is on two floors and has been equipped with a shaft lift to access the first floor. Although none of the rooms have en suite facilities, there are several assisted bathrooms and separate toilet facilities throughout the Home. Some of the bedrooms at the front of the property have the benefit of a small balcony. There are three lounges within the Home plus a large dining room and a number of smaller sitting areas where service users and their visitors may meet. The enclosed rear gardens are easily accessible and have attractive shaded areas where residents are able to sit when the weather permits. The provider supplies information about the home, including the most recent CSCI report in a file at the entrance of Arle House. Current fees range from £352.70 to £693. Hairdressing, chiropody and any personal items are charged extra. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the home and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection of Arle House over two days in December 2006. During the visit, she chose the care of five of the residents for particular scrutiny. She looked at the pre-admission assessment processes, their care records and all relevant documentation. The inspector also spoke to each of these people, visited their bedrooms and, where possible, observed their interaction with members of staff. The inspector read selected personnel and recruitment records; walked around the property, particularly noting a number of environmental improvements since the last visit; observed the service of breakfast and a mid day meal and watched the residents’ participation in a social event, which took place on the first day of the inspection. She also spoke with some of the staff who were on duty on these days. The medication administration systems were examined, as were the systems in place to handle any concerns or complaints. Finally, the inspector had the opportunity to talk to the Manager and the administrator, particularly in relation to general management issues. Both were open and most cooperative in providing information as requested. Prior to the inspection, CSCI surveys were distributed to residents, relatives and members of staff working at the home. Nine were returned from residents although in the majority of cases, a relative or member of staff completed the form for them; ten surveys were received from staff and eighteen comment cards were sent in from relatives and advocates. Many of their comments and opinions are reflected in the content of this report. What the service does well: Any person interested in moving into Arle House is fully assessed to ensure that the home is able to meet all his or her needs. Staff are provided with the opportunity to attend a wide variety of training to assist them to carry out their duties appropriately. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 6 There is also a good focus on quality improvement with evidence that any identified issues are addressed appropriately. What has improved since the last inspection? What they could do better: The home has still to produce a detailed service user guide to provide necessary information for prospective and current residents. However, this is now in draft form and temporary measures are being introduced until the document is published. Although generally addressed well, a number of medication issues have been identified on this occasion. These must now be rectified to ensure that residents are not put at any risk. Further improvements are also required in the standards of record keeping, particularly in relation to training and residents’ personal details. However, these are now being addressed at Arle House. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 7 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. Arle House DS0000064574.V318616.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 Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 1, 3, 5 and 6 A thorough assessment process plus the provision of literature about the home enables prospective residents to make an informed decision regarding their admission and gives them assurance that their needs will be met. EVIDENCE: Since the last inspection the Statement of Purpose has been fully reviewed and updated to reflect all the changes at the home. This information is provided in a folder, which is located in the front hall of Arle House. The new service user guide, to be called the resident’s handbook, is still in draft form and will be available shortly. In the meantime, the acting manager showed the inspector the additional documentation, which is being collated and will be provided to current and prospective residents until the new handbook is available. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 10 The acting manager normally takes responsibility for assessing any prospective residents for the home; a comprehensive record is maintained of the process and retained in the person’s care records. Most people are admitted from hospital and there were records to show that any other relevant personnel who have been involved in the person’s care also provide additional information. However, in one case, it transpired that this was inaccurate. Although the majority of prospective residents are usually unable to visit the home prior to their admission, relatives or advocates are welcome to look around the property and to see the facilities provided. One lady now living in the home had previously lived close to Arle House and knew the home well. She had been most reassured to be able to remain close to her surviving friends and family. Intermediate care is not provided at this home. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 7, 8, 9 and 10 Although the care planning systems in place provide the staff with the information they require to care for all the residents’ needs, this is not always undertaken in a consistent fashion. In addition, the medication systems also require some minor adjustment to ensure that residents are not put at any risk of potential errors. However, residents are treated with kindness and respect. EVIDENCE: Written care plans are developed for each resident based on a full assessment of care needs. It was evident that there has been a good focus on these documents in recent months as there was a considerable improvement in the examples seen on this occasion. On the whole, clear and appropriate guidance had been recorded for the members of staff providing care. Where there had been any changes in condition, these had been identified at the reviews and documented. Detailed risk assessments had also been developed where appropriate. A few isolated Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 12 issues were identified and discussed with the nursing staff on duty. The missing information was provided during the inspection. In addition to the ongoing work, residents and/or an advocate are involved in a full six monthly review of all the care provided. Signed records are maintained of these meetings. Discussion with the residents and observation of the care documentation shows that the residents are receiving care from external medical personnel when required. Regular monitoring of residents’ weights is conducted, particularly if there is any deterioration in the resident’s physical condition. Nutritional supplements are provided when required. The risk of possible vulnerability to developing pressure sores is also assessed and pressure relief equipment provided as appropriate. There were comments from five relatives, which suggested that some residents might not always be receiving consistent hygiene care. This was not apparent during the inspection but staff must be mindful of this issue. Since the last inspection, a replacement controlled drug storage cabinet has been installed in the nurses’ room; this area is also now kept secure with the provision of a keypad locking system on the outer door. Medications are ordered and stored correctly. A photograph of each resident is provided to aid identification although this had not yet been arranged for a recently admitted person. A pharmaceutical reference book is available for staff use when administering medications. The management of controlled drugs was checked; these processes are now conducted correctly. Any allergies are also recorded accurately and in a consistent fashion. It was observed that handwritten medications relating to two of the selected residents had not been signed by the nurse making the record and countersigned by another witness, as is required. There were also examples of medications prescribed as, ‘as required’ with no associated care plan to guide staff in the correct administration of these drugs. Members of staff were observed speaking to residents in a friendly manner. Interaction between the staffing team and the residents was particularly positive during the service of the lunchtime meal; there appeared to be a good rapport between all those present. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12, 13, 14 and 15 There are now improved opportunities for varied and stimulating activities to occupy the residents and thus improve their quality of life. Residents are also able to maintain any links they wish with family, friends and the local community, thus adding interest to their lives through social contact. As far as possible, they are enabled to exercise choice in their daily lives. Residents at this home are offered a reasonable standard and choice of food. EVIDENCE: There is now a commendable programme of activities arranged in Arle House. These are well advertised and in a format to ensure that all the residents are aware of what is planned to take place. The home has also been successful in recruiting an activities coordinator. In addition, delegated carers are given the responsibility of ensuring that each planned event takes place. As a result, residents are given the opportunity to enjoy entertainment and other activities to suit their individual tastes and Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 14 needs. This has made a significant difference to their life styles and has been much appreciated. One lady described a cake making session that she had taken part in and commented, “It was so nice to do some proper cooking again”. Another showed off some decorations she had made. However, residents are given the choice of whether to be involved. One person was happy to sit quietly in her bedroom with her pet budgerigar for company; her preference was respected. During the inspector’s visit, the majority of the residents really enjoyed a carol concert performed by a local primary school. Some were also taken out for a trip to see the Christmas lights in Cheltenham and Gloucester. Several residents have made their own private arrangements for telephones although a facility is available at Arle House. Friends and relatives are welcome to visit at any time so long as the resident is content to see them. Some were seen in the home during the visit. One gentleman commented favourably on the festive decorations and also said, “They’re OK here – always busy but a nice lot”. However there was a mixed response in the surveys returned by family and friends. Although the majority (65 ) were satisfied with the care provided, others had reservations. Most felt that this was due to lack of available staff and one person felt that more training was required. 17 would like communications with relatives and advocates improved. The acting manager is trying to address these issues. It was noted that a newsletter is now published to ensure that everyone is aware of any special events in the home or items of particular interest. Residents are given the opportunity to make choices about what they will eat and how they will spend their days. Information is readily available on how to source advocacy, if it is required. Following consultation with the residents and staff, new menus have recently been introduced at the home. These will be subject to further review when the first five-week cycle has been completed. On observation the residents appeared to be being offered a good choice and variety of food. The service of breakfast and the mid day meal was seen on this visit. Twelve people had chosen some form of cooked breakfast; others preferred cereal or an alternative option. One person said, “Breakfast is my favourite meal”. Most of the residents ate their main meal in the large dining room; on this occasion the room was well ventilated. Those people with poor appetites were offered dietary supplements and those requiring assistance were provided with appropriate equipment or were fed by one of the carers. These processes were undertaken in a sensitive fashion; residents were given adequate time to eat their meal in peace. The kitchen was reasonably clean and well organised. The cook explained the special measures, which had been introduced to satisfy the ethnic dietary needs of one of the residents. Special diets are prepared and served when required. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16 and 18 A satisfactory complaints system enables residents and their families to feel assured that their views would be listened to and acted upon. Residents are offered a good level of protection against abuse. EVIDENCE: A comprehensive Complaints Procedure has been prepared for the home. A copy of the document is provided to each prospective resident and/or advocate with other information about Arle House. The details are also displayed in the front hall of the home. There has been one formal complaint about Arle House since the last inspection although the issues identified related to earlier in the year. These matters were addressed promptly, fully investigated and a response provided for the complainant. The home also has detailed policies to address all forms of abuse. The policies are readily available for staff to read and, since the last inspection, members of staff have been reminded of the details of the whistle blowing procedures. Abuse issues are covered in the Induction Programme, which each newly appointed member of staff attends. There has also been further formal training on the subject during 2006; the majority of the staff were given the opportunity to attend these workshops. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 16 Brochures addressing these issues are available in the home. POVA (Protection of Vulnerable Adults) legislation is correctly followed at Arle House. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19, 20, 21, 24 and 26 Residents are provided with a good standard of clean accommodation, which meets their respective needs. EVIDENCE: On this visit it was evident that there had been a focus on improving the general environment of the home. Throughout the two days, all areas seen appeared reasonably clean and fresh. The home was noticeably tidier and more ‘homely’ in appearance. It was also looking festive in preparation for the forthcoming Christmas celebrations. There were attractive and tasteful decorations throughout the property. Residents had been involved in preparing the decorations that were displayed. A programme of redecoration and general maintenance is undertaken; records of recent progress were shown to the inspector. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 18 All the communal rooms are furnished with sturdy comfortable chairs; a new carpet has just been provided for the lounge on the ground floor. A bathroom on the ground floor was completely refurbished in the autumn but unfortunately this facility cannot yet be utilised due to installation difficulties. There remain an adequate number of bathing facilities provided throughout the home. A visit was made to the bedroom of each person who had been selected for case tracking. All the rooms had been personalised with photographs and treasured possessions; some had already been decorated for Christmas. One person showed the inspector her china collection, which she had been able to bring into the home when she was admitted; another had a large number of soft toys displayed on her bed and chairs. As reported at previous inspections, there has still been no improvement to the cramped and difficult laundry conditions. However, it was observed that some of the residents’ personal clothes are now ironed before being returned to the owner. Three relatives have commented in their questionnaires that residents’ clothing is frequently missing and/or people are not always wearing their own clothes. It was observed that most clothing is discreetly labelled to try to prevent these mistakes occurring. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 27, 28, 29 and 30 Despite recent achievements, further improvements in staff allocation and training would ensure that residents are fully protected. EVIDENCE: On this occasion there were fifty residents living in the home. Observation of the staffing rotas showed that there were normally two nurses and nine/ten carers on duty each morning to look after the residents. Shift patterns are currently being rearranged in an attempt to improve care during the day. Seven carers plus two nurses, where possible (currently four days a week) cover the evenings with a nurse and three carers working overnight. Team building exercises have also been introduced in the home. It is anticipated that all these additional measures should help to meet the shortfalls identified in questionnaires returned from relatives and staff. Many people commented that the home was often short of staff, which adversely affected the care given to the residents. Of the twenty-nine carers employed at the home, eleven have achieved a National Vocational Qualification, Level 2 in Care. Six carers are undertaking the training at the current time and a further two people have now commenced NVQ, Level 3 in Care. One person is already qualified to this level. The home is Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 20 making good progress towards ensuring that at least 50 of the care staff are trained to National Vocational Qualification, Level 2 in Care or equivalent. The personnel documentation relating to staff employed since the last inspection was seen on this occasion. Correct recruitment processes had been followed with the provision of a completed application form; full details of any previous employment documented; comprehensive records had been made of the interview processes, and correct POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening completed. Two written references had also been provided for the applicant. Arrangements are made to ensure that each member of staff attends mandatory and appropriate additional training to undertake their duties. The records showed that good progress is being made to ensure that this programme is completed. The acting manager is supporting the person delegated to co-ordinate training to ensure accurate records are maintained. However, it was observed that induction processes are not fully recorded, as is required. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31, 33, 35 and 38 Good management systems are being introduced to ensure that the financial interests, and the health, safety and welfare of people using the service are safeguarded. There is also evident commitment in the Home to improve the services for the benefit of the residents living there. EVIDENCE: The Commission for Social Care Inspection is currently processing the acting manager’s application to be Registered Manager of Arle House. She is an experienced trained nurse who has already undertaken this role successfully in Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 22 an alternative care home. The acting manager has completed the Registered Manager’s Award and has also attended regular update courses on all aspects of care. The home will now have the benefit of strong leadership and committed stable management. The home now has a good focus on quality improvement. Any complaints, accidents or adverse incidents, and satisfaction with the provision of food are all monitored closely. The Orders of St John Care Trust conducted a relatives’ satisfaction survey earlier in the year. The acting manager has developed an action plan to address the outcomes of this survey. In the latter part of this year, she has arranged a number of meetings to gain feedback from staff and to give guidance on the implementation of the necessary improvement measures. Some of these have already been addressed. The Administrator continues to take responsibility for the personal monies for the majority of the residents in the home; the records relating to the residents selected for case tracking were checked on this occasion. It was observed that meticulous records are maintained and that individual secure storage is provided. At present the home is unaware of each residents’ status in relation to ‘Power of Attorney’. This important information is now being requested and will be maintained on file. Records were provided to show that statutory maintenance/inspection of equipment and services is arranged in a timely fashion. Where faults are identified, these are rectified as necessary. Water temperatures are checked at outlets on a monthly basis; in recent months these have remained within safe levels. Fire prevention measures are addressed appropriately and staff receive training on health and safety issues. It was evident that good infection control processes were employed following the outbreak of an infection earlier in the year. The residents concerned have now recovered. An Environmental Health inspection was undertaken in June 2006; issues highlighted for improvement have now been corrected. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 23 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 2 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x x 3 x 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 2 x x 3 Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 6 (a & b) Requirement The Service User’s Guide must be fully reviewed and updated. Once completed, copies must be made available to current and prospective residents. A copy must also be provided to the Commission for Social Care Inspection. (This requirement has been repeated from the last inspection.) Members of staff must ensure that residents receive consistent care, particularly in relation to hygiene needs. All medications handwritten by a member of the nursing staff must be signed by the person making the record and countersigned by another person (This requirement has been repeated from the last inspection.) Staff must have definitive guidance in the correct administration of ‘as prescribed’ medications. A record must be maintained of the induction processes. Timescale for action 31/01/07 2. OP8 12(1a) 31/12/06 3 OP9 13(2) 31/12/06 4 OP9 13(2) 31/12/06 5 OP30 Schedule 4.6g 31/01/07 Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 25 6 OP35 Schedule 3.3(b) A record must be maintained of each resident’s status in relation to ‘Power of Attorney’ processes. 31/01/07 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 3 4 Refer to Standard OP9 OP26 OP27 OP28 Good Practice Recommendations It is recommended that an associated care plan should be provided for staff to give guidance in the correct administration of ‘as prescribed’ medications. It is recommended that consideration should be given to improving the cramped laundry facilities. It is recommended that the staffing adaptations already commenced are developed further to ensure that adequate staff are always on duty to meet residents’ needs. At least 50 care staff should be trained to National Vocational Qualification, Level 2 in Care or equivalent. Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Arle House DS0000064574.V318616.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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