Inspection on 09/05/05 for Arliemoor

This inspection was carried out on 9th May 2005.

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

Arliemoor 06/11/06

Arliemoor 15/12/05

Arliemoor 09/12/04

Arliemoor 19/04/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Arliemoor Halsdon Cross Holsworthy Devon EX22 6NX Lead Inspector Patricia Hellier Announced 9 May 2005 th 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 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 Stationary 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. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arliemoor Address Halsdon Cross, Holsworthy, Devon, EX22 6NX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01409 254232 01409 259321 Mrs Jacqueline Rowe Care Home 8 Category(ies) of MD Mental Disability [8] registration, with number of places Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/12/2004 Brief Description of the Service: Arliemoor is a large farmhouse providing residential care for younger men and women suffering from poor mental health. They do not provide facilities for blind people or those with a history of arson. It provides accommodation for 8 service users and has a new recreation room and office facility. It is set in ten acres of countryside and has no close neighbours. The owners have a number of dogs and horses and are happy for service users to become involved in their care. The grounds currently include a spacious garden, poly tunnel with tropical plants, a basic gym and a workshop area. Transport is provided by the home so that service users have access to education, social and leisure events, individual interests, families and friends and links with health services. There is also a bus service in the vicinity, although some service users prefer to use their bikes or walk to Holsworthy, which is two miles away. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over three and a half hours on 9 May 2005. The Registered Manager, Jackie Rowe, was present during the inspection. All residents and members of staff on duty also took part in the inspection. The pharmacist inspector was also present to review all the medication policies and practices. The inspector looked around parts of the building and a number of records were inspected. Prior to the inspection the pre inspection information was reviewed together with an updated Statement of Purpose. Two comment cards were received 1 from a relative and 1 from a resident. Both said that the home is good and caters well for the residents’ needs. What the service does well: What has improved since the last inspection? The information available for prospective residents has been updated. The upstairs bathroom and toilet have been redecorated and a new shower installed in the second bathroom. The lounge and dining room have been redecorated and refurbished following a house meeting to discuss the colour schemes. The potholes in the drive have been filled in and the grounds made safe and wheelchair accessible. Care plans have been improved and now clearly state the identified needs actions and evaluation for each resident. Good multiprofessional records were also available. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 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. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 The Residents’ guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for a recently admitted resident. The resident when spoken to said ‘I am well looked after they know what I need’. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Care planning and risk assessments provide staff with the information they require to meet residents’ needs safely. The home consults families and relevant professionals appropriately, over decisions and dilemmas in residents’ lives. EVIDENCE: Residents’ choices are encouraged and the staff work hard to ensure they are appropriate and the resident can fulfil them. For example 2 residents wanted to go shopping in Bude and with the help of staff arranged the transport. Care plans provide accessible information and guidance about needs and set individual goals that encourage independent living skills. Risks are carefully identified and minimised. Restrictions on choice or freedom are recorded and risk assessed in individual plans. Relatives and care managers are involved in regular care plan reviews and are kept up to date with any changes of need or care for the resident. The individual care plans include behavioural management guidelines for residents who are likely to become aggressive or harm themselves. These have been compiled in consultation with other professionals, such as psychologists and nurse specialists. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15,16,17 Links with the community are good and support service users’ social and educational opportunities. Families, if near enough are encouraged to visit if the resident chooses. The meals in the home are good and offer both choice and variety. Specialist dietary needs are catered for. EVIDENCE: The home provides a wide and varied range of activities which residents chose to participate in or not. These range from swimming, keep fit, archery, pub outings, ten-pin bowling, arts and crafts, personal shopping and horse riding. Links with family and outside friends are encouraged and monitored to enable the residents to feel secure in their relationships and activities. The residents’ rights and responsibilities are respected for example one resident spoke of discussing the positives and negatives for a particular activity with a member of staff. The resident said they were then able to make their choice fully aware of the potential implications. The staff were aware and records show that the situation was handled with respect and sensitivity. The food is good and well presented. Residents are able to assist in the kitchen and help themselves to snacks in the presence of staff. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The health needs of service users are well met. Good multi-disciplinary working takes place on a regular basis. Medicines, administration and medical needs are well managed. EVIDENCE: Care plans confirm that healthcare needs are assessed regularly and the home has good links with local GP practices and district nurses. The home uses specialist professionals to assess residents with complex needs who challenge the service, and to provide guidance and training to the staff in supporting residents through difficult times. The CSCI pharmacy inspector reviewed the medication systems of storage and administration. These were observed to have improved since the last inspection with a good audit trail of medicines received into and leaving the home. The storage facilities are appropriate. Training record show staff have received training and competency assessment to ensure safe practice. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Residents are confident that they are listened to and their requests acted upon. Staffs knowledge and understanding of Adult Protection issues provides a safe environment to protect residents’ from abuse. EVIDENCE: There have been no complaints since the last inspection. Minutes of a “Home Meeting” showed discussion of grievances between residents and staff. Two residents said this meeting had been very helpful and these meetings happened regularly. Staff spoken with demonstrated a good awareness and understanding of the complaints procedure and whistle blowing policy and all staff had received training in Adult Protection. The home has abuse awareness policies that are in line with the Department of Health guidance on “No Secrets”. The home keeps good financial records that are clear, accurate and up to date. Policy and practice on the storage and handling of residents monies is good. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,30 Residents are provided with safe, comfortable and well decorated surroundings. There are sufficient bathroom facilities ensuring residents privacy needs are met. EVIDENCE: Since the last inspection the potholes in the driveway have been filled thus providing safe access to the home. The lounge and dining room have been redecorated and refurbished, the choice of materials having been discussed at a “home meeting”. Three residents said it was nice to be part of making the home. The 2 shared bathrooms have been redecorated and a new shower unit fitted in one of them. The residents who use these rooms said they did not feel that privacy was lacking. Other residents have en–suite facilities. The home is clean and hygienic, with good provision of a gate to the kitchen to prevent the dogs entering that area. Smoking is allowed in one area and this was observed to be clean and measures taken to reduce the smoke odour permeating the home. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35 An effective, competent and experienced staff team supports residents. The procedures for the recruitment of staff are inconsistent and do not always provide the safeguards for the protection of people living in the home. EVIDENCE: Residents spoken to said that the staff were kind and caring and always there to help. During the inspection staff were observed spending time with residents and assisting them in decision making. Staff turnover is low but some new staff have been recruited. The files of three staff members most recently employed indicated that the home had not undertaken all the necessary recruitment checks to ensure protection of residents. One file did not contain a Criminal Record Bureau (CRB) check and two files did not have proof of identity. One staff member spoken with said that she had completed an application form and been asked to bring in proof of identity which she did. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 The home is managed effectively, efficiently and safely. The home regularly reviews its performance through a self assessment process at staff meetings and seeking the views of residents. EVIDENCE: The provider gives clear leadership, guidance and direction to the staff to ensure residents receive consistent quality care. She has appointed a manager who is undertaking the Registered Managers Award to ensure that best management practice is maintained for the benefit of residents. Quality assurance takes place informally through discussion with residents individually and at “home meetings”. The comments and results are not reviewed to ensure the monitoring of standards. All residents spoken with praised the staff and said they liked living at the home and confirmed that their views are sought. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place. Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 4 x x 4 4 3 Standard No 31 32 33 34 35 36 Score x x x 1 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arliemoor Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 17 NO 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. 1. Standard 1 Regulation 4.1 (c) Requirement The registered person shall compile in relation to the care home a written statement which shall consist of: (c) a statement as to the matters listed in Schedule 1 and supply a copy to the Commission The registered person shall notemploy a person to wrk at the care home unless: (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1-7 of Schedule 2 Timescale for action 31/07/05 2. 34 19.1 (b) 31/07/05 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 Good Practice Recommendations Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Exeter Office, Suites 1 & 7 Renslade House Bonhay Road Exeter, EX4 3AY 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 Arliemoor D54-D06 3641 Arliemoor 214975 090505 Stage 4.doc Version 1.30 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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