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Inspection on 10/02/09 for Arlington House

Also see our care home review for Arlington House for more information

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arlington House 88 Ackers Road Stockton Heath Warrington Cheshire WA4 2EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joan Adam     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Arlington House 88 Ackers Road Stockton Heath Warrington Cheshire WA4 2EA 01925267576 F/P01925267576 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Neil Allcock,Mrs Sally Allcock Name of registered manager (if applicable) Rose Jewel Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 21 Date of last inspection Brief description of the care home Arlington House is a two storey detached property set in its own grounds in a residential area close to Stockton Heath village. The home provides accommodation and personal care for up to twenty one elderly people. It is staffed by a manager, who is registered with the Commission for Social Care Inspection, and a team of care assistants, with ancillary staff employed for housekeeping and catering duties. Care Homes for Older People Page 4 of 23 care home 21 Over 65 0 21 21 0 Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We made an unannounced visit to Arlington House on 10th February 2009. We were accompanied by an expert by experience ( a person who, because of their shared experienceof using services, and/or ways of communicating,visits a service with an inspector to help them get a picture of what it is like to live in or use the service).The expert by experience spent time talking with residents/relatives and had lunch with the people who live at the home. During the visit we spoke to the proprietors, the manager, some staff members and some residents. Before the visit the manager was asked to complete a questionare called an Annual Quality Assurrance Assessment (AQAA) to provide us with up to date infromation about the home. Some of the comments we received and the information is detailed in this report. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they live at Arlington House so they know their needs can be met. Evidence: Care files for two residents who have recently come to live at the home were looked at. Assessments of their needs had been completed by the manager before they came to live at Arlington House so that they knew their needs could be met there. This information was used to write a care plan for the person to let staff know what their needs were and how they could meet them. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Arlington House have their health, personal and social needs met in a dignified way. Evidence: We looked at the AQAA. This showed us that people who live in the home should expect to receive care in a way that they choose. We saw that each person has a plan of care, which gives staff instructions on how to provide care in a way which people preferred. A moving and handling assessment had been completed on each resident so that staff would know how to move them safely. Choices were recorded such as when they liked to get up, where they spent their day and how their spiritual needs were met. Visits from other health care professionals such as G.Ps and district nurses were recorded so staff would know when these visits had taken place and why. The reviews were detailed as were the daily records so staff would know what changes, if any, had been made. The atmosphere in the home was warm and welcoming and all staff were seen to be friendly and appeared to have good relationships with the people in their Care Homes for Older People Page 11 of 23 Evidence: care. When spoken with staff were aware of peoples needs and their likes and dislikes. The expert by experience spoke with people who live in the home and they said that everything is OK Ive been here since Christmas and its wonderful I would not want to be anywhere else Medicines are managed well. Policies and procedures are in place for the safe management of medications and staff training has taken place so that staff are aware of their responsibilities regarding the safety of medicines in the home. The home uses a nomad system for medication so that staff can see which medicines have been given out each day. All medication administration sheets had been completed. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Arlington House are able to take part in some activities and mealtimes were a positive experience. Evidence: We looked at the AQAA which told us that the provision of activities on offer is limited at present, however, an activities co-ordinator role has been introduced and a more varied programme is to be introduced. We found some activities on offer such as bingo, sing-a -longs, hand massages and some quizzes. These had been recorded in a dairy and the names of people who wished to join in had been recorded. Outside entertainers are booked monthly to come in to the home. Visitors were seen to come and go throughout the day and appeared to have good relationships with the staff at the home. Relatives spoken with said the staff are very helpful There is a varied menu on offer at Arlington House and the lunch looked good and appetising. The expert by experience had lunch with people who live in the home. Lunch was egg, sausage,chips and peas followed by jam sponge and custard. He said that The dining room could only seat 12 people, the slow eaters had a table in the conservatory. The residents appeared to enjoy their meal, with several empty plates Care Homes for Older People Page 13 of 23 Evidence: being returned to the kitchen. The tables were laid with clean cloths, cutlery and condiments, the portions were adequate but the food could have been warmer and the plates were cold. The home has a four week rolling menu which is reviewed periodically and these were displayed in the hallway with the following meals. Breakfast, toast and cereal,tea and coffee. Lunch was a cooked meal with dessert, tea is a buffet style meal. Drinks and snacks are available on request throughout the day and evening. The menus were discussed with the owners and manager and it was suggested that a list of alternative meals could be displayed fro those who did not want what was on the main menu. Staff did know the likes and dislikes of the people living at the home. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Arlington House are confident that their complaints are listened to and staff have received training so that they know what to do to protect people. Evidence: We looked at the AQAA which told us that no complaints had been made to the home in the last year. It also told us that staff have received training in how to protect people rights and the complaints procedure. People spoken with said that they knew how to make a complaint. I would talk to the carers or the manager People could be confident that their complaints would be listened to. The home had policies and procedures on the prevention of abuse and whistle blowing. The safeguarding procedure is how the local council and other agencies respond to allegations of abuse against vulnerable people. Staff have received training about safeguarding people from abuse so that they know how to deal with any incident or suspicion of abuse. Further training is booked for 4th March 2009. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Arlington House live in a well maintained clean and comfortable environment. Evidence: During the visit to the home we walked around the home and all areas were cleaned to a high standard with no odours present. The decor of the home was of a good standard and each bedroom was well personalised. The expert by experience was shown around the home by the owner and he commented that The rooms I saw were well furnished with evidence of personalisation by the residents. I was informed that the rooms are cleaned every two days and that every effort is made to ensure that residents laundry is labeled so that it does not get mixed up. The proprietor confirmed that a deep cleaning of bedrooms is completed every other day but if a room needs to be cleaned daily this would be aranged. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support from skilled staff that they like. Evidence: We looked at the homes AQAA which showed us that a variety of staff are employed to provide care and support to the people who live in the home and that the staff was recruited correctly. We found this to be true. We found that staff are supplied in sufficient numbers to meet peoples needs and people who live in the home said they thought that there was enough staff on duty on each shift. People said that if they needed help this was supplied quickly. the girls answer my bell when I ring all the girls are very helpful At present the staff are working in the laundry, however, since the increase in numbers of people who live in the home they said they are finding it more difficult to fit this in. We saw that most of the staff working in the home have achieved a national vocational qualification in care. This shows that staff have had formal training to carry out their roles. We saw staff training is on-going and that all staff have received mandatory training in key subjects. This means that staff have been given the skills to promote peoples health and welfare. The home has acquired a training package on all mandatory training which is to be delivered to all staff by the deputy manager. Care Homes for Older People Page 17 of 23 Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the views of people who live, work and visit the home are listened to. Evidence: The manager is experienced and has worked managed the home for quite some time. She has achieved an NVQ level 4 in management. Resident/relative meetings are also held on a regular basis and the manager has an open door policy. It was observed that the manager had a good relationship with relatives present on the day of the visit. Questionnaires are sent to relatives to check their satisfaction with the home and a report of the findings were present in the service user guide. Comments such as the home is a good place for my relative staff are very good , were recorded. Following discussion with the owner and manager the quality assurrance and auditing of the home is an area that is to be developed over the next twelve months. Regular staff meetings take place for all grades of staff, however there were no minutes taken from the last meetings held. Staff spoken with Care Homes for Older People Page 19 of 23 Evidence: confirmed that meetings had taken place. Resident/relative meetings are also held on a regular basis and the manager has an open door policy. It was observed that the manager had a good relationship with relatives present on the day of the visit. Questionnaires are sent to relatives to check their satisfaction with the home and a report of the findings were present in the service user guide. Comments such as the home is a good place for my relative staff are very good , were recorded. Regular fire drills and staff training sessions are held to make sure staff know what to do in case of fire and there was a record of the names of staff attending. The AQAA gave us details of when equipment in the home had been checked and serviced to make sure that it continues to be safe and effective. There is a robust recruitment system in place so that all staff employed have the correct safety checks so that the manager knows they are safe to work with elderly people. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 12 38 Activities on offer at the home should be improved so that people who live at the home have enough to do. It is recommended that a more detailed auditing system is developed to identify strengths and areas of weakness. Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!