Random inspection report
Care homes for older people
Name: Address: Arlington House Arlington House Kents Road Wellswood Torquay Devon TQ1 2NN two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stella Lindsay Date: 2 5 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Arlington House Arlington House Kents Road Wellswood Torquay Devon TQ1 2NN 01803294477 01803212255 manncmann61@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Edward Brian Mann,Mrs Caroline Susan Mann Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 30 dementia old age, not falling within any other category Conditions of registration: 30 0 This care home service can provide care for thirty elderly people over the age of 65 who may also have dementia and/or a physical disability. Date of last inspection Brief description of the care home The last key inspection was carried out on 24th June 2008, when the home was found to be providing a good service.
Care Homes for Older People Page 2 of 10 Brief description of the care home Arlington House Care Home offers accommodation with personal care to older people (65 ), older people with physical disability and older people with dementia. The building itself is a large detached property located in the Wellswood area of Torquay. It is close to local shops and amenities and a short bus ride from the town centre. The home is registered to provide care for up to 30 residents both male and female. Accommodation is provided over 3 levels with the home having a passenger lift and a stair lift as well as a range of other aids and adaptations to support those with mobility problems. With regard to residents bedrooms, the home has 20 single bedrooms, (11 of which have en suite facilities) and 5 double bedrooms (all of which have en suite facilities). A few of the bedrooms require the resident to be mobile as access necessitates using stairs. In terms of communal space, Arlington House has one large lounge, a second lounge area and a dining room as well as a small library area. The weekly fees charged ranges (as of 23/06/08) between 350 pounds and 450 pounds and are dependent on the needs of the person. Inspection reports are available in the home. The service users guide is displayed in the reception area of the home. Care Homes for Older People Page 3 of 10 What we found:
This Random Inspection was carried out on Thursday 25th February 2010, between 7.30am and 5.30pm. We made this visit because concerns about residents care had been brought to the attention of the Torbay Care Trusts Safeguarding Adults team. District Nurses had found that some residents had sustained cuts and bruises on arms and legs. Accident reports had been made, but no action had been taken to prevent it happening again. An Occupational Therapist who visited to look into this matter found that poor moving and handling practices accounted for the wounds. No individual was found to be culpable. There was also concern about lack of knowledge and poor care in relation to tissue viability, skin care and provision of fluids. Torbay Care Trust had immediately provided professional guidance as well as enough staff from their Crisis Response Team, and latterly from other registered agencies, to ensure safe care for all residents. They provided professional staff to assess peoples needs and give guidance to staff, and they provided equipment to meet peoples needs. They provided training for all staff in Moving and Handling, and also provided staff training in Control of infection. They did this to give Arlington House the opportunity to improve the quality of care provided to meet peoples assessed needs. Other concerns had included failure of staff to provide drinks regularly and record peoples fluid intake, when they were unwell and in need of such monitoring, and that people had no way of calling for help as they could not reach the call bell. We met with the home owners and the new manager as well as seven Arlington House staff, and five staff provided by the TCT. We met with or observed eleven of the residents, either in their own room or in the lounge. What the care home does well: What they could do better:
More staff need to be provided in order to meet the assessed needs of residents. They must be kept up to date with the training needed to provide a safe and satisfactory service. They must have time to read, understand, and follow the guidance given by professionals who have assessed the needs of residents at Arlington House during February 2010. Six residents needed two staff for transfers. Following assessment, much equipment had been provided by the Torbay Care Trust, in order that residents could be transferred safely. Agency staff told us the new slings had not yet been labeled with each residents name. Residents continence care needed to be assessed individually, and care
Care Homes for Older People Page 4 of 10 plans produced for care by day and night. Agency staff told us they were still finding the wrong pads in peoples rooms. They said they had observed that pads were used instead of taking people to the toilet, as it saved time. Fluid charts were kept for some residents. These must be monitored by management, to consider whether the person is being given the right fluids and the right amount, and action taken about any concern. Drinks were not offered every hour. We saw jugs of juice beside people who were able to sit to a table. We found TCT staff giving individual attention to people confined to their rooms. Staff levels must be sufficient to allow for individual attention. New leads for the call bells in peoples rooms had been provided, and the handyman was fitting them during our visit. We saw that they were still being placed out of reach of residents. Some would not think to use them, but staff told us that some had pressed them too often. Work must be done to help residents get accustomed to the call system, and recorded visits made instead for people who are unable to use it. No social activities were observed during this inspection, but the hairdresser attended some of the residents. Staff told us that they normally had provided social activities in the lounge before lunch. Residents confirmed that they were missing their activities recently, and that they had enjoyed bingo, skittles and quizzes. An agency staff member told us that one resident had needed feeding today, though she had been told that this person was able to feed herself. The TCT Pharmacist was inspecting the homes medication system on the day of this visit, and found major omissions, where residents had not been given their medication, and also a failure to store controlled drugs suitably or dispose of medication promptly. Staff told us that residents did not have their own flannels or hair brushes. The home owner promptly ordered some. It would be good practice for residents to be supported to buy their own personal requisites. There is a keyworker system, but it had not been effective. Management must have proper arrangements to monitor the quality of the care provided and their staffs performance. Responsibilities of the home owner, Manager, Senior care worker and Juniors in their keyworker role must be clarified and monitored. Daily monitoring is needed to ensure that staff are following professional guidance in moving and handling, skin care, continence care, food and fluid intake, administration of medication, and access to staff attention. We did not inspect the outstanding requirement from the last inspection. 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 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 25 13(4)(c) The manager must ensure 23/07/2008 that a system for checking the water regular for the hot water for full emersion baths is provided close to 43 ?C Care Homes for Older People Page 6 of 10 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, 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 1 8 18 Management must ensure 15/03/2010 that staff follow professional guidance with respect to the intake and recording of food and fluid intake, according to individual care plans and risk assessments. There must be enough staff to carry this out in a timely way. Management must monitor the quality of the care provided. This is so that residents are cared for in a safe and satisfactory way. 2 8 13 Professional advice must be obtained in respect to residents continence needs, and care plans agreed for their care by night and day to enable staff to provide good individual care. 02/04/2010 3 8 18 Management must ensure 15/03/2010 that staff follow professional guidance with respect to moving and handling residents, according to individual care plans and risk
Page 7 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 assessments. There must be enough staff to carry this out in a timely way. Management must monitor the quality of the care provided. This is so that care is provided to residents in a safe way. 4 8 18 Management must ensure 15/03/2010 that staff follow professional guidance with respect to tissue viability and skin care,according to individual care plans and risk assessments. There must be enough staff to carry this out in a timely way. Management must monitor the quality of the care provided. This is so that residents are cared for in a safe and satisfactory way. 5 22 12 Call bells must be placed within reach of each service user, unless they are not able to use it, in which case an alternative method of assuring their ability to get attention when they need it is agreed and recorded. This is to make sure people can get help when they need it. 6 30 18 Training must be provided in 18/06/2010 relation to good care of people with dementia, including communication skills, plus person centred
Page 8 of 10 15/03/2010 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 care planning and effective risk assessment. This is in order to provide care in a safe and suitable way for people who have dementia. 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 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
