CARE HOMES FOR OLDER PEOPLE
Arlington House Care Home 7 Arington Drive Mapperley Park Nottingham NG3 5EN Lead Inspector
Elaine Cray Unannounced Inspection 1:00 12 December 2005
th 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 Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 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. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Arlington House Care Home Address 7 Arington Drive Mapperley Park Nottingham NG3 5EN 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) 0115 962 4397 0115 962 4397 Mrs Margaret Clarke Karen Margaret Clarke Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Arlington House is a large detached property, situated in a residential suburb of Mapperley Park, which has good public transport links to the city centre and there are local shops and a post office nearby. The house has been extended and converted to provide comfortable living accommodation for up to 18 older people. The home is set in landscaped and well maintained gardens. The property is well decorated and comfortably furnished with a choice of lounge areas. The bedrooms are provided over two floors; there is no lift access between floors. The home is well staffed and training is available. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 12th December 2005 over a period of 4 hours. The owner and manager were present throughout the visit. Five staff, including an awake night staff were interviewed. Care practices and interactions between staff and residents were observed. Residents presented as very happy, relaxed and well cared for. Two care plans and a variety of records were inspected. What the service does well: What has improved since the last inspection?
The owner has ensured that appropriate checks are carried out on all staff working at the home and has completed risk assessments on radiators and associated pipe work. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 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. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 7 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 Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Arrangements for assessing the needs of residents are well managed. EVIDENCE: There is an assessment of need process, records were available and had been included each care plan. Discussion with the manager and the care plans demonstrated that the resident, family members and representatives are included in the assessment process. Assessment of residents needs were thorough and well detailed. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 and 11 The health care and medical needs were identified, promoted and well met. There is a warm and interactive rapport in the home and residents rights to privacy and choice are treated with respect and dignity. EVIDENCE: Two care plans were viewed on this inspection. Medical histories, health assessments and how and who were involved in meeting these needs were recorded in each plan. The manager and staff on duty at the time of this inspection provided a clear and detailed insight into the medical and health needs of the residents. The regular visits and details of consultations made by doctors, district nurses, the optician, chiropodist and other medical professionals are recorded. Records provided evidence that the home liaises with relevant medical agencies to seek advice and further consultation when necessary. The manager and owner have escorted residents to hospital appointments.
Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 10 There was a warm and respectful rapport between the staff and residents. Discussion with staff and observations throughout the visit evidenced a very sensitive and respectful approach to ensuring the privacy and dignity of residents is respected. The manager and staff provided a clear commitment to caring for the residents at the home and provided a dedicated insight into caring for residents who become increasingly frail and supporting both residents and their families through the processes of death and bereavement. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 This home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents. EVIDENCE: Relatives and friends are able to visit the home as often as they wish and are encouraged to be involved in the care of the residents. Some residents go out into the local community, enjoy visiting family and church visits. Staff presented a clear commitment to enabling residents to have choice and control over their lives and staff were knowledgeable about the individual likes, dislikes and daily routines of the residents. Some service users were observed to be enjoying the company in the lounge, whilst others preferred the privacy of their own rooms. When interviewing night staff at 10:00 pm, one resident was still up watching TV whilst others had gone to bed at different times. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 and 18 The staff have a clear awareness of the need to provide a safe environment for residents and to promote and protect the legal rights of the residents. EVIDENCE: The manager and staff presented a good understanding of the vulnerability of older people living at the home, the need for consistent observation and care and providing a safe environment. However, one staff member was not sure about the adult protection reporting procedures and agencies outside of the home. Risk assessments were detailed and included in the care plan. All residents are on the electoral register. Staff confirmed that the owner of the home transports residents who wish to visit the local polling station, whilst other residents have postal votes arranged. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this inspection. EVIDENCE: Not Applicable Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The staffing arrangements in the home are well managed and staff working there are able to meet the needs of the residents. EVIDENCE: On the day of this inspection, the home was adequately staffed. The manager and many of the staff have worked at the home for an extensive period of time and provide a good level of experience. Interviews with staff confirmed that training is available and identified that staff have an in depth knowledge of how to meet the residents’ needs. The owner confirmed her knowledge of the Criminal Records Bureau and the need to provide appropriate checks before any member of staff commences employment at the home on the day of this inspection. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 37 and 38 The management of the home was well organised, with clear lines of accountability, roles and responsibilities. Records were, well maintained, accurate and up to date and health and safety checks had been carried out. EVIDENCE: The manager, who is a qualified nurse, was present throughout this inspection and provided a thorough knowledge of the, residents’ needs, management systems and the running of the home. Staff were very positive about the management of the home and felt very supported. The manager stores and manages the spending money of some residents and individual records and receipts are maintained. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 16 The health and safety procedures, checks and servicing agreements are well managed in the home. Fire safety checks had been regularly completed. Record keeping in the home was detailed, accurate and up to date. Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X X 3 X 3 3 Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP18 Regulation 13.6 Requirement Provide an update for staff on adult protection procedures Timescale for action 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Arlington House Care Home DS0000002186.V266256.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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