Inspection on 28/08/07 for Arlington House Care Home

This inspection was carried out on 28th August 2007.

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

Arlington House Care Home 04/07/06

Arlington House Care Home 12/12/05

Arlington House Care Home 07/06/05

Arlington House Care Home 01/12/04

Arlington House Care Home 07/07/04

Arlington House Care Home 20/11/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Arlington House Care Home 7 Arlington Drive Mapperley Park Nottingham NG3 5EN Lead Inspector Richard Ramsden Key Unannounced Inspection 28th August 2007 10:00 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.V348307.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. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arlington House Care Home Address 7 Arlington 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 Mr John Clarke Karen Margaret Clarke Mrs 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.V348307.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2006 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. The homes current weekly fee range is £323 to £368. A copy of the last inspection report was available in the home. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one day it took approximately 7 hours. It included the inspection of care and other records, a discussion with three members of the management team and one member of care staff. The inspector spoke with three residents and one visitor to the home. Two service user satisfaction questionnaires and two carer/relative satisfaction questionnaires were received prior to the inspection. A partial tour of the building was also completed. Two residents were Case tracked, which means that their care plans were examined against the actual care they receive. The inspector also discussed the possibility of amending the homes conditions of registration although having examined the registration certificate it is unlikely that any changes will be necessary. Prior to completing this visit the inspector assessed the homes service history and the last inspection report. What the service does well: The people living at Arlington House and their representatives are generally very satisfied with the services provided. The home is well managed and run in the best interests of the residents. Residents and staff spoken with during the inspection confirmed that they have confidence in the management teams abilities and that they are involved in the decision-making within the home. Residents meetings and frequent discussions with the care managers also helps to ensure that people living at Arlington house are able to voice their opinions about the way in which the home is run. People said that they are very satisfied with their bedrooms and confirmed that they had been encouraged to personalise them with small items of furniture photographs etc. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 6 The care staff are well trained and many have worked at the home for a long time. This experience and training helps to provide continuity and stability for the residents. Residents said that the home provides a good programme of activities and entertainment. Care plans a comprehensive and reviewed frequently enough to ensure that staff always know what assistance and support each resident requires. Health care records are particularly well maintained. Residents said that staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. Two people said that the staff are always busy but still find time to socialise. The observed interaction between staff and residents was of a very good standard. What has improved since the last inspection? What they could do better: The registered person needs to ensure that staff do not commence employment until a new Criminal Records Bureau clearance has been received. Staff records should also include proof of identity. A risk assessment must be completed with all residents who wish to administer their own medication and it would be beneficial for photographs to be attached Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 7 to all medication administration records as this will help to ensure that the medication is given to the correct person. Residents’ personal records such as bathing and bowel charts should be recorded individually so that they can be viewed confidentially. 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. Arlington House Care Home DS0000002186.V348307.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 Arlington House Care Home DS0000002186.V348307.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): 3. The staff are ensuring that they can meet the needs of prospective residents by obtaining preadmission assessments. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents records are assessed as part of this inspection. The records of one of the residents contained preadmission assessment, which had been completed by a social worker. The second resident had been admitted as an emergency and consequently a preadmission assessment had not been completed. The senior staff advised Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 10 the inspector that they always obtain a preadmission assessment for all planned admissions to the home. The home does not provide intermediate care. Arlington House Care Home DS0000002186.V348307.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): 7,8,9,10. Residents individual care plans contain sufficient information and are reviewed regularly enough to ensure that staff are aware of what support and assistance each resident requires. The homes medication is generally well managed and residents believe that they are treated with respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents care plans were viewed as part of this visit. The care plans contain sufficient infestation and were reviewed frequently enough to ensure that staff have up-to-date information about the care and support each resident requires. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 12 The individual residents or their representatives had signed the care plans to confirm their involvement in the care planning and review process. (This is good practice). The home is keeping centralised bathing and bowel records for the residents, which cannot be viewed, in a confidential format. Records show that residents’ health care needs are being appropriately met; this was confirmed by three of the residents and one visitor who were spoken with during the inspection. The homes medication systems have been well maintained. Two residents have chosen to administer all or some of their own medication. A risk assessment had been completed with one of the residents, but the senior staff had just sought the views of the residents’ doctor for the other resident who administers their own medication. Staff were reminded that risk assessments must be completed with all residents who wish to manage their own medication to ensure the health and safety of all the residents in the home. All medication administration records had been appropriately signed each time the medication is given to the resident for whom it is prescribed. It was however noticed that there are no photographs of the individual residents attached to their medication administration records. Photographs can help staff to ensure that they are administering the medication to the correct resident. The records of receipt and disposal of medication have been well maintained and medication is generally stored securely. It was however noted that insulin was being kept in a refrigerator in the main kitchen and residents could potentially have had access to this. The insulin was moved to another refrigerator in a locked area of the home, so that it was no longer accessible to residents. The homes controlled medication was checked at random and had been well maintained. All of the residents spoken with said that the staff are friendly and respectful and ensure that their privacy and dignity is maintained at all times. The visitor spoken with during the inspection also confirmed this. The observed interaction between staff and residents was of a very good standard. Arlington House Care Home DS0000002186.V348307.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): 12,13,14,15. The lifestyle experienced in the home appears to match the residents’ expectations and preferences. People are encouraged main contact with family and friends; residents are satisfied with the food provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The senior staff were able to demonstrate that the home provides a good range of activities and entertainment to stimulate the residents. The programme of activities is prominently displayed in the main reception area. The residents spoken with confirmed that the home does provide a variety of activities although one person stated that they choose not to participate in the activities provided. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 14 One person informed the inspector that they had enjoyed the entertainer who had visited home the home on the evening prior to this inspection. Residents and a visitor confirmed that visitors are made welcome in the home at any time and that refreshments are always provided. The visitor stated that she or her sister-in-law visit their relative in the home most days. Individual residents care plans give details of how residents can be encouraged to make decisions about their daily lives. (This is good practice). There are also residents meetings where people are encouraged to express their opinions about the way in which the home is run. One resident who had only recently been admitted to the home was using his own car to continue his contact with family and friends. He also informed the inspector that he is doing voluntary work at a local charity shop. All of the residents spoken with said that they are satisfied with the meals provided by the home and that alternatives will be provided if they do not want the food suggested on the menu. One person said that they would like to have a cooked breakfast, on occasions, but that this is not available. The lunch on the day of inspection was well balanced and appeared appetising. Arlington House Care Home DS0000002186.V348307.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): 16,18. The home has an accessible complaints procedure and staff are ensuring the residents are protected from abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed in the home and in the literature supplied to prospective residents. The homes complaints records show that there have been no complaints since the last inspection. The residents spoken with confirmed that they would speak to one of the management staff if they had any concerns or complaints. They all believe their concerns would be dealt with appropriately. All staff have received basic training in safeguarding adults. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 16 The home has an appropriate Whistle blowing procedure and the member of staff spoken with during the inspection was clear about her responsibility to report any possible abuse she may observe. Arlington House Care Home DS0000002186.V348307.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): 19,26. The accommodation has been maintained to a very good standard. It was pleasant and hygienic at the time of this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this visit. The accommodation has been maintained to a very good standard. Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 18 The residents bedrooms viewed during this visit were comfortably furnished and people had clearly been encouraged to personalise their rooms with photographs, ornaments and small items of furniture. All of the residents spoken with stated that they liked their bedrooms and confirmed that they can use them at any time. One person said that her bedroom had recently been redecorated and that she had been encouraged to choose the colour scheme. (This is good practice). All of the residents and the visitor spoken with during the inspection confirmed that the home is always clean and hygienic. The gardens are very well maintained and provided a pleasant outlook from most of the residents’ bedrooms and the communal areas. Arlington House Care Home DS0000002186.V348307.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): 27,28,29,30. There was sufficient, competent and qualified staff to support the residents. The homes recruitment policies and practices are not always supporting and protecting residents. The registered person was able to demonstrate a commitment to staff training and development. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota provided for the week of this inspection showed that adequate staffing levels are being provided to meet the assessed needs of the residents. Residents stated that although staff are always busy they do find time to socialise and ensure that residents individual needs are always met. The personal records of the two most recently recruited members of staff were assessed as part of this visit. The records each contained two satisfactory references however there was no proof of the staffs identity on the files and the criminal records bureau clearance forms had been obtained by previous employers. The senior staff stated that they were unaware that criminal Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 20 records bureau clearances are not transferable and that a new clearances need to be obtained before any new members of staff commence employment. The information provided by the manager prior to the inspection shows that 8 of the 15 care staff have completed NVQ level 2 or above and another member of staff is currently completing the training. The staff training records observed during this visit show that a considerable amount of training has been provided. The member of care staff spoken with during the inspection confirmed this. Arlington House Care Home DS0000002186.V348307.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): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked the health and safety of residents and staff is promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This is a family run business and two members of the family are jointly registered as the managers. One of the managers is a Registered General Nurse, who is working towards her Registered Managers Award. The other Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 22 joint manager has many years experience of managing the home. One of the other managers is a qualified social worker. Residents, staff and the visitor said that the management team of very approachable and that they seek their views about the way in which the home is run. Quality monitoring systems are in place and the managers have used the information gathered to produce an annual development plan for the home. (This is good practice). Staff do manage some residents personal money, the records were checked at random and were well maintained. The areas of health and safety checked during this visit had all been well maintained. Staff are now recording water outlet temperatures on a regular basis. The homes Fire records have also been well maintained. Arlington House Care Home DS0000002186.V348307.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Arlington House Care Home DS0000002186.V348307.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 OP9 Regulation 13 (2) Requirement The registered person must ensure that risk assessments are completed with all residents who wish to administer their own medication. The risk assessments must be reviewed regularly to ensure the health and safety of all the residents in the home. The registered person must ensure all staff files contain information as set out in schedule 2 and schedule 4 of the care homes regulations 2001. Outstanding from 04/10/06. New staff must not commence work until a new satisfactory Criminal Records Bureau clearance has been received. Timescale for action 28/08/07 2. OP29 19 Sch. 2 andSched ule 4 01/10/07 3. OP29 19 Sch.2 28/08/07 Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 25 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 OP7 Good Practice Recommendations The residents bathing & bowel charts should be recorded on a separate sheet for each person to enable them to be viewed confidentially. A photograph of each resident should be attached to his or her individual medication administration records to help ensure that the medication is always given to the correct resident. 2. OP9 Arlington House Care Home DS0000002186.V348307.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Arlington House Care Home DS0000002186.V348307.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. Re-publishing this information is in breach of the terms of use of that website. 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