Inspection on 07/06/05 for Arlington House Care Home

This inspection was carried out on 7th June 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 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 28/08/07

Arlington House Care Home 04/07/06

Arlington House Care Home 12/12/05

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 7 Arlington Drive Mapperley Park Nottingham NG3 5EN Lead Inspector Elaine Cray Unannounced 7 June 2005 10:00 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 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. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arlington House Address 7 Alington Drive Mapperley Nottingham NG3 5EN 0115 962 4397 0115 962 4397 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) Mrs Margaret Clarke Mrs Margaret Clarke CRD 18 Category(ies) of OP Old Age - Both male and Female. registration, with number of places C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st December 2004 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. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 7th June 2005 over a period of 3.5 hours. The owner/manager was present for part of the visit and the deputy care manager and staff provided information throughout the visit. Seven residents were spoken with and all expressed a high level of satisfaction with the care provided in the home. The lunchtime meal and the medication round was observed and the cook was also spoken with. Two care plans and a variety of records were inspected and a partial tour of the building was made. What the service does well: Arlington offers a homely and well maintained environment. The manager and staff encourage residents to be as independent as possible and to be part of the day to day running of the home. Residents are treated with a high level of dignity and respect and staff have an excellent understanding of the individual needs, preferences and personalities of each resident. There is a warm rapport between staff and residents. Residents presented as well groomed and there was lots of conversation and laughing between residents and the staff. Residents liked living at the home, they said they were happy, the staff were very kind and always helpful and they all enjoyed talking with each other in the lounge and particularly at lunchtime, when both the food and social company was very satisfying. Care plans are comprehensive and form a good basis for an assessment of need and to provide the day to day support to enable residents to maintain their independence and be provided with appropriate care and support. Health care needs are well met and the staff at the home liaises well with health care and medical agencies. The management team and staff form a cohesive team, with good communication between themselves, with the residents and with other professionals. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 4 and 5 The home provides accurate information about the services available to prospective service users, relatives and representatives, who are able to visit the home to look around and meet the manager, residents and staff to discuss the prospective service user’s needs and to find out about the running of the home. EVIDENCE: Service users spoken with said that they or their relative had visited the home prior to moving in. One gentleman said he came and had an enjoyable lunch, was able to meet the other people who lived at the home and then decided if he wanted to move in. The manager and service users confirmed that the needs of each service user and the services available are discussed before moving into the home. All service users were very complimentary about the staff and how helpful and supportive they had been they had first moved to the home. Staff were very informative, encouraged them to personalise their bedrooms and reassured them about the changes. All service users spoken with said that they settled very quickly in the home. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 9 Terms and conditions are available and copies had been prepared and were issued to the relatives of one recently admitted service user at the time of this inspection. The manager invited the relative to read through the documents at his own leisure, discuss with the service user and discuss and/or sign if he was happy. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7, 9 and 10 The health care and medical needs were identified and promoted. 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. Several residents commented that their health has improved greatly since living at the home. One resident was concerned about her dentist and optician appointments, which were managed by her relative. The manager checked the care plan and reassured the resident that she would speak with her relative, although medical checks had been carried out and recorded in the care plan. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 11 The manager was heard explaining about forthcoming medical appointments with residents as they had received letters about influenza injections and two ladies were due to have hearing aid checks. All service users were told that they had full choice about the medical and health services on offer. The lunchtime giving out of medication was observed on this inspection and the senior member of staff demonstrated a good knowledge of the policies and procedures relating to administrating medication. There was a warm and respectful rapport between the staff and residents. Staff were observed to provide a sensitive level of care in terms of ensuring the privacy and dignity of residents is respected. Residents said that staff were very polite and kind, knocking on bedroom doors and speaking to people with respect. Residents said that staff help with personal care and take their wishes around privacy into account. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 14 and 15 This home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents. Catering arrangements were well managed and provide residents with regular and a well balanced choice of meals in a pleasant and social environment. EVIDENCE: One resident said that he was able to do as he did at home but he felt safer and more confident as he had help when he needed it and lots of people to talk with. Another resident said she can spend time as she likes as she did at home but doesn’t have the cooking and cleaning to do and the staff help her remain independent. Some service users were observed to be enjoying the company in the lounge, whilst others preferred the privacy of their own rooms. All residents spoken with on this visit said that they enjoy living at the home and felt that they could do as they please and choose how their daily routines happen. Some residents had their own newspaper and others enjoyed going out to see family or friends, arranging when to see the hairdresser and joining in a selection of activities, including visiting musical artists and quizzes. All residents said that the food was very good. The lunchtime meal was observed and tables were attractively set with table cloths, flowers, serviettes and jugs of water. Each resident was asked about their choices at the time of C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 13 the meal and vegetables are provided in serving dishes so that residents can help themselves. A hot drink is offered at the end of each meal. The meal time was a relaxed and social time, staff served residents with respect and helped some residents to eat their meal in a sensitive and discreet way. The menus are varied, balance and nutritional. Most meals are cooked from fresh produce and the cook provides home baking on a daily basis. The kitchen was well organised, clean and all safety checks were carried out regularly. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 The staff have a clear awareness of the need to provide a safe environment for residents. Residents are confident that they are able to express any concerns to the owner, manager, staff and relatives and that these matters will be addressed. EVIDENCE: The manager and staff presented a good understanding of the vulnerability of older people living at the home, the need for consistent observation, individual assessment of risk and providing a safe environment. Risk assessments were well documented within the care planning format. All residents spoken with on this inspection presented a clear confidence that they could discuss any concern with the owner, manager and staff in the home. They felt listened to and whilst many had no reason to complain, residents felt that every effort was made by the staff to rectify any concerns. The complaints record verified that concerns are appropriately dealt with in the home. The inspector experienced a group of residents who were able to say what they felt. There was a clear theme of empowerment running through the home. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 20, 23, 24, 25 and 26 The home presents as well maintained, homely, well decorated, comfortable and exceptionally clean. The lack of radiator covers poses risks to the safety of residents. EVIDENCE: All lounges and the dining room were viewed and presented as clean, well decorated and very homely, with comfortable furnishings, lots of pictures, ornaments, plants and flowers. Some of the pictures had been embroidered by one of the residents. A number of bedrooms were viewed. Each bedroom presented its own individual style, dependent on the wishes and likes of the resident. All bedrooms were well furnished, safely maintained, well decorated and clean. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 16 Residents said they liked their bedrooms, the choice of lounges available and they were particularly complimentary about the well kept gardens and views from the majority of rooms in the home. Whilst the management team have produced very good risk assessments in relation to the surface temperature of radiators and associated pipe work; covers to radiators have not been provided as required from the previous inspection, but the manager has obtained quotes and is due to provide a schedule of works to the Commission. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The staffing arrangements in the home are, on the whole, well managed and staff working there are able to meet the needs of the residents. Required checks for some members of staff had not been carried out. 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. Regular training is provided and the manager is developing a staff supervision system. All the residents spoken with on this visit gave positive comments about the staff, using terms such as “so kind”, “lovely, very kind and always helpful” and “always respectful”. All residents felt safe and well looked after, with staff encouraging them to be independent and providing support when needed and requested. Discussion with the manager and observation of the staff demonstrated that staff were knowledgeable about the needs of the residents, were aware of the policies and procedures of the home and the inspector observed appropriate care practices throughout the inspection. The majority of staff files had the required information and background checks, however, one temporary domestic, the handyperson and a member of staff C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 18 returning to work at the home did not have CRB checks returned. Although the manager had applied for criminal background checks, she had received confirmation of the POVA checks and an immediate requirement to carry out these checks was left with the owner/manager of the home. Staff training in Moving and Handling, Health and Safety and First Aid had been provided in the past year. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36 and 37 The management of the home was well organised, with clear lines of accountability, roles and responsibilities. Records were, on the whole, well maintained, accurate and up to date. EVIDENCE: The owner of the home is also the manager and delegates some of the care management to the management team. The manager was present for a period of time throughout this inspection. A member of the management team was present throughout the visit and had a thorough knowledge of the management and administration systems and the running of the home. The owner/manager is present at the home on a daily basis was observed to maintain positive relationships with both the residents and the staff. The majority of staff have worked together for an extensive period of time and the staff team provides positive and informal support to each other. The manager C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 20 and staff reported that information about the needs of the residents and the routines in the home are shared on a daily basis and this was evidenced by the inspector. A member of the management team is responsible for the introduction of a formal staff supervision system, which includes a recording format. Some staff supervision had been provided but not as regularly as required and records were minimal in content. Record keeping in the home was detailed, accurate and up to date. Care plans were very comprehensive and practical for the day to day care for each resident and other required records were available in the home. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 4 15 4 COMPLAINTS AND PROTECTION 3 4 x x 3 4 1 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 Standard No 16 17 18 Score 3 x x x 3 3 x x 2 3 x C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 22 YES 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 25 Regulation 13.4 Requirement Timescale for action 1st January 2006 2. 29 19.5 3. 36 18 It is required that all pipe work and radiators are guarded or have guaranteed low temperature surfaces Note: This requirement was made at a previous inspection Ensure all required checks, Immediate including POVA, are applied for and ensure that staff do nor commence employment unless they have a positive POVA check returned whilst awaiting confirmation of the CRB application. Ensure formal staff supervision is 1st provided at regular intervals. September 2005 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 36 Good Practice Recommendations Consider improving the recording of staff supervision sessions. C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Edgeley House Riverside Business Tottle Road Nottingham NG2 1RT 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 C53 C03 S2186 Arlington House V227534 070605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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