Inspection on 01/12/05 for Arnold House

This inspection was carried out on 1st December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arnold House 02/02/07

Arnold House 12/11/04

Arnold House 20/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Arnold House 154 Shooters Hill Rd Blackheath London SE3 8RP Lead Inspector Sue Grindlay Unannounced Inspection 1st December 2005 10.00 Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 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 Arnold House DS0000006753.V259899.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 Adults 18-65. 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. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arnold House Address 154 Shooters Hill Rd Blackheath London SE3 8RP 020 8319 4084 020 8319 8752 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) Milbury Care Services Limited Mr Olufemi Adeyemi Akinwale Care Home 23 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (8) of places Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 8 places registered for LD(E) in respect of named services users only. Date of last inspection 6th May 2005 Brief Description of the Service: Arnold House is one of a group if six homes for adults with a learning disability, who are resident in the London Borough of Greenwich. It is managed by Milbury Care Services Limited, and has links with the Greenwich Community Learning Disabilities Team. The Home is registered for twenty-three residents, and eight named individuals are over the age of 65. The Home is a modern, two-storey building divided into four flats, two on each floor. The flats have interconnecting doors between the lounge areas, and these are open during the day to allow the residents to socialise. Each flat functions as a separate unit with its own Home leader, staff group, communal facilities and front door. Each flat contains five bedrooms, a bathroom, shower room, laundry, kitchen and ‘quiet room’. There is a large communal garden to the rear, and a drive at the front with parking for several cars. The Home is close to a parade of shops, and buses run past the door towards the shopping centres of Lewisham and Woolwich. A single storey building attached to the Home contains the administrative offices for Milbury Care Services, and a large room that is used for staff meetings, social events and training purposes. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection over four and a half hours, and was the second inspection of the inspection year. Key standards not inspected on the previous inspection were covered, and issues arising from the last report were also revisited. The manager, a home leader and two staff members were spoken to, and a number of service users were spoken to during the tour of the building. Medication and two care plans were looked at in one flat, and three staff files and the complaints record were seen. Provider reports were also read. No relatives or professionals were seen on this occasion. What the service does well: What has improved since the last inspection? What they could do better: The Quality Audit is delayed again this year, and information about making a complaint is still not freely available. Some issues around the recording of health needs have been highlighted on this visit. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 6 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. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards were assessed from this section. The client group remains the same as before. The new service user at the last inspection was reviewed in a multi-disciplinary forum after three months, and it was decided that he was appropriately placed at Arnold House. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 Service users make decisions about their lives with assistance as required. EVIDENCE: Service users are encouraged to make decisions about their lives from what to wear, or what to eat and where to go on holiday. One service user had seen a chair that he liked in another service user’s room, and had decided to buy one for himself. This had been delivered and was waiting to be unpacked in his room. The physiotherapist had recommended a new bed for one service user, and this was a high-specification bed with a pressure mattress and cot sides. The service user had not signed consent for the use of cot sides, although these were in use with her current bed, and it is recommended that a consent form be devised and this is placed on the service user’s file to show that this has been an agreed course of action (Recommendation 1). Another service user was proud to show his bedroom, and said that he had chosen the colour of the carpet himself. One service user has a befriender and they go together to watch football matches. Another has a befriender who visits the Home for a chat. Many of the service users took up the offer of a flu vaccination at the local G.P. surgery. One service user elected not to have one. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15, 16 and 17 Residents at Arnold House enjoy a comfortable, healthy and stimulating lifestyle. EVIDENCE: Many of the service users attend day centres, where they do a range of activities. One service user has a regular weekend cleaning job at another Home. The Home also arranges opportunities for stimulating and enjoyable outings. As well as taking holidays in Norfolk, Canterbury, Crete and Portugal, some service users have had day trips abroad, to Ostend and Calais. They spent the day shopping, having a meal, visiting a chocolate factory, and sightseeing. The trip in a mini-bus on the Eurotunnel train was apparently talked about for some time. Some holidays are taken with friends from other flats, so that service users get a chance to mix, and have a break from their flatmates! One service user was enthusiastic about his trip to Kew gardens the previous day. Family links are supported wherever possible. Two sisters go ‘home’ every weekend, and the family and the home communicate with each other through Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 11 a communication book. One service user had had a birthday party at the Home and this became more like a family reunion. The family wrote to staff afterwards saying, “Thank you for a lovely party – you did us proud. Thanks for making [the resident] so happy”. Staff were preparing for the Christmas party that weekend, and said that two of the service users had invited their girlfriends. The degree to which residents can assist with housekeeping tasks is limited but some are keen to help. One service user likes to hoover and empty the bin. Some can make a cup of tea and help to clear the table. One service user makes it his job to take the rubbish out each evening. Another likes to deliver letters to the service user. A four-week menu has been drawn up in each flat in consultation with the service users. This can be varied according to need. For example the day of the inspection was quite chilly, so service users in one flat elected to have hot soup for lunch instead of the sandwiches that were on the menu. The meal for that evening in one flat was mince and pasta with frozen vegetables, and two care workers had bought the ingredients that day in the weekly shop. The mince was good quality lean beef steak mince. At the Person-in Control report of 5/9/05 a staff member had said that the money for food allocation was not enough. The manager said that it equated to approximately £30 a head per week, and staff confirmed that they had spent around £140, but kept some back for little extras during the week. This appeared an adequate amount. The manager said that he has a float that can be used if there is a shortfall. There was a range of fruit including apples, pears, bananas and easy-peel clementines, and lemons that were to make hot lemon drinks to stave off colds and flu. They had also bought a range of fresh vegetables including parsnips, carrots and broccoli, and considered it part of their role to introduce service users to new foodstuffs. This particular flat had introduced prune juice and cranberry juice and had encouraged more fruit consumption, and this has been helpful in promoting good bowel habits. Staff acknowledged that there is much information in the public domain now about good eating habits, and they had clearly been pro-active in helping service users to eat healthily. This standard is exceeded. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The Home’s policies are satisfactory, but staff must ensure accurate recording especially in this area of work. EVIDENCE: The medication for one service user was seen and some anomalies discussed with the manager and home leader. A health sheet in the care plan had not been updated since 2001, and was out of date in terms of the medication prescribed. A nursing assessment in 2000 had stated that this service user was allergic to penicillin, but the current MAR chart states, “Allergies – None known”. This must be checked with the G.P. as soon as possible. A staff member had inadvertently signed for one prescribed drug for the following day, and it was suggested that this error be recorded on the back of the MAR chart. The mar charts were in a folder and the index at the front had the service users numbered. The charts were in that order within the folder, but the dividers were not numbered, and it is recommended that they are numbered for easy access to the correct chart. These matters are subject to two requirements and two recommendations (Requirements 1 and 2) (Recommendations 2 and 3). Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Service users know that they will be listened to and they are safe from harm. EVIDENCE: Arnold House has a revised complaints procedure. The form to record complaints is well set out with space for details of the complaint, date of acknowledgement, action taken and resolution. There had only been one complaint since the last inspection, and this had been resolved through discussion with the relative involved. The company, Milbury, has a colourful service users’ guide to the complaints procedure with picture cues. Unfortunately it is too ‘busy’ in that there is too much on the page, it refers to a different home (Erindale) and has the logo of the National Care standards Commission instead of the Commission for Social Care Inspection! This should be revised, simplified and customised for Arnold House, and this is a further recommendation. A laminated copy should be available in each flat and a copy sent to the Commission when completed (Recommendation 4). Staff spoke to residents in a calm, and friendly way. A notice in the office corridor informs staff about whistle blowing, and lists the names and contact numbers of the operations manager, the Regional Director and the Director of Quality Assurance. All staff have received POVA training, and have also attended Non Violent Crisis Intervention. A signed statement in the file of a new staff member says that they had received, read and understood the policy in respect of the Protection of Vulnerable Adults. This was undated and it is recommended that all such documents be dated (Recommendation 5). Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 26 The Home provides a safe and comfortable environment for its residents. EVIDENCE: New kitchen units and flooring have been installed in Flats A and D, and the kitchens look very modern and fresh. Staff in one of the flats were keen to buy blinds and other accessories to complete the makeover! The manager said that he was disappointed that cooker hoods had not been fitted, and it is recommended that these be added to the kitchens, to remove odours and create a more pleasant environment (Recommendation 6). Bathrooms were reasonably clean and tidy, but the shower curtains in two of the flats were mouldy and torn, and these should be replaced (Recommendation 7). Elsewhere there has been redecoration, and the communal areas were all bright, cheerful and well maintained. Service users’ bedrooms were all individually decorated, and had evidence of personal interests, such as cars, horses, dolls or football. One had relatively few possessions, and a staff member said that he did not like too many knickknacks, but he did have a brand new reclining chair. In one bedroom a bedside lamp was on the floor, and there did not appear to be a bedside table to put it on. This was brought to a member of staff’s attention. It was also noted that Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 15 the duvets on some of the beds were quite thin, and staff said that the home is quite warm. However, it is recommended that an audit be made of bedding in each flat to check that it is still serviceable, and to ensure that service users are warm and comfortable at night (Recommendation 8). Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 36 Staff are committed to their work and are conscientious to fulfil their roles. They are well supported and trained. EVIDENCE: The Home has seventeen out of twenty-six care workers trained to NVQ level 2. This equates to a 70 target, which is commendable. One staff member who is an assessor commented on the fact that she had seen some positive staff attributes through her work as an NVQ assessor, and hoped to harness people’s individual strengths and skills. Another staff member spoke about ‘compassionate staff’, and said that she looked forward to coming to work. The manager said that twenty staff had received letters of commendation for six months attendance with no sick leave. This is a positive acknowledgment to staff and this standard is exceeded. Three staff files were viewed. Two were well set out with an index corresponding to different sections in the file. One file had a copy of a passport as proof of identity. This was endorsed with the word, “Original seen” and signed and dated by a manager, and this is good practice. One was an older record and the documentation was not all in one place, but was collated at the time of the inspection. The pay anomalies between Milbury and the former provider London and Quadrant had been raised at the last inspection, and staff said that Milbury have now offered new contracts for those who wish to transfer, and this is a good resolution. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 17 A staff member said that there had recently been a rotation of staff within the Home, and service users and staff viewed this change positively. They had taken part in a team building exercise facilitated by someone from the British Institute of Learning Disability and this had reinforced the positive feelings that staff had about the team and the Home, and raised staff morale. Staff files had evidence of formal supervision and appraisal, and staff corroborated that this occurred. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The Home is well-run and systems are in place to safeguard and monitor the welfare of service users. EVIDENCE: The manager stated that when a new inspection report is available, he sends a letter to the relatives saying that they can receive a copy if they wish to do so. He also brings it to the staff meeting for discussion. Regulation 26 reports are completed on a monthly basis and copies are sent to the Commission. These reports include interviews with a service user and a staff member, and these give a real flavour about what it is like to live and work in the Home. The Quality Audit was due to take place in September but has not yet been done. It is recommended that when the audit is completed, the results are collated and made available to relatives, service users, staff and the Commission (Recommendation 9). The Fire Authority recently carried out a programmed inspection at the Home under the Fire Precautions (Workplace) Regulations 1997, and it was found to be satisfactory. No other fire precautions were looked at on this occasion. A Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 19 sharps box seen in one flat had no name or date of opening, and it is recommended that they be marked with this information (Recommendation 10). Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 4 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arnold House Score X X 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X 3 DS0000006753.V259899.R01.S.doc Version 5.0 Page 21 NO 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 YA20 Regulation 15(2)(b) Requirement The Registered Person must ensure that health profile sheets in care plans are kept up to date in terms of health needs and prescribed medication. The Registered Person must ensure that any allergies are clearly noted in care plans and on MAR charts to prevent any adverse reactions. Timescale for action 09/01/06 2. YA20 13(4)(c) 09/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA7 YA20 Good Practice Recommendations It is recommended that a form be devised for service users or their relatives to give consent for the use of cot sides. It is recommended that the circumstances of any error on the MAR chart be noted on the reverse, signed and dated to ensure that mistakes are not compounded through lack of information. It is recommended that dividers in the medication folder be numbered to correspond with the index, for easier access. DS0000006753.V259899.R01.S.doc Version 5.0 Page 22 3. YA20 Arnold House 4. YA22 5. 6. 7. 8. 9. 10. YA23 YA24 YA24 YA26 YA39 YA42 It is recommended that Milbury’s complaints guide for service users be revised, simplified, and customised for Arnold House. A laminated copy should be available in each flat, and a copy sent to the Commission. It is recommended that all signed statements that staff have read and understood policies, especially the policy in respect of POVA are dated. It is recommended that cooker hoods are fitted in the new kitchens, to remove cooking odours and to make the environment more pleasant. It is recommended that torn or stained shower curtains are replaced. It is recommended that an audit of bedding be made in each flat, to ensure that service users are warm and comfortable at night. It is recommended that the Quality Audit results are collated and made available to relatives, service users, staff and the Commission. It is recommended that all sharps boxes have the name and address of the home and the date of opening written on them. Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Arnold House DS0000006753.V259899.R01.S.doc Version 5.0 Page 24 - 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!