CARE HOME ADULTS 18-65
Arnold House 66 The Ridgeway Enfield Middlesex EN2 8JA Lead Inspector
Jane Ray Key Unannounced Inspection 18th September 2006 09:45 Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 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 DS0000010574.V308923.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 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 DS0000010574.V308923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Arnold House Address 66 The Ridgeway Enfield Middlesex EN2 8JA 020 8363 1660 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) www.leonard-cheshire.org.uk Leonard Cheshire Mrs Rita June Stroud Care Home 21 Category(ies) of Physical disability (21) registration, with number of places Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Four specified service users who are over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as any of the specified service users vacates the home. 13th December 2005 Date of last inspection Brief Description of the Service: Arnold House is a care home registered to provide care to 21 people who have a physical disability. The care home is owned and managed by the Leonard Cheshire Foundation, which is a voluntary organisation providing care services to people with disabilities. The care home is in a building, which was bequeathed to the Leonard Cheshire Foundation by the Arnold family. There are extensive grounds to the rear of the care home. The organisation is working on plans to demolish the existing building and replace it with a new purpose built service in the existing grounds of the home. Accommodation is provided in single bedrooms on the ground floor and there are a number of communal rooms and a physiotherapy area available for service users also on the ground floor. The homes administrative offices are on the first floor, as well as accommodation for staff. The organisational mission is: To work with disabled people throughout the world, regardless of their colour, race or creed, by providing the environment necessary for each individuals physical, mental and spiritual wellbeing. At the time of the inspection there were twenty service users living in the service. The current range of fees in the home is from £665 - £994 a week. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on the 18 September 2006 and was unannounced. A colleague, who was undertaking her induction training, accompanied the inspector. The inspection lasted for seven hours and was the key annual inspection. The inspection looked at how the home was performing in terms of the key National Minimum Standards for Younger Adults and the associated regulations. The inspector was able to speak to four current service users. The inspector was also able to spend time talking to the care supervisor as well as three members of care staff who were working in the home. The inspector did a tour of the premises and also looked at a range of records including service users records, staff files and health and safety documentation. In addition the inspector had received a pre-inspection questionnaire completed by the home and eight feedback forms completed by the service users. What the service does well:
The home provides a high standard of care and support to a group of service users with a range of complex needs. Service users continue to benefit from the experience of multidisciplinary working to ensure their personal care, social and emotional health needs are met. The care supervisor and staff demonstrated a good knowledge of the service users and were able to recognise their individual needs. The service users are supported to have their individual needs met by a key working and care planning system. Service user participation is actively encouraged through regular meetings and service users say they feel able to openly raise any issues of concern. The service users are offered access a range of leisure activities that they said they really enjoyed. The service users said they enjoyed the food and are offered an alternative when they do not like what is on the menu.
Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 6 The home has a well established and very stable team of staff who are being supported by an appropriate management structure. The home is comfortable and homely and the service users each have a single bedroom that is personalised to their taste. The home also has access to a vehicle that is helpful in facilitating some of the community activities. The service users are protected and supported by the effective use of policies and procedures including medication systems, adult protection procedures, comprehensive environmental risk assessments and health and safety procedures. What has improved since the last inspection? What they could do better:
Eleven requirements and two recommendations were made at this inspection. A requirement was made under the heading choice of home for the service to ensure all the service users have updated contracts between the service users and the home. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 7 Two requirements were made under the heading individual needs and choices. These were to ensure each service users social worker is invited to a review meeting at least every 12 months. The service users also need to have a Waterlow risk assessment and if they are at a high risk of developing a pressure sore then a care plan needs to be in place to address this. A requirement was made in the lifestyle section to ensure the catering staff all have their food hygiene training updated. A recommendation was also made to support the service users to access more community based educational and employment opportunities. A requirement was made under the heading of personal and healthcare to ensure that where a service user chooses not to access healthcare appointments that this is clearly recorded in their case notes. It is also recommended that the local healthcare team are contacted again to arrange for them to provide some training for service users on how to manage their own healthcare issues including diabetes and other conditions. Two requirements were made in the section concerns, complaints and protection. The first was for the outcomes of complaints to be clearly recorded with the timescale for this issue to be resolved. It is also required that where service users need some support to manage their finances that the arrangements for this support is recorded in their case notes. One requirement was made in the environment section to ensure flooding in bedroom 20 caused by a drain not working properly is resolved. In the section on staffing one requirement was made for staff to receive training on pressure care and supporting service users who have depression or abuse alcohol. This will help the staff to meet the specialist needs of the service users. Two requirements were made in the section called conduct and management of the home. One was to update the annual quality assurance exercise seeking the views of service users, relatives, care professionals and other stakeholders on how the service could be improved. Secondly the electrical installation certificate had expired and needs to be updated. 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 DS0000010574.V308923.R01.S.doc Version 5.2 Page 8 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 DS0000010574.V308923.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Service users are having their complex needs effectively met by the home. Service users can be assured they can spend time in the home as part of the admission process. Updated contracts between the home and the service users need to be available for all the service users. EVIDENCE: The inspector read the Statement of Purpose and Service User Guide and these documents contained all the necessary information and are in a clear format that is accessible to the service users. There have been two new admissions to the home in the last 12 months. As part of the process the service users are able to discuss their individual needs and aspirations and these are recorded in their case notes as was seen in the four records that were inspected. The inspector was able to speak to four service users who talked about their admission to the home. They said they were offered visits and a trial stay to see if they wanted to move to the home unless they were in hospital and visits were not possible. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 10 The inspector looked at the contracts for four service users between the home and the service user and one service user who had been living in the service for many years did not have a current contract in place. The inspector observed that the staff were supporting the service users in an appropriate manner that reflected their knowledge and understanding of their individual needs. The service users were also observed to be comfortable and relaxed within their home environment. Many of the service users are able to discuss their wishes with the staff and the staff were observed to be listening carefully to the service users. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 11 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): 6,7,8 and 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Service users are each supported to have comprehensive individual care plans and are working towards clearly defined goals agreed in partnership with families and other care professionals. Service users are supported to make decisions about their daily lives within the home and service user meetings take place regularly. Risk assessments, particularly in relation to pressure care need to be further developed. EVIDENCE: Four service user case notes were inspected. Each service user has detailed individual care plans that are written in a person centred style. These reflect the decisions made at their review meeting. These meetings take place six monthly with the service user and the staff in the home but two service users had not had a meeting with their care manager in the last 12 months. These review meetings were clearly recorded and demonstrated multi-disciplinary working. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 12 The care plan goals are clear and easy to understand and are monitored on an ongoing basis. These goals focus on supporting the service users to gain greater independence and to look a how their lives can be further enhanced by improved personal care or by addressing healthcare issues. Service users said that they had been involved in preparing their care plans and attended their review meetings. The four service users all had a named key worker. The service users all knew the name of their key worker. The staff when interviewed understood fully their role as a key worker. The four service user case notes inspected all included individual risk assessments. These covered moving and handling, the use if cot sides and risks identified in the service users own bedroom. The service users all have a physical disability and the four records inspected did not include a pressure care Waterlow assessment and where a high risk was identified a pressure care plan. Throughout the inspection the service uses were observed being consulted about decisions concerning their daily lives. This included being asked what they wanted to drink or eat and whether they wished to participate in activities. The staff explained that none of the service users have advocates at present. The record of the service user meetings was inspected. These took place on a regular monthly basis and discussed a wide range of issues relating to the home including health and safety matters, food, transport, use of the computer and social activities. The service users who were interviewed said they felt the staff really listened to the views and suggestions made by the service users. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The service users are supported to have full and active lifestyles. They also enjoy contact with their relatives and friends. The service users enjoy the food prepared by the home and the menu is healthy and nutritious. EVIDENCE: The home now employs a full time activities organiser. There is an ongoing programme of activities and on the day of the inspection the service users were offered a quiz game, music session, bingo and physiotherapy. The service users said they choose which activities to join and enjoyed the activity programme. One service user said her favourite activity was cooking. The leisure activities enjoyed by the service users include going to the local pub or eating out on a regular basis. In addition other activities outside the home include shopping, and day excursions. Each service user has a daily
Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 14 activity record and three were inspected and these showed that the service users were enjoying an active lifestyle. One service user said she enjoyed participating in broader activities linked to the organisation. She made cards to sell at the fete and has also helped go to planning meetings linked to the future development of the home. It was noted that there was little evidence of service users accessing colleges and employment opportunities. At the time of the inspection the main vehicle used by the home to transport service users was broken but was in the process of being repaired. The service users told the inspector that they have contact with their families. They are made welcome in the home or service users are supported to go to their family homes. One service user explained that she has a boyfriend who lives in another Leonard Cheshire Home and arrangements were made for him to come and spend a week staying at her home. The service users explained that they make holiday arrangements on an individual basis and one said she had been to Spain and another said he did not want to have a holiday. It was observed that there was a comfortable atmosphere in the home with the staff communicating appropriately with the service users. The service users were observed to be relaxed with the staff. The service users all said that they choose for themselves when they wish to go to bed or get up. One service user was observed having a late breakfast and said she had chosen to stay up late and watch a film and then get up later in the morning. The service users were all observed to have a key for their room. The menu for the week was inspected and this offered a healthy and varied diet. The home has a four-week rolling menu. The service users when asked said they enjoyed the food and could always ask for an alternative if required. The cook explained that there are a few service users who are diabetic but there are no other special dietary needs at present. The service users are supported to check their weight each month and the home has a set of scales suitable for wheelchair users. It was noted that two of the kitchen staff had received food hygiene training but this training needed to be refreshed. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 15 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): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Service users are supported to receive personal care according to their individual needs and wishes. Service users are supported to access healthcare services based on their requirements. Service users have their safety maintained by appropriate medication administration procedures. EVIDENCE: The service users spoken to said they were given support with their personal care based on their individual needs. The service users said that the staff ensured they maintained their privacy and dignity whilst supporting them with their care. The service users said they chose their own clothes and they were all appropriately dressed. One service user was observed to have bare feet but she said she did not want to wear any shoes. The service users have access to physiotherapy input directly in the home and access individual specialist mobility aids from the local wheelchair service. Four service user case notes were inspected. These all contained a record of the healthcare appointments they had attended. These included appointments with the GP, dentist, optician, chiropodist and specialist appointments. One service user had no record of a dental or optical appointment and the staff
Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 16 explained that this is because she has chosen not to access these services. It should be noted in the service users case notes that she has chosen not to access primary healthcare services. The home has just changed to Boots the Chemist for pharmacy input. The medication administration records were inspected and were completed correctly. The medication entering the home is recorded in a separate book but now the Boots records are available this can now be recorded on the medication administration record. There is a separate record for medication returned to the pharmacist. Three of the service users take a controlled medication and this was appropriately stored and the necessary records were in place. The senior staff administer the medication and the medication training record was inspected for one team leader and was appropriate. The temperature of the medication cupboard and fridge is monitored on a daily basis. At the time of the inspection none of the service users were selfadministering medication. The Care Supervisor explained that they have contacted the local healthcare team and requested them to come and provide some training for the service users and staff on issues including diabetes. They are still waiting for a training date to be confirmed. The service user case notes include a record of the service users wishes in the event of their death. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Service users can be confident that they will protected by a robust adult protection procedure and that staff have received the appropriate training. The complaints procedure is available in a user-friendly format and service users said they would feel able to raise any concerns. There needs to be a clear record of how service users are supported to manage their monies. EVIDENCE: The inspector looked at the complaints procedure and it was in a format accessible for the service users. The record of complaints was inspected. There had been one complaint in the previous 12 months and there was no record available of how the complaint was resolved and the timescale for this to be completed. The service users said they all felt able to raise any concerns with the staff or manager. The inspector saw that the home had the Enfield protection of vulnerable adults procedures. Staff training records were inspected for three members of staff. These indicated that all of the staff had received training on adult protection. The staff explained that all the service users are supported to manage their own money and have a lockable safe in their bedroom. Some service users are assisted by their families with their monies or by the manager. There needs to be a clear record in the service users case notes of whether they need support to manage their finances and how this support is provided.
Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 18 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 30 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The service users live in a homely, comfortable and safe environment that is clean and well maintained. There are long term plans to replace the existing building which is needed to meet the service users needs in the future. EVIDENCE: The service users live in a homely, comfortable and safe environment. The home is maintained internally and externally on an ongoing basis. The building however is not fully suitable for the service users as some of the bedrooms are too small and do not all have en-suite bathing facilities. The old building is increasingly difficult to maintain. The home is equipped for people with a physical disability and incorporates full wheelchair access on the ground floor and hoists and other specialist individual equipment. The maintenance records show these are being checked and maintained on an ongoing basis. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 19 Since the previous inspection there has been additional storage provided for the disability equipment. The home was very clean and tidy and the laundry equipment was all working appropriately. In bedroom 20 the drain in the bathroom was not working properly and water had entered the bedroom and wet the carpet. This needs to be resolved. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 20 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): 31,32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The service users are supported by a stable staff team. The staff receive a comprehensive induction and have ongoing supervision and training. All the staff have completed the necessary recruitment checks. Staff would benefit from some additional training on pressure care, mental health and alcohol abuse to support them in their specialist work with the service users. EVIDENCE: The inspector looked at the staff job descriptions, which were available in the staff files and these were very comprehensive. The inspector looked at the rota. The staff team consists of a manager, care supervisor, three team leaders and a team of carers. There is also a comprehensive team of housekeeping and maintenance staff. The staff turnover is very low and three members of staff have left in the last year and six new staff have commenced working in the home. The care supervisor explained that the home does not use agency staff. During the day there are usually seven staff working in the morning and four in the late afternoon and evening. At night there are two waking members of staff. The care supervisor showed the inspector the training records for the staff and these showed that 17 care staff had completed NVQ2 in care and 2 had
Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 21 completed NVQ3. This means that more than 50 of the care staff have an NVQ in care which is very positive. The recruitment checks were inspected for four staff and these were fully in place including two references and application form. Three of the staff had a record of a CRB disclosure. One recently recruited member of staff had a POVA check and was working with supervision whilst waiting for the CRB disclosure. Each member of staff had a signed record of their contractual details. The induction records were inspected for four staff. These induction records were complete and included a company induction. The staff training records were inspected for four staff. Staff had all received the necessary health and safety training including moving and handling, food hygiene, first aid and fire safety. During the inspection it was noted that some of the service users had some more specialist needs and training in pressure care and supporting service users with issues of depression and alcohol abuse would be beneficial. The staff supervision records were inspected for four staff. All the staff were receiving regular individual supervision on a two monthly basis. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 22 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): 37,39 and 42 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The service users are benefiting from living in a well managed service where the focus is on providing a high standard of care and support. Health and safety measures to protect the service users are mainly in place although a certificate to confirm the electrical installations has been checked needs to be renewed. EVIDENCE: The home has a registered manager who was not present at the inspection. The care supervisor supported the inspection process in a very competent and knowledgeable manner. This reflected the organised systems of management in the home. Since the last inspection the home has not completed another quality assurance exercise. This exercise needs to take place on an annual basis and seek the views of service users, relatives and other care professionals and stakeholders on ways in which the service could be improved. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 23 The home has appropriately reported any serious incidents concerning the service users to the CSCI. Fire safety measures are in place. The fire safety records were inspected and weekly fire alarm checks and monthly fire drills are recorded. The fire alarm and extinguishers had received their service and records were available to confirm this had taken place. The home has a comprehensive fire safety risk assessment as well as general work place health and safety risk assessments. The certificates were in place to confirm the gas system and portable electrical appliances had been serviced. The certificate to confirm the electrical installations had been serviced had expired and needed to be renewed. The staff training records showed that staff had received appropriate health and safety training including fire safety, first aid, moving and handling and food hygiene. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 4 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 3 x 2 x x 2 x Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 25 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 YA5 Regulation 5(1)(b) Requirement The registered person must ensure all the service users have an up to date contract between the home and the service user. The registered person must ensure that each service users social worker is invited to a review meeting every 12 months. The registered person must ensure that each service user has a Waterlow risk assessment completed and where the risk of developing a pressure sore is high that there is a care plan in place to address this issue. The registered person must ensure all the catering staff have their food hygiene training updated. The registered person must ensure that where a service user chooses not to access healthcare appointments that this is recorded in their case notes. The registered person must ensure that the complaints record includes a record of the outcome of a complaint and the timescale for the issue to be
DS0000010574.V308923.R01.S.doc Timescale for action 30/11/06 2. YA6 15(2) 30/11/06 3. YA9 13(4)(c) 31/10/06 4. YA17 13(3) 31/10/06 5. YA19 12(1) 31/10/06 6. YA22 22(1)-(8) 31/10/06 Arnold House Version 5.2 Page 26 resolved. 7. YA23 12(3) The registered person must ensure that where a service user needs some support to manage their monies that the way this support is provided is recorded in the service users case notes. The registered person must resolve the flooding in bedroom 20. The registered person must provide staff training on pressure care and supporting service users who have depression or alcohol abuse. The registered person must update the annual quality assurance exercise. The registered person must update the electrical installation certificate. 31/10/06 8. 9. YA24 YA35 23(2)(b) 18(1)(c) 31/10/06 30/11/06 10. 11. YA39 YA42 24(1) 13(4) 30/11/06 31/10/06 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 YA12 YA19 Good Practice Recommendations It is recommended that the service users are supported to access more opportunities to go to college or access employment opportunities within the wider community. It is recommended, to enable personal development for service users who are diabetic to receive/attend a talk by the district nurse to enable them to make informed choices about how to manage their health. This approach could also be used to inform service users of their own conditions such as MS and strokes for example. Arnold House DS0000010574.V308923.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 DS0000010574.V308923.R01.S.doc Version 5.2 Page 28 - 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!
