Inspection on 02/08/05 for Arnold House

This inspection was carried out on 2nd August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arnold House 16/04/07

Arnold House 18/09/06

Arnold House 13/12/05

Arnold House 15/02/05

Arnold House 27/07/04

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

CARE HOME ADULTS 18-65 Arnold House 66 The Ridgeway Enfield Middlesex EN2 8JA Lead Inspector Rebecca Bauers Unannounced 2nd August 2005 @ 12.00 noon 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Arnold House Address 66 The Ridgeway, Enfield, Middlesex EN2 8JA 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) 020 8363 1660 Rosemarie Mitchell for Leonard Cheshire Foundation Rita Stroud PC Care Home 21 beds Category(ies) of PD Physical Disability registration, with number of places Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Four specified service users who are over 65 years of age may remain accommodated in the home. 2. The home must advise the registering authority at such times as any of the four specified service users vacates the home. Date of last inspection 15 February 2005 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 Organisation, which is a voluntary organisation providing care services to people with disabilities. The care home is in a beautiful building which was bequeathed to the Leonard Cheshire Organisation by the Arnold family. There are extensive grounds to the rear of the care 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 home’s 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 individual’s physical, mental and spiritual wellbeing.” Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 2nd of August 2005 as part of the annual inspection programme to identify progress with previous requirements and to check standards of care against the core standards. The inspection took five and a half hours to complete. A partial tour of the home took place; six service users were spoken to individually and as a group. No relatives spoke to the inspector. Care records, quality assurance audits, staff records and health and safety records were examined. Four staff were spoken to and the inspector was present during the handover between shifts. The registered manager was not present during the inspection. The inspector was accompanied by the care supervisor throughout the inspection. Further information was obtained from the pre-inspection questionnaire, comment cards and the homes summary of a recent quality assurance survey. Three comment cards were received in total, one from a GP and two from service users. Positive comments were given with regard to the care received and the caring enthusiastic attitude of the staff team to meet the needs of the service users. What the service does well: The service users benefit from knowing that their assessed needs are reflected in their individual plans. Risk assessments are in place to promote service users independence. Service users benefit from the experience of multidisciplinary working to ensure that their personal care, social and emotional health needs are met. The environmental conditions are homely and welcoming and the home ensures that service users, relatives and other professional’s views are listened to and addressed to improve service provision. Service users benefit from a well-established staff team who understand their needs and are provided with the support and information to work with service users in a consistent way. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 6 The home is well managed and all health and safety checks are carried out to ensure the health welfare and safety of service users. Service users say that the staff are helpful and friendly. All service users said that they felt comfortable in the home and enjoyed the food and indoor activities. What has improved since the last inspection? Fourteen requirements and four recommendations were made at the last inspection. Ten of the requirements and three of the recommendations were met at this inspection. Care staff are now receiving regular supervision to promote continuity in practice and care for service users. Staff have been appropriately trained in food hygiene and manual handling and lifting to ensure the safety of service users. Service users are benefiting from person centred individual plans with clearly identified support needs and preferences with regard to the type of care they prefer. The homes complaints logbook is now in place and the service users have been given the CSCI’s contact details in the event that they wish to make a complaint. Staff records now contain current photo ID for all staff. A policy and procedure is now in place covering the POVA checks and CRB checks required prior to employment. The homes risk assessments have been reviewed and updated to safeguard the staff and service users. Monetary transactions are signed for by the registered manager and service user where possible to safeguard against potential financial abuse. Decisions made by service users are now being evidenced in daily notes and individual plans. The reasons for providing a front door key or not have now been documented in the individual plans. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 7 What they could do better: Ten requirements were made at this inspection, four were restated. Two recommendations were made, one was restated. One requirement was made under the section individual needs and choices which concerned the lack of multidisciplinary reviews with the placing authority which are required to ensure that the placement remains suitable and that the individuals needs can continue to be met by staff. Three requirements were made under the heading lifestyle, one was restated. Service users must be supported to have access to the local community and for this to be facilitated by designated drivers during the weekends. In addition all service users must be offered a one-week holiday each year as part of the contract price. Appropriate leisure activities are an integral part of an individual’s life and must be promoted to enhance the wellbeing of service users. Two requirements are made under the relevant section of the report, one was restated under the section personal and healthcare support concerning medication administration records and the recording of health appointment outcomes to safeguard service users and to ensure their needs are being met. One requirement is restated under the heading environment for adequate storage facilities for physiotherapy equipment and wheelchairs to enable more space for service users to mobilise without any potential obstruction. Three requirements were made under the heading staffing which concerned, verification of staff competence from a district nurse, supervisions for managers and the need to have CRB certificates/copies available in the home. Recommendations were made for the long shifts to be reviewed to safe guard service users and to ensure that staff remain effective in the care that they provide. Secondly for policies and procedures to be reviewed every two /three years. Please contact the provider for advice of actions taken in response to this Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 9 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 Standards Statutory Requirements Identified During the Inspection Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 10 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 standard(s) 1,2 Service users can feel confident that the staff in the home have a good knowledge of their needs and aspirations. Service users have relevant information in the statement of purpose to make informed choices about the home. EVIDENCE: A requirement made at the last inspection for the complaints document “have your say” contained within the statement of purpose to include the contact details of the Commission had been progressed and was available to service users if they wished to make a complaint. There have been two new admissions since the last inspection. There was evidence on file that individual aspirations and needs are assessed prior to admission. Service users can feel confident that the staff in home have a good knowledge of their needs. One service user spoken to said, “I feel that I have settled in well to the home although I am still finding my way around. The staff are very kind and know what I need.” Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 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 standard(s) 6,7,9 Service users generally know that their assessed needs, preferences and support needs are documented in their individual plans although some service users are involved in the redevelopment of their new plans and this is ongoing. Annual multidisciplinary reviews with the placing authority are not taking place to ensure that the placement remains suitable. Appropriate risk assessments are in place to promote service users independence. EVIDENCE: A requirement made at the last inspection for the registered person to ensure that all service users have a service user plan in place with clearly identified support needs documented to enable continuity of care had been progressed. The four service user plans examined including two for the service users who had recently moved into the home contained a profile of the individual and then specific support needs stating what preferences the service users have with regard to the care they receive and what support is needed by staff. The plan had been written in a person centred way. Some of the service user plans require ongoing work to make them more person centred and the inspector was informed by the care supervisor that these would be completed within the next three months. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 12 A recommendation made at the last inspection for staff to assist service users to make day-to-day decisions and for these to be recorded in the case records had been progressed. Daily notes indicated decisions made by service users and those individual plans that had been developed with service users indicated decisions and preferences with regard to their daily care. Care plans are reviewed every six months within the home and there was evidence to support this. There was however a lack of multidisciplinary reviews carried out by the placing authority. None of the four case files examined contained annual reviews. This must be rectified. Appropriate risk assessments were in place for all service users, which included manual handling and lifting bathing and swimming for example. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,16,17 Service users are not accessing the local community nor are they engaging in leisure activities including holidays that they choose due to the lack of funding, transport on weekends and there no longer being a full time activities coordinator. Service users are having regular appropriate contact with family and friends. Service users benefit from well-balanced healthy meals and an environment that is conducive to a relaxing experience. EVIDENCE: A requirement made at the last inspection for there to be sufficient drivers available to enable service users to carry out the activities they choose to do particularly during the weekends had not been progressed. Although the inspector was informed that this is currently being worked on. The requirement is restated. The six service users spoken to said that the number of times in which they go out during the week had reduced considerably in the last two months and that they may only go swimming once a month or to the cinema once a month. They said that they do occupy themselves in the home and that indoor Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 14 activities are arranged by the home. Service users said that they enjoyed the barbeque the night before when they had a chance to meet other service users from other Leonard Cheshire homes. Service users must be supported to access the local community so that they can participate in leisure activities that they are interested in and to promote their wellbeing. The service user surveys administered by the home in April 2005 also demonstrated that service users would like to access the community more frequently. A requirement made at the last inspection for the registered provider to write to the placing authority to negotiate finance for a one-week service user holiday for 2005/2006 had not been fully progressed. The inspector was informed that negotiations are currently taking place. This requirement is restated for the third time to ensure that all service users have an opportunity to go away on holiday. Service users do have regular contact with family and friends; this was evidenced through conversation and case files. A recommendation made at the last inspection for the registered person to provide service users with a front door key unless the reason for not doing so is recorded in the service user plan had been achieved. The individual plans examined provided details with regard to a service user holding a key or not as the case may be, demonstrating the level of some service users independence. A requirement made at the last inspection for all kitchen assistants to receive food hygiene training had been progressed. Certificates were seen on staff files. Service users were positive in their comments about the food provided in the home, menus were seen as providing healthy well-balanced meals that had been developed with a dietician. The dining area had recently been decorated. Service users commented that they appreciated the light and airy feel of the room. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Service users say that they receive personal care in the way that they prefer. Service users physical and emotional health needs are identified although it is not always clear that they are being met which could be detrimental to service users well-being. Service users are not being protected by the homes medication policies and procedures. EVIDENCE: A restated requirement for the details of health appointments attended by service users and the outcomes of these appointments to be recorded in the service user file had been partially complied with. Details of health appointments attended such as GP, chiropodist, hospital appointments and blood tests had been documented however the outcome of these appointments had not been completed in three out of four cases examined. This must be rectified to ensure that service users with complex health needs can be sure that any follow up appointments and actions are understood and followed by staff in a consistent manner. In the four individual plans examined service users preferences with regard to personal care support needed had been fully documented. Service users spoken to acknowledged that staff are always courteous in the way in which they support them with their personal care needs. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 16 The homes medication policy and procedures are not being followed to protect service users. Three of the eight separate medication administration sheets examined showed gaps where staff had not indicated if medication had been refused or given. This must be rectified to ensure that service users are protected from medication errors and to safeguard their well being. Service users who self-medicate have appropriate assessments in place to ensure that safe administration occurs and to promote their independence. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 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 standard(s) 22,23 Service users do feel that their views are listened to and acted upon. Appropriate records substantiate this. Service users are protected from potential abuse, neglect and self-harm through adequate adult protection procedures that safeguard service users. EVIDENCE: Service users feel that their views are listened to and acted upon. A recent service user survey conducted in April 2005 indicated that service users are generally happy with the care they receive, they are involved with the development of their own individual plans, they know who they can talk to if they are unhappy or would like to talk to someone in confidence, that staff treat them with respect, they like the food and have enough to eat but would like to be able to access the wider community more frequently. Service users spoken to confirmed this during conversation. A requirement made at the last inspection for a complaints logbook to be in place to record all complaints had been progressed. Complaints records were seen and five minor complaints had been made and had been investigated appropriately. Staff have received adult protection training and were knowledgeable in respect of what to do in the event of an allegation of abuse being made and who to report to. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 18 A requirement made at the last inspection for all monetary transactions made and recorded between service users and the registered manager to be signed by both parties had been carried out. Records were seen and complete. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 19 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 standard(s) 24,29,30 Service users do live in a homely, comfortable and safe environment. There are no adequate facilities to store specialist equipment. The home is clean and hygienic. EVIDENCE: Service users live in a homely, comfortable and safe environment. The dining area had recently been decorated making it light and airy much to the service users appreciation. The home has a range of equipment for service users including overhead tracking hoists, mobile hoists and assisted bathrooms, there was evidence of regular maintenance checks. Wheelchair servicing and maintenance records were also available to ensure the safety of service users. A requirement made at the last inspection for adequate safe storage facilities to be provided to store mobility equipment and for the storage and recharging of wheelchairs had not been progressed and the requirement is restated for the safety of staff and service users. The home is clean and hygienic. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 20 Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 21 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,36 Service users are supported by a competent consistent staff team although their competency in some cases must be verified. The homes recruitment policy and practices are not protecting service users fully. Service users benefit from well supported care staff although the managers still require support to promote continuity for service users. The continued effectiveness of staff whilst on fourteen-hour shifts is debatable and could jeopardise the health and safety of service users and staff. EVIDENCE: A requirement made at the last inspection for all care staff to receive supervision at least every two months had been progressed. Four care staff files were examined and found to contain records of regular supervision. However the care supervisor’s file showed that the last supervision given was on the 18/2/05 and prior to that 4/6/04. This is not adequate to ensure consistent working within the management team and must be rectified. A requirement made at the last inspection for all staff files to have photo ID on file had been achieved. All other relevant information to protect service users was on file including copies of CRB certificates in most cases. However for two newly recruited staff, the CRB information had been sent via e-mail from the Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 22 organisations human resources department stating the name of the person, the disclosure number and the date the check was carried out. This is not satisfactory, the CRB certificate or copy must be held on file or made available on inspection, this must be rectified to protect service users fully. A recommendation made for the recruitment policy and procedure to be updated to include the need to carry out POVA checks prior to employment and in line with new legislation had been achieved. The organisation has a separate policy and procedure entitled ‘disclosure for prospective employees’ which covers the need for POVA checks and CRB checks prior to employment to protect service users. The inspector identified through discussion with staff that some staff had been trained by the district nurse to change stoma bags for example. This is a nursing task and should only be carried out by competent staff. There must be a record on the service users file and the training file of named staff deemed competent by the district nurse to carry out such a task to safeguard service users and staff. The rota demonstrated that in some instances care staff and senior managers are on shift for fourteen hours in one day, this length of shift is not conducive to safe working and could prove to be a risk to service users and care staffs health and safety. These shift patterns should be reviewed and reduced. Agency staff are not used in the home. The home have a bank of staff that they call on when required so service users are supported by a consistent staff team. Service users spoke positively about the staff stating that they were ‘caring and kind.’ Staff spoken to say that morale is good, that they are receiving supervision on a more regular basis and that they have recently received training in manual handling and lifting. Health and safety training in planned for this month. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 23 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,42 Service users benefit from a management approach that is open and can feel confident that their views are listened to and are used in the development of the service they receive. The health, safety and welfare of service users are promoted and protected. EVIDENCE: Staff spoke positively about the registered manager and senior managers and felt that they were approachable and supportive. This has had a positive effect on staff morale, which benefits service users. The registered manager has achieved NVQ level 4 and the registered manager award. A requirement made at the last inspection for the homes risk assessment to be reviewed and updated had been achieved over the last six months. This included fire risk assessments and an emergency plan. All relevant certificates were in place following safety checks to protect the health, safety and welfare of service users. A requirement made for all staff to receive manual handling Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 24 and lifting training had been achieved, all staff files examined contained valid certificates of achievement. Staff were knowledgeable with regard to the correct procedures for lifting service users safely. A requirement made at the last inspection for a summary of results to be produced following a quality assurance audit carried out in April 2005 had been achieved and was available for inspection and to service users. Actions for development and improvement of the service for service users had been identified. Service users can feel confident that their views underpin development within the home. A recommendation made at the last inspection for all policies and procedures that had not been reviewed in the last two/three years to be reviewed had not been progressed. This should be addressed. Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 25 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 2 3 Standard No 11 12 13 14 15 16 17 x 3 2 1 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 x 1 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arnold House Score 3 1 2 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 3 x G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 26 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 14 Regulation 16(2) Requirement Timescale for action 1/12/05 2. 19 17(1)(a) Schedule 3 (3)(k)(m) 3. 14 16(2)(n) The registered provider must write formally to the placing authorities to negotiate finance for a one week service user holiday for 2005/ 2006 as this is now part of the national minimum standards that registered care homes are to comply with. This requirement is restated from the last two inspections. Timescale for action was 1/8/05. The registered person must 1/9/05 ensure that the details of the outcomes of health appointments are recorded in the service user file in a clearly identified section. This requirement is amended and restated from the last two inspections. Timescale for action was 1/4/05. The registered person must 1/10/05 ensure that there are sufficient drivers available to enable service users to carry out the activities they choose to do particularly during weekends. This requirement is restated from the last inspection. Timescale for action was 1/6/05. Version 1.40 Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Page 27 4. 29 23(2)(m)( 3)(a)(ii) 5. 6 15(2) 6. 13 16(2)(m)( n) 7. 20 13(2) 8. 32 17(1)(a)( m) 9. 34 17(2) Schedule 2 (7) 18(2) 10. 36 The registered person must ensure that adequate storage facilities are provided to store mobility equipment and for the storage/recharging of wheelchairs. This requirement is restated from the last inspection. Timescale for action was 1/8/05. The registered person must ensure that all service users have a multidisiciplinary annual review with their placing authority. The registered person must ensure that all service users are given the opportunity to access the community on a regular basis. The registered person must ensure that the administration of medication is recorded accurately and that there are no gaps in the records. Refusal of medication must be coded appropriatley. The registered person must ensure that there is a record held on service users file of the named staff trained by the district nurse to support them with for example stoma care. The registered person must ensure that copies of CRB certificates for staff recently employed are held on thier personal files. The registered person must ensure that the manager and care supervisor receive 1to1 documented supervision at least every two months 1/11/05 1/10/05 1/9/05 1/9/05 1/9/05 1/9/05 1/9/05 Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 28 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 40 Good Practice Recommendations It is recommended that the registered person review all policies and procedures that have not been reviewed in the last two/three years. This recommendation is restated from the last inspection. The registered person should review the rota to reduce the long fourteen hour shifts that some staff undertake during the week and on some weekends. 2. 33 Arnold House G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 29 Commission for Social Care Inspection 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 G59 S10574 Arnold House V240489 02.08.05 Stage 4.doc Version 1.40 Page 30 - 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!