Inspection on 04/10/05 for Arrowsmith Lodge Rest Home

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Arrowsmith Lodge Rest Home 15/07/08

Arrowsmith Lodge Rest Home 06/07/06

Arrowsmith Lodge Rest Home 25/04/05

Arrowsmith Lodge Rest Home 06/01/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Arrowsmith Lodge Rest Home Bournes Row Hoghton Lancashire PR5 0DR Lead Inspector Della Lovell Announced Inspection 4th October 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Arrowsmith Lodge Rest Home DS0000061375.V251687.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arrowsmith Lodge Rest Home Address Bournes Row Hoghton Lancashire PR5 0DR 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) 01254 854311 Mrs Kesavamalar Rajaratnam Care Home 16 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (16), Physical of places disability (1) Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 16 service users to include: Up to 16 service users in the category of OP (Older People) Up to 1 named female service user in the category LD (Learning Disability) Up to 1 named female service user in the category PD (Physical Disability) This condition will no longer apply should the service user no longer reside at Arrowsmith Lodge Care Home or, due to advancing age, fall into the category OP (Older People). Staffing should be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 25th April 2005 2. Date of last inspection Brief Description of the Service: Arrowsmith Lodge is a purpose built home, set in a quiet residential area of Hoghton. The home provides services for up to 16 older people, it does not provide nursing care, but provides social and personal care in a small, homely environment. At present, the home offers accommodation in a single or shared rooms. The sizes of the rooms vary greatly and there are two rooms with en suite facilities. There are three lounge areas, one of which is a conservatory, leading via a ramp to a large garden area, and another includes the dining area. The service users have access to the first floor by a passenger lift. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one day in October 2005. Information regarding standards not assessed at this inspection can be located in the previous inspection report. During the inspection discussion took place with the manager/ provider, staff members, service users and two relatives. A number of documents were examined as part of the inspection and a tour of the home was undertaken. What the service does well: What has improved since the last inspection? What they could do better: The new owner took over Arrowsmith Lodge approximately 18 months ago at that time very little refurbishment and development had taken place and the home had a large number of requirements and recommendations outstanding. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 6 The new provider and staff have worked hard and have significantly reduced the number of requirements and recommendations. However there is still work to do. The registered person must review the homes planned programme of refurbishment and decoration to ensure that areas of the home in need of attention are refurbished. The homes risk assessments must identify all the risks and the action the home has taken to reduce the risk. All risk assessments must be reviewed on a regular basis. Arrowsmith Lodge has gone thorough a lot of change over the past 3 years it is important that the new provider establishes good consultation process with staff, service users, relatives and stakeholders to actively seek their views on how the home is achieving goals for the service users. Policies and procedures should be reviewed and up dated in line with any changes. 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. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 4 The home had a good assessment procedure which ensures service users needs are assessed and met. EVIDENCE: Since the last inspection the registered person had developed a good format to ensure service users needs are assessed and planned for. Observation of service users files showed that all new service users are admitted only on the basis of a full assessment and for individuals referred through social services the registered manager had obtained a local authority assessment. One new service user had been visited by the registered person prior to admission, since admission care staff described how there had been some general improvements in the service users health. Two family members told the inspector that the staff were very hard working and caring and felt that their relatives needs were being met and that they were happy with the care provided at Arrowsmith lodge. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 9 The home’s statement of purpose had been amended to ensure that all service users have the information they need to make an informed choice about where to live. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Each service users had an individual care plan, which provided comprehensive information and detail to ensure that service users health, personal and social care needs can be fully met. Service users are cared for in such away that ensures their dignity and privacy. EVIDENCE: Since the last inspection the registered person has introduced a new care planning system. On the day of the visit each service user had an individual care plan, which provided comprehensive information and detail to ensure that service users health, personal and social care needs can be fully met. The files of three service users were examined. Resident’s care was clearly recorded providing clear instructions to staff on how to meet the individual needs. Care plans are reviewed and service users and their families are invited to be involved in the process. Each service users file contained records for monitoring and recording any health care intervention. These records were up to date and provided detailed information. One relative said that the staff are respectful to her mum and the inspector saw examples of staff caring and speaking to service users in a sensitive manner. One service user told the inspector that the staff are always kind and respect her privacy when assisting with personal care. On the day of Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 11 the visit a number of service users where being seen by the visiting chiropodist. One of the main bathrooms in the home had been refurbished and made into an assisted shower room. Although the bathroom door had a lock fitted there was no shower curtain around the shower area. The registered person should consider fitting a shower curtain to provide additional privacy. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 14 The home provides service users with choice and flexibility, which ensures service users, have control over their lives. EVIDENCE: Since the last inspection the home has employed an activity coordinator for three 2-hour sessions each week. Service users social interests, likes and dislikes are recorded at the point of admission. The activity coordinator tends to ask the service users on the day what they would like to do. One relative told the inspector that she visits the home most days, there was no restrictions on visiting and felt that the service users were benefiting from having the new activity sessions. The home should ensure that the needs and disabilities are taken into consideration and individual one to one time is provided for service users who are unable to participate in-group sessions. Service users told the inspector that they enjoyed doing some of the things. One service user said that she liked having her nails painted. On the morning of the visit a religious service was taking place in the home and the activity coordinator was provided a session in the afternoon. The home provides flexibility with regards to daily routine and a record is kept for each service user’s preferred time of getting up in the morning. On the day Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 13 of the visit one-service users was not feeling too well and the cook was going through a number of alternatives for her meal at lunchtime. Service users are encourage to maintain their own financial affairs as long as possible and there was a leaflet with regards to the local advocacy services in the entrance of the home. Some service users had brought small pieces of furniture into the home and two had their own armchairs. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Arrangements for the protection of service users ensures their safety. EVIDENCE: This standards was not fully assessed however since the last inspection the requirement to ensure that all staff left in charge of the home are provided with training on the Protection of Vulnerable Adults had been addressed and staff were able to confirm this. The home had reviewed the homes policy and procedure and a format had been developed to record any incidents. The inspector made a minor recommendation on the day to include a named designated manager with specific responsibility for addressing and reporting concern. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,25 and 26 The home is clean and tidy however improvements are still needed to ensure service users live in a safe and comfortable environment. EVIDENCE: Since the last inspection the registered person has made a number of improvements to the environment of the home. One bathroom has been made into an assisted shower room and the other bathroom has been redecorated. One lounge has benefited from new furniture and decoration however the other lounge and conservatory still requires refurbishment. Some bedrooms have been re-decorated but some still are in need. Improvements to the environment are still needed to ensure the continued comfort of service users. The registered person should review the existing refurbishment programme to ensure that action is taken where needed. The registered person will need to take into consideration the future plans for Arrowsmith Lodge when prioritising the work needed. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 16 At the time of the inspection there was old furniture outside of the home that needed removing, the garden was tidy but the perimeter wall remains in need of repair. The registered person has built a temporary laundry outside the main building. The home procedure for transporting soiled clothing to the laundry is through the conservatory door and not through the dining area or kitchen. The laundry was suitable for the purpose, clean and tidy and there were instructions for staff to follow with regards to infection control. The registered person should ensure that a store of gloves and aprons are kept in the laundry room. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The policies and procedure for the recruitment of staff are robust and provide safeguards for the protection of service users. Staff at the home are provided with training to ensure they are competent to do the job. EVIDENCE: The home had a recruitment procedure in place, which ensured the Protection of Vulnerable Adults. Personnel files showed that a thorough recruitment and selection process had taken place and all new staff had undertaken induction training. Since the last inspection all staff files had been audited and a new system in place to ensure that all information required by law is in place. The registered person had developed a training matrix in the home, which clearly showed what training staff had undertaken and what training was needed. Certificates were seen on the staff files. The registered person was currently ensuring that all staff were provided and kept up to date with mandatory training and other more specialised training which equipped them with the necessary skills to carry out their role confidently and competently. Staff said that they felt supported by the training and other staff told the inspector that there was a lot of training going on in the home at the present time. A number of staff were working towards their NVQ Level 2 qualification one staff member said that she was enjoying the training. The registered person was aware of the need to ensure 50 of the staff have an NVQ qualification. The inspector noted that a high number of service users living at Arrowsmith Lodge required a high level of assistance from care staff. Staffing levels in the home were sufficient for the number of service users living in the home. Staff spoken too said that they felt they had enough staff on duty to meet the needs Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 18 of the current service users but sometimes in the afternoon there was little time to talk with service users. The registered person was currently looking at the staffing levels on each shift. There was a rota available in the home showing staff on duty. The registered person must include all person working in the home on the rota this should include the activity coordinator. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35,36 and 38 The home is well managed which ensures service users interests are safeguarded. However the registered person should develop formal ways to consult with service users and relatives. Improvements are needed to the homes risk assessments to ensure the continued safety of service users. EVIDENCE: The registered provider is also the manager, one staff member said that the manager works really hard and has made some good changes. Relatives on the day of the visit said that the staff were very good and they could always talk to the manager of the home. The manager had developed regular staff meetings for staff and there was a good record of this. Staff said that they could put items forward for the agenda and that the manager would consider their views. The registered manager should consider formally seeking staff, family and service users views on the different aspects of the home. This could be Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 20 achieved through questionnaires, group and individual meetings. The inspector noted that the policies and the procedures had not been reviewed and one old policy was not applicable to the home. The registered person should undertake the homes policies and procedure and review on an annual basis. The home provides written records of all service users financial transactions and receipts and records were well maintained. The registered person is an appointee for one service user living in the home. Since the last inspection formal supervision sessions had commenced and these were seen documented on the staff files. The registered person should ensure that staff receive supervision sessions six times a year. On the day of the visit the registered provider was able to show the inspector a number of certificates for servicing of equipment in the home. Since the last inspection the registered person had closely monitored the water temperature in the bedrooms and bathrooms and had the water system checked for legionella. There was both a fire and environmental risk assessment in place. However more detail is needed in identifying the risk and what action is taken to minimise risk. The registered person should ensure that all risk assessment are reviewed on a regular basis. Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 2 3 3 X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 3 x 2 Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 22 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 OP20OP19 Regulation 23(2)(b) (c)(d) Timescale for action The registered person should 30/12/05 inspect each room including communal areas and devise a planned programme of refurbishment and decoration in a priority order, the plan should include timescale. The registered person must 30/11/05 ensure that none guarded pipe work and radiators are clearly risk assessed and action taken to minimise any risk. The registered person must 30/11/05 ensure that the duty rota shows all staff working in the home. The registered person must 30/11/05 ensure that the homes risk assessment provides detailed information on the risk identified and the action the home is taking to minimise the risk. All risk assessment must be 30/12/05 reviewed on a regular basis and up dated accordingly. The registered person must 30/01/06 develop formal ways to actively seek the views of service users, family and stakeholders on how the home is achieving goals for DS0000061375.V251687.R01.S.doc Version 5.0 Page 23 Requirement 2 OP25 13(4)(a) (b)(c) 3 4 OP27 OP38 Schedule 4 13 (4)(a)(c) 5 6 OP38 OP33 13(4)(a) (c) 12(1)(a) 24(1)(a)( b) Arrowsmith Lodge Rest Home service users. 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 3 Refer to Standard 7 10 12 Good Practice Recommendations The registered person should ensure that all care plans are reviewed on a monthly basis. The registered person should consider fitting a shower curtain in the new shower room on the first floor. The home should ensure that the activities provided and planned take in to consideration the needs and disabilities of the current service users and individual one to one time is provided for service users who are unable to participate in group sessions. The whistle blowing policy should ensure that staff will protect against victimisation. The registered person should ensure that the homes policy for the protection of vulnerable abuse includes; - A clear procedure for reporting and addressing concerns - Guidance to help staff who have concerns about malpractise to raise the concerns with the right people on the basis of needs to know The registered person should ensure that there is a store of aprons and gloves in the laundry room. The registered person must make appropriate arrangements to ensure staff are appropriately qualified to NVQ Level 2 by 2005. The registered person should undertake to review the homes policies and procedures yearly. The registered person should provide training for the person undertaking risk assessments. The registered person should ensure that staff receive supervision 6 times a year. 4 5 18 18 6 7 8 9 10 26 28 33 38 36 Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Arrowsmith Lodge Rest Home DS0000061375.V251687.R01.S.doc Version 5.0 Page 25 - 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!