Inspection on 23/05/07 for Arthur Lodge

This inspection was carried out on 23rd May 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arthur Lodge 23/03/09

Arthur Lodge 30/09/08

Arthur Lodge 08/04/08

Arthur Lodge 12/10/06

Arthur Lodge 24/10/05

Arthur Lodge 04/07/05

Arthur Lodge 23/02/05

Arthur Lodge 24/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Arthur Lodge 16 - 18 Arthur Road London N9 9AE Lead Inspector Susan Shamash Key Unannounced Inspection 23rd May 2007 12:30 Arthur Lodge DS0000010577.V336478.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 Arthur Lodge DS0000010577.V336478.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. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arthur Lodge Address 16 - 18 Arthur Road London N9 9AE 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) 020 8345 5743 020 8345 5743 Mr Dhenraj Hurdowar Mr Dhenraj Hurdowar Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (1) of places Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2006 Brief Description of the Service: Arthur Lodge is a care home for 11 adults with learning disabilities. It was originally registered as a small home for 3 people, but expanded in 2001 to accommodate six people. In Spring 2005 it expanded further with the conversion of a neighbouring property so that Arthur Lodge now has 3 places for respite care and 8 places for long-term residents. Mr Hurdowar both owns and manages the home. The home is situated in a residential street, a short walk from the local shops and business premises in nearby Edmonton Green. It consists of 2 adjoining properties with a shared garden at the rear. The residents’ rooms are located on the ground and first floors. The home has a vehicle so that people living at the home can get out and about. Weekly fees as of May 2007 are £650 - £750 and the most recent CSCI inspection reports can be obtained from the home’s office, or the CSCI website at www.csci.org.uk Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over approximately six hours. The proprietor and manager, Mr Hurdowar was available to assist me throughout the visit, although he was also involved in facilitating an emergency admission to the home. I spoke to five people living at the home, the new deputy manager and three other staff members during the visit, and conducted a tour of the premises and viewed various records and policies. What the service does well: What has improved since the last inspection? Resident meetings were being held regularly and minutes of these meetings were being recorded. As required at the previous inspection, the practice of decanting medication for some people living at the home into wallets had been stopped to avoid mistakes in the administration. The home’s policy for protecting vulnerable adults from abuse had been updated to reflect the role and policy of the local authority. A couple of maintenance issues that needed improvement had been addressed, improving the comfort of people living at the home. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Arthur Lodge DS0000010577.V336478.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 Arthur Lodge DS0000010577.V336478.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the home have their needs assessed and their aspirations recognised before moving to the home, to ensure that these can be supported appropriately. EVIDENCE: At the beginning of this visit, eight people were living at the home on a permanent basis and one was there for a respite service. However an emergency admission was received during the inspection. I witnessed the manager talking with the new person during the inspection, to ascertain their needs, and showing them around the building in the presence of their social worker. I inspected the care records of four people living at the home, including one person staying at the home on a respite basis. The files included full assessments of their individual needs, based on the activities of daily living. The records were suitably detailed and included risk assessments and information about social and cultural needs as appropriate. I also spoke to five people living at the home who confirmed that they had been involved in the assessments from when they moved into the home and had received sufficient information about the way the home is run. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home have their needs and goals set out in an individual plan of care. They are encouraged to make decisions about their own lives and supported to take risks in pursuit of as independent a life as possible. However they cannot be assured that their confidentiality will be adequately protected within the home. EVIDENCE: Individual plans of care were seen for four people living at the home. These were seen to take a holistic approach to people’s care. The plans were regularly reviewed with any changes being documented. Most had an annual review by the placing authority as appropriate, but it is recommended that the manager contact all relevant local authorities to ensure that people living at the home have at least an annual review with their social workers. Notes should be kept of the main outcomes of any review meetings with social services, for the interim period before the formal minutes are received, to ensure that the needs of people living at the home are met appropriately. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 11 Care plans indicated that people are enabled to make choices in their day-today lives, for example on what to wear, what activities to pursue and when to go to bed. Their cultural and religious needs are also assessed, so that these can be addressed appropriately. Risk assessments were available alongside the care plans in sufficient detail to show how risks could be minimised for individual people living at the home. These were reviewed at least six-monthly as appropriate. People I spoke to advised that they were aware of their care plans and had been consulted about them as indicated in the plans. One person advised that they had concerns about the amount of monies they were receiving, and it was noted that their care plan addressed this area. To further empower people living at the home, it is recommended that personcentred planning formats be considered in order to upgrade care plans, particularly for people living at the home on a permanent basis. Training in this area may be available from the local authority. I was concerned to note that the manager’s office, which is the current storage place for all residents’ care plans, cannot be locked, as it leads directly into the rooms of two people living at the home. Whilst staff files were locked away in a filing cabinet, there was insufficient lockable space to lock away residents’ files. In addition some residents’ files were found downstairs close to the deputy manager’s desk, where there is also no lockable storage space. This compromises the confidentiality of people living at the home, and a requirement is made accordingly. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have a range of appropriate activities to choose from, many of which are based in the local community. They have good contact with family and friends. They can be assured that their rights and responsibilities will be recognised and are able to eat an appropriate range of meals that meets their nutritional needs. EVIDENCE: The likes and dislikes of people living at the home are recorded in respect of activities available to them. Information was also recorded about people’s cultural needs including religion, preferred language and food preferences. They have individual weekly activities plans including such activities as indoor games, videos and music, college courses, bowling and cinema trips and visits to restaurants and pubs. People living at the home are part of the local community utilising local shopping and recreational facilities such as those detailed above. During the Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 13 inspection, I observed three people out in the local area with a staff member, using the home’s vehicle. Most people were out during the inspection at local colleges and day centres, and returned towards the end of my visit. However, I noted that for people who were not out during the day, there appeared to be a limited number of indoor activities for them to be engaged in. It is therefore recommended that a greater selection of in-house activities be available to people living at the home. Most of the current people living at the home have contact on a regular basis with family and others. Details of this contact were clearly recorded in peoples care plans and those spoken to confirmed that they were encouraged to keep in touch with these contacts. Residents meetings take place regularly, and I was able to inspect the minutes of these meetings. Discussion had taken place at the most recent inspection, regarding holiday plans for this year. One person was to go to Cyprus, another to Liverpool and others were considering a break at a Butlins holiday resort. Meeting minutes showed that people living at the home are respected and their views taken into account. My observations indicated that where able, they are encouraged to participate in the running of the home and to carry out tasks such as keeping their rooms tidy, making drinks etc. The manager and staff were seen to show respect to people living at the home during the inspection. All people spoken to living at the home, spoke positively about the food served. One person, discussing the food, told me ‘there is always plenty of it, and very nice it is too’. Stocks of food seen on the day of the inspection were sufficient including fresh vegetables and cultural alternatives, and were related to the menus seen during the inspection. The main meal of the day is taken in the evening when all residents are at home. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home receive support in a way they need and prefer and their health needs are given appropriate priority. Improvements had been made to improve the medication administration systems to ensure that people’s health is appropriately protected, although there remains room for improvement in this area. EVIDENCE: People’s preferences in the way they are cared for are outlined within their assessments and care plans. Those spoken with during the inspection said that staff treated them well, helping them in an appropriate manner. A keyworker system is in place to help promote an individualised care service. Inspection of care files indicated that people’s health needs form an integral part of assessments and care plans. Records are kept of appointments with health professionals, which also serve as a reminder of when new appointments such as check ups with opticians and dentists are needed. The home operates a monitored dosage system of medicine administration. Most people living at the home take some form of medication and none are Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 15 able to self-administer their own prescriptions. Staff who administer medication have had training in uses and side effects. People spoken to during the inspection confirmed that their medication was given at regular times. At the previous inspection a requirement was made regarding the decanting of some people’s medication from bottles into seven-day medication wallets, which places people at an additional risk of mistakes being. As required, the manager had ceased this practice within the care home, so that all medicines were either in blister packs or administered directly from their original containers on the day of the inspection. There were no gaps in the medication administration records and appropriate arrangements were in place for the safe storage of medicines. However I was concerned to note that no guidelines were in place for the administration of PRN (as and when) medicines that may affect behaviour, as prescribed to relevant people in consultation with their GP e.g. Lorazepam. Although records indicated that such medicines are used very sparingly, there were no records of the reason for administration when it did occur. A requirement is made accordingly, and records of the circumstances prior to administration of such medicines, and the effect of their administration must be completed on each occasion. Since using a new format for recording medication administration, the practice of recording medicines received at the home or returned to the pharmacy had stopped so that there is no clear audit trail. This is required to ensure the protection of people living at the home from inappropriate use of their medication. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home feel their views are important to the operation of the home. Complaints are handled appropriately and the policy on protecting vulnerable adults has been improved to further protect people living at the home. EVIDENCE: The home has an appropriate complaints policy and procedure in place. This is given to people living at the home and their representatives as part of the service users guide. No complaints had been recorded since the previous inspection, but three complaints prior to this had been dealt with appropriately. None of the people I spoke to, had any complaints or issues of concern to raise and all indicated that they would feel able to complain to the manager if they were unhappy about something at the home. The home has a policy on the protection of vulnerable adults. As required at the previous inspection it had been updated to include the relevant London borough’s policy and procedure. Staff have received training in adult protection and the manager was aware of the procedures to be followed in addressing allegations of abuse. However the inspector was concerned that an adult protection incident that had taken place since the previous inspection, had not been notified to the CSCI. The manager advised that they had been told that social services were notifying the CSCI, however it remains the responsibility of the registered service, to ensure Regulation 37 notifications (of serious incidents affecting the Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 17 wellbeing of people living at the home) are sent to the CSCI without delay. This is required later in the report. Arthur Lodge DS0000010577.V336478.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home live in a homely, comfortable and generally safe environment. The home environment is generally clean and hygienic, although there is room for improvement in hand-drying facilities to further protect people living at the home from infection. EVIDENCE: At the previous inspection the owner/manager advised that he intended to replace the shower base in the downstairs shower room where this has become worn with use, however this had not yet been undertaken. I found the premises to be homely, with the bedrooms of people living at the home personalised with items of interest such as pictures and photographs. Requirements made at the previous inspection regarding putting a new toilet seat in the upstairs bathroom opposite the office and ensuring the carpet in one of the ground floor bedrooms was refitted, had been addressed as required. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 19 Staff and people living at the home advised that facilities at the home met their needs and that when repairs were necessary, these were carried out swiftly, as appropriate to improve the environment for all concerned. The home was found to be odour free and was clean and tidy during the visit. A small number of issues were found that require attention. The springs on the identified sofa in the lounge area, near the entrance to the home were worn, and this must therefore be replaced. Although soap and hand-washing facilities were available in all bathrooms and toilets, the use of shared hand towels for hand-drying in these areas presents an infection control risk. I was told by the manager that the previous provision of paper towels in these areas, had been stopped due to people living at the home blocking the toilets when disposing of them. I discussed possible alternatives with the manager, including flushable towels or air driers. As discussed under Standard 10, the storage of care files for people living at the home does not protect their confidentiality and this must be addressed. It is recommended that an additional lockable cabinet be placed in the manager’s office or near to the deputy manager’s desk, for the storage of confidential information relating to people living at the home. Arthur Lodge DS0000010577.V336478.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from a trained, supervised and competent staff team. The recruitment policies and practices of the home are designed to support and protect them. There is room for improvement in staff training to ensure that the needs of all people living at the home are fully and safely met. EVIDENCE: More than fifty percent of the current staff group have achieved National Vocational Qualifications at level two or above or are undertaking this training. Staff spoken to presented as professional and knowledgeable about people living at the home. Residents were also very positive in their comments about the staff team, and I witnessed appropriate and supportive interactions in the home. Four staff files were inspected, and evidence was available that prospective staff complete application forms, attend interviews, have references taken up on them and are subject to Criminal Records Bureau checks prior to being allowed to work at the home. Files also included photo identity checks for each staff member. Staff spoken to confirmed these practices and said they Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 21 received an induction period to familiarise themselves with procedures and people living at the home. However files did not provide any evidence that induction training had been provided, or of what this consisted of. This is required. I saw evidence in the form of certificates held of files that various training courses had taken place since the last inspection. Newer staff members still had a range of training to undertake, however longer-serving staff members had undertaken mandatory courses including first aid, adult protection, fire safety, epilepsy and manual handling. However not all of these staff had undertaken food hygiene training within the last year. It is required that this training be undertaken by all staff involved in the preparation, serving or handling of food at the home. Records of supervision sessions indicated that regular one-to-one sessions are held with all staff members, and this was confirmed by staff spoken to. Arthur Lodge DS0000010577.V336478.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well run so that people living there can be confident that there health, safety and welfare is promoted and protected. However they cannot yet be confident that their views underpin self-monitoring, review and development of the home. Their finances are also not sufficiently protected by the home’s procedures. EVIDENCE: The registered provider and manager has owned and managed the home for a number of years and holds a City and Guilds qualification which although relevant to care home management has now been superseded by the NVQ care and management qualifications which he has yet to pursue. It remains recommended that the registered manager should obtain qualifications at NVQ level 4 in both management and care. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 23 Staff spoken to on the day of inspection said that they had a good relationship with him and respected his management of the home. Although a quality assurance manual is available in the home, there is no evidence that surveys of people living at the home, visitors and other relevant health care professionals have been carried out, although this was required at the previous inspection. No annual quality audit or action plan had yet been undertaken. The manager advised that this was due to his needing further guidance on how to carry this out, and awaiting the Annual Quality Assurance Assessment (AQAA) tool from the CSCI. I agreed to send him the AQAA format and recommended that he might look at CSCI feedback forms for an idea of a format for questionnaires. This requirement is restated. Records of staff and resident meetings were available indicating that these meetings were used to discuss a range of topics and consult with staff and people living at the home. For ease of reference, it is recommended that previous medication records be maintained on each resident’s care file to aid monitoring procedures. I was concerned to note that an adult protection investigation had been carried out for the home, but the CSCI had not been notified. The manager advised that this was because he had been told by social services staff that they would be contacting the CSCI. However it is required that all serious events affecting the wellbeing of people living at the home must be reported to the CSCI without delay. It remains required that this incident be formally notified to the CSCI, with details as to action taken to address the issue. The manager holds money for safekeeping for a number of people living at the home, and procedures were generally found to be appropriate to ensure that their monies are protected, with records of all transactions recorded and use of a safe to store monies. However I was concerned to note that pin numbers were being held on behalf of some residents, as this places them at an increased risk of financial abuse. It is therefore required that arrangements for supporting residents with their finances should be reviewed so that no pin numbers are kept on behalf of residents, and audits should be undertaken regularly to ensure that the balances recorded match monies stored on behalf of each person. Appropriate health and safety records were available for the home including safety certificates for gas and electrical installations and portable appliances, and current service certificates for fire equipment safety. Records also indicated that weekly fire alarm tests are carried out as appropriate, and regular drills are held at the home. However insufficient Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 24 detail was recorded regarding fire drills, and it is required that records specify the time, staff and residents involved as well as any relevant issues that arise. Not all fire doors at the home were self-closing and these must be checked regularly to ensure that they remain effectively self-closing at all times. A fire risk assessment was available for the home, and this needs to be reviewed sixmonthly. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X 2 2 X Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 YA10 Regulation 12(4a) 23(2l) Requirement Timescale for action 13/07/07 2. YA20 13(2) The registered person must ensure the confidentiality of all private information relating to people living at the home, so that their privacy is respected. The registered person must 29/06/07 ensure that clear guidelines are recorded for the administration of PRN (as and when) medicines that may affect behaviour, as prescribed to relevant residents in consultation with their GP. Records of the circumstances prior to administration and the effect of administration must be completed on each occasion. All medicines received at the home or returned to the pharmacy must also be recorded so that there is a clear audit trail to ensure that the medication needs of people living at the home are met. The registered person must ensure that the identified shower tray (flooring) is replaced. 3. YA24 16(2j) 27/07/07 Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 27 4. YA30 23(2bd) 5. YA35 18(1ci) The identified sofa in the lounge near the entrance to the home must also be replaced, to ensure the comfort of people living at the home. The registered person must 27/07/07 ensure that hygienic handdrying facilities are available in each toilet/bathroom e.g. paper towels or an air dryer, to ensure the health of people living at the home. The registered person must 10/08/07 ensure that records are maintained of the content of each staff member’s induction training. 6. YA39 7. YA41 8. YA41 Food hygiene training must be provided to all staff involved in the preparation, serving or handling of food at the home, to ensure that the needs of people living at the home are fully and safely met. 24 The registered person must ensure that the process for monitoring and reviewing the quality of care provided by Arthur Lodge incorporates the views and wishes of residents and includes an annual audit and action plan, to ensure the quality of care for people living at the home. (Previous timescale of 31/01/06 and 31/01/07 not met.) 37 The registered person must ensure that the CSCI is notified without delay, of any serious event affecting the wellbeing of people living at the home, to ensure that appropriate action is taken to ensure their safety. 17(2) Sched The registered person must 4(9) ensure that arrangements for supporting people living at the home with their finances are DS0000010577.V336478.R01.S.doc 10/08/07 15/06/07 29/06/07 Arthur Lodge Version 5.2 Page 28 9. YA42 reviewed so that no pin numbers are kept on their behalf, and audits are undertaken regularly to ensure that records tally with monies stored on behalf of each person, to ensure that residents are protected from financial abuse. 13(4) The registered person must 13/07/07 23(4ac(iv)e) ensure that records of fire drills held at the home specify the time, staff and residents involved as well as any relevant issues that arise. Fire doors at the home must be checked regularly to ensure that they remain effectively self-closing at all times and the fire risk assessment for the home must be reviewed sixmonthly, to ensure the safety of people living at the home. 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 YA6 Good Practice Recommendations It is recommended that person-centred planning formats be considered, particularly for people living permanently at the home, training may be available from the local authority. It is recommended that the manager contact all relevant local authorities to ensure that people living at the home have at least an annual review with their social workers. Notes should be kept of the main outcomes of any review meetings with social services, for the interim period before the formal minutes are received. It is recommended that a greater selection of in-house activities be available to people living at the home. It is recommended that an additional lockable cabinet be DS0000010577.V336478.R01.S.doc Version 5.2 Page 29 2. YA6 3. 4. YA14 YA24 Arthur Lodge 5. 6. YA37 YA41 placed in the manager’s office or near to the deputy manager’s desk, for the storage of confidential information relating to people living at the home. It remains recommended that the registered manager obtain qualifications at NVQ level 4 in both management and care. It is recommended that previous medication records be maintained on each resident’s care file to aid monitoring procedures. Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Arthur Lodge DS0000010577.V336478.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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