Inspection on 09/06/06 for Arthur Roberts House

This inspection was carried out on 9th June 2006.

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

Arthur Roberts House 31/07/07

Arthur Roberts House 24/11/05

Arthur Roberts House 01/07/05

Arthur Roberts House 28/10/04

Arthur Roberts House 07/06/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Arthur Roberts House Arthur Roberts House 121 Burnthouse Lane Exeter Devon EX2 6NB Lead Inspector Rachel Doyle Key Unannounced Inspection 09:00 9th June 2006 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 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 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. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Arthur Roberts House Address Arthur Roberts House 121 Burnthouse Lane Exeter Devon EX2 6NB 01392 274388 01392 210251 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) Devon County Council Pauline May Lake Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23) Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Arthur Roberts House provides personal care and accommodation for up to 23 older people who live with dementia or mental health related problems. The home does not employ registered nurses. The Home is situated in the Wonford area of Exeter within close walking distance from local shops and on a regularly served bus route into the centre of the city. The building provides level access with a large secure lawned garden. Accommodation is provided on 2 floors with a shaft lift allowing easy access to both. Bedrooms are all single occupancy and there are four shared living areas, two on each floor. There is a small car parking area. The Home also offers short-term respite care. The Home now has a no smoking policy for all new admissions. Those residents who are smokers are still able to continue to smoke in designated areas. The average cost of care is £556 per week at the time of inspection. Additional costs, not covered in the fees, include some transport, private chiropody, hairdressing and personal items such as toiletries and newspapers. Current information about the service, including CSCI reports, is not always given to prospective residents/representatives within a structured assessment process. The most recent report was not on display, although reports from June and October 04 were on a notice board. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this unannounced inspection over a period of approximately 7 hours. There were 21 residents (plus 2 beds being held for residents in hospital) living at the Home at the time of the inspection. During the inspection the inspectors case-tracked 6 residents, which helps us to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day. The inspectors also spent a considerable time observing the care and attention given to residents by staff. Several staff were spoken with during the day, including care staff, ancillary staff, assistant managers and agency staff. Prior to the inspection surveys were sent to relatives to obtain their views of the service provided; 5 were returned. The majority of residents are unable to complete comment cards due to their communication difficulties. Staff surveys were left at the Home in order to hear their confidential views; 5 were returned. Health and social care professionals were also contacted prior to the inspection including 5 GPs, community psychiatric nurse and community care worker. The inspectors toured the premises and a sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files, service and maintenance certificates and fire safety records. The manager had completed a pre-inspection questionnaire and the inspectors appreciated the preparation undertaken by the manager to assist with this inspection and found staff very helpful on the day. The organisation and the manager are keen to work towards the improvements necessary to ensure that all residents receive the care they need and a staff member commented that that they had read the previous report and taken the requirements and recommendations on board and felt that staff had responded well by looking towards a positive future. What the service does well: The outside environment is well maintained and being used for residents to enjoy in the fine weather with seating areas in the shade. The home is very clean and tidy and provides a homely setting. Meals are well managed and provide a balanced and nutritious menu in a congenial setting. Staff showed some good skills and understanding in the needs of people with dementia. The Home had made a focus of the World Cup, decorated the Home with bunting and rented a new TV for the occasion. Residents said they were looking forward to watching the football and banter was generated through the Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 6 efforts of the staff. The Home had a pro-active approach to stimulating conversation between staff and some residents with vintage film actors and posters on display. The food was nutritious, well presented and alternatives and seconds were offered. Staff were aware of residents’ likes and dislikes. Condiments were offered, although staff would then put on the salt, pepper etc rather than let the residents do this. Residents were encouraged to be independent with their meals and given plenty of time to finish. The dining rooms were set out nicely. What has improved since the last inspection? What they could do better: 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. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 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 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 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): 2, 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process to the home is adequate although an inconsistent process could potentially put residents at risk resulting in needs not being met. EVIDENCE: The assessment process was discussed with the assistant manager. There were assessments in half of the case-tracked care files by social services. None were able to be seen that were done by the Home and an assessment had not been done for a recent short-term admission. This process does not fully ensure that the Home can meet residents’ needs. The assistant manager said that there is either a form to use or the assessment is done on a piece of paper. The manager confirmed that they visit prospective residents in hospital or in the home setting as necessary and that service users may visit the Home prior to admission. There was no evidence of a clear process in which the Home judges whether they can meet prospective residents’ needs and then confirms this to the service user, one staff member ‘just knew’. Information provided to Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 9 prospective and current residents/representatives is not consistent. The care files contained the Home’s terms and conditions, however some of these had been signed by residents who clearly would not be able to understand the contents. The Home does not provide intermediate care. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are generally met and there have been improvements to the care planning process. Further development of these plans and other care records will need to continue to ensure that all residents’ health and personal care needs are met. Medication administration is well managed with clear systems promoting good health. EVIDENCE: Six residents were case-tracked. This means that all records are looked at for specific residents. The Home has implemented new holistic care plans. The format includes good assessments especially relating to personal care. Notes were excellent about wound care, maintaining independence, being sensitive to the resident and dependency profiles. However, details of care planning relating to mental health needs were brief, such as ‘dementia’ and did not clearly state how this affected the individual or what actions staff needed to do to meet the residents’ needs. Risk assessments were comprehensive and Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 11 linked to mental health issues such as confusion. There are also easy to read summaries including updates, district nurse visits and reference to care plans if there are changes. One agency carer had received a brief handover and said that they were not aware of any resident’s individual needs or mobility and realising that a resident had severe sight impairment by accident. This was also not clear in the care plan. Two health professionals commented that there were some staff that lacked understanding of the client group. Other entries did not show adequate follow up to comments such as ‘shouting well’ or ‘washed and dressed’ with no record of the resident’s input or ‘wanders’ with no further explanation. Another agency worker’s interaction with residents was minimal. Other staff interacted very well with residents in the communal areas, such as noticing that a resident wished to go into the garden but knowing that they wouldn’t ask themselves and being discreet about asking about personal care needs. Care of residents in their rooms or those with limited communication skills was not always satisfactory especially relating to fluid intake and change of position (to ensure that residents pressure areas are looked after), one resident did not have access to a drink for most of the day other than at lunch and fluid balance records in general were not complete or used effectively. This resident’s key-worker had expressed in supervision that they were finding being the key-worker for this resident difficult but this had not been reallocated, the focus being on the staff member. Another resident who was case-tracked needed better management of their fluid intake. There was a fluid balance chart to record what was drunk in the day, but the input was measured in fluid ounces and the output in millilitres. Neither of these were totalled- meaning that staff could not be sure if this resident had enough to drink. On the other hand, the assistant manager was very proactive in speaking to external professionals about these residents increasing needs. An agency carer tried to give this resident a drink but was unsuccessful. The assistant manager managed successfully with a different sort of cup and this information was handed over to other staff later. The fluid balance chart was not recorded when drinks were given. Two staff gave different answers as to where the fluid chart was kept. The weight chart for this resident had not been completed for several months and again it would be important to know whether this person was losing weight. One resident required specific pressure area care and this was seen to occur as per the care plan. There is a key-worker system but some staff did not all know what this was or which resident they were caring for. Two staff were very aware of their role as key worker and explained how they made sure they took a particular interest in their allocated residents. Four relatives’ surveys were satisfactory with all the respondents confirming that they were ‘satisfied with the overall care provided by the Home’ and that a Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 12 resident was ‘well looked after at the Home’. A relative visiting said they were very happy with all the care being provided. All 7 health professionals’ surveys commented that they found the overall care to be satisfactory. One GP when asked if specialist advice was incorporated into the care plan commented ‘I believe so’. Another had had several calls from the Home, indicating that multidisciplinary advice is sought by the Home. Medical input was accessed appropriately for residents. Most records of visiting professionals were detailed, especially District Nurses. Medication administration is well managed; records correct and all staff involved have received appropriate training, which promotes residents’ health and welfare. One member of staff explained how they had benefited from the dementia training and understood now the different types of dementia and how dementia can affect people in different ways. Also that everyone was an individual and needed to be treated differently. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 13 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, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been improvements in the management of meeting residents’ social and leisure needs, which needs to continue and include those residents with limited capacity. Meals are well managed and provide choice and daily variation in a congenial setting. EVIDENCE: The Home had made a focus of the World Cup, decorated the Home with bunting and rented a new TV for the occasion. Residents said they were looking forward to watching the football and banter was generated through the efforts of the staff. The Home had a pro-active approach to stimulating conversation between staff and some residents with vintage film actors and posters on display. One dining room had been made into a tearoom and a staff member plays the guitar during tea. Most staff were seen to chat and interact well with residents in the communal areas, playing games and facilitating conversations between vocal residents in the communal areas. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 14 In general residents were offered choices such as what they wanted to do, with their meals and drinks and personal care. One decision has been made by staff relating to how a resident is cared for, which is not resident focussed. Staff are aware of it but this has not been addressed in a multidisciplinary meeting. Interaction with those residents in their rooms and those with limited communication skills was minimal unless task orientated or in passing, activities recorded were less and did not include meaningful one to one time. One relative said that the resident would like more stimulation, as they got very bored. However, some plans included activity records with good social history sheets involving families. Activities recorded include sing-alongs, tea in the garden, newspaper reading, ice-cream cornet and the Home now has use of a bus and some residents have been out in the bus, which they said they enjoyed. The staff want more trips to happen for the residents but need another ‘driver’ to enable this to happen. Some staff agreed that they think there should be more activities for residents. The inspectors took lunch with the residents in both dining rooms. The food was nutritious, well presented and alternatives and seconds were offered. Staff were aware of residents’ likes and dislikes. Condiments were offered, although staff would then put on the salt, pepper etc rather than let the residents do this. Residents were encouraged to be independent with their meals and given plenty of time to finish. The dining rooms were set out nicely. In general staff were attentive to residents needs and one carer showed excellent skills in encouraging someone who was reluctant to eat their meal. The kitchen was well organised and fresh food is ordered regularly. The chef has many years experience in providing meals in care homes and was very knowledgeable about the likes and dislikes of residents, the best way to serve meals, and keep a close eye on checking whether the residents are enjoying their meals. The chef likes to make a lot of his own cakes and quiches rather than rely on ready-made produce. He also showed an awareness of making sure that residents needed extra fluids in the heat, and had a supply of ice lollies/ice creams available. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 15 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): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are not always protected from harm or abuse by sound follow up procedures although staff are knowledgeable about the topic in general. The complaints system and recording needs to be more robust to ensure that complainants’ views are heard and acted upon. EVIDENCE: The complaints book was looked at. One complaint was dealt with appropriately; another was not. One relative commented that they were not aware of the complaints procedure, however this is displayed in the foyer and in the Statement of Purpose. Staff spoken to were aware of Protection of Vulnerable Adult (POVA) procedures and staff had undergone POVA training. However, there were issues relating to this topic in residents’ daily notes, which had not been addressed. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 16 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, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment, although the building is dated, is clean and provides a comfortable living space, with a well-maintained and accessible outside area. EVIDENCE: There are a number of communal areas at the home so that residents can choose where they spend their day. The garden has been made to look lovely, with seating areas in the sun and shade, a large and well-kept lawn area and flowers. Rooms have been personalised and the Home has sought relatives’ assistance to achieve this with lovely photographs etc for those residents who have limited communication and/or capacity to make decisions. Staff had knowledge of infection control issues such as MRSA and there was clear documentation showing good practice. There are gloves, paper towels and liquid soap around the Home, one agency carer being reminded by the assistant manager about their correct use during the inspection. The sluice and laundry areas were clean and the Home in general was hygienic. The Home has a Health and Safety representative who is able to monitor health and Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 17 safety issues such as infection control. The inspector met with one of the domestic staff who had worked at the home for some time. She was knowledgeable about infection control. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 18 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, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff recruitment procedures are adequate although care must be taken that all files consistently contain the required documents. Residents benefit from friendly, well trained staff who in general have a good understanding of residents’ needs. EVIDENCE: There was an assistant manager, 6 carers (3 were agency staff, one extra), the cook and kitchen assistant and 4 domestics on duty during the inspection. One relative commented ‘staff are very friendly and kind in difficult circumstances’. Two relatives felt that the Home needed more staff, one adding that it was a good care home. There is minimal clerical support and staff felt that assistant managers have to spend time in the office rather than on the floor. During the morning two agency care assistants were left on one floor whilst a permanent carer went off to do some shopping for a resident. This meant that the agency staff, who may have not had recent dementia training, nor the in depth knowledge of the needs of the residents, were the two carers looking after a large number of residents. When the assistant manager was visible she was excellent in the supervision of these staff- but often needed to be in the office. Staff commented that communication could be improved between assistant managers and carers on the floor. One relative said that they could tell that it Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 19 was a ‘home’ not a hospital, it being homely and lovely staff. Nearly all staff have had training in dementia care, including ancillary staff and 7 staff are working through a comprehensive Distance Learning course in Dementia and finding it very interesting. Other training given is relevant and varied including Protection of Vulnerable Adults, staff supervision training, and food hygiene. It was difficult to see if staff are up to date with mandatory training, as the staff member responsible for this has made no progress updating files since the last inspection. Staff said that they enjoyed working at the Home, some had for many years with one saying that ‘they loved working there’. Four staff recruitment records were looked at. These were all correct other than one had no references in the file. To fully protect residents all files need to be up to date. The permanent staff spoken to all had a good understanding of how to care for people with dementia- they spoke of giving people choices, treating people with respect and thinking of people as individuals. These qualities were shown throughout the inspection by the permanent members of staff. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 20 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): 31, 32, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager provides guidance and support to staff to ensure that the Home has the ability to meet residents’ needs and that improvements continue. Practices in the Home do not always ensure that there is a safe environment for residents. EVIDENCE: The staff survey responses indicate that staff feel supported in their role and that permanent staff were continuing to gel together as a team. Staff felt that they had been well supported in recent training and praised for their work on the Distance Learning course. Staff have all received staff supervision sessions. These are 1:1 sessions with management and staff where competency, training, policies and procedures and any other issues in the Home can be Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 21 discussed in a formalised setting to ensure quality care. One staff member commented positively that the Home has ‘come on in leaps and bounds’, although some things take longer than others; they felt that the Home was progressing. Staff Health and Safety risk assessments and sickness monitoring were excellent, which helps to ensure that staff on duty are fit to perform their roles safely and that procedures for residents are carried out safely. The Home is about to implement a Quality Assurance survey and will liaise with Age Concern as residents’ independent advocates and send the report to CSCI. Care files contained good Manual Handling risk assessments. Forms were readily available for staff to inform CSCI of any issues concerning residents’ welfare. An immediate requirement was made in relation to Control of Substances Hazardous to Health (COSHH) storage and was addressed during the inspection to ensure that the environment is safe for residents. Window restrictors were in place and radiators covered as necessary but bath water was very hot on the first floor and there were no bath thermometer or temperature records, which could result in a risk of scalding. There had been an audit of many records and systems by Devon County Council earlier in the week, which raised some issues that the manager will address. Three residents’ personal monies were looked at. Whilst their records were accurate the actual money is kept in one central cash tin- rather than separate cash boxes for each resident. There is one central resident account, however individual interest is worked out on a regular basis. Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 22 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 X 2 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 X 1 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 23 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 OP3 Regulation 14 (1) Requirement You shall not provide accommodation to a resident unless their needs have been assessed by a suitably trained person, appropriate consultation with the resident/representative and confirmed in writing that the Home can meet their needs. (This refers to there being a clear admission assessment process and records for all residents admitted to the Home.) Timescale for action 09/08/06 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 24 2. OP8 12 (1) 3. OP18 13 (6) 4. OP29 17 (2) The registered person shall ensure that the Home is conducted so as to promote and make proper provision for the health and welfare of service users and to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. (This refers to ensuring that all residents including those who have limited communication skills or are in their rooms have all their needs met and are checked regularly especially relating to pressure area care and fluid intake. Also ensuring that all agency staff are given enough information to be able to meet residents’ needs and that they are aware of the Home’s policies and ethos relating to maintaining residents’ independence, choice and their competency in communication skills.) The registered person must make suitable arrangements, by training staff or other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. (This is a requirement from the previous two inspections relating to process. This inspection refers to following up incidents noted in records appropriately and must be a priority.) The registered person must maintain in the care home the records specified in Schedule 4. (This refers to two references.) 09/07/06 09/07/06 09/08/06 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 25 5. OP38 13 (4) (a) You must ensure that all parts of the Home, which are accessible to residents, are as far as reasonably practicable free from hazards to their health and safety. (This refers to COSHH items in unlocked cupboards and was an immediate requirement, which was addressed at the time and confirmed in writing and to hot bath water temperatures.) 09/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP2 OP7 OP8 OP12 Good Practice Recommendations It is recommended that the Home’s terms and conditions are discussed with residents if they have capacity and if not with their representatives and that this is recorded. It is recommended that care plans include detailed records as to how mental health needs are to be met and follow up. It is recommended that all staff are clear about the keyworker role and that they are supported to ensure that the residents needs are met. It is recommended that appropriate stimulation is offered to all residents including those with limited communication and mobility and that decisions relating to this are resident focussed. It is recommended that all complaints are clearly recorded and investigated using the Home’s complaints procedure including actions taken and response to the complainant. It is recommended that there are enough staff to carry out all duties including clerical. It is recommended that the Home devises a system so that it is easy to monitor which staff are up to date with mandatory training and follow up those who need it. It is recommended that service users’ monies are kept separately in cash boxes in the home 5. 6. 7. 8. OP16 OP27 OP30 OP35 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Arthur Roberts House DS0000039616.V289748.R01.S.doc Version 5.1 Page 27 - 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. 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