Inspection on 14/06/05 for Arthur`s Court

This inspection was carried out on 14th June 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

Arthur`s Court 29/12/09

Arthur`s Court 28/03/09

Arthur`s Court 13/02/08

Arthur`s Court 21/08/07

Arthur`s Court 21/11/06

Arthur`s Court 18/07/06

Arthur`s Court 31/01/06

Arthur`s Court 25/02/05

Arthur`s Court 14/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Arthurs Court 27 Highfield Road Street Somerset BA16 OJG Lead Inspector Justine Button Unannounced 14th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arthurs Court Address 27 Highfield Road Street Somerset BA16 OJG 01458 442319 01458 447254 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) European Care (UK) Limited Care Home with Nursing 40 Category(ies) of Old Age registration, with number Physical Disability of places Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, not less than 60 years, who require general nursing care. 2. Places for up to ten clients for personal care. 3. Up to four persons in the age range 18-59 years who require general nursing care. 4. Places for up to 30 clients for nursing care. 5. Registered for a total of 40 places in categories OP and PD. Date of last inspection 25th February 2005 Brief Description of the Service: Arthur’s Court is a care home for up to 40 service users, with a maximum of 30 receiving general nursing care and a maximum of 10 receiving personal care. It was purpose built in 1992 as a nursing home on two floors. It is situated on the outskirts of the town of Street, within walking distance of some shops. The majority of rooms are for single occupancy and 14 have en-suite facilities. There are seven baths available at the service and two shower rooms. In addition to the en-suite facilites there are an additional ten toilet facilites. There are a number of communal spaces including a large lounge and dining area on the ground floor and a smaller lounge/diner on the upper floor. There is a small kitchen area also on this floor. The main commercial kitchen is on the lower floor. There is an in house laundry service. The upper floor is accessible by a passenger lift. The home has small gardens, which are well maintained and accessible with help. Arthurs Court is owned by European Care Ltd, a private company, which owns other, care homes across the country. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors conducted this unannounced inspection over the course of one day. The inspectors were able to speak with a large number of the residents as well as staff on duty. The manager, Mrs Barbara Waymont, was available on the day of inspection. The inspectors would like to thank the residents and staff for their time and hospitality shown to the inspector during their visit. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. A number of requirements were made at the last inspection. The inspection also focused on the work completed in achieving these shortfalls. Records examined were care plans, medication records, staff recruitment files and some health and safety records. Other records will be examined at subsequent inspection visits. A tour of the building was carried out on this visit. What the service does well: People living at Arthur’s Court stated that they liked the staff and appreciated the hard work that they did. The majority stated that the food was of good standard and that they enjoyed the meals. A large percentage of the people who live at the home were frail and nursed in bed on the day of inspection. These people received appropriate care. The home was on the whole clean, tidy, smelt fresh and odour free on the day of inspection. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: A number of issues were raised at the inspection that require the attention of the management team. Staff files were viewed and these demonstrated that sufficient checks for new staff are not in place. Two written references need to be obtained prior to the staff member commencing work. One of these should be from the last employer. This was not seen in all case for all staff that have recently commenced employment at Arthur’s Court. Staff training records could not confirm that all staff had received all necessary training including moving & handling, fire safety and induction. It could not be confirmed if the Registered nurses had undertaken training relevant to their roles. This is required for them to maintain their registration as specified by the Nursing and Midwifery Council (NMC). Some issues with regard to spread of infection need to be addressed. Bar soap was seen in communal bathrooms. This may contribute to the spread of infection if it is used by anybody else other than the person to whom it belongs. Some of the flip top bins are in need of replacement as they were broken. The manager was also asked to review the staff hand washing facilities by the ground floor sluice area. Staff need to avoid ambiguous statements in the care plans. Statements seen included “ensure adequate fluids or turn regularly”. The plans of care need to be specific and give clear guidance to the care staff. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 7 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. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 9 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 standard(s) EVIDENCE: These standards were not assessed on this inspection. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 Care planning has improved, care must be taken to ensure clear guidance id given to staff on all occasions. The home must continue trying to achieve more service user involvement. Medications management was safe and well organised in all but one aspect. Service users are treated thoughtfully, with respect and are well cared for if very frail or very ill. EVIDENCE: Care plans were sampled, personal details and contacts were recorded. Service users had recorded care needs assessments and subsequent reviews of care. The plans of care related to the care given for people who live at the service (case tracking) There was evidence in the care plans of input by the community health care professionals such as the chiropodist, dentist, optician and continence advisor. Out patient appointments and GP visits were recorded and care plans had been reviewed. Staff need to avoid ambiguous statements in the care plans. Statements seen included “ensure adequate fluids or turn regularly”. The plans of care need to be specific e.g. how much fluid or how Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 11 frequently the person needs support to change position thus giving clear guidance to the care staff. Pressure relieving equipment was seen in use and all manual handling was risk assessed for the individual service users in their care plans. Medications management was sampled and was of a good standard. The home is using a community based pharmacy service, which was reported to be very helpful. Specific conditions where blood tests are required are monitored by the pharmacy service and tests are prompted. Eight people who live at the service had hand transcribed entries on the MAR (Medication Administration Record) The staff member who has written these entries should check that the correct prescription has been entered with another staff member. Both should then sign the MAR. This is required to reduce the risk of error. This was not seen. Service users all spoke positively of the care they receive from the staff at the home. Staff were seen knocking on bedroom doors. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The inspectors observed good practice and visitors were made welcome. The home’s ethos supports choice, independence and values the individual. The catering was good. EVIDENCE: Service users spoke highly of their freedom and choices in daily life. One person reported that they sometimes feel bored. Activities are offered and are led by the activities coordinator. The range of activities on offer appears to have improved since previous inspections. Activities for the week were on display in the hallway. These included a sherry/coffee morning, bingo, Holy Communion; sing along, domino club and listening to classical music. As `the activities programme is on display in the hallway it could not be evidenced how people who spend time in their bedrooms or are immobile are informed of the opportunities that are on offer. Visitors were seen and all said that they felt welcomed. Satisfaction with the care of their relatives was expressed. Comments about the food from those who were asked included ‘food is good’, and ‘has improved recently’. Lunch was observed and was seen nicely served at well-presented tables. The menu looked appetising, Tomato soup or orange juice was served initially followed by gammon with mashed potatoes, carrots Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 13 and sprouts. An alternative of jacket potato with cheese and or beans was available. A choice of desserts was then offered. Hot drinks are served between meals with biscuits; homemade cakes are served with afternoon tea. The Environmental Health Officer had visited the kitchens on the 03/06/05. This report stated “an excellent level of food hygiene compliance” One recommendation was made in this report and this has been actioned by the kitchen staff. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 standard(s) 16,18 Complaints are dealt with appropriately. Although no incidents of abuse have been reported. It could not be confirmed if service users are protected to the fullest extent. EVIDENCE: The complaints log was viewed during the inspection. One complaint has been received since the last inspection. This complaint had been dealt with appropriately and in line with company policy by the management team. The complaints procedure needs to be updated to reflect the changes from the NCSC to the CSCI. Service users are not protected from abuse to the fullest extent as staff recruitment is not robust (see standards on staffing). Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26 The service is well maintained. The environment is clean, tidy and odour free in most areas. The service is appropriate for it’s purpose with specialist equipment available. The majority of rooms are single occupancy. There are adequate bathing and toilet facilities. EVIDENCE: A tour of the building was conducted. The majority of areas were clean, tidy and smelt fresh. The majority of bedrooms are for single occupancy with fourteen having ensuite facilities. A number of bed tables seen were to be dirty or in a poor state of repair. Some of these may be in need of replacement. People spoken to during the inspection stated that they were happy with their rooms and that they were able to bring in personal possessions if they wished. Specialist equipment is available such as adjustable beds and hoists. There are adequate numbers of bathrooms all of which are adapted for the needs of the people who live at the service. The hot water from some of the hand basins was at a temperature such that it was difficult to wash your hands Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 16 with it. This needs to be reviewed. The water from the baths is thermostatically controlled. There is a large lounge/dining area on the ground floor and also a conservatory. There is a smaller dining room on the first floor. These rooms are appropriately furnished and decorated. They were well lit. A number of issues were raised with regard to the control of infection. Bar soap was observed in the communal bathrooms. This needs to be returned to the bedroom of the individual after they have bathed. A number of the bins had broken or inoperable lids. These need to be replaced. The sluice on the ground floor has no hand washing facilities. Staff have to go to the nearest bathroom to wash their hands touching various door handles. This is not in line with infection control guidelines and needs to be reviewed by the management team. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 The home has a dedicated core staff team. There are sufficient numbers of staff on duty. It could not be confirmed if all staff have undertaken the necessary training in order to meet the needs of the people who live at the service. The homes recruitment practises are not robust. EVIDENCE: The staff duty rotas were not viewed on this occasion. There were however adequate staff on duty on the day of the inspection and staff spoken to confirmed that the staffing levels have been maintained. Each staff member has an individual training file. These have not been maintained. It could not be confirmed if all staff have received all mandatory training. Two files had no training documented. There have been difficulties recently in securing fire safety training. An induction programme is available to all new staff members. New staff members are supported to complete this programme by the more senior care staff. The senior care staff stated that they themselves would like additional training on how to fulfil this role. It could not be confirmed from the staff files if all staff has completed an induction programme. The manager stated that new staff are supernummary for at least three days prior to commencing work. A training plan was seen for the rest of the year. This showed that training opportunities to complete mandatory training would be available for staff. The training files could not confirm if the Registered nurses had undertaken training relevant to their roles. This is required for them to maintain their registration as specified by the Nursing and Midwifery Council (NMC). Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 18 Three staff recruitment files were viewed. These showed that necessary information was gained with the exception of references. None of the three files showed that two written references had been obtained and that one had been obtained from the last employer. Criminal Record Bureau and POVA checks had been obtained. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36,37, 38 This home generally has good occupancy rates. Service users speak well of the care and service they receive. Records are well managed and are stored securely. Health and safety was not inspected in its entirety but those areas seen were well maintained and managed. EVIDENCE: Mrs Waymont the current manager has recently returned to work at the service. Mrs Waymont has managed the service previously. This employment has not been confirmed by the CSCI’s “fit persons” process. Mrs Waymont needs to apply to become registered as soon as possible. Documents seen were stored in an appropriate and securely. Hoists and fire equipment had been serviced in line with good practise. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 20 There are regular resident and staff meetings. These are minutes from these meetings. The minutes of the resident meeting are on display in the entrance hall. Documentation was available to demonstrate that staff receive regular staff supervision. Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x 3 3 3 Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement It is required that all hand transcribed enteries on the medication administration records are checked by two people. These checks need to be documented.This is an outstanding requirement with a timescale of 30/04/05 It is required that bar soap be removed from communal bathrooms. That foot operated flip top bins are available in all staff hand washing areas. That the provision of adequate infection control measures are in place in the ground floor sluice. It is required that two written references are obtsained for all employees prior to commencment of emplyment That all staff all necessary mandatory and additional training in order that they can fulfill indivdual job roles. This is an outstanding requirement from the last inspection with a timescale 30/05/05 Timescale for action 30/07/05 2. OP26 13(3) 30/08/05 3. OP29 schedule 2 18(1) (a) 30/07/05 4. OP30 30/08/05 Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 23 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 OP7 Good Practice Recommendations It is recommended that service user plans specifiy the care and support that individual require and avoid ambiguous statements. Service users and or their representatives should be involved in the development and review of the service user plans. It is recommended that the temperature of the hot water in the wash hand basin be reduced. 2. 3. OP21 Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Arthurs Court D53 - D02 S45674 Arthurs Court V231625 140605 Stage 4.doc Version 1.30 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. 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