Inspection on 19/06/06 for Arun Lodge Rest Home

This inspection was carried out on 19th June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arun Lodge Rest Home 04/01/06

Arun Lodge Rest Home 27/07/05

Arun Lodge Rest Home 28/02/05

Arun Lodge Rest Home 19/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Arun Lodge Rest Home 6-8 Stocker Road Bognor Regis West Sussex PO21 2QF Lead Inspector Mrs D Peel Unannounced Inspection 19th June 2006 10:00 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 Arun Lodge Rest Home DS0000014367.V293248.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. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Arun Lodge Rest Home Address 6-8 Stocker Road Bognor Regis West Sussex PO21 2QF 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) 01243 866056 Mrs Annette Rawlins Mrs Jacky Hambleton Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Arun Lodge is a care home able to provide personal care and support to up to 21 Older People over 65 years of age. The property is detached and situated close to the sea, shops and other local facilities on the outskirts of Bognor Regis. It is easily accessible by public transport. Communal space consists of two lounges and a spacious dining room. All bedrooms are single and many have en suite facilities. There are additional bathrooms and toilets throughout the home. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on the 19th June 2006. The intended outcomes for 34 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home the inspector reviewed information provided by the manager in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other information received from the provider since the last visit to the home on the 4th January 2006 A case tracking exercise for four residents was undertaken to look at how the assessed needs of this group of residents with diverse needs were being met. Residents were spoken with to gain some information about what it is like to live at the home. All comments made were positive and commended the dedication of the management and staff working at the home. Two residents questionnaires were returned to the inspector after the visit to the home which made positive comments about the home. The inspector visited all communal and private accommodation, speaking with residents who preferred to spend time in their own rooms and viewing the provision of homely accommodation. Staff were observed assisting and interacting with residents in the dining room. The atmosphere was relaxed and friendly, residents were spoken with meaningfully and staff demonstrated respect and recognition of individual residents needs. The records of four staff were inspected and staff were spoken with informally during the visit. Samples of other records required to be kept by the home were viewed during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. The current scale of fees being charged at the home is from £325 to £420 per week. What the service does well: The residents living at the home say that they see the other residents and staff as their family. One resident spoken with during the visit said, “ The home is good. We have a few confused people but we make them feel that they are part of the family and everyone is treated as equally.” Those residents, who are able, are encouraged to retain an independent lifestyle, accessing local communal facilities and maintaining relationships with their families and friends. Residents spoken with say that they are satisfied with the standard of meals and have plenty of choice of home cooked food. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 6 There is a low turnover of staff and over 50 of carers have a National Vocational Qualification in Care (NVQ). Management systems within the home are good and the residents are confident that the home is run in the best interests of residents. 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. Arun Lodge Rest Home DS0000014367.V293248.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 Arun Lodge Rest Home DS0000014367.V293248.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): 1,2,3,4,5,6 Prospective residents and their families are provided with the information they need to make an informed choice about the home and are encouraged to visit the home before making a choice. Residents and their relatives/advocates have a contract but not all residents are aware of the contract. Residents are assessed prior to moving into the home to make sure that the home can meet their needs. The outcomes for residents are good. EVIDENCE: Arun Lodge has a Statement of Purpose and Service User Guide, which describes the facilities and services available at the home. The most recent version was provided to the Inspector some weeks prior to the visit to the home and included a copy of the terms and conditions of residency at the home. Four residents have moved into the home since the last visit in January 2006. Case tracking for two of these four residents showed that both residents had had their needs assessed prior to moving into the home by a senior member of staff. This written documentation was included in the residents care records. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 9 One resident had spent part of the day at the home with their son and daughter to get a feel for what it would be like to live at the home. They had intended to visit a number of homes but had been satisfied with the information available and the experience of visiting the home enabling them to make a decision about moving in permanently. Another resident residents had had the opportunity to spend periods of respite care at the home on previous occasions; this had enabled them to make a decision about moving into the home. The manager and provider described the admissions procedure and gave examples of how prospective residents are given an opportunity to visit the home and “get a taste” of what it would be like to live at Arun Lodge. Copies of contracts for three of the resident’s case tracked at this visit were viewed. The manager told the inspector that the contract for the resident who had most recently come to live at the home was still being agreed. One resident returning a resident survey to the inspector commented that they had not received a contract. Arun Lodge does not offer intermediate care. Arun Lodge Rest Home DS0000014367.V293248.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): 7,8,9,10 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. The homes medication procedures ensure that medication is well managed. Staff treat residents as individuals, recognising their need to be treated with respect and that their right to privacy is maintained. Outcomes for residents are good EVIDENCE: The four care plans viewed at this visit had been developed from a detailed assessment of need. The care plans had been reviewed monthly but there was no evidence to confirm that residents or their representatives had been involved in the review of the care plan. This matter was discussed with the manager who has agreed to encourage residents to contribute to review of their care plans and if possible sign the review. Daily progress notes are in use to monitor the heath and welfare of residents. On the day of this visit a District Nurse visited to see a residents who had had a fall the previous evening. Three residents were expecting visits from a GP. One resident who was part of the case tracking exercise confirmed that they were waiting for a visit from the GP. This person also has particular diet needs identified in their care plan. This Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 11 matter was discussed with the resident who confirmed that they felt that these needs were recognised and were being met by the staff at the home. The home has a medication policy, which was provided prior to the visit to the home. The policy had been reviewed on the 3rd June 2006. The inspector observed the secure storage and administration of medication during the visit to the home to see if the policy was being followed. Records of medication administration were viewed for the four residents who were part of the case tracking exercise. These were observed to be completed clearly and up to date with no gaps in recording identified. The manager told the inspector that two staff had had training in the Safe Handling of Medicines since the last visit to the home. The course material had been used to provide other staff with an information booklet for their reference. Staff records confirmed that this training had taken place for two staff. Residents spoken with in the privacy of their room and at lunch time were of the opinion that are encouraged to maintain their independence for as long as they can and that staff treat them as individuals, treating them with respect and dignity. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, The home has flexible routines which allows those who are able, to exercise choice and some control over their lives. Activities are offered and residents who are able are encouraged to be part of the community. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Home cooked food is provided to a good standard with choices of alternatives available. Outcomes for residents are good EVIDENCE: Residents spoken with during the visit were keen to talk about their lifestyle at the home. It was evident that from these discussions these residents are able to continue with their preferred routines. One resident spoken with prefers to stay in their room. They were able to talk about happenings in the home and seemed well informed by staff. This person did not feel that they were isolated. They were pleased that they were able to remain private and felt that as they had been living at the home for eleven years that they were in a good position to confirm that their needs are being met. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 13 Some residents at the home choose not to take part in activities but others enjoy the weekly visits by the PAT dog and a pianist. The PAT dog visited on the day of the inspectors visit to the home. Residents in the lounge were pleased to see the dog called “Gilly” who is an ex greyhound racer. Other activities include: Bi monthly musical entertainment, Activise Exercise class every two weeks. Demonstrations and seasonal fairs and parties. One resident spoke about a recent visit to the theatre in Worthing with the Local Lions Club to see the Fiddler On The Roof musical. They said how much they had enjoyed this opportunity. The inspector was shown a photograph of a recent outing of one resident with a member of staff to the seafront. The inspector joined residents for the main meal of the day, which was chicken casserole, a portion of mash potatoes, fresh broccoli and carrots. The meal was nicely presented and was tasty and of a good texture. Dessert was homemade apple and blackberry pie with custard followed by coffee or tea. During the visit residents confirmed their satisfaction of the meals and choices of meals at Arun Lodge. A selection of menus was provided prior to the visit to the home, which showed variety and choice. Feedback from one resident is a returned to the inspector after the visit to the home reported that that person usually liked the food and another resident said that they always liked the food. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints procedure enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. The homes adult protection procedure is now clear and residents are protected by arrangements in place to protect residents from being placed at risk of harm or abuse. Outcomes for residents are good. EVIDENCE: Residents spoken with during this visit were aware of the homes complaints procedure and told the inspector that they always raise any concerns which they have directly with the manager or the owner who is on the premises most days. The complaints procedure is on display in the home and a copy is included in the Statement of Purpose and Service User Guide. Both resident surveys returned to the inspector after the visit reported that the resident knew how to make a compliant. There have been no complaints made to the manager or provider since the last visit to the home by the inspector and no complaints made to CSCI. Since the last visit to Arun Lodge the provider and manager have revised its own policies and procedures to safeguard residents from abuse. They are now clear and follow the West Sussex Multi Agency Adult Protection procedures. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 15 All staff have now been trained in using the procedures and have certificates to show that they have attended training in recognising and responding to adult protection matters. The manager and provider have also attended additional adult protection training since the last visit to the home by the inspector. Arun Lodge Rest Home DS0000014367.V293248.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): 19,20,21,22,23,24,25,26 Continuing improvements to the home have provided residents with a homely environment to enjoy. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them. The home is clean and residents take pride in their home. The outcomes for residents are good. EVIDENCE: The inspector visited all parts of communal and private accommodation. Arun Lodge was observed to be clean and the environment feels homely. A further four bedrooms have been redecorated and refurbished since the last visit in January 2006. Hallways have been repainted and a ramp has been provided for easier access from the entrance through one lounge to other areas of the ground floor. Furniture in bedrooms is gradually being replaced and includes at least one lockable cupboard or drawer. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 17 Residents living at the home have made their bedrooms their own by having their own possessions around them. Some residents have items of furniture in their rooms, which they have been able to bring to the home. Some radiators remain uncovered but risk assessments have been carried out to safe guard residents until the covers are put in place. The main lounge and the dining room are used every day by the majority of residents who tell the inspector that they regard Arun Lodge as their home. The decking provided in the rear garden last summer has proved to be very popular with residents and is currently being extended to allow for safe access in a wheelchair. The provider is still considering plans for a link corridor on the second floor which will enable lift access to four bedrooms which are currently not accessible by lift. Arun Lodge Rest Home DS0000014367.V293248.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): Staffing levels at the home are meeting the needs of the residents living at the home. Recruitment procedures safeguard and protect residents at the home. Staff have taken part in training and Vocational Qualifications to maintain their skills and ensure that residents are safe. Outcomes for residents are good EVIDENCE: Duty rotas were provided by the provider at the inspector’s request some weeks prior to this unannounced visit to the home. During the visit the visit it was observed that staff were readily available to attend to residents needs when needed. Staff records and information provided by the manager of the home prior to the visit about the qualifications of staff show that just over 50 of staff have an NVQ qualification. Five carers have achieved level 3 and three other carers are to commence level 3. The records of four staff were examined during the visit to see if recruitment policies of the home were being followed and to ensure that those employed had Criminal Record Bureau Clearance and Protection of Vulnerable Adult Clearance. It was noted that one person being inducted was awaiting the return of the CRB and POVA clearance but the manager told the inspector that they are supervised when working with residents. Other required documentation was in place for the recently employed staff but some evidence of identification for other staff had not been kept after a clear POVA and CRB had been received. The inspector has recommended that copies Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 19 of identification should be kept within the home for all staff although the providers have evidence that they have seen it before making the application to the Criminal record Bureau. The training programme at the home has been extended since the last visit to the home and the provider is able to demonstrate the changing needs of residents can be met by additional training to meet the particular needs of individual residents. Arun Lodge Rest Home DS0000014367.V293248.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): 31,32,33,35,36,37,38 The home is well managed providing leadership and guidance for staff. Quality assurance systems are in place to ensure that the views of residents, their families and friends are sought to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. Those residents who have requested that the providers look after some money for them know that their financial interests are being safeguarded. The manager was able to demonstrate that the formal supervision of staff is taking place and that an appraisal system has been established. Environmental risk assessments are in place, which protect residents from the majority of environmental risks to their heath and safety. Outcomes for residents are good Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 21 EVIDENCE: Residents spoken with knew the managerial structure of the home and feel that the provider and manager act in the best interests of residents living at the home. The manager had acquired the relevant qualification and experience to run the home and together the provider and manager provide strong leadership for the staff team. Discussions with residents and staff demonstrate that the ethos of the home is open and transparent. Staff meetings are regularly held and the provider and manager take time almost everyday to work with residents and along side staff in the home. Since the last visit to the home a quality assurance policy has been written. The quality assurance system has proved to be effective with the introduction of an innovative way of getting residents to give feedback through quizzes about different subject matter within the home. Arun Lodge holds the Investors in People Award which it intends to put forward for renewal this year. A few residents have monies kept by the home on their behalf. The records of records of incoming and outgoing expenditures were observed and those sampled were correct. Other records seen during this inspection unless mentioned in other areas of the report were in good order. Environmental risk assessments are in place which also cover the remaining unguarded radiators within the home. Arun Lodge Rest Home DS0000014367.V293248.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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 3 3 3 Arun Lodge Rest Home DS0000014367.V293248.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard OP7 OP2 OP29 Good Practice Recommendations The manager should find a way of evidencing that residents are involved in the review of their care plan. Residents living at the home should be fully aware of the terms and conditions of living at the home and be offered a copy of the contract. Copies of identification of all staff should be kept within the home even though the providers have evidence that they have seen it before making the application to the Criminal record Bureau. Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Arun Lodge Rest Home DS0000014367.V293248.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!