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 4th January 2006 11.00a 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.V275407.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.V275407.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.V275407.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th July 2005 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.V275407.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours on the 4th January 2006. This was the second visit to the home this year and it was carried out to complete the annual inspection programme for the year 2005 required by the Care Standards Act 2000. The inspector arrived at 11am was met by the registered manager and the owner of the home who are present at the home on most days. During the visit the inspector met the majority of the 17 residents living at the home and spoke with 6 residents at length about there views of the home. The care records of two residents were viewed during the visit along with other records, which showed how care needs were being met. The records of two recently employed staff were also inspected and staff were spoken with informally during the visit. Not all the National Minimum Standards for Older People were assessed at this inspection but throughout the year all key standards have been assessed. This report may be read in conjunction with the previous report dated 27th July 2005 to gain broader assessment of the homes provision of a care service. What the service does well: What has improved since the last inspection?
Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 6 The home continues to make improvements to the environment. Since the last visit to the home five bedrooms have been redecorated. Carpets have been replaced in three bedrooms and new bedroom furniture has been purchased for a number of rooms. Residents told the inspector that a keep fit class has now been added to the programme of activities at the home and a PAT dog visits regularly. Care plans continue to improve and now included each resident’s assessment of need. A problem with medication practice identified at the last inspection has now been reviewed and the manger has confirmed that medication practices are being monitored. 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.V275407.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.V275407.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): 3 Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. EVIDENCE: The care plans for two residents who had moved into the home since the last visit in July 2005 were viewed at this visit. Both plans included a needs assessment carried out prior to moving into the home. The assessments had then been used to develop a plan of care. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 9 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, 9,10 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. Medication practices have been reviewed to ensure that residents health is not put at risk. EVIDENCE: Care plans viewed at this visit had been developed from a detailed needs assessment. They had been reviewed regularly and include an area in which residents can contribute to the plans with additional comments about the service. Daily progress notes are in use to monitor the heath and well being of residents. Since the last visit to the home the manager has met with the other care staff to review medication practice at the home. Procedures are now in place to record any medication wastage. Staff are aware that prescribed topical medication should not be used by residents for whom they are not prescribed. Residents feel that they are encouraged to maintain their independence for as long as they are able and that staff treat them as individuals, treating them with respect and dignity. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 10 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): No standards were assessed at this visit. Standards 12,13,14 and 15 scored 4 at the inspection carried out on the 27th July 2005. EVIDENCE: Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 11 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 There is a clear complaints procedure, which 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 not clear which could result in incidents not following the West Sussex Multi Agency Adult protection procedures for investigation. EVIDENCE: The complaints procedure is available in the Service User Guide and on display on the notice board. It is clear and specifies how complaints should be made, with an assurance that any complaint will be responded to within 28 days. There have been no complaints made to the home or to the Commission for Social Care and Inspection (CSCI) since the last visit to the home. Arun Lodge has its own policies and procedures to safeguard residents from abuse but they now need to be revised to ensure that they follow the West Sussex Multi Agency Adult Protection procedures. The majority of staff have had training in adult protection issues and the manager confirmed that further training is to be provided. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 12 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 There is an ongoing maintenance plan to improve the decoration of the home, which is providing the residents living at the home with a more homely, safe, comfortable surroundings. The home is clean and residents have a comfortable, homely environment to live in. EVIDENCE: All parts of communal and private accommodation were visited. Arun Lodge was observed to be clean and had a fresh appearance. The ongoing maintenance programme continues to address areas of the home which need to be updated and since the last visit five bedrooms have been redecorated. Furniture in bedrooms is gradually being replaced and includes at least one lockable cupboard or drawer. The carpets in three bedrooms have been replaced. 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.
Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 13 Some radiators remain uncovered but risk assessments have been carried out to safe guard residents until the covers are put in place. Since the last visit to the home the Fire Officer has visited to give advice about automatic door closes for bedroom doors. The provider is in the process of getting quotes for doors, which residents want to be left open. As a result of the Fire officer’s visit the resident who had a bedroom on the upper floor of the home has now relocated to a lower floor. The inspector discussed this matter with the resident who said that they liked the room which they have now and have become settled. The Environmental Heath Officer visited in July 2005 making a number of requirements. The provider confirmed that these had been carried out. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 14 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): 28 Arun Lodge provides well-qualified staff so that residents are able to feel safe and well looked after. EVIDENCE: The provider confirmed that over 50 percent cent of the care staff have achieved a NVQ qualification at level 2 or above and others are have enrolled on the NVQ programme. . Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 15 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): 31,33,38 The home is well managed providing leadership and guidance for staff. There is no formal quality assurance system in place to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home Environmental risk assessments are in place, which protect residents from the majority of environmental risks to their heath and safety. EVIDENCE: The residents and staff at Arun lodge feel that the home is well managed. Residents say that they know that they can discuss any issues, which they have with the manager and the provider. The manager has now completed the NVQ Level 4 Registered Managers Award has been in the manager’s role for over a year. The provider has liaised with the Fire Officer with regard to wedging bedroom doors open and advice has been given which the provider has agreed to carry
Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 16 out. Quotes are currently being sought for the installation of a number of self releasing devices. It was noted during the visit that two bedroom doors were being wedged open where residents were poorly in bed. Until the self-releasing devices are put in place fire risk assessments are to be carried out. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 17 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 1 x x x x 2 Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP33 Regulation 24.1 Requirement A formal quality assurance system must be established Timescale for action 01/04/06 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 Refer to Standard 18 37 Good Practice Recommendations The homes adult protection procedures should be reviewed to ensure that they follow the West Sussex Multi Agency procedures. Risk assessments should be in place to ensure that residents are not at risk for any doors which remain open whilst residents are poorly in bed and until self releasing devices can be fitted. Arun Lodge Rest Home DS0000014367.V275407.R01.S.doc Version 5.1 Page 19 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
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