Inspection on 27/07/05 for Arundel Close (1)

This inspection was carried out on 27th July 2005.

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

Arundel Close (1) 27/02/09

Arundel Close (1) 13/02/07

Arundel Close (1) 17/11/05

Arundel Close (1) 21/02/05

Arundel Close (1) 01/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Arundel Close (1) 1 Arundel Close Chippenham Wiltshire SN14 0PR Lead Inspector Malcolm Kippax Unannounced 27th July 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Arundel Close (1) Address 1 Arundel Close Chippenham Wiltshire SN14 0PR 01249 651112 01249 765520 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) United Response Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number of places Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: 1 Arundel Close is one of a number of homes that are run by the national charity, United Response. The home is a detached property in a residential area of Chippenham. 1 Arundel Close fits in well with the neighbouring properties. The accommodation is domestic in style and includes a louge, a dining room, a recreation and four single bedrooms. Service users receive support from a manager and a permanent staff team. Relief staff members also regularly work in the home. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 1.30pm and lasted for 4¼ hours. The four service users, the acting manager and staff members were met with. Only limited conversation was possible with the service users. Two service users were having home-based days and two service users returned from day activities later in the afternoon. The accommodation was looked at and a selection of the home’s records was examined, including two of the service users’ care records. A manager has been registered since the last inspection but is no longer in post. Mr T. Smith a senior support worker and a former manager with United Response is managing the home until a new manager is appointed. What the service does well: What has improved since the last inspection? What they could do better: Service users need support with their medication but they have been at risk because of how this has been dealt with by staff. This must improve to ensure that service users always receive the right medication and it is well recorded. Staff members should have better information about the service users’ personal goals. This will help staff to focus on supporting service users in areas that will enhance their quality of life. Heath details also need to be kept up to date to ensure that problems do not arise because the information is no longer accurate. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 6 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. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not looked at on this occasion. EVIDENCE: Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Service users benefit from the information that staff members have about their day to day needs. Although objectives are identified, a lack of detail about personal goals and progress with achieving these may affect the service users’ quality of life. EVIDENCE: The service users care records included good information about the service users’ daily routines and guidelines for personal support. One staff member confirmed that the care records were a good way of keeping up to date with what the service users have done and recent events. A requirement was identified at the last inspection about the need to take a coordinated and more holistic approach to the management of particular conditions such as diabetes and epilepsy. This has been discussed further with the acting manager since the inspection and the timescale extended for meeting this requirement. Records show that the service users’ needs are discussed at review meetings and objectives are identified. The objectives varied in detail. One service user’s individual plan included objectives that were mostly repeated from the previous review meeting. It also included objectives that would apply to most Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 10 service users, such as ‘Careful monitoring of health’ and ‘Maximisation of opportunity and experience in accordance with needs and wishes’. Where more specific objectives had been identified, ‘achieve by’ dates and progress were not consistently recorded. A personal approach was evident in a slide presentation that was seen during the inspection. This was made for a review meeting to show how one service user spent his time and was an imaginative way of presenting the information. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 17 Service users are supported with participating in activities that they enjoy however there are limited opportunities for two service users. Service users like the meals and being involved in the practical arrangements EVIDENCE: A timetable of weekly activities was seen in one of the service user’s files. This was dated July 2002. Conversations with those present confirmed that this timetable no longer applied. The acting manager said that two service users’ day activities continued to be affected by the closure of the resource centre that they previously attended. Efforts are being made to find alternative activities. Staff members are supporting service users with some individual sessions to compensate for the lack of day centre and other outside activities. The home’s diary and monthly activity sheets showed details of the sessions taking place, including crafts and literacy & numeracy work. The service users had produced some nice art and craftwork, which was kept in the home. A swimming session planned for the afternoon of the inspection had to be cancelled because the pool was closed. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 12 The other two service users returned during the afternoon from well established day activities. One service user had been making cakes, which he enjoyed doing and he said that he was happy with his activities. The service users had tea together in the dining room. One service user had helped to lay the table. The meal was freshly prepared by a staff member and enjoyed by service users. Service users also assist under supervision and one person used the kitchen during the afternoon to make drinks for herself and for others, which she was keen to do. The acting manager showed knowledge of the dietary needs of one service user who has diabetes. Staff members said that the menus attempted to combine the service users’ likes and dislikes with healthy eating and a reduction in processed and fatty foods. A dietician had attended a staff meeting in 2004. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Service users benefit from staff awareness of their health needs although problems may arise because of a lack of up to date information. Service users have been at risk from a recent error and inconsistencies in the administration of their medication. EVIDENCE: The daily reports and other current records showed that staff monitor the service users’ health needs on a regular basis and provide support with appointments. A staff member spoke about her role as keyworker to one service user, which includes maintaining an overview of her health and welfare. The service users’ care files included an ‘Intimate and Personal Support’ assessment and a ‘Medical Profile’. These were not up to date, having been written in 1999 and reviewed annually up to June 2003. The acting manager reported on an error involving the administration of medication that had been given to a service user. There had been a delay in the reporting this error to the Commission. The acting manager said that he was investigating the circumstances and had identified some shortcomings in how information about changes in medication are received by staff and Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 14 recorded in the home. The acting manager said that the procedures and guidance to staff were now being made more explicit. The current medication records were up to date, however a record was not being kept when medication is received in the home as part of a monitored dosage system. Since the inspection, the acting manager has sent a detailed report to the Commission about the investigation, with recommendations made. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not looked at on this occasion EVIDENCE: Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The accommodation is meeting the service users’ needs. Service users’ benefit from a homely and domestic environment. EVIDENCE: The home is domestic in style and therefore in keeping with its stated aims. Service users are well placed for being able to reach the amenities and facilities that they use in and around Chippenham. The home looked well maintained, decorated and furnished. The fire officer last inspected the premises in May 2003 and reported that the fire safety measures were satisfactory for the intended use. An environmental health inspection also took place in 2003 and no specific actions were highlighted. One service user likes having his own en-suite bathroom. New floor coverings have been fitted in some of the domestic areas. The décor in the ground floor shower has received attention and the acting manager said that he was looking at further ways in which this facility could be improved. Service users looked comfortable using the communal rooms. The lounge is a nice room, with good chairs to relax in and to watch television. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 36 Service users benefit from the presence of experienced members of staff, although there is a high use of relief and agency staff Staff members receive support through ‘Collective Team Management’, although individual supervision, or an appropriate alternative, should also be available EVIDENCE: There were two vacancies for staff members. The permanent staff members have several years’ experience of supporting the service users. Examples of the employment and training records were seen and these had been updated since the last inspection. Members of the staff team were covering some additional duties although the home’s staff rota showed that relief and occasionally agency staff members are needed while the vacancies continue. Permanent staff members were working alongside the relief staff, with two people working in the home when the four service users are present. One member of staff covers ‘sleeping-in’ duty after 10pm. The relationships between staff members and service users looked friendly and positive. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 18 A staff member said that meetings are held each month with the acting manager present. Minutes are kept of these meetings. The home’s system of ‘Collective Team Management’ includes group supervision, under which each staff member receives supervision from their peers and the manager together. At the last inspection it was recommended that consideration is given to the introduction of individual formal supervision at least 6 times a year. This has not happened although it was agreed with the acting manager that it was important that staff members had an opportunity to raise issues directly with the manager, if they did not feel that this could be shared with others through the system of collective team management and peer group supervision. A staff member spoken with said that she like the responsibility and way of working that resulted from collective team management. She recognised that some people would take to it more quickly than others. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 Records are generally well maintained. Some of the service users’ records are in need of attention to ensure that service users benefit from well informed staff members EVIDENCE: Daily records and reports included good detail about what the service users are doing and their individual routines. A staff member said that the home’s communication book and handover sheets were also a good way of keeping up to date with things. The service users’ personal files are bulky and contain a mixture of documents that are used for occasional reference, and other information that is referred to on a more frequent basis. The files also contain various records that are regularly completed by staff members. Some information could be archived, which would create a more slimmed down file and a clearer presentation of up to date information and the records that are in regular use. The acting manager acknowledged that the files would benefit from attention. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 20 As previously stated in this report, recommendations have been about the recording of service users’ goals and objectives and the need to keep assessments up to date. Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 x x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arundel Close (1) Score x 2 1 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 x x v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 22 YES 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 6 Regulation 15 Requirement The Registered Person must ensure that all care planning information is up to date and that a holistic view of the management of conditions such as diabetes is maintained. Information about the service users health and care needs must be kept up to date Medication must be accurately administered and recorded at all times A record must be maintained of all medication that is received into the home Errors in the administration of medication must be notified to the Commission without delay Timescale for action BY 31/08/05 2. 3. 4. 5. 19 20 20 20 12 13 13 37 FROM 28/07/05 FROM 28/07/05 FROM 28/07/05 FROM 28/07/05 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 6 12 Good Practice Recommendations That the service users progress in meeting their objectives and personal goals is regularly monitored and recorded That efforts continue to be made to support service users v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 23 Arundel Close (1) 3. 4. 36 41 with finding new activities outside the home That the arrangments for collective team management include staff members being offered the opportunity to discuss any matters individually with the homes manager That the service users personal files receive attention in order to produce a clearer presentation of the documents and forms that are in regular and current use Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Arundel Close (1) v242822 d51_d01_s28238_arundel(1)_v242822_270705_stage4.doc Version 1.40 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!