Inspection on 06/06/05 for Arundel House

This inspection was carried out on 6th 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

Arundel House 11/03/09

Arundel House 13/06/06

Arundel House 01/12/05

Arundel House 15/10/04

Arundel House 21/06/04

Similar services:

Southfields

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Insight - Eastchurch

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33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Arundel House 34 Garratts Lane Banstead Surrey SM7 2EB Lead Inspector Lisa Johnson Announced 06 June 2005 10:00 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 House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arundel House Address 34 Garratts Lane Banstead Surrey SM7 2EB 01737 361076 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) Surrey County Council - Adults & Community Care, Alma House, Alma Road, Reigate, Surrey, RH2 0AZ Mrs Corinne Elizabeth Brown Care Home (CRH) 20 Category(ies) of Learning disability (LD) 16 registration, with number Sensory impairment (SI) 3 of places Mental disorder, excluding learning disability or dementia (MD) 1 Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Accommodation and services may be provided in respect of respite care for named persons aged 60-65 years with prior written agreement of the NCSC. 2 Respite care may be provided to a maximum of 2 persons at any one time. 3 That the registered managers duties must be soley for Arundel House. 4 That the Evening Break Service Staffing arrangements must be totally separate from the homes staffing arrangements. 5 The matters detailed in the attached schedule of requirements, must be completed within the stated timescales. Date of last inspection 15 October 2004 Brief Description of the Service: Arundel House is a large Residential Care Home. The home is registered for twenty service users with a learning disability. One service user has a mental disability and three service users have a sensory disability. The home also caters for two respite care beds. All bedrooms are single. One of the units in the home is currently not occupied and although some work has been completed it is not ready yet for occupancy. The grounds are extensive and there is ample parking at the front of the home. The home has its own transport and there are local amenities nearby. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for 2005/2006 and was announced, which meant that the home knew that the Commission for Social Care Inspection were visiting. One inspector carried out the inspection, which started at 10 am and finished at 4.40 pm. The first part of the inspection consisted of the inspector talking to the home manager and touring the premises. Many of the service users were out at activities until 3.30 pm, but some of the service users had told the manager that they would like to speak to the inspector on their return to the home in the afternoon. The inspector sampled a number of documents that were kept in the home and spoke to two members of staff to gain their views about working in the home, as well as attending a staff handover. The inspector then spoke to five service users to talk about their lives at Arundel House. The inspector would like to thank the staff and service users for their assistance and hospitality in carrying out this inspection. What the service does well: What has improved since the last inspection? A number of requirements made at the last inspection have received action. Cleaning materials have been stored and locked away in cupboards safely and a cleaning schedule for the home has been implemented. Some of the carpets have been replaced or cleaned and work to improve the ventilation in the Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 6 laundry room has been completed. Emergency light testing has taken place and repairs carried out to a broken light. A showerhead has been replaced and a curtain rail that was broken has now been secured. The inspector found the lights in the fridges to be in good working order and a water certificate was available. The homes registration certificate was displayed in the entrance hall and monthly visits by the responsible individual were being completed regularly. The accident and incident book has been numbered and police checks for staff were available on their personnel files with application forms. 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. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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 House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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) 1, 2, 3 & 5 Adequate information was available that this would assist prospective service users to make an informed choice as to whether the home would be a suitable place to live. Pre-admission assessments were completed and service user contracts were in place. EVIDENCE: The homes statement of purpose was sampled and found to be detailed and informative. The document consisted of a description of the services provided and description of the accommodation. The qualifications and experience of the staff were available as well as a copy of the complaints procedure. A copy of the complaints procedure was also available in the home devised using symbols and a pictorial format. The relatives comment cards showed that the majority of the relatives were aware of the homes complaint policy and that inspection reports had been made available to them. It was positive to note that the inspection reports for the home were observed to be on display. All prospective service users receive an assessment prior to admission to the home. A new service user had moved into the home recently and evidence was seen that that the service completes its own assessment. A statement of terms and conditions for service users was available. A service use guide was implemented and the manager stated that each service user had been issued with an information folder. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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, 7,8, 9&10 Individual care plans are in place and these included risk assessments. Service users are involved in making decisions about their lives and were able to participate in aspects of life in the home. Information regarding service users was kept in a confidential manner. EVIDENCE: Each service user had an individual care plan which was person centred in its approach. The plans were detailed and included identified risks. There was evidence where possible service users had signed their plans. Six monthly reviews take place and review dates were recorded and monitored. Weekly service user meetings are held in the home, one service user confirmed this and said, “we have a meeting every week, and I can help choose my meals”. The inspector spoke to other service users in the home and they stated that they help with cooking and clearly enjoyed being involved in household activities. One service user said “I help clean my room, make my bed and I help with the vacuuming”. Some of the service users in the home have communication difficulties and the staff have implemented non verbal means of communication such as makaton, Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 10 signs and symbols and pictorial formats of information to assist all service users in participating in all aspects in the home. It was pleasing to see service users looking at information displayed i.e., the duty rota and activities board. The inspector attended a staff hand over which was detailed. The meeting was carried out in private in the office. Service users records were maintained in the office and kept in a safe place. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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) 11, 12, 13, 15, 16 &17 The home is able to support service users opportunities for stimulation through providing appropriate leisure and recreational activities. Service users are able to maintain contact with family, friends and local community. EVIDENCE: It was clear from care plans that personal development was encouraged and that age appropriate activities take place. There was a good range of activities in the home. A number of the service users in the home attend the Bentley day service. One service user stated that he likes to go to the shops. At the time of the inspection one service user had been to the town with a staff member to buy a neck chain that he wished to purchase. One member of staff stated that service users go on outings to the local pub; go to the cinema and bowling. Some of the service users attend activities with the local scout group, while others attend a Sunday and a Tuesday club. The inspector asked the service users what they enjoyed doing, they stated they liked attending activities at the scout group and going to the pub. A service user said, “I like playing football and I like drawing”. Another service user showed the inspector his bus pass and said “I like going to Sutton on the bus”. A service user was knitting, Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 12 which she said that she enjoyed. Some of the service users had a good range of personal effects in their rooms and it was clear that service users had a range of hobbies and interests which was on display in their rooms. Some of the service users have relatives who they maintain contact with. All the comments from relatives reflected that they are able to visit the home at anytime and that privacy is maintained. Four of the service users in the home have advocates. Mealtimes are flexible the menu is planned weekly in consultation with the service users. Likes and dislikes are catered for. The menus seen offered a nutritious and varied choice. Snacks and drinks were available. One service user was observed to be making himself some toast on return from activities and another (who been in the home on the day of the inspection) was observed to have drinks and snacks, some of which he had purchased at the local shops with support from a member of staff. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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) 18, 19 & 20 The home demonstrates that detailed individual plans are in place that meet the personal and health care needs of service users. Appropriate arrangements were in place for the administration of medication. EVIDENCE: The staff team have a good understanding of the support needs of the service users. Personal and healthcare needs are documented in their individual plan. Evidence was seen that health checks take place. The home liaises with the local GP, dietician, and Community team for people with learning disabilities including speech therapy. Comments were received from some of the health and social care professionals who work with the home and state that the home communicates and works in partnership. They commented that specialist advice is incorporated into the service user plan. Some of the staff have attended specialist training in restrictive physical interventions. Risk assessments are in place and evidence was seen that these are reviewed. Medication records were sampled; there were no gaps in recording of medication .The home attempts to have two staff when administering medication. There were medication profiles in place. An agreed homely remedies list was available. The controlled medication cupboard was seen and an appropriate storage cupboard is in place and the register was maintained correctly. A stock check was sampled with a staff member and was found to be correct. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 14 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) 22&23 The home is able to demonstrate that service users, relatives and friends views are important and listened to and service users are appropriately protected. Policies were in place in respect of complaints and adult protection. EVIDENCE: There is a clear complaints policy available which is also available in symbol and pictorial format. There have been two complaints recorded since the last inspection. Comments were received from a number of relatives by questionnaires and it was found that relatives were satisfied with the overall care provided. A number of questionnaires were received from service users who were also happy and were aware of whom to speak to if they have any concerns. During the inspection positive interaction was observed between service users and staff. Dignity, privacy and respect were maintained and the staff were aware of the service users rights to make choices. Permission was gained from service users before entering bedrooms. Service users spoken to said that they were happy living in the home. One service user with communication difficulties smiled and appeared relaxed. The home made available the updated Surrey Adult Protection procedure and evidence was seen that staff have undertaken adult protection training. Two staff spoken to were clear that they would report any incidences of abuse if they witnessed it occurring. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 15 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, 25, 26, 27, 28, 29 &30 The home has made some progress in improving the environment of the home, but there are still some décor improvements to be made and some safety issues to be addressed. EVIDENCE: Each unit has its own lounge; there is a large room, which is used for parties and social events, and a games room, which has a range of activities. The service users bedrooms were personalised to their choice. The home was found to be clean and a schedule for the home cleaning has been implemented. Information boards with symbols and pictorial format assisted service users with communication difficulties to be as independent as possible. The inspector was concerned about the temperature of the water in one of the bedroom sinks. Temperature records were sampled and it was found that there were occasional difficulties with either the water being too hot or being two cold. One tap in the home was reported not to be working. An immediate requirement was made that the thermostatic controls are attended to in order to ensure the safety of service users. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 16 There are several toilets on the ground floor and some on the first floor. A toilet seat was found to be in need of replacement as well as flooring and one of the showers requires deep cleaning due to mould around the seals. A window restrictor was found to be in need of replacement in the ground floor laundry room. The home has purchased some new carpets, but it was found that the sitting room carpet in Ruby unit requires deep cleaning as it was stained. A kitchen cupboard door in Jade unit requires recovering and some of the doorframes need repainting, particularly in Jade and Azure units. On examining the fridge temperatures there were found to be some gaps in daily records and a requirement has been made in respect of this. The home has large front and rear gardens and a central patio. It was observed that the garden was overgrown and that the grass was very long making the garden unsafe for the service users, and a requirement was made as a result. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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) 31,32. 33,34,35 &36 The staffing levels in the home were adequate to meet the needs of service users. The staff team were motivated about their training and development and work positively with service users in the home. Appropriate recruitment practices were in place to ensure the safety and protection of service users. EVIDENCE: Two personnel files were sampled and were found to contain police checks and the required information. The staff duty rota was examined and staffing levels were found to be satisfactory, although there is some staff vacancies resulting in some agency staff being used. Some of the service users in the home receive extra funded one to one support. Staff supervision records were sampled and evidence was seen that this is taking place and was confirmed by one member of staff who stated that she received supervision monthly. There is a good induction training programme in place and a new member of staff spoken to supported this. He stated that he had been appointed a “buddy” to support him and that the staff were helpful and that he was completing an induction training checklist. Evidence was seen that staff development and training is implemented, staff records were maintained. Mandatory training was recorded including medication and first aid. A range of other training has taken place including disability equality, Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 18 Widget training, death dying and bereavement, appraisal and supervision. One member of staff spoken to felt she was supported in attending training courses. Some staff have completed National Vocational Qualifications training and some are completing the course. It was observed that staff had an understanding of their role and responsibilities and that good teamwork was in place. However a requirement has been made that staff receive updated fire safety training as this was found to be out of date. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 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) 37, 38, 39, 40, 41, 42 &43 The home is running well and the manager is providing leadership, but there were some health and safety issues that must be addressed. These are detailed under the relevant standards throughout this report. EVIDENCE: The manager holds a management qualification and is in the process of completing the Registered Managers Award. The manager has undertaken relevant training to update her knowledge. Evidence was available that staff are supported through supervision and attend training. Five staff have obtained NVQ qualifications and five staff are in the process of completing the programme. A number of staff have completed first aid training and this was recorded in staff records. Team meetings are held. Policies and procedures were sampled such as fire, food hygiene, first aid, control of harmful substances, environmental risk assessment, health and safety policies and manual handling were available. Evidence was available that policies are communicated to the staff team. Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 20 Service user meetings are held and evidence was sampled. Monthly visits by the registered provider as required under Regulation 26 of the Care Homes Regulations 2001 were found to be taking place. Arundel House H58 S34534 Arundel House V221312 060605 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 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arundel House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 3 3 H58 S34534 Arundel House V221312 060605 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 42 Regulation 13 (4)(c ) Requirement Timescale for action immediate 6/6/05 2. 3. 4. 5. 6. 7. 8. 9. 10. 42 24 24 24 13 24 24 24 42 The temperature of the water must be regularly checked and monitored to ensure the safety and comfort of service users. The hot water temperature must be as close as possible to 43 degrees centrigrade. 13 (4) ( c) The temperature of the fridge must be recorded daily. 23 (2) (b) The toilet seat in Azure unit must be changed. 23(2) (b) The flooring in one of the toilets must be replaced. 13 (4) (a) The window restrictor in the (c) downstairs laundry room must be replaced. 23 (2) (d) The mould around the shower tray must be attended to. 23 (2) (d) The carpet in Ruby unit must be deep cleaned 23 (2) (d) The doors and frames must be repainted in the corridors. 23 (2) (0) The front and rear of the garden must be maintained to make it safe for the service users. 23 (4) (d) Fire training must be updated for all staff. immediate 6/6/05 1 month 6/7/05 2 months 6/8/05 1 week 13/6/05 1 month 6/7/05 .1 month 6/7/05 3 months 6/9/05 immediate 6/6/05 1 month 6/7/05 Arundel House H58 S34534 Arundel House V221312 060605 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 Good Practice Recommendations Arundel House H58 S34534 Arundel House V221312 060605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 House H58 S34534 Arundel House V221312 060605 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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