Inspection on 02/02/07 for Aspen Court

This inspection was carried out on 2nd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Aspen Court 24/03/09

Aspen Court 29/09/05

Aspen Court 01/06/05

Aspen Court 10/11/04

Aspen Court 11/05/04

Aspen Court 26/09/02

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Aspen Court Aspen Drive Spondon Derby DE21 7SG Lead Inspector Angela Kennedy Key Unannounced Inspection 2nd February 2007 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 Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 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. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aspen Court Address Aspen Drive Spondon Derby DE21 7SG 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) 01332 672289 www.bupa.com BUPA Care Homes (BNH) Limited Ann Susan Rice Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 Brief Description of the Service: Aspen Court care home provides nursing for 40 people aged 65 years and over. The home is a two-storey purpose built building, situated near to Sponden village and local facilities. The home has 36 single and 2 shared rooms, all rooms have ensuite facilities. The home is on two floors accessed by stairs and a passenger lift. The lounge and dining areas are on the ground floor. Residents have access to a well set out garden. The fees per week at the time of this inspection were in line with the local authority for residents whose care was funded or part funded by the local authority, and up to £655 for privately funded residents. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place over approximately 6 hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with residents and their representatives. The inspection was focused on assessing compliance with defined key National Minimum Standards. The registered manager was present at the inspection. Staff were involved in supplying information during the inspection and to ascertain their views of the service in relation to the training and support provided to them. Three residents and four visitors were also spoken with to gain their views on the service. What the service does well: What has improved since the last inspection? The home has made good progress towards meeting the requirements and recommendations from the last inspection report. New care planning systems were in the process of being implemented at the time of inspection and provided clear and detailed information on the care and support that each resident required. This ensured that the staff team were provided with detailed instruction as to how each individuals assessed needs were to be met. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 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 Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Aspen Court had a good needs assessment process in place. People who use the service could be confident that the home would determine that their needs could be met before they moved in. EVIDENCE: Shortfalls in assessment of resident’s needs were identified at previous inspections; all of these shortfalls have now been addressed. The personal files of three residents were looked at and evidence was in place to demonstrate that needs assessments had been undertaken prior to admission. Within two of the resident’s files new care planning systems had Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 9 been implemented and provided clear and detailed information on the care and support that each resident required. This ensured that the staff team were provided with detailed instruction as to how each individuals assessed needs were to be met. Aspen Court had completed assessments even when the local authority had undertaken an assessment of needs. This demonstrated that a thorough approach to assessment of needs was undertaken. Resident’s medication at the time of admission was listed, this include the dosage, times and frequency of all medicines. The assessments undertaken by Aspen Court contained all the required information to ensure that residents’ needs could be appropriately determined. From each individual’s needs assessment personal care plans had been developed. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The comprehensive plans of care demonstrated that residents’ health and personal care needs were met and the medication practices in place indicated that resident’s safety was maintained. Residents were treated respectfully and their wishes regarding the time of their death were acknowledged and treated with sensitivity and respect. EVIDENCE: Two of the three residents files seen had been transferred to the new care planning systems that were being implemented. The new care planning systems provided clear and detailed information on the care and support that each resident required. The third residents file also provided information regarding the residents assessed needs and the support that was required by staff to meet this Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 11 residents needs, this information however did not provide the comprehensive information that was seen within the two residents files that had been transferred to the new system. All of the care plans set out the health, personal and social care needs of the residents and were regularly updated by staff. There were nominated key workers and named nurses for residents and they had particular input into the care plan documentation for the relevant resident. The care plans looked at, contained assessments that identified the needs and support of each resident with regard to falls, mobility, moving and handling, pressure areas, nutrition, bathing, maintaining a safe environment and general risk assessments that were appropriate to each individual resident. The care plans contained details of input by other healthcare professionals such as dentists, chiropodists, opticians and general practitioners. The residents spoken with confirmed that staff consulted them about care matters and involved them in review processes. Staff spoken with were knowledgeable about the care needs of residents and were familiar with the care plans. Evidence was also in place to demonstrate that care managers and primary care teams as appropriate to the individual residents, undertook a review of their care. The arrangements for the safe keeping and handling of medicines was assessed and found to be satisfactory. Medication administration records had been completed correctly and medication was stored appropriately according to pharmaceutical instruction. The registered manager confirmed that at the time of inspection none of the residents self-administered their medication. Residents and relatives spoken with said that staff were respectful of residents privacy and dignity. Staff were observed during the inspection and demonstrated a respectful approach to residents, such as knocking on bedroom doors before entering. End of life care plans were seen within all of the residents’ files looked at. These care plans demonstrated that residents wishes and the wishes of their relatives had been sought regarding end of life care. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 12 Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The daily routines and range of activities available met resident’s needs. Resident’s maintained contact with family and friends as they wished and residents’ were encouraged to exercise control and choice over their lives as much as possible. The meals provided appeared nutritious in content and alternative dishes were available. EVIDENCE: An activities co-ordinator was employed at Aspen Court and a range of activities was available to residents, this included; bingo, quizzes, reminiscence therapy – where a reminiscence room decorated with memorabilia was provided, movement to music, skittles, art and craft work, movies and one to one shopping trips within the local community. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 14 Relatives were encouraged to participate in activities; an example of this was the quizzes that were held on Wednesday’s where relatives were invited to join in. A hair stylist visited Aspen Court on Thursday’s for any residents who wished to use this service, and foot spas and manicure services were also available each Thursday for any residents who wished to participate. A greenhouse was in place within the garden area of Aspen Court and residents who expressed an interest were encouraged to help with potting plants. Seating was available within the garden area, as was a bird table and fishpond. External companies visited Aspen Court on a monthly basis to provide entertainment. The registered manager stated that none of the residents went out to church but several residents participated in monthly communion that was held within Aspen Court. Religious festivals were celebrated such as Easter and Christmas and the registered manager confirmed that if any resident wished to see the local priest or vicar this would be arranged for them. Residents spoken with felt the routines at Aspen Court were flexible and stated that they were able to move around the home freely and participate in activities if they chose to. They confirmed that they were able to choose when to get up and when to retire to bed. Visiting at Aspen Court was open and relatives spoken with stated that they were made to feel welcome by the staff team. Residents spoken with said they were able to meet with their visitors either within their private accommodation or the communal areas, as they preferred. Some of the resident’s had chosen to have private telephone lines installed within their own rooms. A payphone was also available for residents use. At the last inspection some residents had commented that they found some of the meals to be bland and repetitive. A recommendation was left for residents to be consulted about the meals provided. The residents spoken with at this inspection confirmed that some consultation regarding the meals had taken place and felt there had been some improvement in the quality of the meals provided. Two of the three residents spoken with felt that the variety of meals provided could be improved upon. The menus at Aspen Court ran over a four-week period. Cooked breakfasts were available each day and a vegetarian option was available at each meal. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 15 ‘Light Bites’ were available for residents in between the main meal times if required. Kitchen staff were on duty each day from 7.30am to 6pm and the registered manager confirmed that sandwiches and additional foods were made available for residents out of the kitchen staffs hours. All staff were or had undertaken a distance-learning course in nutrition. Literature was available to all staff in a diet directory that contained fact sheets on nutrition and specialist diets. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information that Aspen Court had about complaints was good. This meant that residents and their relatives were informed of what to do if they were not happy with the service and care provided. Resident’s legal rights were protected. The home has satisfactory adult protection systems in place for safeguarding adults. The systems in place safeguard residents living at the home. EVIDENCE: The complaints procedure was displayed within the home and within the service user guide. The complaints procedure was clear and included the 28-day timescale for response to complaints. The contact details for the commission for social care inspection were also included. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 17 Six complaints had been received at Aspen Court since its last Key inspection in September 2005. These complaints had been dealt with satisfactorily and were documented clearly and demonstrated the action that was taken and the outcome of the complaints. Residents spoken with confirmed that if they had any concerns or complaints they would speak with a relative, a member of staff or the manager. All three residents felt that the staff were approachable and said they would feel comfortable speaking with them and felt confident that any issues they had would be listened to and acted upon. Residents were able to vote if they chose to and the registered manager confirmed that most residents chose to vote using postal votes. The registered manager confirmed that Advocacy services were available to residents and were used as and when required. Satisfactory adult protection systems were in place and this included local authority guidance. Staff attended in house training on prevention of abuse/safeguarding adults and the registered manager and deputy manager had attended local authority training. Safeguarding adults’ training was also included within staff induction. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,24.26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Residents lived in a safe environment that was maintained to a good standard. Residents had the specialist equipment needed to ensure their independence was maintained and promoted. Resident’s private accommodation provided a comfortable environment, however this will be further enhanced once works are completed, by ensuring residents privacy is maintained. EVIDENCE: A tour of the building was undertaken and all areas seen were found to be well maintained. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 19 Bathrooms and toilets contained the appropriate moving and handling aids and equipment and new moving and handling equipment had been purchased since the last inspection, to ensure residents assessed needs could be met. The laundry area contained sufficient equipment to ensure residents clothing could be laundered at the appropriate temperatures to meet disinfection standards. Residents and their relatives confirmed that they were happy with the laundry facilities and it was observed that residents clothing appeared clean and well ironed. A requirement was left at the last inspection regarding the fitting of suitable locks to bedroom doors; this requirement had been made on the previous three inspections. Discussions took place with the manager who stated that this work was being undertaken but at the time of this inspection was not completed, as master keys to all bedrooms were not yet in place. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28.29.30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Aspen Court had staff in sufficient numbers and with appropriate training to meet the needs of the residents. There were appropriate recruitment procedures in place to safeguard residents EVIDENCE: The staffing rotas were examined and demonstrated that six care staff were on duty in the morning and afternoon with two qualified nurses, and at night three care staff were on duty with one qualified nurse. The manager’s hours were supernumerary and the deputy manager worked eighteen hours a week supernumerary and the remainder of the week on shift. Residents and relatives felt that there were sufficient numbers of staff to meet residents’ needs and stated that staff demonstrated a caring approach. One relative spoken with stated that the communication to them by staff had raised some concerns, however this relative stated that since speaking with the manager regarding these concerns the communication had improved and staff had informed this relative of any issues regarding their parent’s health. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 21 Two other relatives spoken with confirmed that they were happy with the communication between staff and themselves and stated that they were always kept informed of any concerns or health care issues. Separate staffing arrangements were in place for catering, housekeeping and maintenance duties. Eleven care staff had achieved a national vocational qualification (NVQ) in care at level 2 and five staff were undertaking NVQ 2 in care. Three staff had achieved an NVQ at level 3 in care, this demonstrates that the staff team had the training required to ensure resident’s needs could be met. The recruitment files of three staff were examined and there was evidence of an appropriate recruitment system in place to safeguard residents. This included satisfactory criminal records bureau checks, two satisfactory written references and the required identification documents. All of the three staff files seen had a written contract of employment in place that had been signed by the staff member. The staffs training records were examined and a training matrix was in place, which ensured that staff received mandatory training updates when required. There were training opportunities for subjects in addition to mandatory training and this was informed by residents assessed needs and through staff supervision and staff appraisal. The induction package for care staff and qualified nurses at Aspen Court was also examined This was found to be robust in detail, incorporating all of the required areas of induction as set out by the national training organisation workforce. Three members of staff were spoken with and all three stated that the training opportunities and support provided was of a high standard. All three staff felt that their training needs were met. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed and run in the best interests of residents. Residents financial interests were safeguarded and the health safety and welfare of residents and staff was maintained by the practices in place. EVIDENCE: The registered manager had been in post for several years and had achieved a management qualification and a national vocational qualification in care at level 4. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 23 Staff that was spoken with were very complimentary regarding the managers ability to run the service. Residents and relatives spoken with reported that the manager and staff team were approachable and demonstrated a caring and respectful attitude. Good procedures were in place for monitoring the care and services provided at Aspen Court and included; monthly internal audits on all areas of the home from maintenance, domestic, catering and clinical issues where care plans, records and the evaluation of care was assessed. Resident’s customer satisfaction surveys were also undertaken and the results of these surveys were published to the residents including how any issues identified were to be resolved. Residents meetings were held every three months. The residents spoken with felt that their views and opinions were sought, and stated that any issues or areas of concern they had were acted upon. The system for handling residents’ personal monies was examined and suitable accounting procedures were in place that protected residents from financial abuse. Some of the safe working practices of the service was assessed and found to be maintained to a good standard these included; the weekly testing of fire alarms and the testing of the emergency lighting systems, nurse call systems and water temperatures. A robust record of maintenance call outs was kept along with the actions taken and results. Up to date service certificates were in place for gas and electrical appliances, moving and handling equipment and water chlorination. Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 24 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 3 X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Aspen Court DS0000002137.V327960.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP24 Regulation 12 Requirement A phased programme must be carried out to fit suitable locks to bedroom doors. This requirement is carried forward from the previous four inspection reports. (Timescale extended for works to be completed) Timescale for action 30/06/07 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 OP9 Good Practice Recommendations Further consultation should be made with residents about the variety of meals provided to ensure that meals are appealing and meet individual needs. 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