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Inspection on 22/08/05 for Aspen Court Nursing Home

Also see our care home review for Aspen Court Nursing Home for more information

This inspection was carried out on 22nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has 75 Residents and provides nursing care on the top floor, EMI on the middle floor and residential care on the ground floor. Despite the size of the home, staff encourage residents to self medicate. Residents spoken to liked the staff and commented that they were kind. There was a range of activities taking part in the home, these were not restricted to one particular floor of the home. Photos of outings where a coach has been arranged to take them out to an event, could be seen around the home.

What has improved since the last inspection?

The home now informs the Commission for Social Care Inspection of any allegations or misconduct of any person who works at the home. All staff receives appropriate documented supervision, on a regular basis.

What the care home could do better:

It was noted during the tour of the home that equipment is being stored in the en-suit bathrooms. Although some of these residents were not using the bathrooms it is still inappropriate. It was also noted that food containers opened were not labelled, this was the case with the individual fridges on each floors and the main fridges in the kitchen. Service Users files looked at did not have a fully documented pre-assessment when moving into the home, that indicates their needs would be met. The Care Plans were documented, but being used and documented as a daily record. There were too many medication sheets in the folder, that resulted in some of the sheets being torn and falling out. The home must have policies andprocedure that clearly show when medication is prescribed and not given. The storage of medication must allow staff to be able to find the medication and must be stored appropriately. Service users were seen to be waiting a long time for their meals, this was also mention by a resident spoken to.

CARE HOMES FOR OLDER PEOPLE Aspen Court Nursing Home 17 Dod Street Poplar London E14 Lead Inspector Helen Fontaine Unannounced Inspection 22 August 2005 at 10:00am nd 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 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 Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Aspen Court Nursing Home Address 17 Dod Street, Poplar, London, E14 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) 020 7538 9789 020 7515 0938 Southern Cross Healthcare Mrs Mary Kenny Care Home 75 Category(ies) of Old age, not falling within any other category registration, with number (75) of places Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 29th September 2004 Brief Description of the Service: Aspen Court is registered with the Stratford East London Commission for Social Care Inspection Area Office as a care home for older people that also provide nursing. It is owned and managed by Southern Cross Healthcare that is one of the largest providers in the UK. In its statement of purpose, the home underlines its commitment to individualised care and provision of an environment that service users regard as their home. The premises are purpose built and have their own parking facilities. All rooms (69 single and 3 double) have en-suite facilities and are fully furnished. Various communal areas are available, including a garden. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours and was carried out as part of the yearly inspections. The last inspection was in September 2004, letters sent to the registered person following that inspection can be obtained from the Commission for Social Care Inspection office on request. The Inspector looked round some parts of the building and a number of records were inspected. A number of residents were spoken to, some visitors and two members of staff were spoken to. What the service does well: What has improved since the last inspection? What they could do better: It was noted during the tour of the home that equipment is being stored in the en-suit bathrooms. Although some of these residents were not using the bathrooms it is still inappropriate. It was also noted that food containers opened were not labelled, this was the case with the individual fridges on each floors and the main fridges in the kitchen. Service Users files looked at did not have a fully documented pre-assessment when moving into the home, that indicates their needs would be met. The Care Plans were documented, but being used and documented as a daily record. There were too many medication sheets in the folder, that resulted in some of the sheets being torn and falling out. The home must have policies and Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 6 procedure that clearly show when medication is prescribed and not given. The storage of medication must allow staff to be able to find the medication and must be stored appropriately. Service users were seen to be waiting a long time for their meals, this was also mention by a resident spoken to. 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. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 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 standard(s) 3 The admission procedure was in place but the assessment prior to people moving in the service was not adequate. EVIDENCE: The procedure and paper work was adequate, but on inspection it was found that important area of the assessment had not been completed. The failure could have serious repercussion for the health and welfare of the residents. The Manager said that new documentation is starting to be used and felt that this would cover all the points that were raised. The new documentation was looked at and on the ground floor these had been fully completed, however the new files looked at on the other floors, still had areas uncompleted. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 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 standard(s) 7 and 9 The care plans were being used and documented as a daily record. There were concerns over the procedures for administering and safe keeping of medication. EVIDENCE: During the inspection Service Users files were looked at, all the care plans covered all aspects of health, personal and social care but were being used as a daily record. The Staff Nurse spoken to, did not know that this was not the procedure that needed to be followed. The Manager said that they in the process of using new documentation and this would resolve this situation. It was noted during the inspection, that residents were encouraged to be responsible for their own medication. The necessary risk assessments were in place and the Staff Nurse spoken to said that they did like to help residents to achieve this. However when looking through the medication sheets, it was noted that too many sheet were in one folder, which resulted in them getting torn. One residents sheet was checked and a spray that this resident had been prescribed had not been given. The Staff Nurse was unable to find the spray and it was noted that a cupboard the member of staff was looking in had a number of creams and bandages. The cupboard was stacked inappropriately and there was no way of establishing which Service User these items were for. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 10 The home must make sure that the homes policies and procedures for dealing with medication are followed. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13 and 15 Social activities are well organised, creative and provided stimulation and interest for people living in the home. It was noted that residents sitting at the tables had to wait for over half an hour, before they received their meal. EVIDENCE: A number of people living in the home were spoken to most of them commented that they enjoyed the food. However one resident spoken to said that they had waited so long for their breakfast that they had given up and gone back to their room. It was observed during the inspection that residents sat at the dinning table, had to wait for over half an hour before their meals were served. The home must make sure that Service Users are not sitting at the dinning room table, longer than necessary. The home has an activities worker, but the Manager said that it is not just this workers responsibility for activities but all the staff responsibility. It was observed during the inspection that residents were in the dinning room of the ground floor, taking part in an art group. There were photos around the home of outings and the Manager said that they do hire a coach to take people out. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 12 During the inspection visitors were spoken to and they said that on the whole they felt their relative was well cared for. Another Service Users spoken to said that they had visitors and had contact with organisations that offered them advice. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 Service Users do have their complaints listened to, but one resident did not feel these were acted on. EVIDENCE: A resident spoken to had a number of issues with the home, they were not sure that these were being acted on. The Manager said that every effort is being made to address the issues raised and that this is the only resident with any problems. Family visiting said that they had a few minor issues with the home, these they had not conveyed to the Manager. The home does notify the Commission for Social Care Inspection of any issues and other residents spoken said they were felt confident that any complaints would be dealt with. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 23, 24 and 26 The home does need to keep the home free from hazards, with equipment stored appropriately. No odours were present during the inspection and necessary areas were checked. EVIDENCE: The Maintenance man was present during the inspection and was observed checking the water temperatures. There was a maintenance book on each floor and from the dates and signatures these were dealt with promptly. It was noted the very good interaction between the Maintenance man and the Service Users. Service Users each had their own rooms with en-suit facilities and one room seen was a double allowing a married couple to remain together. Each room was personalized and each resident was able to have their possessions in their room. The Manager said that one Service Users, whose daughter felt money had been taken from the room had a locked draw arranged. It was noted that a number of en-suit bathrooms had stored in them, wheelchairs and other Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 15 equipment. The Manager said that this was only done when the residents were in the lounge or when the Service Users did not use the en-suit. The home must make sure that all areas of the home are free from hazards and that equipment is stored appropriately. The home was clean and pleasant and well decorated, a relative spoken to said that they was an odour in the lounges. The Manager said that there are occasions when there are accidents, but every effort is made to keep the home odour free. During the tour of the building, all the lounges were visited and there was no odours detected. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The procedures for the recruitment of staff are robust and do offer protection to people living in the home. EVIDENCE: The staff files of three members employed since the last inspection indicated that the home had undertaken all the necessary recruitment checks to ensure the protection of the residents. Criminal Records Bureau checks had been done and two references were seen on the staff files. During the inspection of the staff files, it was noted that staff had a number of training certificates and the Manager said that they do a number of training sessions in the home. During the inspection a new member of staff was seen to be doing their induction, which included meeting the residents and looking at their care plans. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 The home does now have a robust supervision procedure, this had been a requirement from the previous inspection. The labelling and dating of stored food was found not to be done on some occassions. EVIDENCE: During the inspection staff files were looked and the supervision files were seen to have regular supervision notes. The Manager said that now they have an administration worker, that the files although adequate would be kept in a more orderly state. It was noted that some stored food containers in both the single fridges on each floor and in the main kitchen were not labelled. The Home must make sure that all the food containes that are opened are clearly labelled. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 1 COMPLAINTS AND PROTECTION 1 x x x 3 3 x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x 3 x 1 Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 19 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 OP3 Regulation 14(1) Requirement The Registered Person must ensure that before a Service User enters the home their needs have been assessed and been assured that these will be met. The Registered Person must ensure that a written plan as to how the Service Users needs are met and the Care Plan is not used as a daily record. The Registered Person shall make arrangements for the recording, handling, safekeeping, safe administration of medicines. The Registered Person shall provide food which is prepared and available at such time that is required by the Service Users. The Registered Person shall ensure that Service Users have access to hazard free parts of the home and that equipment is not stored in En-suit bathrooms. The Registered Person shall ensure that stored food is labelled and dated. Timescale for action 24/02/06 2. OP7 15(1) 24/02/06 3. OP9 13(2) 24/11/05 4. OP15 16(2) 24/11/05 5. OP19 13(4) 24/11/05 6. OP38 16(j) 24/11/05 Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 20 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 OP16 Good Practice Recommendations All the complaints are fully investigated and all the Service users feel those complaints are being dealt with. Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ 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 Aspen Court Nursing Home G57 G06 S7350 Aspen Court Nursing Home V245635 220805 Stage 4.doc Version 1.40 Page 22 - 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. 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