Inspection on 19/08/05 for Aughton Park Residential Home

This inspection was carried out on 19th August 2005.

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

Aughton Park Residential Home 17/05/07

Aughton Park Residential Home 15/01/06

Aughton Park Residential Home 06/12/04

Aughton Park Residential Home 29/06/04

Aughton Park Residential Home 09/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Aughton Park Residential Home Aughton Park Drive Aughton Ormskirk L39 5BX Lead Inspector Val Turley Unannounced 19 August 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 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. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Aughton Park Residential Home Address Aughton Park Drive Aughton Ormskirk L39 5BX 01695 576996 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) Methodist Homes for the Aged Ms Michelle Morris Care Home 48 Category(ies) of OP Old Age (35) registration, with number DE(E) Dementia - over 65 (12) of places DE Dementia (1) Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered for a maximum of 48 service users to include: 2) Up to 35 service users in the category OP - (Old Age not falling within any other category). 3) Up to 12 service users in the category of DE(E) (Dementia over 65 years of age) 4) Up to 1 service user in the category of DE (Dementia) 5) The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 6) Staffing must be provided to meet the dependency needs of service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 6 December 2004 Brief Description of the Service: Aughton Park Care Home is a new purpose built home providing 24-hour personal care for up to 48 older people. The home is situated in a residential area of Aughton, West Lancashire, and provides accommodation on two floors. The dementia unit is self -contained within one wing on the ground floor. All of the bedrooms have a shower en-suite facility, have at least 12 sq m of space and are for single occupancy. The home has four lounge areas, which are situated throughout the two floors. There is one main dining area and the dementia unit has its own small dining area. Access to the first floor of the home is by a passenger lift. The home has private grounds to the rear with the dementia unit having its own secure garden. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day in August 2005 by one regulation inspector. The inspection involved discussion with and observation of the service users who lived at the home and also discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on three of the service users living at the home. Two of these service users were resident within the dementia unit. All records relating to these individual were inspected along with their room occupied at the home. The service users were invited to discuss their experiences of the home with the inspector, however this was not to the exclusion of other people living at the home. What the service does well: The home provided a friendly, comfortable, clean and generally safe environment for service users, staff and visitors. The building was well maintained and the facilities provided were excellent. The pre-admission process was conducted in a thorough and thoughtful way and was appreciated by service users and families. The home had good systems in place to ensure that the health needs of service users were being met. Staff were praised by both service users and visitors for their kindness and attentive approach. They supported service users to maintain contact with their families and friends and worked towards ensuring that visits were as successful as possible. The home also employed an activities organiser who provided a valuable service for the service users. The home enjoyed the involvement of a number of volunteers who worked in the home on a regular basis providing additional support for service users. Links were maintained with the community and a number of local churches conducted services within the home. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 6 The home had a number of quality assurance processes in place, which involved input from the service users, relatives and visitors. These had all had a mainly positive response with any concerns raised being identified and necessary actions undertaken. Service users were encouraged to become involved in the inspection process, as were staff, visitors and volunteers. What has improved since the last inspection? 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. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 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 Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 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 home had a thorough pre-admission assessment procedure in place, which was used to determine whether appropriate support could be provided for potential service users. EVIDENCE: Admission documentation was examined for three recently admitted service users. Information collated prior to their admission was detailed and covered all aspects of their personal care support needs. The information was collected from a variety of sources including GP’s, a day centre, care managers and family members and used to determine whether the needs of the service user could be met at the home. Each of the service users had a care plan in place with information from the pre-admission procedure being used to provide a foundation for these. One of the service users and a relative of another spoke of their experiences in the pre-admission period and praised the staff for their approach and sensitivity during such a very difficult time. The relative spoken stated ‘It was very difficult for me putting my father in a home, but it has worked out very well’. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 9 Discussion with one of the assistant managers confirmed that senior members of staff were responsible for undertaking the pre-admission assessment. The member of staff spoken to also confirmed the discussions held with a potential service user and his family. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 The care planning process was not thorough enough to ensure that individual service user needs were consistently met. The home had good systems in place to ensure that the health needs of the service users were being met. EVIDENCE: The care plans of three service users were examined. It was noted that not all of the information collected as part of the pre-admission process had been carried over to the care plans. This information included service users preferences about the care and routines they preferred and information about one service users dislikes. The fact that one of the service users wore glasses was not carried over to his care plan. The omission of this type of information in the care plans could leave service users feeling insecure and unsettled in an already unfamiliar environment. There was a record of service users preferred daily routines on each of the files examined. These contained basic details only. Additional detail would assist staff to provide a positive person centred service and environment for service users. One of the service users had presented some challenging behaviour since his admission to the dementia unit and this had placed himself and other service users in potentially vulnerable situations. Although these incidents had been recorded, his care plan had not been reviewed or amended to reflect his Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 11 specific supervision needs, leaving himself and other service users still potentially at risk. There was a dependency on the knowledge and memory of the staff to ensure that service users individual needs were met. Accurate documentation and a thorough care planning process would help ensure that the needs of the service users were met consistently. More information concerning service users interests and hobbies with particular reference to those they enjoyed in their early lives should be included within the care plans so that staff are aware of a service users interests and can arrange suitable activities for them. A relative spoken to on the day of the inspection said that she could not praise staff enough. She stated that all the staff she had met were very kind and attentive to her father and did all that they could to make him feel comfortable. They had also responded quickly and appropriately to any health needs that he had presented. She had had access to her father’s care plan. One of the service users stated that although she had found it difficult making the decision to move into the home, the staff had been very kind and attentive and she could not fault the care that had been provided. She had also been supported to attend a number of health care appointments. There was evidence on the service users files that appropriate referrals to health professionals had been made and that service users received attention from the District Nurse, community psychiatric nurse and the chiropodist. On the day of the inspection an audiologist was present within the home undertaking hearing tests. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 12 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 The staff worked towards providing suitable social activities for the service users but did not always have sufficient staff numbers or details of service users interests to provide these. Service users were supported where it was appropriate, to maintain contact with family, friends and the local community and so benefit socially and emotionally from these contacts. EVIDENCE: The home employed an activities organiser who worked across the home. She worked for two sessions a week within the dementia unit. Staff stated that her sessions were always appreciated and that service users did not have to join if they did not wish to. This was confirmed by one of the service users. A member of staff within the dementia unit said that the staff team often found it difficult to organise activities themselves, especially when the unit did not have its full quota of staff. It was acknowledged by another member of staff that care plans did not always have sufficient detail with regard to service users preferred routines of daily living and that some work was planned to remedy this. This was seen to be particularly important for the service users within the dementia unit who weren’t always able to voice their preferences or opinions. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 13 Conflicting information was found on two of the service users files with regard to the service users religion. This could cause confusion and distress for the service users if attending the wrong religious service in the home. There was information displayed indicating that religious services were held in the home and a service user and a member of staff confirmed these did take place. It was clear from a visiting relative and from the appropriate policy that visitors were welcome at any reasonable time. Service users records also confirmed that they received visitors and that staff worked with them to ensure that the visits were as successful as possible. This was confirmed in discussion with a member of staff. Staff were observed to be courteous to visitors and appeared to have a good relationship with them. The home had a number of committed volunteers who worked on a regular basis in the home. The volunteer present on the day of the inspection appeared to have a good working relationship with both the service users and the staff. The volunteer said she thoroughly enjoyed her work at the home and would not continue there if she were in anyway dissatisfied with the standard of care provided. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 14 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 Although the home had a comprehensive complaints policy in place a response to one complaint had been misleading, therefore possibly leaving vulnerable service users at risk. EVIDENCE: The home had a comprehensive complaints policy and procedure in place. Two complaints had been made since the last inspection. These had been dealt with by the manager of the home within the appropriate timescale. The complaints made had been in respect of staffing issues within the dementia unit and the supervision provided for one of the service users. The manager’s response to the complainant was misleading and this issue will be dealt with separately from the inspection process. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 15 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 The home was in a good state of repair, well decorated and homely. It provided a safe and pleasant environment for the service users living there. EVIDENCE: Aughton Park is a purpose built home and as such is spacious and well planned. The home was well maintained and the furnishing, fittings and decoration were all in good order. One service user stated that she lived in a very comfortable home, which was always kept clean. A visitor present on the day of the inspection said that she was always impressed by the homes high standards of cleanliness and how comfortable it was. The gardens were pleasant and well maintained with the dementia unit having its own secure garden. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 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) 27 The support needs of some of the service users at the home were increasing and could be challenging at times. The numbers of staff deployed may not be sufficient to meet the needs of the service users. EVIDENCE: On the day of the inspection the home the number of staff on duty were as specified on the rota. Staff expressed some concern about staffing levels in general. There was recognition that the needs of the service users in the main body of the home were increasing and because of this extra demands were being placed on staff. Concern was also expressed about the numbers of staff working in the dementia unit. Staff stated that they did not always have the correct numbers of staff on duty and although they could always call for help from the main body of the home, the deficit meant that they were not always in a position to organise any activities for service users. The level of support required for some of the service users detracted from the time that could be spent with the group as a whole. Concern was also expressed about the numbers of staff on night duty. Only one member of staff was based in the dementia unit at night and staff were concerned that because of the support needs of the service users in the unit and the main body of the home that this arrangement was not adequate, leaving both service users and staff at risk. Information documented on service users files indicated that there were service users who needed the support of two members of staff when receiving personal care and another who presented challenging behaviour. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 17 A visitor spoken to on the day of the inspection stated that she had always been happy with the number of staff on duty and a service user stated that she was always attended to promptly whenever she used her buzzer to call staff for assistance. In contrast to these views one relative had written to the home expressing his concern about staffing levels in the dementia unit. A number of volunteers were involved in the home and although it was recognised that they provided a useful and valued service, the home should question some of the roles they have taken on to ensure that they are not undertaking duties which are the responsibility of care staff, in particular the escorting of service users to medical appointments. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 18 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) 33 and 38 The home had a number of quality assurance processes in place, which helped to ensure the safety and well being of the service users. EVIDENCE: The home had a number of internal quality assurance processes in place. The service users had been involved in these and action identified for each area assessed. Questionnaires had been sent to service users, relatives, visitors, and volunteers and the responses regarding the care provided in the home were positive on all those returned. There was documentary evidence that an internal audit had taken place and any necessary action identified through this process had been recorded. A volunteer spoken to on the day of the inspection stated that she regarded herself as an intermediary between staff and service users and that they often raised any concerns they had with her. She was happy in this role and felt she provided an important service in helping to resolve minor concerns for service users. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 19 On the day of the inspection senior staff encouraged service users, visitors, volunteers and staff to become involved in the inspection process allowing the to express their views as to the quality of service provided to the home. There was documentary evidence that the building, equipment and systems were maintained and serviced. Training relevant to health and safety issues was provided and there was evidence that this had taken place on the files of four members of staff, which were examined. A safe environment was therefore provided for service users, staff and visitors. The home not reported to the Commission for Social Care Inspection a number of incidents, which had adversely affected the well-being, or safety of the service users and had potentially placed service users in a vulnerable situation by not doing this. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 20 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x x x x 3 x x x x 2 Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 21 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 7 Regulation 15(1) Requirement Care plans must reflect the service users needs in respect of their health and welfare and indicate how these needs are to be met. The registered person must ensure that the home is conducted so as to make proper provision for the supervision of service users. The registered person must arrange activities and provide facilities for recreation having regard to the needs and wishes of the service users. The registered person must make suitable arrangements to ensure that the care home is conducted with due regard to the religous persuasion of service users. The registered provider must review the inspection procedures followed during their monthly unannounced visit, to ensure that responses to complaints are dealt with in a satisfactory manner. The registered person must ensure that at all times suitably qualified persons are working at Timescale for action 31/10/05 2. 7 12(b) 30/9/05 3. 12 16(2)(m) 31/10/05 4. 12 12(4)(b) 30/9/05 5. 16 26(4)(b), 22(3) 30/9/05 6. 27 18(1)(a) 30/9/05 Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 22 7. 38 37(1)(d) the care home in numbers as are appropriate for the health and welfare of service users. Any event which adversely 30/9/05 affects the well being of or safety of any service user must be reported to the Commission for Social Care Inspection. 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 12 27 Good Practice Recommendations Service users preferred routines of daily living should be recorded in more detail. Volunteers should not undertake duties which are the responsibility of care staff. Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Aughton Park Residential Home F57 F08 S38560 Aughton Park Residential Home V245233 190805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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