Inspection on 11/12/06 for The Arches

This inspection was carried out on 11th December 2006.

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 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

The Arches 24/11/09

The Arches 04/12/08

The Arches 04/12/07

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Arches The Arches 11 Priory Road Cottingham East Riding of Yorks HU16 4RR Lead Inspector Pam Dimishky Key Unannounced Inspection 11th December 2006 09:20 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 The Arches DS0000067117.V322064.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. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Arches Address The Arches 11 Priory Road Cottingham East Riding of Yorks HU16 4RR 01482 842222 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) Mrs Lota Hopewell Mr Derrol Paul Hopewell Mrs Samantha Sutcliffe Care Home 39 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (39) of places The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: The Arches is a brick building located in Cottingham not far from local amenities, transport and shops. The home is currently registered for 39 and looks after people over the age of sixty-five including those with dementia. The accommodation is situated on two floors; a passenger lift provides access to the first floor as well as two staircases. One double room is available, and the rest are single including eighteen which have en suite toilet facilities. The home has three lounges and a separate dining room. One of the lounges is a conservatory and is used as a smoking area. There is a car park to the front and pleasant secure garden to the rear of the home with paved pathways, seating areas, lawn and pond. Some rooms have patio doors leading directly onto the garden; all residents are able to sit out during the summer months. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, the first under the new ownership, took place over two days and a period of 7.00 hours. The inspector looked around all of the building, a number of records were examined and eleven residents, four visitors, two members of staff and the deputy manager were spoken to. All the key standards were assessed at this inspection. Questionnaires were forwarded to residents, relatives, staff and health and social care professionals in contact with the home 61 of which were returned to the Commission; some of the responses have been reflected in this report. Fees for the home range from £330 to £380. Items not covered by the fee include chiropody (£10 per visit), hairdressing (£4 set, £2 trim and £13 perm), newspapers at cost, toiletries, private optician, and dentist. What the service does well: The Arches is clean, comfortable and homely with evidence of ongoing maintenance and improvements in the décor and furnishings. Interaction between residents and staff is caring and relaxed; residents spoken to were complimentary about the staff and the home, although a general comment was that the staff are always busy. However, it was clear that residents found staff caring and felt safe when being assisted. Residents are encouraged to retain their independence as much as possible and one lady spoke of her daily trips into Cottingham to shop and post letters for those who are unable to do so. All the residents spoken to were happy with their room and from observation during the tour of the building it is evident residents are encouraged to personalise their rooms with their own possessions and memorabilia. Family and friends are made welcome at any reasonable time and are able to visit in private if this is their wish. Activities organised in the run up to Christmas include a Christmas party, Christmas Fayre and Christmas Show with an entertainer. Residents said Christmas time is always good and they were clearly looking forward to the festivities; friends and relatives are also invited. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 8 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 The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 9 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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The admission procedure includes a proper assessment being made of residents moving into the service to ensure the home can meet their needs. The home is not registered for intermediate care. EVIDENCE: To ensure the home can meet care needs the manager visits prospective residents in their own home or hospital and makes a thorough assessment of their needs; confirmation that these needs can be met is made in writing by the home. The home does not accept residents assessed as requiring solely intermediate care. The Arches DS0000067117.V322064.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Health needs are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: Six case records were examined and found to be very comprehensive. The care plan, detailing personal and social care needs, is developed from the initial assessment and is regularly reviewed; daily records are kept of the care provided to meet the care plan. The home has arrangements in place for accessing support and advice from health service professionals including general practitioner, district nurse, community psychiatric nurse, dental, optical and chiropody services. Three residents have pressure sores, acquired whilst in hospital, and the district nurse is attending; one resident is being visited daily. At the time of this inspection the district nurse and a number of general practitioners were observed visiting and advising staff. Special equipment for residents is arranged through the district nurse and at the time The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 11 of this inspection three special beds were being used for individual residents. Sixteen residents returning the pre-inspection questionnaire indicated they receive the care and support they need, two said usually and two sometimes; similar responses were received regarding the medical support provided. In conversation with individual residents, it was evident that they felt staff are good in delivering personal care, they feel safe and are treated with respect and their privacy upheld. The staff who were interviewed were able to demonstrate how they ensure residents privacy and dignity is maintained and how, as much as possible, they are supported to retain their independence. The home uses a monitored dosage system for administering medications. Medications were checked during July 2006 by the supplying pharmacist, and the ensuing advisory report was noted to generally have found everything in order albeit there were a few recommendations. Six residents’ medication, method of storage and records were checked at this inspection and found to be in order. The controlled drugs cabinet had a broken lock and this needs to be repaired or replaced to meet requirements for storage of this type of drug. The book, recording medications returned to the pharmacist, had pages which were not dated. Suitable signage was noted on the door of a resident who needs oxygen therapy. All staff administering medications have received training. None of the residents self medicate at the present time. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Daily life and social activities generally meet the expectations of the residents living in the home. However, there is no choice offered for the main meal of the day which may not always be of good quality. EVIDENCE: Although the home has a good Christmas programme with a Christmas party, Christmas Fayre and Christmas show with an entertainer, the normal activities programme is fairly basic, with the exception of Friday when an activities coordinator is employed. One resident said she enjoyed the arts and crafts, but other activities were clearly not enjoyed by all. Some residents were not happy that since the home has come under new ownership, mini bus trips have not taken place. One resident said a relative had taken her into Cottingham to shop and see the lights, but no one else has seen them so far this year. However, the deputy manager said a new mini bus has been purchased and is currently being modified to have a tail lift for use with wheelchairs. Trips out are programmed to take place every Tuesday. The home supplies a selection of newspapers and other newspapers can be purchased by the residents individually; at the time of the inspection Christmas songs were being played in the lounge areas and a number of residents were noted reading the daily The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 13 news and generally putting the world to rights. Holy Communion takes place in the home every Sunday and arrangements are in place for an Evangelical choir to visit over the Christmas period. A telephone is available for residents use in the entrance to the home, and a number of residents have their own telephone in their room. Visitors to the home are welcomed at any reasonable time and the deputy manager, said relatives and friends are also invited to the Christmas activities. Residents who are able, can go out of the home as and when they wish and one resident enjoys going out every day to shop and post letters for those who are less able. The inspector was shown two weeks menus which indicate choices are offered for breakfast and tea, but for the main meal of the day there is no choice. Residents made mixed comments about the food, both in the pre-inspection questionnaires and verbally to the inspector. One resident said the food is good usually except for the quality of the meat, which can be tough. On the day of the inspection roast pork lunch had been prepared and the inspector observed it looked nicely presented and appetising, however, it was noted when staff where clearing the plates most of the meat was returned and discarded. Another resident stated she does not enjoy any of the food provided by the home and buys in a sandwich every day for tea. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system and policy and procedure for the protection of vulnerable adults which ensures vulnerable adults ensure residents are protected from abuse. EVIDENCE: The home has a complaints procedure and a copy is displayed in each bedroom. No complaints have been recorded since July 2005. However, it is evident residents have raised concerns with the home and these have not been recorded. The deputy manager was advised it is good practice to record all concerns raised, even if these are satisfactorily resolved before becoming a formal complaint, as this will demonstrate if any patterns emerge. Procedures for protecting vulnerable adults and for whistle blowing are in place and there is evidence of staff attending protection of vulnerable adults awareness courses; five staff attending the week of the inspection and other staff to attend a later course. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is generally good providing residents with an attractive, clean and homely place to live. EVIDENCE: The Arches is suitable for its stated purpose, clean, homely, comfortable with evidence of ongoing maintenance and refurbishment. At the time of this inspection Christmas decorations were seen throughout the home making everywhere look very festive. Since the home came under new ownership a number of items of equipment have been replaced ie new tumble dryer, dishwasher, boiler, three new beds, carpet shampooer and vacuum. The deputy manager stated wheelchairs are cleaned and checked weekly and a contract is in place for maintenance and repairs. Wheelchairs looked clean and in good condition at the time of this inspection, although one questionnaire returned to the Commission commented “wheelchairs are in a poor and dirty condition”. A report dated July 2006 from the gas installation engineer requested a broken chain in the kitchen, used for fixing the cooker to the wall, should be repaired The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 16 or replaced; this work remains outstanding. The seal on the door of the dairy refrigerator, which is in a bad state and unable to be cleaned properly, also needs replacing. A number of residents’ rooms were seen to have been highly personalised with items of their own furniture and memorabilia. However, one room has had the carpet replaced with laminate flooring rather than carpet. If this action has been taken for a specific purpose, then it must be with the agreement of the resident and/or relatives and because the flooring is not non-slip, then risk assessments must be in place. Cleanliness in the home is generally good, only one room, despite the best efforts of the staff, having an unpleasant odour. Some towels were noted to not be of good quality and one in a toilet opposite the lounge was soiled and removed by the deputy manager. One bathroom had storage boxes which needed sorting; clothing and toiletries belonging to residents should be kept in individual rooms. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current recruitment practice is sufficient to ensure residents are protected from abuse and following an increase in night staff, sufficient numbers of care staff are now deployed at all times to meet the needs of the residents. However, the home cannot be sure residents are supported and protected until training is complete. EVIDENCE: Thirty-nine residents are living in the home and rotas generally indicated sufficient staff on duty at all times to meet residents’ needs. However, some nights had only two members of staff on duty but this was rectified by the second day of the inspection by a third member of staff being employed. Six records were examined for new staff recruited since the home came under new ownership; all indicated current Criminal Records Bureau checks had been made. Case records for two members of staff recruited from abroad indicated residency permits had expired and the deputy manager agreed to check this with those concerned. Since the home came under new ownership, staff turnover has increased and some training and supervision is outstanding although the inspector was assured this is being addressed; information taken from the pre-inspection questionnaire indicates future training which will include new staff. Of the two members of staff interviewed, one was receiving supervision six weekly and the other had not had supervision for six months. From discussion with staff and from questionnaires completed by staff it is evident training in some mandatory subjects is outstanding. Some staff have The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 18 not had fire training and one questionnaire returned to the Commission, commented “training is very basic”. Due to staff turnover, the home has been setback in achieving a ratio of 50 of care staff being trained to NVQ level II or equivalent. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is suitably qualified and experienced to run the home and there are quality monitoring systems in place to ensure the home is run in the best interests of the residents. However, the person registered is not making monthly reports of visits to the home which has the potential to put residents at risk. EVIDENCE: The manager has more than two years experience of managing a care home and has an NVQ level IV qualification in management and care. There are quality monitoring systems in place to measure success in meeting the aims and objectives of the home; the home has parts I and II of the local authority quality development scheme. The registered provider is making regular visits to the home, however, some residents said they did not see much of the new owner and would like the opportunity to speak to her. The Commission has The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 20 received reports, required by regulation for monthly, unannounced visits by the registered provider, but only for alternate months. The home is not involved in the financial affairs of any resident, these are managed by the resident or their representative. All residents receive their full personal allowance to dispose of as they wish and records are kept for the management of the allowances. The pre-inspection questionnaire indicates that all maintenance and associated records are complete. Maintenance certificates for the bath hoist and mobile hoist were seen dated September 2006. The home has only one mobile hoist, and to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff a mobile hoist should be available on each floor. The date for the electrical wiring certificate was not complete in the pre-inspection questionnaire, and the deputy manager was unable to provide the certificate. Fire extinguishers were checked during September 2006; fire training is outstanding for all staff although the deputy manager stated fire safety is discussed as part of induction. The employers public liability certificate was noted in the entrance to the home and seen to be current to 4th June 2007. Accident records were examined and found to be in order. The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 21 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 X X 2 The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? New Service 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 2 Standard OP9 OP12 Regulation 13 16 Requirement The lock on the controlled drugs cabinet must be repaired or replaced Residents must be consulted about their social interests and arrangements made for them to engage in local, social and community activities if they wish Ensure food provided to residents is properly prepared A record must be kept of all complaints and the action taken in respect of any such complaint The chain used to secure the cooker to the wall must be repaired or replaced The seal on the dairy refrigerator must be repaired or replaced to ensure effective cleaning Ensure sufficient suitably qualified, competent and experienced persons are working at the care home at all times Timescale for action 30/01/07 30/01/07 3 4 5 6 7 OP15 OP16 OP19 OP19 OP27 16 17 (Sch 4) 23 23 18 11/12/06 11/12/06 30/01/07 30/01/07 31/12/06 The Arches DS0000067117.V322064.R01.S.doc Version 5.2 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 2 3 4 5 6 Refer to Standard OP9 OP15 OP24 OP28 OP29 OP38 Good Practice Recommendations The book used for returning medications to the pharmacist should include the date returned Menus should provide a choice for the main meal of the day Residents’ rooms should be carpeted or equivalent (room 38) unless agreed with the resident and/or their representative. A minimum ratio of 50 trained members of care staff (NVQ II or equivalent) should be employed in the home Two references should be obtained in respect of all staff working in the home, including one from the last employer A mobile hoist should be available on each floor to ensure as far as is reasonably practicable the health, safety and welfare of residents and staff The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 The Arches DS0000067117.V322064.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!