Care Home: Aaron Lodge

What the care home does well Staff working at Aaron Lodge are experienced in supporting people with dementia and spend time interacting with the people living there as well as supporting them to meet their care needs. This helps to create a calm welcoming atmosphere that supports the people living there to feel comfortable and at ease to use communal areas of the home and their bedrooms as they chose. Staff also have a good understanding of how to support people whose behaviour can become verbally or physically aggressive. They are aware of how to provide this support in a way that respects the person and calms the situation down. Some risk assessments and care plans are in place to guide staff in how to provide this support. Advice is obtained from other professionals to help them support people with their health. This helps to ensure that any issues that arise can be quickly and effectively managed for the person. What the care home could do better: If somebody is admitted to Aaron Lodge as an emergency, full information about them and the support they need is not always obtained as soon as possible. In not obtaining a social services assessment or carrying out their own assessment within a couple of days the organisation are not ensuring that all the information possible is available to help staff plan how to successfully support the person and meet their needs and choices. Care plans regarding peoples risk of or actual pressure sores are not as detailed as theyshould be. This could lead to staff who may be unfamiliar with the person not being fully aware of how to support the person successfully. Although care plans contain information about peoples behaviour that may be detrimental to others they do not always contain information about relationships between people who live at Aaron Lodge who may become verbally argumentative with each other. Clear guidance in how staff support people to manage this should be included in care plans to ensure all staff are providing consistent support. Staff have not had up to date training in first aid, this could lead to staff not being aware of how to support people successfully in the event that an accident or incident occurred. Training records for staff in other areas are patchy and it is therefore difficult to establish what training staff have had in supporting people with dementia communication and supporting them to manage their behaviour. This could lead to staff training not being thoroughly planned to ensure staff are all aware of how to meet their role in supporting people safely and well. Random inspection report Care homes for older people Name: Address: Aaron Lodge Marmaduke Street Liverpool Merseyside L7 1PA two star good service 14/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lorraine Farrar Date: 0 3 1 2 2 0 0 9 Information about the care home Name of care home: Address: Aaron Lodge Marmaduke Street Liverpool Merseyside L7 1PA 01512610005 F/P01512610005 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Aaroncare Limited care home 48 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 48 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE. The maximum number of service users who can be accommodated is: 48 Date of last inspection Brief description of the care home Located near the centre of Liverpool, Aaron Lodge is registered to provide personal care and support for up 48 people who have dementia. The building is purpose built over two floors and provides everyone with their own bedroom. Accommodation including bedrooms, bathrooms, lounges and dining areas is provided on both floors with a lift available to the first floor. Due to its location Aaron Lodge is well placed for accessing local shops, public transport and the town centre. 1 4 0 4 2 0 0 9 Care Homes for Older People Page 2 of 10 What we found: We looked at assessment information obtained by the home for three of the people who live there. We found that where a person moves into the home as an emergency then copies of any social services or health assessments are not always obtained. We also found that the home do not always complete their own assessment form before the person moves in or as soon as possible afterwards. These assessments help everyone to decide if the home is the right place for the person to live, they also help staff plan how to support the person successfully. A lack of assessment information when the person moves into the home may lead to staff not being aware of the persons needs and choices and therefore not supporting them as successfully as they should. During our visit we were told that one of the people living at Aaron Lodge had a pressure sore and another persons skin is being monitored as it is starting to develop a pressure sore. We looked at records for both of these people and found that staff had sought advice from health professionals in dealing with these, however it was not always clearly recorded when health professionals had visited the person. We also found that a series of assessments are regularly carried out on areas such as the persons weight and the risk of their skin breaking down. These assessments help to identify where somebodys health may be at risk so that advice can be obtained and support put into place for the person. Records of the support provided regarding peoples skin were varied. For example one plan identified the equipment provide to support the persons skin integrity another plan did not. One person had recently had a swab taken to identity any infection. Although records indicated that this had occurred the persons care plan had not been updated. This could lead to information not being easily available to guide staff on how to successfully support the person. During our visit we talked with staff about supporting those people living at Aaron Lodge whose behaviour could be verbally or physically aggressive towards others. We also looked at records for three people who live there. We found that staff had a good understanding of supporting people when they become upset and of how to support them with their behaviour. Staff explained that they try to distract the person, talk with them and respect their views. We observed throughout our visit that the atmosphere in the home was calm with staff taking time to interact with the people living there. This helps to ensure that people feel comfortable in their home and lessens the risk of people becoming upset or agitated. We found that care plans and risk assessments were in place for supporting people who are known to become verbally aggressive. Staff we spoke with explained that two of the people living there can argue with each other and they take action to diffuse this. However no record of this relationship was available in either persons care plan. Although staff were clear that the relationship was not to the detriment of either person and were all aware of how to support the people concerned, a lack of care planning in this area could lead to unfamiliar staff being unaware of how to support people successfully. Records and discussions with staff showed that where a persons behaviour becomes unpredictable through their health staff are aware of this and take action to monitor the person. This includes diffusing the situation and distracting the person and obtaining Care Homes for Older People Page 3 of 10 advice from health professionals. Staff we spoke with during our visit were all experienced in supporting people who have dementia and were able to explain how they support people when they become upset or aggressive. We discussed training with staff in awareness of dementia, communication, managing difficult behaviour and first and looked at training records that were available during our visit. Staff told us that they had had in house training in awareness of dementia and this included communication and supporting people with their behaviour. Records we saw during our visit also indicated that this training had been given to staff. However the up to date training matrix sent to us by the organisation showed that nine members of staff are currently undertaking a national course in caring for people with dementia and that further training booked for December 2009 in awareness of dementia, supporting people with their behaviour and communication. Records indicated that only one member of staff has had up to date first aid training, again the organisation have informed us that this training is booked for staff in December 2009. The training matrix evidenced that most staff have had basic training in areas such as the protection of vulnerable adults, food hygiene and fire. It also showed that staff have training in more specialist areas relating to the people they support. This included training for some staff in the Mental Capacity Act and laws around depriving people of their liberty. However the fact that records appear patchy regarding the training staff have had and that only one member of staff has had first aid training could lead to staff not receiving the training they need to support people safely and successfully. What the care home does well: What they could do better: If somebody is admitted to Aaron Lodge as an emergency, full information about them and the support they need is not always obtained as soon as possible. In not obtaining a social services assessment or carrying out their own assessment within a couple of days the organisation are not ensuring that all the information possible is available to help staff plan how to successfully support the person and meet their needs and choices. Care plans regarding peoples risk of or actual pressure sores are not as detailed as they Care Homes for Older People Page 4 of 10 should be. This could lead to staff who may be unfamiliar with the person not being fully aware of how to support the person successfully. Although care plans contain information about peoples behaviour that may be detrimental to others they do not always contain information about relationships between people who live at Aaron Lodge who may become verbally argumentative with each other. Clear guidance in how staff support people to manage this should be included in care plans to ensure all staff are providing consistent support. Staff have not had up to date training in first aid, this could lead to staff not being aware of how to support people successfully in the event that an accident or incident occurred. Training records for staff in other areas are patchy and it is therefore difficult to establish what training staff have had in supporting people with dementia communication and supporting them to manage their behaviour. This could lead to staff training not being thoroughly planned to ensure staff are all aware of how to meet their role in supporting people safely and well. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 14 The service must obtain a copy of a Local Authority assessment of individuals needs before they come to live at Aaron Lodge so that their needs can be consistently met 15/05/2009 2 7 13 Medicines must be given to people correctly as prescribed. This is important because receiving medicines at the wrong dose, wrong time or not at all can seriously affect their health and wellbeing. 31/05/2009 3 7 15 Those who use the service 15/05/2009 and their Representatives should sign to confirm the contents of their care plan or otherwise so that they are involved and consulted about the care they or their relatives or provided with. Care Homes for Older People Page 6 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 A system must be put into 08/01/2010 place to obtain full assessment information for anybody moving into the home. Where they are admitted as an emergency the home must carry out an assessment within forty eight hours of their arrival and ensure they obtain copies of assessments from relevant authorities. This will help to ensure that the information is available for staff to plan how to support the person successfully. 2 8 15 Care plans for anybody living 08/01/2010 in the home who is identified as having or being at risk of pressure sores must be reviewed and if needed updated. This must include ensuring all equipment provided is included in the plan, and records of when health professionals visit are clearly recorded along with any actions taken. Page 7 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This will help to ensure staff have up to date information readily available to support the person successfully. 3 9 15 Care plans and risk 08/01/2010 assessments must be put into place regarding the two people identified at inspection whose relationship can include verbally arguments. This will help to ensure all staff are aware of how to support the people concerned and deal appropriately with the situation. 4 30 18 The organisation must ensure that training records for all staff are up to date. They must also produce a training plan for staff over the next twelve months that includes both basic areas of care and the more specialist support the people living at Aaron Lodge require. This will help to ensure staff are equipped with the skills and knowledge to support people safely and successfully. 08/01/2010 Care Homes for Older People Page 8 of 10 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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