Care Home: Arden Court Care Centre

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What the care home does well People`s needs are assessed before they move into the home to make sure that Arden Court has the facilities to meet their needs. Residents have access to local healthcare services to meet their needs. Menus are planned to help ensure that people receive nutritionally balanced meals. The home was clean and pleasantly decorated. People`s bedrooms were personalised. Staff are aware and familiar with people`s needs and wishes. Policies and procedures were in place to support and promote people health, safety and wellbeing.Arden Court Care CentreDS0000006693.V376819.R01.S.docVersion 5.2 What has improved since the last inspection? Improvements had been made to the way they manage, monitor and dispense medication throughout the day. We saw that the content and detail of information contained in people`s care plans had improved since we last visited. What the care home could do better: Daily records should contain information about the person`s activities that day. Risk assessment should consider all known information to ensure that the identified risk is fully assessed. A record of staff Criminal Record Bureau disclosure numbers and date of the disclosure should be maintained on their recruitment file. Key inspection report CARE HOMES FOR OLDER PEOPLE Arden Court Care Centre 76 Half Edge Lane Eccles Manchester M30 9BA Lead Inspector Adele Berriman Key Unannounced Inspection 23rd July 2009 11:30 DS0000006693.V376819.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought 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. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arden Court Care Centre Address 76 Half Edge Lane Eccles Manchester M30 9BA 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) 0161 707 9330 0161 707 9698 ardencourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Lisa Marie Astley Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (3) of places Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 47 service users who require nursing or personal care may be accommodated. Three named service users are under 65 years of age and require care by reason of physical disability. If any of these service users leave or reach the age of 65 years the category will revert to OP. 7th July 2008 Date of last inspection Brief Description of the Service: Arden Court is a care home providing nursing and personal care for up to 47 older people. The registered owners are Ashbourne Eton Ltd. The single room accommodation is provided on two floors with communal day areas on both floors. Access to the first and second floors is by a passenger lift. Entry to the building is via steps or an access ramp and a manned reception is provided. The grounds include a large garden area with some car parking to the rear and side of the building. The home is on a main bus route, is close to the motorway network and a train station is five minutes away in Eccles town centre. The cost of the service is between £380.99 and £600.00 per week. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means that people who use the service experience good quality outcomes. This visit took place as part of a key inspection of the home which also included a review of all of the information received by the Commission since the previous inspection in 2008. The visit commenced at 11.30 and finished at 6.45pm. During the visit we spoke to six residents, two visitors, two staff and the care manager. Throughout our visit observations were made of care practices and staff interaction. A selection of records, policies and procedures were seen and a tour of some areas of the building was made. During the visit the key National Minimum Standards for Older People were assessed. Prior to our visit taking place the manager had completed an Annual Quality Assurance Assessment (AQAA). This document gave the opportunity for them to tell us what they thought they did well, how they felt they had improved over the last 12 months and their plans for improvement in the next 12 months. The completed AQAA told us the information we asked for. What the service does well: People’s needs are assessed before they move into the home to make sure that Arden Court has the facilities to meet their needs. Residents have access to local healthcare services to meet their needs. Menus are planned to help ensure that people receive nutritionally balanced meals. The home was clean and pleasantly decorated. People’s bedrooms were personalised. Staff are aware and familiar with people’s needs and wishes. Policies and procedures were in place to support and promote people health, safety and wellbeing. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they move into Arden Court so they know their needs can be met. EVIDENCE: We saw that a pre admission assessment was carried out prior to a person moving into Arden Court. The purpose of this assessment was to ensure that the home was aware of people’s individual needs and to ensure that the home had the facilities to meet all of the needs identified. We saw that information gained during the pre admission assessment process was recorded on a set recording format. The document gave the opportunity Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 9 to record people’s health, nursing and care needs. We saw that completed pre admission assessments formed part of individual’s care plans. They told us that prospective residents were given the opportunity to visit the home to spend time with residents and staff before they made a decision to move into Arden Court. Intermediate care facilities are not available at Arden Court. Arden Court Care Centre DS0000006693.V376819.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Arden Court have their needs met and their care is provided in a manner that protects their dignity and privacy. EVIDENCE: Each person had their own file that contained their personal information, pre admission information and their care plan. We looked at four people’s care plans. We saw that the contents and detail of the care plans had improved since we last visited. People’s needs relating to medical and social care needs were recorded and records told us that care plans were reviewed on a monthly basis. Daily records formed part of the people’s care plans. We looked at several of these records and we saw that they did not always contain all of the Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 11 information about the person’s day. For example, we saw many records that stated ‘safety maintained, eating and drinking, continence needs met, pressure relief given, bowels evacuated.’ Detailed records of people’s day to day activity should be maintained at all time help ensure that people are receiving the service they require. Risk assessments specific to people’s needs and wishes formed part of individual’s care plans. We saw risk assessments relating to moving and handling, continence, pressure areas, nutrition and smoking. The majority of the assessments that we saw were detailed and were being reviewed on a regular basis. We saw one assessment stating that the person had experienced some weight loss. The assessment tool stated that the person’s weight should be reviewed monthly but there was no evidence that the person had been weighed since May 2009. We saw that the nutritional care plan and assessment for one person did not fully contain the information/advice that had been written by the dietician. To ensure that all risks to individuals are considered assessments should consider all information available about the situation. This will help ensure that people receive the support they require. We saw records that demonstrated people have regular access to local health care services and that they were registered with a local GP. The majority of people who completed a survey form told us that the home always makes sure that they get the medical care they need. One person told us “if you need a doctor they will always get one.” We saw that policies and procedures were available for staff relating to the safe storage, administration and disposal of medication. Appropriate storage facilities were available and all medication administered was recorded on a Medication Administration Record (MAR). We looked at a selection of MAR’s and the majority of them were completed appropriately. We saw that one person had been prescribed a particular shampoo, however, the MAR sheet did not demonstrate when the shampoo had been used. A record of all prescribed medication should be maintained to help ensure people are receiving the treatment when they need it. During our visit we saw staff supporting people in a manner that respected their dignity. The majority of people who completed a survey form told us they always receive the care and support they need. One person told us during the visit that the staff “treat me with respect.” Arden Court Care Centre DS0000006693.V376819.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed and provide daily variation and interest for people living at the home. EVIDENCE: A fulltime activities co-ordinator is employed. We saw that a programme of activities was available around the building. These activities included reading, jigsaws, chatting, dominoes, arts and crafts, music listening, manicures and aromatherapy. They told us that they occasionally had visits from local entertainers. People told us that there were usually activities arranged for them to take part it. One person told us “activities are there for me to do” and another person told us that the home could improve by having “more activities.” Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 13 They told us that they were involved in a gardening project with a local school that involved three pupils and residents of Arden Court growing vegetables and flowers in the garden. We spoke to the facilitator of the project from Age Concern. They told us that the project had been running for approximately five months and had been very successful for all parties involved. They told us that to further promote community involvement they had also been working with another local school on an art project. They told us that ministers of any denomination could be arranged to visit people if they wished. We saw on one person’s care plan that they received monthly visits from a denomination of their choice to enable them to take communion. They told us that visitors were welcome at anytime. We spoke to two visitors during the visit who both said they were always made welcome and were treated with respect. The told us that they had developed a resident and family committee that meets four times a year. They told us that at these meetings new ideas for activities are founded and that the minutes for these meeting were made available to all residents. An electronic system called ‘Nutmeg’ was in use to support the planning of nutritionally balanced meals. The majority of people who completed a survey form told us that they liked the meals at the home. One person told us that the ‘food was very good.’ Weekly menus displayed what food was available and they told us that they had developed a pictorial menu to help people choose what they wanted to eat. Meals were served in two communal dining rooms. People also had an option of having their meals in their room. Arden Court Care Centre DS0000006693.V376819.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by the complaints and safeguarding procedures. EVIDENCE: We saw that information relating to the homes complaints procedure was available in the foyer and people’s bedrooms. A complaints register was available for the service to record complaints and their outcomes. We looked at the registered and it demonstrated that four complaints had been made to the service since we last visited, all of which had been responded to. All of the people who completed a survey form told us that there was someone they could speak to informally at the home if they had a concern and the majority of people told us that they knew how to make a formal complaint about the service. We saw that the service had policies and procedures in place for the protection of vulnerable people. A copy of Salford Social Services safeguarding procedures was also available. Since we last visited two safeguarding adult investigations had taken place under Salford Social Services safeguarding procedures. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 15 Training records demonstrated that the majority of staff had undertaken Protection of Vulnerable Adult and Abuse training since we last visited. One staff member told us that they had watched a film and completed a work book on the subject. They said they had found the training “useful.” Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clean, comfortable and pleasant environment was provided. EVIDENCE: The building was accessible to all by way of a ramped entrance to the front of the building and an internal passenger lift to access both floors. We saw that the rear garden was well maintained with raised flower beds which had been created to make them accessible to all. A handy person is employed at the home to carry out general maintenance and repairs. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 17 We took a tour of some areas of the home, this included the dining, lounge and bathroom areas. We also looked at several bedrooms. We saw that they were furnished to meet people’s needs and people’s personal effects were around them. We saw that areas were pleasantly decorated. Several carpets had been replaced with alternative floor covering since we last visited. Most people who completed survey forms told us that the home was fresh and clean. On the day that we visited the home was clean and tidy. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Arden Court are supported by a team of staff who know them well. EVIDENCE: We saw that two nurses and four carers were on duty to meet the care and nursing needs of people. A fifth carer who should have been on duty was off sick. In addition, a team of laundry and domestic staff were on duty. We observed staff supporting people in a caring and supportive manner. Staff demonstrated a good awareness of people’s needs, wishes and preferences. We saw that the service had a detailed recruitment procedure and policy. We looked at the recruitment files of four people who had been employed since we last visited. The contents of the files demonstrated that written references, proof of identification and appropriately completed application forms had been sought prior to the person starting their role. We saw evidence on the files that appropriate checks of the POVA (Protection of Vulnerable Adults) list had been carried out. We saw no evidence on the staff files to confirm that Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 19 Criminal Record Bureau (CRB) checks had been carried out. This information was held electronically and processed by the organisations head office. Following our visit the registered manager confirmed that CRB checks had been carried out for all staff members and a record of the disclosure numbers were maintained. We recommend that the CRB disclose number and the date it was completed for each individual is entered onto their recruitment file. We looked at the services training matrix which demonstrated that the majority of staff had received training in fire safety, fire drills, food hygiene, moving and handling and the safeguarding of vulnerable adults with the last twelve months. It also demonstrated that several staff had received training in the Control of Substances Hazardous to Health (COSHH), health and safety and nutrition. Staff responsible for the management and dispensing of medication had received training in the safe handling of medication. They told us in their AQAA that eight staff had completed an NVQ qualification level two or above and the manager told us that a further five staff were in the process of registering for the award. People who live a Arden Court made positive comments about the staff. They told us that they “look after me” and “staff are very nice.” Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and safety of people is promoted by the organisations policies and procedures. EVIDENCE: The registered manager of the service had been in post for several years, is a trained nurse and has several years experience in working in a social care environment. Since we last visited the manager had completed her Registered Managers Award. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 21 We saw that they had several ways in which they measured the quality assurance within the home. We saw that surveys were sent to residents periodically to gain their views of living at Arden Court, meetings were held with residents and staff on a regular basis and a resident and family committee had been created. The manager also carries out a monthly surgery for people to attend to discuss any matters they wish. Regular visits are made to Arden Court by a senior member of Southern Cross the registered provider of the home. Copies of the reports of these visits were available with the home. An electronic banking system was available to support people with the management and safekeeping of their monies. All transactions are documented and receipts provided. For security purposes only designated staff are able to access the system. We saw that comprehensive corporate policies and procedures were available to support and maintain the health, safety and wellbeing of people. We saw that these documents were available to the staff team. Systems were in place to ensure the regular monitoring of the fire detection system, the nurse call system and the use of bed rails. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no 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 OP7 Regulation 13 Requirement Risk assessments relating to nutrition must consider all known information in order to appropriately calculate the risk. Actions from completed risk assessments must be followed to ensure that people receive the care and support they require. Timescale for action 31/08/09 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 OP7 Good Practice Recommendations Daily records form part of people’s care plans should fully demonstrate what the person has experienced in their day. All individual risk assessments should consider all of the information available so that all of the risks can be identified. All prescribed shampoo should be signed for on the Medication Administration Record when it has been used. DS0000006693.V376819.R01.S.doc Version 5.2 Page 24 2. OP7 3. OP9 Arden Court Care Centre 4. OP29 A record of individual staff members Criminal Record Bureau disclosure number should be maintained on staff files. Arden Court Care Centre DS0000006693.V376819.R01.S.doc Version 5.2 Page 25 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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