Care Home: Arden House

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What the care home does well Arden House provides a good level of care for people, in attractive and well maintained premises. People receive highly personalised and courteous care from a staff team that has seen little turnover in recent years. The home is well managed and staff have a good team -work approach. They have the training necessary to offer the right care. People are helped to live the lives they want through good levels of staffing and good attention to individualised care. Visitors are made very welcome. One commented. `The staff are always the same, friendly and chatty and always offering a cup of tea when I call.` A GP said the home had a good working relationship with the surgery and was good at consulting with them when there was a concern over health. Medication is safely handled. The food is good and takes into consideration people`s preferences. One person said. `The food is always fresh and well presented.` Complaints are well handled and people said that any comments or suggestions were listened to and taken into consideration when offering care. People are kept safe through assessments of risk and training in the protection of vulnerable adults. People made particular mention of the high quality of laundry provision. What has improved since the last inspection? The recording of medication has improved. All medicines administered are recorded on MAR sheets, which makes it easier to audit medication. The home now employs a dedicated cook. Menus are devised after consultation with people using the service. The person employed to carry out physical activities with people living at the home has begun to develop individualised programmes to improve specific areas of mobility. The dining room is in the process of being extended which will create more social space for people living at the home. This is in addition ot the small extension to the lounge already completed. What the care home could do better: Assessments and care plans could be more detailed to take account of the person as a whole, including any areas where the person is independent. The quality assurance system could be developed to include a range of internal audits. Wider surveys would canvas the views of people coming into contact with the home and those living there in a comprehensive way. This would makes sure that the home takes into consideration what people say about the service, to plans improvements based on this. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arden House Arden House, Flat A Recreation Road Pickering North Yorkshire YO18 7ET     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Ritson     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Arden House Arden House, Flat A Recreation Road Pickering North Yorkshire YO18 7ET 01751473569 01751473569 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Karen Frances Blakey,Mr Steven John Hermann Blakey care home 13 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Arden House is a care home providing personal care and accommodation for 12 older people. The home is located in the market town of Pickering, close to shops, pubs, the post office, doctors surgery, dentist and other amenities. The home has accessible grounds to the front and rear of the accommodation. Garden furniture is available for those people who wish to sit outside. The home is arranged on two floors. The upper floor is serviced by a stair lift. All bedrooms have en-suite facilities. The majority of people have low dependency levels, though thisis changing and more people than last year require support with personal care. Many choose to spend their leisure time in their rooms or make private arrangements to go out. Work is being carried out to Care Homes for Older People Page 4 of 22 Over 65 13 0 Brief description of the care home provide extra room in the dining area and work has been completed on a small extension to the lounge to provide patio doors and a patio for people to sit out. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CQC reports, are available on request at the home. Chiropody and hairdressing are additional costs. Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection for this service took twelve hours. This includes time spent gathering information, examining documentation before and after a site visit. It also includes the time taken to write the report. The site visit took place on 21st April 2009 between 10:00 and 14:30. Information for this inspection was gathered from the following: 1. A visit to the home. 2. Speaking with people living at the home. 3. Speaking with staff. 4. Speaking with Adult and Community care staff. 5. Case tracking three people on the day of the site visit. 6. Reading survey forms from people living at the home and staff. 7. Looking at information provided by the manager prior to the site visit. 8. Notifications sent to the commission from the home since the last inspection. 9. Examining policies, procedures and records kept at the home. 10. Examining Care Homes for Older People Page 6 of 22 information regarding the home on the file kept by CSCI. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: 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 set out 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. Care Homes for Older People Page 8 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 and have the information they need to make a decision about admission. Assessments could be more detailed so that the home can evidence a holistic approach to care. Evidence: Each person has an assessment before admission. This includes all areas of required care, and risk assessments where needed. Each person has a personal history so that staff can get to know each person, what their interests are and what they have done in their lives. Assessments form the basis of the care plan and could be more detailed to provide a clearer picture of what each person needs. The assessments do not always cover the way in which all care needs are met. They do not cover when the person is independent in an area of care or if the need is met by family or another party. The assessment should be a holistic document to give an overview of care needs. Nutritional and social needs for example, should be included as routine. Care Homes for Older People Page 10 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans need more detail to give direction for holistic care, though evidence from health care professionals shows people do receive such care. People are treated with dignity and with regard to privacy. Safe handling of medicines protects them Evidence: Each person has a care plan drawn up from the assessment. This provides adequate information to ensure each person is cared for safely. However, care plans could be more detailed to cover all areas of care need irrespective of how this need is met. This would give a holistic view of each person and would highlight those areas where the person was independent. Verbal evidence from people living at the home and health care professionals suggests that people do in fact receive the care they need to a high standard. Written plans should reflect this. Care plans are reviewed on a monthly basis, the home keeps weight records, records health care professionals visits and advice, and contains risk assessments where needed to keep people safe. Daily notes provide good information about contact with the surgery, other health care professionals and visitors. Notes also record general wellbeing, mood, and how the person has spent their day. This ensures that the staff are able to track changes so Care Homes for Older People Page 11 of 22 Evidence: that care can be adjusted if necessary. A GP was spoken with and commented that the home had a feel-good atmosphere. He added: When I come here I feel I am coming to a good home. Patients are well looked after and staff are always polite and take my advice. We work well together to give the right care. Staff were observed treating people with respect during the inspection. The manager said this was covered in induction and staff said they would always respect each persons right to privacy. The home has policies on privacy and dignity to ensure people are treated correctly.People said they were treated with great courtesy. One person said. They always knock before coming in and are so sensitive and kind when they help with washing and dressing. The home has implemented a new way of recording medication on MAR sheets to ensure that medication is recorded as safely as possible. All medication is packeted, and stock is recorded on coming into the home. Regular auditing of medicine stocks ensures that the staff always know how much medication is stored. The system for ordering, administration and returns along with thorough staff training in the administration of medication ensures that people are kept safe. Care Homes for Older People Page 12 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 are offered a range of individualised activities, visitors are welcomed and people have a well balanced diet they enjoy. Evidence: People living at the home have access to a range of activities arranged by the home and also arrange their own daily routine as they wish. The way in which each person chooses to spend their day is recorded in daily notes so that staff can monitor what people enjoy doing to offer the most appropriate alternatives. Many of the people living at the home wish to pursue their religious observance, and attend church either with assistance from friends or staff at the home. Several people go out for regular walks. The home also has a regular pat dog visit, and a weekly exercise class which most enjoy attending. The exercises are designed individually to assist people with retaining as much mobility as possible. One person has a regular aromatherapy visit, and trips out are arranged during the warmer months. Visitors are welcome at any reasonable time. One visitor said she was always made to feel a part of the home and offered refreshments when she called. She said: The staff make such an effort to get to know you and are so friendly. Other feedback from people showed the home approaches all visitors in the same welcoming way. The home has a cook who devises menus in consultation with the people living at the home. she has a food hygiene Care Homes for Older People Page 13 of 22 Evidence: qualification and caters for specialist diets as required. One person said: The food is very good. All ingredients are fresh and locally sourced with little reliance on convenience or packeted foods. People said they enjoyed the home baking very much. Care Homes for Older People Page 14 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 complaints listened to and acted upon. They are protected from abuse. Evidence: People living at the home said the staff and manager were very good at listening to any concerns or complaints and quickly put things right. The home has a complaints policy and procedure and staff said they would always take any complaint to the manager for her to respond to. This ensures peoples concerns are listened to and responded to. Staff have all received safeguarding training and all understood what to do in the event of suspected abuse. The home has a policy and procedure on abuse awareness. This ensures people remain safe. Care Homes for Older People Page 15 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a safe, well-maintained and comfortable environment. Evidence: The home is well decorated and maintained. It complies with the requirements of the fire authority and environmental health department. There is an attractive sheltered garden area to the rear and a garden to the front where people may walk or sit in the warmer months. A small extension has been built to the front of the lounge providing patio doors so that people can sit out. The home now has a portable ramp so that the home is accessible to wheelchair users. The dining room is in the process of extension at the back to provide extra room and also private accomodation for the owners. People in the home said they had been kept up to date with plans and one person said: I am looking forward to when the work is all done, it promises to be beautiful. People said their laundry was looked after with great care and attention and delicates were well attended to. This ensures people get an individualised laundry service. Care Homes for Older People Page 16 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are well recruited, trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. Evidence: The home has enough staff on duty to ensure people receive the correct care. People said staff had time to chat as well as carry out their duties. A number of staff at the home do not wish to enrol in a course leading to NVQ level 2 in care, however, these staff have many years experience in working with older people and their appraisal shows that they offer good care. Staff are well recruited and references and CRB checks are recorded for each member of staff. Staff each have a training plan, and all had received induction to skills for care guidelines, foundation training and other specialist training as required. This ensures that people benefit from well trained staff. Care Homes for Older People Page 17 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 views and preferences of people influence practice and people are protected by the health and safety procedures of the home. Evidence: The manager is well qualified to run the home. She has NVQ at level 4 and the Registered Managers Award. Staff said they received very good support from her as manager and they felt they worked well alongside her. The home has a basic quality assurance system. People living at the home are surveyed regarding their opinions of the care they receive on an annual basis. Each year one area of care is targeted. The results of these surveys are fed back to people individually who are kept updated if there are planned improvements. People said they were encouraged to voice their opinions at any time and felt the home would respond to suggestions they made. Quality assurance could be extended to canvas the opinions of others coming into the home, relatives and health care professionals and a plan for improvement devised, based on the findings. Care Homes for Older People Page 18 of 22 Evidence: The home does not handle the financial affairs of any people living at the home. However, there are charges for some services, which are made clear in the contract. These are billed direct to the person or a person who is acting on their behalf and accounts kept. Evidence was submitted on the pre inspection questionnaire that all relevant safety checks had been carried out. Several certificates of maintenance were seen and were up to date and in order. The home has comprehensive health and safety policies and procedures and a first aid trained member of staff is on duty at all times. This ensures people are kept safe. Care Homes for Older People Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 22 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, Care Homes 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 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 1 3 Assessments should be more detailed and cover all care needs however these are provided to provide a holistic basis for the care plan. Care plans should be more detailed to give direction for holistic care. The quality assurance system should be expanded to include canvassing the views of those who come into contact with the home and to draw up an improvement plan based on findings. 2 3 7 33 Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!