Care Home: Arundel Park

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What the care home does well The home provides care from a well trained staff team in a pleasant and well maintained environment. Records are organised and well maintained. Regular monitoring and audits ensure that systems and processes are followed. Staff numbers are good and all staff were polite and professional in their interaction with service users. What has improved since the last inspection? The decor and furnishings within the home continue to improve through investment. Bathrooms are now bright and pleasant and a good number of bedrooms have been redecorated to provide a bright bathing environment. What the care home could do better: Nurses should take care to complete medication countdown sheets accurately to avoid the risk of errors. The number and range of activities should be improved in line with the preferences and abilities of the service users. Laundry services should be monitored to ensure that service users receive their own carefully laundered clothing in a timely manner. Menus and catering services should be audited and the views of service users taken into account when preparing menus. Service users should be made aware of the complaints procedure. Lumpy pillows should be replaced. Key inspection report Care homes for older people Name: Address: Arundel Park Sefton Park Care Village Sefton Park Road Liverpool Merseyside L8 0WN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Jeanette Fielding     Date: 0 4 0 2 2 0 1 0 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Arundel Park Sefton Park Care Village Sefton Park Road Liverpool Merseyside L8 0WN 01512917840 01517261999 arundelpark@europeanwellcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: European Wellcare Homes Ltd care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 50 Date of last inspection Brief description of the care home Arundel Park Care Home is part of the Sefton Care village complex. It is situated in the middle of two other care homes in a residential area, close to the city centre. The home is part of the European Wellcare group who have several homes within the Merseyside Area. Arundel Park is purpose built and is registered to provide care for fifty older people who require either nursing or personal care. It is accessible by public transport (mainly bus) and is close to spacious green areas such as Sefton Park. The home provides accommodation in single bedrooms, all with en-suite facilities. Care Homes for Older People Page 4 of 25 Over 65 50 0 1 8 0 3 2 0 0 9 Brief description of the care home There are several lounges and two dining rooms on the ground floor. There are two passenger lifts and two stairways to give access to all areas of the home. The building is centrally heated and individual thermostatically controlled radiators are available in all of the bedrooms. The complex has one main kitchen providing meals for the 3 care homes on the site with small satellite kitchens in each home. There is one laundry unit providing a service for Arundel Park and Greenheys Lodge (another home on the site). Parking facilities are available at the front of the premises. Information on Arundel Park is available in the form of a Statement of Purpose and Service User Guide, copies of which are available in the reception foyer. Care Homes for Older People Page 5 of 25 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: This unannounced key inspection was undertaken over two days and a period of ten hours were spent in the home. As part of the inspection process, all areas of the home were viewed including some of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Observation of the interaction between staff and people who live at the home provided further evidence of the actual care given. The care files of five service users, both new to the home and some who had been accommodated for some time, were case tracked to evaluate their care. Discussions took place with the Programme Manager, the Registered Manager, staff, service users and visitors to the home. The Manager completed an Annual Quality Assurance Assessment (AQAA) form, prior to the inspection, to give additional information regarding the home. Care Homes for Older People Page 6 of 25 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 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 7 of 25 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 8 of 25 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. A comprehensive assessment is undertaken on prospective service users to provide staff with information regarding the care needs of each new service user to ensure that those needs can be met. Evidence: The home has produced a detailed Statement Of Purpose and Service User Guide. These have recently been reviewed and updated and are available in different formats. They are readily accessible to current and prospective service users although some service users stated in the survey forms sent out by CQC that they did not have sufficient information about the home prior to their admission. Service users spoken to during the visits said that they had no problems with the home and three confirmed that they had seen information about the home before their admission. Prospective service users and their relatives are invited to visit the home and to view vacant bedrooms prior to admission. This visit also provides the opportunity to meet Care Homes for Older People Page 9 of 25 Evidence: with other service users and staff. Social workers undertaken an assessment of the service users where possible and provide the home with a report, identifying the care needs that are needed. Each prospective service user is also assessed by the manager, or one of the senior staff, to identify the service users needs and to ensure that those needs can be met. A dedicated preadmission assessment form is completed which identifies care and social needs, equipment necessary to meet those needs and any preferences that the service user has. The preadmission assessments for two recently admitted service users were seen and both were found to contain sufficient information to enable the initial plan of care to be prepared. Details are recorded regarding special diets, mobility and individual abilities. Care Homes for Older People Page 10 of 25 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 provide staff with full information regarding service users needs to ensure that each is provided with the appropriate level of care and support. Evidence: Individual care plans are prepared for each service user. These are prepared, initially based on the information gathered at the preadmission assessment, together with the information gathered at a further assessment which is undertaken on admission to identify any changes in care needs. The plans are then built on and updated as more information is obtained about the service user or as their care needs change. Information is recorded following visits to or by GPs or other healthcare professionals and care plans are updated with information or advice given by these persons. District Nurses and a Physiotherapist were in the home at the time of the visit and were assisting the staff in ensuring that all necessary care needs were identified and were being met for the benefit of the service users. A selection of care files were inspected and were found to include all necessary information for staff. Detailed plans were in place for all aspects of care together with Care Homes for Older People Page 11 of 25 Evidence: information regarding individual preferences. Risk assessments were in place together with risk management plans to remove or reduce any risks to the service users. Protective bed rails are only used following an assessment and an agreement for the use of these is signed by the service user or their next-of-kin. The preferred gender of staff to provide personal care is also identified to protect dignity. A daily record of the care given is prepared by the senior staff, and the key workers also provide evidence of the care they have given. A separate file is maintained for the care of wounds and the District Nurses who attend to service users who are accommodated for personal care maintain their own records. Medications are administered by the qualified nurses. The Medication Administration Record sheets were found to be up to date although nurses need to ensure that daily countdown sheets are recorded accurately. The medication storage areas were clean and organised. The manager is undertaking regular audits of the medications and any discrepancies are addressed as appropriate. Observation of staff and service users at the time of the visit showed that staff spoke discreetly with service users when referring to personal care. Service users interacted with the staff and the staff were polite and professional at all times. All service users are provided with single bedrooms to provide privacy and dignity. Staff were observed to respect these values in their interactions with service users. In the survey forms sent out by CQC, all service users who responded said that they were well cared for by the staff. Care Homes for Older People Page 12 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The number and range of activities does not meet the individual preferences of the service users to provide the level of stimulation that they would like. Evidence: The home employs an activities co-ordinator who arranges trips out and activities within the home. A programme of activities has been prepared and is displayed within the home. The range of activities within the programme is rather limited as only one event is planned for each day and service users stated in the surveys that they were not happy with the range or frequency of the activities. The records show that group and individual activities are provided. The activities are discussed at the monthly service users meetings and an opportunity to discuss these is available in an open forum. An entertainer visits the home each month and arrangements are in place to celebrate birthdays and significant dates. The manager was able to demonstrate that she is aware of the cultural and diverse needs of the service users and arrangements are in place for special dates and events to be celebrated appropriately. One member of staff is currently learning a European language to promote communication with one service user whose English is limited. Shopping trips are arranged for service users who are able to go out to supermarkets, clothing stores and department stores to enable them to choose and purchase personal items. Care Homes for Older People Page 13 of 25 Evidence: Meals are served in the dining room, lounge or the service users own bedroom as they wish. The menu showed that a varied and balanced diet is offered but service users who responded to the CQC survey said that the meals were of poor quality and that they did not enjoy them. Individual preferences should be discussed with service users prior to a review of the menus and an audit of the meals should be undertaken to assess the quality, flavour and presentation of the meals. Relatives and friends are are free to visit service users at the home at any time. Service users can meet with their visitors in one of the communal areas or in their own bedroom as they wish. One relative spoken to said that they were very happy with the care being provided and that the staff were kind, polite and caring. Care Homes for Older People Page 14 of 25 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. The complaints procedure is good so people who live in the home are able to express their concerns and be listened to, their rights are protected and they are safeguarded from abuse. Evidence: The home has a robust complaints procedure and details on how to make a complaint are displayed in the foyer and detailed in the service user guide. The records show that service users and relatives have expressed their concerns to the manager and that these issues have been dealt with appropriately. In the surveys to CQC, some service users stated that they were not aware of how to make a complaint, however, in discussion with a group of service users, they stated that they would express concerns with the manager or their relatives. Two service users said that there were no complaints as the home provided for all their needs in the way they wish. Consideration should be given to raising the complaints procedure with service users at the next service users meeting. All staff are given training on the protection of vulnerable adults during their induction training and are given subsequent updates on this on a regular basis. Evidence of training is documented in the staff training files. Staff spoken to were able to demonstrate that they were aware of the different types of abuse and of the action they would take in the event of abuse being suspected. The home has a whistleblowing policy to enable staff to report any issues to the acting manager. All Care Homes for Older People Page 15 of 25 Evidence: staff are fully vetted prior to commencing work at the home to ensure the protection of service users. Care Homes for Older People Page 16 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Continued investment in the home provides service users with a bright and pleasant environment in which to live. Evidence: Arundel Park is a purpose built care home where accommodation is provided on two floors. Two passenger lifts provide full access to all areas of the home. Service users are all accommodated in single bedrooms, each having en-suite facilities. Since the last inspection, a considerable number of improvements have taken place. Fourteen bedrooms have been redecorated and the service users have been involved in choosing the decor and colour of their rooms. The corridors have been redecorated and areas of the home have had new carpet or flooring fitted. Plans are in place for some windows to be replaced and the programme of redecoration is to continue. Bathrooms have been improved since the last inspection and are much brighter with the provision of paintings on the tiles. Bathrooms were clean and fresh. Some pillows on beds and in the linen store were found to be extremely lumpy and should be replaced. Bedrooms were bright and homely and service users are encouraged to personalise their rooms with pictures, photographs and items of memorabilia. The communal lounge is large and rather impersonal and detracts from the homely environment that Care Homes for Older People Page 17 of 25 Evidence: the manager and staff are striving to achieve. Service users armchairs are placed around the room and does not give the opportunity to see the television or interact with each other. In the surveys to CQC, service users commented on the poor standard of the laundry. They did not always receive their own clothing back and were not happy that they received items of clothing belonging to other service users. This remains outstanding from the previous inspection and a review of the laundry service should take place and regular monitoring undertaken. The home is maintained to a good standard and regular maintenance staff are employed on site to attend to repairs and maintenance. All staff are responsible for recording repair needs in a dedicated book to inform the maintenance staff to ensure that all issues are addressed as soon as possible. All areas of the home were observed to be clean and fresh and there were no unpleasant odours. Infection control policies are in place and it is evident that staff follow procedures at all times. Care Homes for Older People Page 18 of 25 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. Staffing arrangements, recruitment and training ensure that service users are cared for and supported safely. Evidence: The home employs a manager, qualified nurses and care staff to provide care and support to the service users. The home also employs staff to attend to catering, laundry, housekeeping and maintenance staff to ensure the smooth running of the service. The home employs a bank of staff who are available to cover for sickenss and annual leave. The home has a robust recruitment procedure. All prospective staff are required to complete an application form prior to being called for interview. Two references and taken and checks are made through the criminal records and protection of vulnerable adults bureaux. Qualifications are verified and certificates are required to be provided. A full induction training programme is given to all new staff. Training continues to be given to staff to ensure that they have the knowledge and skills to meet the needs of the individual service users. Training is planned in advance and staff are required to attend. The personnel files for four staff were inspected and all were found to be well Care Homes for Older People Page 19 of 25 Evidence: maintained and up to dated. Evidence of training undertaken is held on the files. At present, 61 of the care staff hold NVQ qualifications and additional staff are working towards this qualification. Staff files also held evidence of checks made on them, a copy of their contract and their photograph together with all necessary documentation. Staff confirmed in the survey forms that they had been given training appropriate to their role and responsibilities. They also stated in the surveys that they felt that they provided a high level of care to the service users. Staff were spoken to during the visit to the home and all were able to demonstrate that they were knowledgeable about the care needs of each service user and of the level of care and support that each was to be given. All staff were aware of the different types of abuse and of the action they should take in the event of it being suspected. Regular staff meetings are held for open discussion and the disemmination of information. Care Homes for Older People Page 20 of 25 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 home is well managed and has comprehensive systems, policies and procedures in place to ensure that the health and safety of service users and staff are promoted. Evidence: The registered manager of the home is a qualified nurse who has completed the Registered Managers Award. She is an experienced manager and is supported by senior managers from the company that own the home, European Care Homes Ltd. The manager has an open door policy to ensure that she is readily available for service users, staff and visitors to the home. The manager is involved with budget monitoring and is aware of the need to provide value for money. The manager conducts audits on a weekly basis which include complaints, pressure sores, medications and budgets. Annual self audits are also completed. Monthly visits are made to the home by the Programme Manager who completes a report of her findings as required. The home holds small amounts of money for service users at the request of the service user or their relatives. Detailed records are held of these and receipts are held. Care Homes for Older People Page 21 of 25 Evidence: Details regarding the arrangements in place with regard to service users money is in the service user guide. The money and records are regularly audited and are available to the service user and/or their relatives on request. Regular service user and relatives meetings are held and minutes of the meetings are held. Quality assurance systems are in place to gather the views of service users and stakeholders. The home holds the Investors In People Quality award. All equipment used in the home, and the premises are checked on a regular basis by appropriate companies or authorities. Certificates of safety and compliance are held in the home. All records were found to be well maintained and up to date. Health and safely issues are addressed as soon as they are identified to ensure that service users, staff and visitors are protected. Care Homes for Older People Page 22 of 25 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 23 of 25 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 9 Staff should take care when completing countdown sheets regarding medications to ensure that they are accurate following a physical count of those medications. The range and number of activities provided in the home should be reviewed and amended in line with service users preferences and abilities. Menus should be reviewed following discussion with service users and meals monitored to ensure that quality is maintained. It is recommended that service users are reminded about the complaints procedure to ensure that they are aware of the procedure to be followed. A review of the laundry service should be undertaken to ensure that service users receive their own clothing back and that laundry is attended to in a timely manner. 2 12 3 15 4 18 5 26 Care Homes for Older People Page 24 of 25 Helpline: 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. 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