Care Home: Aspen Court Care Home

What the care home does well Aspen Court provides an appropriate, comfortable and safe environment for older people who have dementia. The home takes appropriate steps to ensure that people thinking of moving to the home and/or their representatives have the information they need to enable them to make an informed decision. People are fully assessed by the home before a placement is offered to ensure that the home can fully meet an individuals assessed needs. The home makes sure that each person has a plan of care which identifies their assessed needs and preferences. Where a person is unable to be involved in the care planning process, the home ensures that appropriate representatives are given this opportunity. This was observed during the inspection. Relatives spoken with were very positive about the care and support offered to their relative. Staff stated that they were encouraged to refer to care plans and that they found them very useful. Care plans now contain detailed information about the preferences of people thus enabling a more person centred approach to care. The home ensures that people have access to a range of appropriate healthcare professionals. Records are maintained. People are given the opportunity to make choices about how they live their lives. Risk assessments are in place where required. People benefit from a wholesome menu and the home has systems in place to enable people to make informed choices. The home follows robust recruitment procedures for staff and these procedures ensure people living at the home are not placed at risk of harm or abuse. What has improved since the last inspection? The home has recruited a manager who has made an application to the Commission to be registered manager. People spoken with during this inspection were very positive about the acting manager. Staff stated that they felt more supported and that staff morale had improved. Staffing levels have increased since the last inspection and staff stated that this has resulted in a positive outcome for people living at the home. The acting manager has introduced dementia training for staff. Staff spoken with were positive about this. Since the last inspection additional orientation aids have been put in place to assist people with dementia. This includes toilets and bathrooms being easier for people to identify and bedroom doors have been personalised and have the provision of furniture, which gives the appearance of a front door. The meal time experience for people has greatly improved. Lunch time has been arranged in two sittings so that staff have more time to spend with people requiring staff assistance. We observed both sittings over the lunch time period. The atmosphere was relaxed and unhurried. The quality of the meals offered were very good. Tables were nicely arranged and attractively laid with table cloths, condiments and flowers. A picture menu was in place on each table. People were offered a choice of refreshments and meals. Meals are now served from hot trolleys to ensure an acceptable temperature. People had access to appropriate protective clothing. Care plans now contain information about the individual`s life and social history. This enables staff to provide a more person centred approach to care. An activity programme is in place which also ensures that people have the opportunity of one to one time. What the care home could do better: The home currently only employs one registered nurse who is specifically trained in mental health. Other registered nurses are trained in general nursing. It has been required that this is reviewed to ensure that appropriate numbers of suitably qualified/trained nurses are available to meet the needs and numbers of people with dementia. The acting manager stated that she intends to ensure that registered nurses are offered training in dementia care. CARE HOMES FOR OLDER PEOPLE Aspen Court Care Home Hope Corner Lane Taunton Somerset TA2 7PB Lead Inspector Kathy McCluskey Unannounced Inspection 10:20 28 March 2008 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aspen Court Care Home Address Hope Corner Lane Taunton Somerset TA2 7PB 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) 01823 346000 01823 346001 www.notarohomes.co.uk N Notaro Homes Limited ****Post Vacant**** Care Home 27 Category(ies) of Dementia - over 65 years of age (27) registration, with number of places Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 27 person over the age of 65 years with a dementia (DE (E)) who require nursing care, including 3 persons from the age of 55 years. 20th September 2007. Date of last inspection Brief Description of the Service: Aspen Court is a purpose built care home found on the same site as its sister home Cedar Lodge. The home is registered with the Commission for Social Care Inspection (CSCI) to provide nursing care for up to 27 persons over the age of 65 years with a dementia with the conditions listed above. All private rooms are single with en-suite facilities. There are communal areas and a secure garden for resident use. The home is owned by N Notaro Homes Limited. The responsible individual is Mr N.Notaro. The home does not currently have a registered manager though an application is currently being processed by the Commission. The current scale of charges range from £570 - £685 per week. Hairdressing, private chiropody, dental care, optical treatment, clothing, toiletries and newspapers are not included. Social Services currently have a block contract with the home for 12 beds. Aspen Court Care Home DS0000066159.V358210.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 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service for each outcome group under four general headings. These are; - excellent, good, adequate and poor. Following the home’s last key inspection, the registered person was required to submit an improvement plan identifying how statutory requirements would be addressed and how the quality of the service would be improved. This was received by the Commission within the required timescales and we were able to see that actions identified in the improvement plan had been implemented. This unannounced key inspection was conducted over one day (7hrs) by CSCI Regulation Inspectors Kathy McCluskey and Jane Poole. On the day of this inspection 25 people were living at the home and we were able to meet with the majority of them. We spoke to a number of staff on duty and were able to meet with two relatives. The acting manager was available throughout this inspection. All records requested were made available and we were given unrestricted access to all parts of the home. We spent time observing staff interactions with people living at the home and we looked at records relating to people’s care and support needs. People living at the home and all staff were very helpful and welcoming and we would like to thank them for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The home has recruited a manager who has made an application to the Commission to be registered manager. People spoken with during this inspection were very positive about the acting manager. Staff stated that they felt more supported and that staff morale had improved. Staffing levels have increased since the last inspection and staff stated that this has resulted in a positive outcome for people living at the home. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 7 The acting manager has introduced dementia training for staff. Staff spoken with were positive about this. Since the last inspection additional orientation aids have been put in place to assist people with dementia. This includes toilets and bathrooms being easier for people to identify and bedroom doors have been personalised and have the provision of furniture, which gives the appearance of a front door. The meal time experience for people has greatly improved. Lunch time has been arranged in two sittings so that staff have more time to spend with people requiring staff assistance. We observed both sittings over the lunch time period. The atmosphere was relaxed and unhurried. The quality of the meals offered were very good. Tables were nicely arranged and attractively laid with table cloths, condiments and flowers. A picture menu was in place on each table. People were offered a choice of refreshments and meals. Meals are now served from hot trolleys to ensure an acceptable temperature. People had access to appropriate protective clothing. Care plans now contain information about the individual’s life and social history. This enables staff to provide a more person centred approach to care. An activity programme is in place which also ensures that people have the opportunity of one to one time. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. Standard 6 is not applicable, as the home is not registered to provide intermediate care. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home ensures that people have the information they need to enable them to make an informed decision about moving there. People are appropriately assessed before a placement is offered. The home ensures that people have the opportunity to ‘test drive’ the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide which provide information about the home and services offered. These documents have been updated to reflect the changes in the management structure. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 10 Three care plans were examined at this inspection and these contained documented evidence that people had been appropriately assessed before a placement was offered. Assessments had also been obtained from appropriate healthcare professionals where available. The acting manager stated that the home were not experiencing any problems in meeting the assessed needs of people currently living at the home. This was also evidenced in care review documentation from individual’s care managers. Since taking up post earlier this year, the acting manager has been proactive in ensuring that staff receive appropriate training in dementia care. The acting manager is also in the process of reviewing the skill mix of staff to ensure that suitably trained and experienced staff are available on each shift. The home has a good supply of mobility and pressure relieving equipment in place and the environment is suitably designed to meet the needs of people with dementia. Orientation aids have improved (refer to standard 22). The home encourages people and their relatives/representatives to visit the home prior to making a decision to move there. The first four weeks are considered a trial period thus enabling all parties to be sure that the home is able to meet the individual’s assessed needs. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s care planning systems have improved and now promote a more person centred approach to care. The home’s procedures for the management and administration of people’s medication are good. People living at the home are treated with respect. EVIDENCE: Care plans for three people living at the home were examined at this inspection. Since taking up post, the acting manager has reviewed the layout of care plans to ensure that they provide clear and accessible information for staff. Staff spoken with confirmed that they were encouraged to read and follow care plans. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 12 Care plans examined contained up to date risk assessments relating to the prevention of falls and pressure sores, nutrition, moving and handling needs and environmental risks. Care plans had been raised to address any concerns highlighted. We were informed that nobody at the home currently had pressure sores. Care plans contained clear information on the assessed needs of individuals and instructions for staff on how needs should be met, were clear and included the preferences of people as appropriate. There was evidence that care plans had been reviewed at least monthly. The majority of people using the service would be unable to be involved in the care planning/review process. Relatives/representatives are encouraged to be involved in this process and this was evident at the time of this inspection. Care plans have been updated and now include detailed information about people in relation to their social/life history and preferences. This is felt to be a positive improvement as it provides valuable and useful information for staff and promotes a more person centred approach to care. Records examined demonstrated that people have access to a range of appropriate healthcare professionals. Details of all visits and the outcome are clearly documented in the individual’s plan of care. Staff update daily records at the end of each shift so that there is a clear picture as to the health and well being of each person living at the home. Staff spoken with were positive about the improvements at the home and stated that they did not experience any problems in meeting the assessed needs of people currently living at the home. Staffing levels have increased (refer to standard 27). Two relatives were spoke with during this inspection and both confirmed that they were very satisfied with the care and support given to their relative. We examined the home’s procedures for the management and administration of people’s medication. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). All medicines were found to be securely stored and there were no excessive stock levels. All available MAR charts were examined and these were found to be appropriately completed. MAR charts have a photograph of individuals to aid identification. Two people were receiving a controlled medication. Stock levels and records were examined and no concerns were noted. Medicines are only administered by the registered nurses on duty. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 13 We observed staff interactions with people living at the home throughout the day. Interactions were noted to be kind and respectful and people appeared to respond positively to staff. Staff were observed knocking on peoples doors before entering their bedrooms and staff were observed offering people choices throughout the day. Those people who were able to express a view were positive about the staff. Relatives spoken with said that the staff were ‘marvellous’ and that they ‘couldn’t do enough to help’. When we spoke to staff they said that the atmosphere at the home had improved and that things were ‘more relaxed’. They said that they worked as a team and that this had a positive outcome for people living there. Staff said that they now had time to spend ‘quality time’ with people living there. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People have the opportunity to join in with a range of activities and staff now have a greater awareness of people’s social history/preferences. Visitors are made welcome at the home. The mealtime experience and quality of food has greatly improved and people are enabled to make informed choices. EVIDENCE: Since taking up post, the acting manager has been proactive in ensuring that people’s social history’s/preferences are obtained. Detailed information was available in the three care plans examined. Information provides staff with very useful information about people’s lives, interests and preferences. Staff spoken with said that they found this information very helpful and that it gave them a better understanding of the people living there. This is a positive improvement. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 15 The home employs an activities co-ordinator who works 0900-1700hrs during the week and alternate weekends. This post is currently advertised as the existing member of staff is leaving. The home has developed a programme of activities and a copy was made available to us. This offered a good range of group activities and also offers one to one time with people. Individual records are maintained for people relating to activities undertaken. The home also displays a list of forthcoming events. Events that have taken place or are planned for this year include; valentines dance, sports relief day, easter party, music and raffle, world elder abuse day and an outing. Throughout the day we spent time observing staff interactions with people living at the home. The activities co-ordinator was not on duty on the day of this inspection but we observed staff spending quality time with people. The atmosphere was relaxed and unhurried and it was apparent that people can choose where and how to spend their day. Relatives spoken with informed us that they were always made to feels welcome at the home and could visit at any time. They told us that they were offered refreshments and could have meals with their relative if they chose to. During this inspection we were able to observe the mealtime experience. The acting manager has introduced two sittings at lunchtime to allow more time for those people who require greater staff assistance. Both mealtimes were relaxed and unhurried. Staff were observed assisting people in an appropriate and dignified manner. Tables were attractively laid with tablecloths, flowers and condiments. Choices of refreshments were available. The day’s menu was available on each table and this had been developed in picture format to better assist those with a cognitive impairment. This is very positive. Appropriate protective clothing was available for staff and people living at the home. People make choices about what they would like to eat from a picture menu book. Staff were observed referring to records to ensure that meals offered were in line with individual’s choices and special diets. The lunchtime meal looked very appetising and plentiful. Soft diets had been attractively presented. Hot trolleys are now used to ensure that meals are served at an acceptable temperature. Staff informed us that the quality of food had greatly improved since the new cook had been employed. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Appropriate systems are in place to allow people to raise concerns. The home takes appropriate steps to reduce the risk of harm or abuse to people living there. EVIDENCE: The home has a complaints procedure available in the home. We were informed that the home had not received any complaints since the last inspection and no formal complaints have been raised with the Commission. The home holds regular carers meetings for relatives/representatives where their views are encouraged. Relatives, staff and people spoken with during the inspection, did not express any concerns. Relatives and staff stated that they found the acting manager very approachable and would not hesitate in raising concerns if they had any. At the time of this inspection the home was taking appropriate steps to reduce the risk of harm or abuse to people living there. Staff are aware of how to raise Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 17 concerns and have access to a range of appropriate policies and procedures including whistle blowing and adult protection policies. Staff are also provided with training in these areas. The home follows robust staff recruitment procedures and staff do not commence employment until all required information is received including criminal record checks and vulnerable adult checks. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People live in a clean and well maintained environment and people are encouraged to personalise their bedrooms. Orientation aids have improved and now provide better assistance for people with dementia. The home takes appropriate steps to reduce the risk of the spread of infection. EVIDENCE: Aspen Court is a purpose built home and accommodation is arranged over two floors. A passenger lift gives access to the first floor. Grab rails are appropriately sited and a nurse call system is installed throughout the home. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 19 The acting manager confirmed that the home has sufficient pressure relieving equipment and hoists. All bedrooms are for single occupancy and all are fitted with en-suite facilities. Bedrooms and communal facilities meet the current National Minimum Standards for size. Profiling beds are available in all bedrooms. In addition to en-suite facilities, the home has an appropriate number of assisted toilet and bathing facilities. During this inspection we were able to view a number of bedrooms and all communal areas. All areas seen were comfortably furnished and well maintained. The home was warm and clean and there were no malodours. It was evident that people living at the home were able to personalise their bedrooms to meet their own needs and choices. Since the last inspection the home have been proactive in providing additional orientation aids to assist people with dementia. Toilet and bathroom doors have been painted yellow to make them easier for people to distinguish. Many bedroom doors have been painted different colours and have been fitted with furniture which gives them the feeling of a ‘front door’. The person’s name along with a picture chosen by them, are also in place on the door. Work is on going to make this provision available on all bedroom doors. This is felt to be positive. One of the lounges is in the process of being refurbished to provide a reminiscence/’old times’ room. The maintenance person has built a period fireplace, which will enhance the ambience of the room. An orientation board is in place in the main upstairs corridor. This provides people living at the home with information about what is going on and which staff are on duty. This could be further improved if photographs of staff were available. As previously mentioned, all areas of the home viewed were clean and free from malodours. There are two cleaners on duty each day in addition to laundry staff. The home takes appropriate steps to reduce the risk of the spread of infection. Staff have access to a good supply of protective clothing and appropriate hand washing facilities and foot-operated bins are in place. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels and staff morale has improved. The home needs to ensure that registered nurses are appropriately trained to meet the needs of people with dementia. People living at the home are protected by the home’s robust staff recruitment procedures. Newly appointed staff follow an appropriate induction period. EVIDENCE: At the last inspection concerns were raised regarding staffing levels which in turn gave concerns to the staff’s ability to meet the assessed needs of people using the service. Staff morale was low and the home did not have a manager in place. At this inspection, positive improvements were noted. A manager was appointed in January of this year and an application for registered manager is currently being processed by the Commission. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 21 Since taking up post, the acting manager has reviewed dependency levels of people living at the home and has increased care staff hours during the mornings. Staff spoken with were very positive about this and felt that they were now able to meet the assessed needs of people living at the home. Staff also stated that the atmosphere at the home was more relaxed and that staff morale had improved. We were informed that 25 people were currently living at the home and that staffing levels were as follows; Morning – 1 registered nurse and 5 care staff Afternoon/eve – 1 registered nurse and 4 care staff Night – 1 registered nurse and 2 care staff (waking) Domestics, laundry, kitchen, maintenance, administrative, and activity staff are employed in addition to care staff. The acting manager works in addition to the care hours shown. The acting manager stated that she was currently in the process of looking at the skill mix of staff to ensure that each shift had a good balance of appropriately skilled and experienced staff. We noted that, in addition to the acting manager, the home only had one registered mental health nurse available. Other registered nurses were trained in general nursing. The acting manager stated that she was currently in the process of addressing this. An additional registered mental nurse was due to commence employment and the acting manager indicated her intention to provide training in dementia to registered general nurses. It has been required that this is addressed within a given timescale given that the home is registered to provide nursing care for people with dementia. The acting manager has developed a training programme for care staff in dementia care. Some staff have received this training and further training is planned. The home currently employs 15 care staff and we were informed that 4 have achieved a minimum of an NVQ level 2 in care. This equates to 27 , which falls short of the 50 recommended in the National Minimum Standards. The acting manager stated her intention to promote NVQ training for staff. We examined the home’s procedures for the recruitment of staff. Three recruitment files were examined for staff recruited since the last inspection. Records were well maintained and contained all required information. There was evidence that staff had not commenced employment until all required information, including criminal record and vulnerable adult checks had been received. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 22 We looked at induction programmes for the staff detailed above and there was evidence that staff follow an appropriate induction programme, which is in line with the Skills for Care Common Induction Standards. We spoke with some staff recently employed and they told us that the induction programme covered everything they needed to know. Staff confirmed that they had received the training they needed to enable them to meet the assessed needs of people living at the home. Staff said that they had found the dementia care training very helpful. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 & 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s management arrangements have improved though these standards could not be fully assessed at this inspection. The home has appropriate quality assurance procedures in place. People’s personal monies are safely managed. The home’s arrangements to ensure that staff are appropriately supervised has improved. Appropriate health and safety procedures are in place and followed. EVIDENCE: Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 24 Since the last inspection the home have appointed a manager who has a wealth of experience in working with older people with dementia. The Commission is currently processing an application for the acting manager to become the home’s registered manager. Until this process is complete, standard 31 & 32 could not be fully assessed. People living at the home, staff and relatives were positive about the appointment of the acting manager. The home has systems in place to monitor the quality of the services and care offered. Copies of the home’s internal quality audits were forwarded to the Commission following the last inspection. Regular meetings are held for relatives/carers and staff where views are encouraged. As part of the home’s quality assurance programme and as required in the Care Homes Regulations, monthly visits are made by a company representative with written reports completed. Reports were examined during this inspection. We were informed that the home does not act as appointee for any people living there but manages small amounts of spending money for people on request. We looked at the records relating to this and found them to be well maintained. Details of transactions and balances are maintained in computerised format on an individual basis. Statements are forwarded to individual’s relatives/representatives as appropriate, on a monthly basis. At the last inspection staff were not receiving formal supervisions and a requirement was raised. At this inspection, we were able to see evidence that the acting manager had taken action to address this. Documented evidence was available and staff spoken with confirmed that they were now better supported. This is positive. We looked at the home’s procedures relating to health and safety. This involved a tour of the premises, observation of practises, discussion with staff and examination of records. The outcome was as follows: FIRE SAFETY – An up to date fire risk assessment was in place. Staff have received training in fire safety. The acting manager stated that following training planned for the following week, all staff would be up to date with their training. Records confirmed that regular in-house checks were being carried out on the home’s fire alarms and emergency lighting. Annual servicing from an external contractor was up to date, dated 26/02/08. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 25 ELECTRICAL SAFETY – The home has an up to date electrical hardwiring certificate. Annual servicing of portable appliances is due this month. The maintenance person was aware of this and assurances that this would be completed were given to the inspectors. GAS SAFETY – Annual servicing was seen to be up to date. EQUIPMENT SERVICING – 6 monthly servicing was found to be up to date. Records indicated that mobile hoists, bath hoists and the passenger lift were last serviced on 19/12/07. It has been recommended that the home maintains all servicing records pertaining to Aspen Court within the home as it took some time to locate the information during the inspection as it was located in a sister home. ACCIDENTS – Records are maintained and accidents pertaining to people living at the home are analysed on a monthly basis by the acting manager. Records focused on reducing the risk of falls and there was evidence of action taken to reduce the risk of reoccurrence. The home needs to ensure that accident records pertaining to staff are used and stored in accordance with the Data Protection Act 1998. This refers to the need to ensure that tear out pages are removed once completed and appropriately stored. Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 26 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 3 x 3 3 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 3 x 3 Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 27 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 OP27 Regulation 18(1)(a) & (c )(i) Requirement The registered person must ensure that suitably trained registered nurses are employed at the home in sufficient numbers as are appropriate for the health & welfare of people living at the home. Timescale for action 30/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP28 Good Practice Recommendations The registered person should ensure that NVQ training is promoted to ensure that at least 50 of care staff achieve a minimum of an NVQ level 2 in Care. The registered person should ensure that all servicing and related records pertaining to the home are maintained at Aspen Court. OP38 Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aspen Court Care Home DS0000066159.V358210.R01.S.doc Version 5.2 Page 29 - 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. 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