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Inspection on 29/04/08 for Alexandra House Care Home

Also see our care home review for Alexandra House Care Home for more information

This is the latest available inspection report for this service, carried out on 29th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A warm and welcoming atmosphere was evident on entering the home and staff were seen to interact with people using the service in a kind and professional manner. Staff were able to discuss the needs of people living at the home and the support that they offer them to a good standard. People using the service all spoke very highly of the staff and life within the home and said that they were able to make their own choices and decisionsabout how they lived their lives. Relatives spoken with said that they were always made welcome when they visited. Plans of care are personalised and reflect service users personal needs and preferences to ensure that they receive care in the way in which they prefer. People using the service are supported and facilitated to access specialist services as needed to ensure that their health care needs are met. Meals are at a good standard and people using the service said that they enjoyed these. Staff recruitment policies and procedures are of a good standard and ensure service users are protected from unsuitable people being employed. People using the service are given an opportunity to have their say about how the home is run and managed.

What has improved since the last inspection?

Plans of care have continued to develop to ensure that people`s individual needs are always addressed. Plans of care are now also updated regularly to ensure that people receive consistency of care. Risk assessments are now in place for all identified risks to ensure that people using the service are safe. Additional manual handling equipment has been ordered to ensure that sufficient equipment is available to meet the needs of people living in the care home. Systems have been implemented to ensure that the personal finances of people living in the home are protected.

CARE HOMES FOR OLDER PEOPLE Alexandra House Care Home Wroughton Court 191 Nottingham Road Eastwood Nottingham NG16 3GP Lead Inspector Karmon Hawley Unannounced Inspection 29th April 2008 09:20 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 Alexandra House Care Home DS0000026407.V363646.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. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Care Home Address Wroughton Court 191 Nottingham Road Eastwood Nottingham NG16 3GP 01773 530601 01773 710924 yates.alan@ntlworld.com 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) Eastgate Limited Mr Alan Yates Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category 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 category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is 38. 11th January 2007 2. Date of last inspection Brief Description of the Service: Alexandra House is purpose built providing nursing and residential care for older people. It is situated in a quiet cul-de-sac in the outskirts of Eastwood, close to local shops, pub, church and bus route into the centre of Eastwood and the nearby city of Nottingham. There are pleasant gardens and a car park to the front and side of the building. There are various seating areas within the home and two separate dinning rooms. The rooms of people using the service are decorated to a satisfactory standard and are personalised. The building is accessible for wheelchair users and there is a lift to the upper floor. Information with regards to fees and the service are made available on the point of enquiry. The current weekly fees range from: £298.21 - £499 (May scheme) there is an additional charge of £20 for an ensuite room. Chiropody and physiotherapy are included in the weekly cost. The registration document was reviewed as part of this inspection to ensure it was correct. No amendments were necessary at this time. Alexandra House Care Home DS0000026407.V363646.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 inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was unannounced and included the lunchtime period. The main method of inspection used is called ‘case tracking’ which involved selecting four residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Three members of staff and two sets of relatives were spoken with as part of this inspection. In addition the views of six residents were sought to form an opinion about the quality of the service. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. The Annual Quality Assurance Assessment was utilised in this inspection, as it was not due back until after the inspection date. What the service does well: A warm and welcoming atmosphere was evident on entering the home and staff were seen to interact with people using the service in a kind and professional manner. Staff were able to discuss the needs of people living at the home and the support that they offer them to a good standard. People using the service all spoke very highly of the staff and life within the home and said that they were able to make their own choices and decisions Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 6 about how they lived their lives. Relatives spoken with said that they were always made welcome when they visited. Plans of care are personalised and reflect service users personal needs and preferences to ensure that they receive care in the way in which they prefer. People using the service are supported and facilitated to access specialist services as needed to ensure that their health care needs are met. Meals are at a good standard and people using the service said that they enjoyed these. Staff recruitment policies and procedures are of a good standard and ensure service users are protected from unsuitable people being employed. People using the service are given an opportunity to have their say about how the home is run and managed. What has improved since the last inspection? What they could do better: To ensure that people living at the care home are able to make a choice as to where they wish to spend their time all communal areas must be available for use at all times. The décor needs improving to ensure that people live in a clean and comfortable environment. Maintenance issues must be dealt with in a timely manner to ensure that people live in a safe and well-maintained environment. Readdress the staffing arrangements to ensure that adequate staff are always available to meet the needs of people living in the care home. Please contact the provider for advice of actions taken in response to this Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 7 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. Alexandra House Care Home DS0000026407.V363646.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 Alexandra House Care Home DS0000026407.V363646.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are assured that their needs will be assessed and met prior to moving into the home. The service does not offer intermediate care services. EVIDENCE: The manager visits people within the community who may wish to use the service to carry out a preadmission assessment before admission to the home. The manager was on such a visit when we arrived at the home. There was evidence of preadmission assessments taking place within those case files examined. People may also visit the home and spend time there prior to making a decision to move in. Care staff spoken with were able to discuss the preadmission procedure and stated that they received appropriate information about people before they moved into the home. The service does not offer intermediate care. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported appropriately to ensure that their individual needs are met. People using the service are protected by the medication policies and procedures in place. EVIDENCE: People using the service undergo various assessments such as the activities of daily living, manual handling, the risk of falls and accidents, nutritional needs and pressure area care. Information gained forms the plan of care. Plans of care in place were personalised and contained the required information according to people’s highlighted needs. The manger is in the process of updating all plans of care to ensure that these are more personalised and person centred, there was evidence of this taking place within one file observed. There was evidence of plans of care and risk assessments being reviewed on a regular basis to ensure continuity of care for the people using the service, thus ensuring that their individual needs are met and complying with the requirements set at the previous visit. Staff spoken with Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 11 demonstrated a good understanding of people’s needs and they were able to discuss the individual care of those people case tracked. People using the service spoken with offered the following comments about their care, ‘the staff have been really supportive, they have helped me to regain my health after I was extremely ill,’ ‘my care plan is reviewed monthly and staff help me as needed’ and ‘the staff look after me well.’ To ensure that the health care needs of people using the service are met staff support them in accessing specialist services such as the doctor, tissue viability nurse, dentist and chiropodist. There was evidence of people accessing these services within their plans of care. The visiting chiropodist was also at the home on the day of the visit attending to people’s needs. Appropriate aids for the maintenance of healthy skin were seen during the brief tour of the home. One person spoken with spoke of their new chair that had been especially made for them following a referral from the manager, they stated ‘my chair is very comfortable and I am pleased that it has a foot stool.’ Staff spoken with confirmed that people using the service are supported and enabled to access these services as required. There were concerns expressed from two members of staff in regard to the amount of manual handling equipment available. This was discussed with the manager who provided evidence to demonstrate that a new hoist was in the process of being purchased which would remedy this concern and comply with the requirement set at the previous visit. A doctor was seen to visit the care home on the day of the visit to attend to the needs of a person using the service following a referral that morning from the nurse in charge. One person spoken with said that they could see the doctor if they needed to and the staff would arrange this. To ensure that people are protected by the service’s medication policies and procedures, these were examined. There were records available of medicines received into the building and of those disposed ensuring that a clear audit trail of medicines is available. Medication record charts were clear and hand written entries had been signed by staff to ensure that these had been checked as correct. There were no gaps in signing for medication administered demonstrating that people using the service receive their prescribed medication. Staff were seen to be respectful to people using the service throughout the visit and they maintained people’s dignity at all times. Staff spoken with stated that they ensured that they maintained people’s privacy and dignity by ensuring that personal care is offered in a respectful manner. Screening was available for use within shared rooms to ensure that privacy and dignity is maintained as necessary when they are in their rooms. Two people using the service stated that they felt that staff were respectful of their needs. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service experience a lifestyle that matches their expectations and preferences. People using the service are enabled to maintain contact with people that are important to them. EVIDENCE: An activities coordinator is employed for two hours a day five days a week. Various activities such as dominoes, exercising, bingo and sing-a-longs are on offer. People using the service spoken with said that they enjoyed the activities very much and looked forward to these. One service user discussed the sing a longs that they joined in, saying that they had good fun when they were doing these. Staff spoken with also confirmed that various activites take place and that they felt that there was sufficient for people to do. People using the service said that they could spend their time as they wished and there were no restrictions place upon them various comments were received in this regard such as ‘ we enjoy sitting down here as were can have some peace and quiet, we all get on well and spend our time chatting, and ‘the staff are very good, I can do as I please and they are here to help me, I go out every Saturday which I enjoy as I get to know what is happening in the Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 13 outside world’ and ‘I often have a lie in on Sundays. Staff spoken with confirmed that the routine of the home is flexible and people are supported to make their own choices and decisions. A church service is offered in the home once a fortnight and Holy Communion is always available when service users require this. To ensure that people using the service are enabled to maintain contacts that are important to them there are no restrictions on visiting and visitors may be received in private. People using the service spoken with said that their visitors are always made welcome when they come to see them. Two relatives spoken with also confirmed that they were made welcome when they visited and that they could visit at any time. Visitors were seen to come and go freely throughout the day. Within service users plans of care there was reference to equality and diversity of people’s individual needs. Reference to religion and people’s needs in regards to practicing their faith was discussed within plans of care examined. Staff stated that all people are treated with respect and according to their individual needs. They also discussed that whatever a service users sexual orientation was this would be accepted and facilitated within care delivered. People using the service stated that, ‘staff listen to me, I feel that they treat me as me and look after me how I want,’ and ‘ the staff are kind, and they treat me respectfully.’ There home treat as such get to know them sit and talk no time shouldn’t be denied anything their rights and choices To ensure that people are offered a wholesome and nutritious diet, the menus were examined. These demonstrated that there was a good variety of nutritious food on offer with choices available at each meal. People using the service spoken with said, ‘ the food is very good, there are choices available, I enjoy it,’ and ‘there is plenty to eat, I enjoy all my food’. Several people were seen to be offered fresh fruit during the morning, which one person said that they really enjoyed. Staff spoken with were able to discuss people’s special needs such as ensuring that a diabetic diet was on offer for those people who required it. The lunchtime meal was briefly observed, this looked appetising and people were seen to enjoy their food. Staff assisted those that required assistance to eat their meal in an appropriate manner. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service and relevant others are confident that if they need to complain that they will be listened to and the complaint addressed to ensure that it is resolved to their satisfaction. People using the service are protected from abuse. EVIDENCE: To ensure that people are aware of how they make a complaint if they need to, a complaints policy is on display in the main entrance area. There have been no complaints received since the previous visit. Staff spoken with were able to discuss the actions that they would take should a complaint be received. People using the service and the relatives spoken with all spoke highly of the staff and the care received and expressed no complaints as such but did state that they felt that more staff were needed at times. They felt that they could approach staff if they had the need and that issues would be resolved. To ensure that people using the service are protected from abuse all staff have attended training in safeguarding adults, when spoken with they were able to discuss the way in which they would deal with poor practice if observed. All staff employed have a satisfactory Criminal Record Bureau check in place (a police check to see if an individual has a police caution or criminal record) staff spoken with were able to confirm that they had undertaken these checks. Two people spoken with said that they felt safe living in the home as they knew that good staff were there to help them. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service currently live in an environment that detracts from their comfort and wellbeing. People using the service are unable to make a choice about using all parts of the home should they wish to. EVIDENCE: Little progress has been made in regards to the redecoration of the home. The décor in the main corridors and lounges remains very ‘tired’ looking with wallpaper coming off in areas. There is also a large stain on the ceiling in the small sitting room, which relatives and people using the service said has been there for months. Carpets in the two lounges also remain stained and well worn. People using the service, relatives and staff all stated that they felt that redecoration was needed in various places throughout the home. The manager stated that bedrooms were being redecorated as they became empty. There was evidence of this occurring, as a decorator was present at the home on the Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 16 day of the visit, therefore the requirements set at the previous visit have been extended to allow for all work to be completed. The conservatory is at present unusable as this was full of unused bedrails; the manager said that these were going to be moved to the other homes in the company in the near future. A maintenance person is employed on a contractual basis to carry out work, however there was evidence seen within the maintenance book that it takes time to get things repaired or remedied. Staff spoken with also felt that it took time for things to be repaired. The gardens were well maintained and one person spoken with said, ‘in the nice weather I enjoy sitting outside by the little pond.’ All areas of the home were clean and tidy, except the carpets as mentioned. Relevant equipment was available in the laundry as was hand-washing facilities around the home. One service user spoken with said that their room was always kept nice and clean and that they had brought in some of their own things. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service feel that their needs are not always met due to the staffing levels employed within the care home. People using the service are protected by the recruitment policies and procedures employed. EVIDENCE: A requirement was set at the previous visit to ensure that systems are in place to ensure that adequate staff are available at busy times to ensure that people’s needs are met. There was evidence on the duty rota to show that additional staff are available on occasion, however due to the current occupancy in the home these staff are not used as frequently as previous. The following comments were received from people using the service and the relatives spoken with ‘staff work very hard and they help me but you have to show patience as there are a lot of us,’ there are not enough staff you have to wait a long time for the toilet,’ and ‘there is a big difference in the staffing levels, they are very good but they can not stretch themselves any further, they used to have time to sit and talk, now they have no time to do this.’ Staff spoken with said that the staff team got on well together and although they felt that peoples’ needs were met they needed extra staff to ensure that they received a quality service where they had time to spend with them. They also felt that not only the numbers of people living in the home should be considered in regard to staffing levels, but also the dependencies of peoples’ needs. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 18 To ensure that staff have the necessary skills and knowledge to meet the needs of people using the service fifty percent of staff have now attained the National Vocational Qualification (a nationally recognised work and theory based qualification) level two or three. One member of staff spoken with was able to confirm this. There was evidence of this qualification being obtained within those staff files examined. To ensure that all new staff are aware of their roles and responsibilities on commencing employment they undertake an induction. There was evidence of staff undertaking an induction within staff files examined. One staff member spoken with said that they had undertaken an induction when they commenced employment. To ensure that people using the service are protected from unsuitable people being employed four staff files were examined to see if they contained all the documentation required by law. All contained the required documentation such as an application form, two reference and identification. Staff spoken with were able to confirm that they had undertaken the recruitment procedure before commencing employment at the care home. The training officer continues to provide all support for new staff and carry out the induction and supervisory practice. In addition to this they facilitate or arrange external trainers to ensure staff have undertaken all compulsory training. The training programme was examined which slowed that staff continue to undertake compulsory training such as fire, manual handling and health and safety. Staff spoken with said that the standard to training was good and that they were continually attending various training courses. Certificates to show training had taken place was available within staff personnel files. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 19 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service live in a home that is well run and managed. The personal finances of people using the service are protected. EVIDENCE: The manager is registered with the Commission for Social Care Inspection and has been in post for approximately two years. He ensures that he remains up to date with mandatory training to ensure that he is able to run the home according to up date practices and policies. Staff spoken with spoke highly of the manager and said that he was approachable and available when needed. People using the service also said, ‘the manager is very approachable and he listens to you’ and ‘the manager is very nice, he is always here if I need him.’ Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 20 To ensure that people using the service have a say in how it is run they have the opportunity to complete questionnaires. Twenty five questionnaires had been returned which offered the following comments: ‘it is a friendlier place these days,’ you couldn’t find better staff anywhere,’ the girls do an excellent job,’ the décor is shabby and there are ongoing maintenance issues,’ they need to use the conservatory more,’ not always enough staff’ and their needs to be meetings for relatives to air their views.’ There was evidence available to show that relatives meeting had been advertised in the past, however no one had turned up. Regular staff meetings take place and the agenda covers issues such as training and development. One person using the service said that they did not have any meetings and that they thought that this would be useful. A requirement was set at the previous visit to ensure that systems are implemented to ensure that the finances of people using the service are protected. The service is not responsible for any person’s personal allowance, should a cost be incurred then relatives are invoiced for this. As money is sometimes brought into the care home a new system has been arranged where money will be deposited into a secure sealed box before being transferred to the administrator. To ensure that relevant maintenance and servicing is taking place within the care home, the hoist and lift certificates were examined, which showed that these had been serviced as required. Staff have received training in health and safety and were able to discuss relevant issues in regard to this. There were a number of wheelchairs and unused equipment stored around the home, however these had been placed to ensure that walk ways and exits were not compromised and arrangements had been made to remove these items from the care home as they were no longer required. Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2,e) Requirement All communal areas must be available for use at any time so that people using the service are able to make a choice as to where they spend their time. The décor should offer service users a clean and comfortable environment. Maintenance issues must be dealt with in a timely manner to ensure that people using the service live in a safe and wellmaintained environment. Systems must be in place to ensure adequate staff are available to fully meet the needs of people living in the home. Timescale for action 20/05/08 2 OP19 23(2,b) 20/06/08 3 OP19 23(2,b) 20/05/08 4 OP27 18(1,a) 20/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 23 1. OP38 Fire door guards are repaired immediately to prevent these being wedged open. If this is not possible to ensure that alternative safe measures are implemented. To consider arranging meetings for the people using the service to enable another channel to be available for them to air their views and opinions. 1 OP33 Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Alexandra House Care Home DS0000026407.V363646.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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