Inspection on 27/11/07 for 25-27a Alexandra Road

This inspection was carried out on 27th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

25-27a Alexandra Road 12/06/06

25-27a Alexandra Road 31/01/06

25-27a Alexandra Road 02/06/05

25-27a Alexandra Road 16/03/05

25-27a Alexandra Road 07/09/04

25-27a Alexandra Road 27/01/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Alexandra Road (25-27a) Weymouth Dorset DT4 7QQ Lead Inspector Marion Hurley Key Unannounced Inspection 27th November 2007 09:30 Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 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 Road (25-27a) DS0000032045.V346562.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 Adults 18-65. 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 Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Road (25-27a) Address Weymouth Dorset DT4 7QQ 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) 01305 760663 01305 770236 www.dorsetforyou.com Dorset County Council Daniel James Crone Care Home 23 Category(ies) of Learning disability (23), Physical disability (3), registration, with number Sensory impairment (2) of places Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Registration: Date of last inspection 12th June 2006 Brief Description of the Service: 25/27a Alexandra Road is a care home providing a service to adults who have a learning disability. The home is located in Weymouth, a short distance from the town centre, and is owned and operated by Dorset Social Care and Health Directorate. Alexandra Road was built in the late 1970s and can accommodate up to 21 people. The home is split into units, accommodating between 3 and 8 people in each unit. Each unit has a lounge, dining room, kitchen and their own bathroom and toilet. Each person has a single bedroom. The home has special adaptations and equipment to meet residents various physical needs. These include ground floor bedrooms; walk in showers, and a Stannah chair lift, which ensures all residents can have access to the first floor. The property is surrounded by gardens and the front entrance is attractively decorated with container plants and to the rear there is a pergola, which is used seasonally. Staffing is provided 24 hours a day and as well as providing personal care and support, service users are encouraged to be part of the local community by taking part in leisure and social activities. The fees charged in the care home are £660.00 per week. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over a period of 10 hours spread over two days, November 27th and December 6th, 2007. An Expert by Experience and their supporter assisted the inspector on the first day. During the two visits time was spent talking with the residents and staff, in addition to the inspector reading and checking all documentation relevant to the standards inspected. Observations were also made of staff interaction with residents and a tour of the home took place. Staff were freely available to discuss their work and both the Senior Community Care Services Officer and the registered manager were on site and extremely helpful in accessing all the information required. Residents all stated that they were very happy living in the home and that staff helped and assisted them to lead the lifestyles of their choice. Staff said they were happy working in the home, they felt committed, and enjoyed working with the residents. The inspector spoke with a care manager and with one relative on the telephone both stated that they were more than happy with the standard of care provided to their respective residents, they also praised the managers and staff for the kindness, respect and interest they showed towards the residents in the home. Residents’ abilities and interests vary enormously from those who are quite independent to others who need a higher level of staff involvement to keep them safe and manage their daily lifestyles. However, irrespective of the residents abilities and needs staff clearly respect and value each persons’ contribution to life at Alexandra Road. An annual quality assurance assessment (AQAA- self-assessment) asking for information about the home was sent to the manager before the visit and information from this has been included as part of the inspection process. Other information used included reports form monthly visits carried out by senior managers from Dorset County Council - Social Service Directorate and notifications received by the CSCI concerning any incidents that had taken place in the home. The inspector would like to thank the residents, staff and managers for their friendly welcome, kind hospitality and support during the inspection process. What the service does well: Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 6 The residents live in a homely, friendly and comfortable environment, which is well maintained. Pre-admission assessments are good and provide detailed information relating to each individual resident, which is then used in the initial formation of care plans. The residents’ goals, choices, activities and chosen lifestyle are respected, and every avenue is explored to enable these to be met. Every effort is made by the managers and staff to ensure that written information is recorded in such a way that can be easily understood by the residents and to this end an excellent format for person centred planning has been introduced. The residents’ healthcare is well supported by the managers and staff with evidence of good working relationships with healthcare professionals. Any risk to the resident is recorded and clear steps are given to staff to ensure that risk levels are kept to a minimum. Risk assessments are in place for all resident activities, which may place the resident (s) at risk. The recording of complaints and adult protection issues are good with evidence of proper investigation and outcomes. The staff receive good work related training, to enable them to meet the diverse needs of the residents. The registered and acting manager have excellent management skills and use their skills to ensure that the high quality of care for the residents is maintained. Attention to all aspects of health and safety are good and both residents and staff live and work in a safe environment. What has improved since the last inspection? Care planning is continually improving and steps are now being taken to ensure that all care plans are person centred and where possible written by the residents themselves. Good practice is ensuring that before this new style of planning is fully introduced to the home/residents all staff will be trained in the proper use of person centred planning. Since the last inspection the higher needs unit, known as “27 up” is now operational and is currently accommodating three people. The fixture and fittings have been carefully chosen to minimise any sensory difficulties residents may have however this does not detract from the homely feel of the unit. Residents benefit from a one to one staff ratio at all times and this enhances their lifestyle ensuring they have the same opportunities to experience everyday tasks but with a high level of staff supervision to ensure their safety. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 7 Since the last inspection the Registered Manger, has been temporarily seconded to another area of work however, they have maintained regular contact with the home and was available on the day of the inspection. The acting manager (Senior Community Care Services Officer) has taken on the role and responsibilities of the registered manager comprehensively and the continuity of running and managing the home has been seamless. 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. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who may be considering Alexandra Road as a home for themselves or a relative have access to the information they need to make an informed choice about whether to move to the home. Residents and or their representatives are actively involved in their own assessment and in the process to ascertain if the home, facilities and staffing could meet their needs appropriately. EVIDENCE: Discussion with residents and inspection of resident files indicated that they had been involved about moving into the home. The files inspected contained admission details, which had been developed for ease of understanding, together with assessments of individual residents’ needs and support plans and other relevant information. The records of the most recently admitted resident indicated that the staff had completed their individual assessment before they had moved in, in order to ensure that the home was able to meet the persons needs satisfactorily. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that their personal goals are reflected in their individual plans and that potential risks are managed. The residents’ needs are appropriately supported, and efforts made to ensure all decisions are in their “best interests”. Residents are encouraged and supported to make decisions and choices about their lives. EVIDENCE: Three care plans were read and showed that they had initially been developed from pre admission assessments. The care plans were well ordered being sectioned off which made access to information easy. All the plans showed detailed information relating to residents’ aspirations, healthcare needs, monitoring charts, personal care needs, and stakeholder involvement including Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 11 visits and risk assessments for each person. Evidence was also available to show that the resident, families and care manager had been involved in the drawing up of these care plans, with signatures of those involved. The home is in the process of developing a person centred planning system, giving the residents even more involvement and understanding through the use of pictures and symbols side by side with key elements of text. All staff will be trained in person centred planning prior to this being fully introduced into the home and evidence was available to show that some training had already taken place and further sessions had been booked. The new format for the plans was available and the inspector considers it to be excellent including sections on “what people who know me admire about me, what is important to me what is important for me”. The plans include communication charts and there are several sub sections to help staff really ascertain what each person might be communicating through their behaviour and gestures “what we think X is communicating, what happens when X does this”. Each plan viewed showed that residents are given the opportunity to make decisions relating to their everyday lives, for example which days to attend the local day centres, trips out into the community, food likes and dislikes, where to go on holiday and what activities to be involved in. Key workers then do their best to support their resident in fulfilling their choices. The care plans viewed showed that each resident is risk assessed for activities they wish to participate in with clear guidance for staff to ensure the level of risk is kept to a minimum. Staff explained how the level of staff support is reduced as the residents achieve their goals and as the resident becomes more confident and aware of their own risks. Discussion with residents indicated they were aware of their care “support” plans. The support plans had been developed using partly a pictorial format to help the residents understand them and most had been signed by the individual resident to indicate they were in agreement with them. Information contained within the case files indicated that a person centred approach to meeting needs was being followed by staff and the recording contained within these was of a good standard, with regular daily entries to show how the residents had been, together with monthly summaries and reviews of the support plans in order to ensure that they were continuing to be appropriate to meet identified needs. Feedback from members of the social service community team indicated that they were happy with the level of care provided at Alexandra Road and discussion with residents confirmed that they had participated in review meetings about their needs. Observations of the care practices showed that residents were able to make decisions about their lives, with support and assistance being offered from staff. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 12 The plans documented further examples of how residents had been supported to make choices and residents indicated that they were happy in this respect. Risk assessments for each of the residents were an integral part of the records and discussion with staff indicated that these were being sensitively applied within a framework that was consistent with individual choice and part of the residents’ everyday lives. Staff members are in the process of revising individual plans and are developing person centred planning. Some staff have already completed training and are starting to work with residents in arranging their planning meetings. These meetings, the venue, format, hospitality arrangements are governed by the wishes of each resident and it was exciting to hear one of them describing who they had chosen to their planning meeting, what music they had chosen and the snacks they were going provide for everybody. The work that has been completed so far is excellent and reflects a genuine person centred approach to planning and the individual residents are totally and genuinely involved. Since the last inspection and the initial development of a “passport – four things you need to know about me” the staff are now in the process of completing them for all residents. The expert who had not seen a “passport “before was very impressed with the work the home had done with residents to create these for everyone living at Alexandra Road and said “ the passport is a mini essential lifestyle plan (ELP). They are easy to carry around. I think all service users should have one” Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to maintain their own interests and links with the community and this enriches their social and recreational opportunities. The meals in the home are good offering both choice and variety and catering for special diets. EVIDENCE: At the start of the visit quite a few of the residents were out at the local day services. Discussion with staff indicated that all of the residents had a day off from their chosen programme of activities, in order to ensure that they had quality time at home with their key worker, to do everyday tasks such as cleaning their rooms, going shopping and developing their skills of daily living. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 14 All the residents are involved in the local community, visiting the local shops, supermarkets, going to the bowls centre, cinema and theatre trips, Mencap club nights, trips out in the community, walking in the park, visiting garden centres. All activities are recorded in the residents’ individual plans. The home specifically does not have its own transport preferring to rely on public transport or walking. The home is well situated to access both local bus and trains. Staff will arrange and book transport for specific outings. Care plans documented the range of opportunities the residents take part in and discussion with them confirmed that they enjoyed these. Residents said they enjoyed “going shopping” or “ going to the pub with staff” and verbal feedback from relatives confirmed that they were encouraged to take part in the life of the home. The managers and staff arrange several parties and special nights during the course of the are in place in respect of visitors and maintaining relationships and files contained evidence of how staff had supported residents in this, with social events being held, to which friends and family members were invited. One resident who had lost contact with their extended family was delighted to tell of their reunion this summer. Staff explained how they helped the resident research the whereabouts of their relatives and this had been both an exciting and successful venture with rewards for all members of the family. Through conversation with residents, it became evident that they are able to develop personal relationships if they wish to. The residents, staff, care plans and evidence in the form of tasks showed that residents are very much involved in housekeeping tasks around the home, such as cleaning their own rooms, doing their laundry, working in the garden (if they choose) and preparing their own drinks, and snack lunches. Residents are able to lock their bedrooms and staff were observed always knocking before entering any bedroom. Residents are able to open their own mail, and key workers are available to read and explain to residents who are not fully able to understand the contents of their letters. Observations of care practices confirmed that residents’ rights were being upheld, with individuals choosing to do activities and spend their lives as they chose. Staff indicated that residents were supported to prepare their own meals if they wanted and plans contained evidence of the residents’ dietary needs being monitored, in order to ensure that their nutritional needs were met, with individual weight being monitored where appropriate. Staff were seen to maintain residents privacy and dignity by knocking on bedroom doors before entering and one member of staff talked of the importance of not talking about residents in front of others. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 15 The main meal is in the evening and the cook prepares this in the large catering kitchen and then the cooked food is taken to each unit. This system works well and the food was still very hot and fresh when served in each unit. Residents told the inspector they had enjoyed their “tea”. Residents in one unit said they had “lots of nice food”. This comment was further validated by checking the menus, which illustrated a varied and healthy diet. The cook stated that the home is allocated a sufficient budget to ensure the quality of meals provided. A choice of two main meals plus an alternative salad is always available. At present the food budget runs into an overspend at the end of each year. The environmental health officers inspected in March 2007 and awarded the home silver status. There are two cooks employed who provide a high standard of meals with a choice at all times. Residents are always asked what they would like to eat and if they don’t like the menu options then the cook will always prepare an individual meal for them. Breakfasts are prepared independently in the units. There was ample fresh fruit available and residents were able to make drinks as and when they wanted with the support of staff where necessary. Where possible the cook purchases local produce however this is limited as Dorset County Council have a contract with a large supplier though the cook commented that the range of foods available was gradually increasing and was of a high quality. On the second visit to the home there was great activity with one group of residents going out for a dinner and disco evening whilst others were walking into Weymouth for the annual Victorian night. Birthdays are celebrated for everyone with staff and residents always getting a birthday cake. The day of the first visit fell on a member of staffs’ birthday and it was most enjoyable to observed the genuine warmth the residents had in celebrating with the member of staff. Residents told the expert “ there is nothing I would change, when it is my birthday I have a cake and presents and go out for a meal”. The expert observed that residents appeared to have a healthy diet and in one of the units people help prepare food, snacks and drinks unsupervised or with minimal staff input. The expert also learnt about the wide range of different activities people enjoy including swimming, bowling, cookery, music, shopping, meals, one off trips to London, in addition to joining in with living skills and domestic chores. People in one unit enjoy a quieter atmosphere and use sensory equipment. One person told the expert “I can invite friends here or go out for a meal” another described going out, “I visit the local shop to buy a lottery ticket and I pick the numbers, the shop assistant talks to me”. Residents and the expert enjoyed exchanging information and the comments given to the expert provided further evidence to support these standards. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of the residents are well met with evidence of multi disciplinary working talking place in a regular basis. The systems of medication administration are good. EVIDENCE: Residents confirmed that staff were supporting their health and personal care needs in a way that they were happy with. Observation of the residents indicated that several are largely independent in relation to their personal care, and discussion with staff revealed that prompts and encouragement was generally sufficient, in order to ensure that these needs were appropriately met. Individual care plans gave detailed information as to the extent of personal support each resident needed and there are some people living at Alexandra Road, which require a much greater level of direct care and support. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 17 Care plans contained health action plans, which documented liaison with other professionals as required, together with appropriate monitoring in respect of the residents’ needs. Detailed records are kept of all visits to and from healthcare professionals. Dorset County Council – social service directorate has policies and procedures relating to the administration of medication. The home uses a monitored dosage system of medication (MDS) issued by the local pharmacy and the medication is supplied in blister packs by the pharmacy and these are colour coded with the details on the MAR sheets. Staff manages the medication as they report that none of the current residents are able or wish to manage their own medication. All records were signed and up to date and there are double signatures on receipt of medicines into the home. Information submitted as part of the pre inspection process indicated that all the staff who were responsible for administration of medication to the residents had received training and this was validate from discussion with individual staff who confirmed that they had received training in this aspect of practice including the management of epilepsy. (seizures) Records indicated that each resident has an annual medication review. The pharmacist visited in June 2007 and no significant recommendations were made however, it is recommended that the home obtain a letter from the residents’ GPs confirming the use of homely remedies. Care plans contained copies of good quality health action plans, which documented liaison with other professionals as required, together with appropriate monitoring in respect of the residents’ needs. A relative commented, “My relative is very happy living at Alexandra Road… I feel that all their needs are met, the standard of care is very good” The home works as part of the multi agency services available in the locality. Staff spoke of close working relationships with a variety of other professionals (occupational and physiotherapists, psychology and psychiatric consultants). This information was further evidenced from references in individual records. Advocacy services are available to all the residents and staff have previously worked with members of Dorset People First and with the co-ordinator of the South West Network for Total Communication who supported the development of the individual passports. Residents told the expert “ staff are lovely here looking after me” Residents are able to choose their own clothing that reflects their personality. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Dorset County Council Social Service Directorate have comprehensive procedures for the safeguarding of adults, whistle blowing and concerns and complaints which staff implement in their daily work to ensure the welfare and safety of each person living at Alexandra Road. People who live at Alexandra Road are protected from harm and can be confident that any grievances will be listened to and acted upon. Staff have a good knowledge and understanding of adult protection issues, which protects residents from abuse and self harm. EVIDENCE: There are clear policies and procedures in place relating to the making of complaints. There have been no complaints since the last inspection but previous ones had been appropriately recorded and investigated and replied to within the timescales set out in the complaints policy and procedure. Dorset County Council- Social Service Directorate has comprehensive policies in place in respect of complaints about the service and regarding the protection of vulnerable adults. Information about using the complaints procedure has been developed in order to make it easier for the residents to understand and a “grumble sheet “ has been devised. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 19 Despite these efforts by the home, discussion with staff and observations indicated that owing to some of the residents’ restricted verbal skills and the levels of understanding experienced by them, some would not be able to fully grasp how to use the procedures. However staff have learnt specialist methods of communicating using total communication tools and makaton (sign language) in order to help communication with residents. Observations of the staff and discussion with them indicated that they had a good understanding of the residents needs and were able to interpret if anything was wrong or upsetting them. The homes log contained no entries since the last inspection and discussions with the manager confirmed that appropriate action had been taken to resolve any issues that had previously arisen. Residents were observed being very relaxed and confident in their interactions with staff and there was much banter and goodwill. The home’s staff induction process includes training in Protection of Vulnerable Adult / safeguarding procedures and discussion with the manager and staff confirmed that they were aware of these and that they would take appropriate action if this was needed. The manager indicated that all the residents had individual bank accounts and inspection of the associated records for these confirmed that robust systems were in place, in order to ensure that their financial interests were being satisfactorily safeguarded. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from living in a homely environment that is clean, safe and homely. EVIDENCE: At the time of the visits the premises were undergoing major work, which included the fitting of new double glazed windows and a fire safety sprinkler system. The contractors and staff were working together to ensure that the premises remained safe and there were comfortable areas for the residents at all times. Once the work is completed a programme of decoration will be completed with new furniture for the communal areas. The contractors were completing the work in sections and all parts not affected were clean, homely bright and cheerful. In addition to the current major works there is an annual renewal programme to ensure that the home is kept to a good standard of repair and decoration. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 21 Bedrooms were comfortable and personalised and those viewed clearly reflected the resident’s interests and tastes. Laundry is managed by staff with some of the residents helping to do their own. The managers explained that the laundry is to be redesigned to reflect the style of a commercial laundrette and this it is hoped will make it more practical for residents to take some level of responsibility for their own laundry. There are policies and procedures in place to ensure that bodily or chemical spillages are cleaned up appropriately and do not place staff at risk. Staff are provided with protective clothing if required to prevent the spread of cross infection. Staff were aware of infection control procedures and training records further verified this information. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents individual and joint needs are met by an effective and appropriately trained and supervised staff team. Residents are supported and protected by the homes recruitment policy and practice. EVIDENCE: An inspection of the home’s rota, daily records and discussion with staff evidenced that residents benefit from having adequate staff to meet their needs at all times however, there are occasions when there is only one member of staff in some of the units and whilst this does not affect the quality of direct care to each resident staff said it can impose some restriction on residents participating in activities outside the home. The home has its own bank of relief staff who work to help cover sickness and annual holidays who work flexibly and with the permanent staff group to help the home respond to residents needs. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 23 Records viewed and discussions with staff showed that staff are trained and supervised to a high standard and staff felt supported by the management team and organisation. Records and discussion with staff showed that a range of training was provided including access to National Vocational Qualifications (NVQ) training. In addition to supervision regular staff meetings and shift handovers are held. Staff recruitment is co-ordinated from Dorset County Council Human Resource team and occasionally the home has to chase up information and checks already completed but not passed on to the home however, recruitment procedures are thorough and it is more an issue of ensuring prompt communication between headquarters and the home. All the residents chatted very freely about the staff and were clearly proud of “their key worker” and described them as “lovely, great, good fun, I really like them all”. Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff team that is led by competent and experienced managers enhances the care of residents and ensures the home is run in the best interests of the people who live there. The Senior Community Care Services Officer has taken on the role and responsibilities as acting manager efficiently and has maintained positive leadership in the home. EVIDENCE: Both the registered manager and acting manager (Senior Community Care Services Officer) have worked in the home for many years and both have an Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 25 excellent understanding of the needs of the residents, the staff and the principles and structure for running and managing a home in the best interests of the residents. The managers work hard and are supported by their staff to ensure that all documentation is up to date and that staff are kept well informed of policies and procedures. Both residents and staff spoke highly of the managers and the offices were well organised with all documentation filed in safe and orderly fashion. The managers and senior staff have developed a quality assurance system to ensure that the views of the residents, relatives and stakeholders and staff are sought. Together with monitoring systems in place the managers are aware of what aspects of the working life and delivery of care may need to be developed. Dorset County Council – Social Service Directorate has robust policies and procedures in place to ensure that the environment is safe for both residents and staff living and working in the home. All appliances in the home had up to date maintenance certificates and information taken from the AQAA and records seen on the day showed that the facilities and equipment within the home were being appropriately maintained and routinely tested. All staff with the exception of recently recruited staff have received most mandatory training. All staff receive induction training in line with Skills for Care specification. Observations on the day, records viewed and discussion with staff evidenced that the acting manager delivered an effective resident led service. Residents and staff spoke highly of the acting manager (Senior Community Care Services Officer) and felt they were very approachable and inclusive in their management style. Staff stated that they have attended training on a number of safe working practices and individual records provided further evidence. Appropriate resident and environmental risk assessments were in place and quality monitoring are completed. Alexandra Road (25-27a) DS0000032045.V346562.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 Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? 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 YA42 Regulation 23(4)(d) Requirement All staff must receive mandatory fire training within the specified time limits e.g. night staff quarterly. Timescale for action 31/01/08 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 Refer to Standard YA14 Good Practice Recommendations It recommended that all residents should have up to seven days paid annual holiday. This recommendation has been carried forward from previous inspections and needs to be addressed. It is recommended a letter from the resident’s GP be obtained confirming the suitability of homely remedies. It is recommended that all information held with Dorset County Council Human resources team be transferred to the home staff files as quickly as possible. e.g. each file must contain up to date identification to include a current photograph. Please note the home was immediately working to address this recommendation. 2 3 YA20 YA34 Alexandra Road (25-27a) DS0000032045.V346562.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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