Inspection on 17/04/07 for Alba Rose

This inspection was carried out on 17th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alba Rose 16/01/06

Alba Rose 01/09/05

Alba Rose 01/03/05

Alba Rose 06/10/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Alba Rose Keldhead Hall Middleton Road Pickering North Yorkshire YO18 8NR Lead Inspector Karen Ritson Key Unannounced Inspection 17th April 2007 09:30 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 Alba Rose DS0000007625.V335003.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. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alba Rose Address Keldhead Hall Middleton Road Pickering North Yorkshire YO18 8NR 01751 472754 01751 477170 albarose@freenetname.co.uk 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) Alba Rose Partnership Mrs Ann Lesley Barnes Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: Alba Rose is situated at the Western edge of Pickering, is set in its own grounds and overlooks a small paddock. It was formerly a convent as well as a private residence, but has now been converted to provide care for nineteen residents on three floors, with a passenger lift. There are seventeen single bedrooms and one shared room, which are on all three levels. All bedrooms except one single have en suite facilities. There are large landscaped gardens providing easy access for residents, and parking is available on site. Alba Rose provides personal and social care for residents over the age of 65 and there are close links with the community nursing team. The home has a ‘minibus’ with wheelchair access, which is used to maintain links with the local community. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. The home charges from £395 to £450 each week. Hairdressing, chiropody, papers, taxis, escorted transport to appointments and trips out are not included in this cost. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took 14 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 17/04/07 between 9:30am and 5pm. Information for this inspection was gathered from the following: • • • • • • • • • • A tour of the premises Observations of care throughout the day of the site visit. Speaking with service users. Speaking with the manager and proprietors. Case tracking service users on the day of the site visit. Looking at information provided by the home in a pre inspection questionnaire. Notifications sent to the commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager and proprietor were present throughout the day of the site visit. What the service does well: This home offers an excellent level of care. The home is clean and well decorated with very pleasant grounds. The manager find out what each person needs help with before they move into the home. This is written down in an assessment of care. She tells each person whether the home can offer the care needed and gives out information so that people can decide for themselves if it is a suitable place. Once a service user has moved in, the staff regularly talk with them about what help they need and write this down in a plan of care. The plan is changed whenever needed. The home asks doctors and other health care people to contribute to the plan of care. Service users are treated with dignity. One said: ‘The staff always make me feel at ease no matter what help I need.’ The home cares for any service users who are at the end of life with kindness and patience. One relative said: Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 6 ‘My mother received loving care whilst dying.’ Any complaints are listened to and acted on and staff are trained in how to keep people safe and recognise if any person is not being treated properly. There are a good number of staff. This makes sure care can be given in a relaxed, unhurried way. One service user said: ‘There is always time to chat.’ Staff are well trained and are happy to learn more. The manager is well qualified. The home regularly asks service users what they think about the care they receive. All comments are gathered together and a plan is drawn up to improve the service based on this. The home also carries out its own quality checks across all areas of care and the building. All health and safety checks are up to date which makes sure service users stay safe. What has improved since the last inspection? 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. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 7 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 Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 8 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 and 3. 6 is not applicable. People who use the service experience excellent quality outcomes in this area. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. They are at the centre of the needs assessment and they have a contract, which clearly tells them about the service they will receive. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has updated its service user guide, which covers all information needed for service users and their representatives to decide whether the home is suitable. Assessments are detailed and include all required areas. Service Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 9 users are closely consulted and their opinion is central. A wide consultation is also carried out to gain details from health care professionals and others to draw up as detailed and accurate a picture of needs as possible. A service user said. ‘I was there when they assessed what I needed. I was able to say what I thought were the most important things and it was all written down.’ Another service user said. ‘I was given information about the home before I decided to come here. I read this and my daughter came to have a look round.’ The clear documentation and person centred approach of the home ensures that each of the service user is appropriately placed within the home and that each individuals needs are met. Alba Rose DS0000007625.V335003.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, 10 and 11 People who use the service experience excellent quality outcomes in this area. Individuals are closely involved in decisions about their lives, and play an active role in planning the care and support they receive. They are treated with dignity at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff work alongside service users in developing a care plan and in devising achievable goals. This process is service user led. The service users and staff discuss goals, which are agreed and recorded. Management keep in mind that goals should be specific, measurable, achievable, realistic and timely. It was clear from speaking with service users that each goal is individually tailored and arranged in an order of priority decided by the service user. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 11 One said: ‘When I first came here it was most important for me to know I would get my meals, so that was one of my top goals. But now I can think about improving my life in other ways. Getting meals is what happens for everyone.’ Each member of staff carries a prompt card describing each service users top three goals so that these may be focused upon when offering care. Each area of the care plan is reviewed each month with goals adjusted according to need. Those who express unrealistic hopes are advised in a way that helps a more achievable goal to be agreed. One health care professional said: ‘Their observational skills are very good. They advocate well when asked but never impose themselves or make assumptions about a service users’ wish to have support.’ She went on to say: ’They are good at supporting people in the areas most important to them. For example, a patient needed a great deal of reassurance with attending an outpatient appointment and they focused their attention exactly where it was needed.’ This approach ensures that the care received is appropriate and focused on individual changing needs. The home has strong links with the local surgeries and all contacts with these and any other external agencies are recorded. This ensures that the care plan is widely informed and therefore most likely to meet specific care needs. Medication is handled appropriately and staff have had suitable accredited training. The home has recently improved the way in which the medicines are moved about the home and this has reduced the risk of error. Medication administration is subject to regular internal quality audits and the pharmacist is regularly consulted. Some of the service users choose to self medicate, and a risk assessment is in place for these people. The approach to medication preserves service users welfare. The home has recently revised its policy on end of life care. Although it is not always possible to care for service users to the end of their lives it is for some. A relative had written to express her appreciation of the care her mother received at the end of her life at the home, she wrote: ‘I would like to comment on the loving care my mother received whilst dying. The care workers turned and washed her, spoke to her and supported myself, Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 12 my children and relatives throughout. We were so pleased she died surrounded by people she knew.’ A McMillan nurse said that the home had helped pilot the ‘Liverpool pathway’, a model for palliative care. She felt the staff had followed the guidance well and had used the new system of writing down their observations with an eagerness to learn and benefit each individual cared for. This approach ensures service users receive empathic and knowledgeable care at the end of their lives. This openness to learning and willingness to consult widely improves the level of care offered across all the standards in this outcome group. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 13 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 People who use the service experience excellent quality outcomes in this area. People who use this service are enabled to make choices about their life style. Social, educational, cultural and recreational activities exceed individual’s expectations. They have a balanced diet they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home consults service users about the way they wish to live their lives both on an individual basis and through the regular service user meetings. A large programme of pursuits is offered following consultation by the recently appointed recreational facilitator. At present these include baking, craft, jigsaws and games, physical exercise with a visiting personal trainer, quizzes and reminiscence, scrabble, dominoes, bingo and debating club. The residents have also invited a magician, bell ringers, woodturning demonstration, a cast from a local theatre, singers and outside speakers on a variety of subjects. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 14 Local secondary school students have also been invited to visit the home and there is a plan for some residents to assist with the student ‘enrichment’ classes through visiting the school. Various events have been arranged through the service user meetings, these include the organisation and execution of an Easter fair. A resident had submitted her report about the event to the local newspaper. The residents also choose to fund raise for various charities. Visitors to the home said they were made welcome at all reasonable times. Service users are enabled to exercise considerable choice and control over the way they live their lives. One service user said: ’It’s all about what we want; the whole thing is geared up for us. If we decide on a goal then the staff do their utmost to help us see it through.’ Service users decide on menu options in their meetings. The home sometimes holds a themed evening when more experimental choices are offered. Individual choice and dietary requirements are met. If required, each service user receives a nutritional assessment and this, along with regular weight records, help staff to plan individual meal requirements and monitor nutritional wellbeing. Service users obviously enjoyed the meals on offer very much. A midday mealtime was observed and the food was of a high quality. Service users comments included: ‘Good food with lots of home grown vegetables.’ ‘The meals are first class.’ Through frequent consultation and acting upon comments, service users have a lifestyle which meets and in many cases exceeds their expectations. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 15 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 People who use the service experience excellent quality outcomes in this area. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users all said that any concern was listened to, acted upon and taken seriously by the staff. There had been two internal complaints since the last inspection. Both had been thoroughly investigated according to policy and procedure and the results recorded. Neither had been substantiated. One service user said: ‘I know I can say if there is a problem or concern. We can talk to any of the staff and of course we get our views across in our meetings. Our concerns are always acted upon but I must say I don’t usually have any.’’ All other service users said they had no complaints. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 16 Service users are protected from abuse through well -trained staff. All staff understood the abuse policy and procedure and were aware of the procedure for the Protection of Vulnerable Adults. This ensures that Service users are safe and well cared for. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 17 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 People who use the service experience excellent quality outcomes in this area. People who use the service live in a safe, well-maintained and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained and redecorated on a regular basis. There are sufficient toilet and bathing facilities and communal space is pleasantly laid out. There is an area where service users may sit, near to a raised border planted and tended by service users, or they may make use of the gazebo nearby. A vegetable garden and greenhouse are towards the end of the garden. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 18 One service user said: ‘Recent redecoration is lovely.’ Another commented that the home was always clean and well looked after. Each room is decorated to individual taste. One service user had written in the care plan that the room was not to be kept too tidy and staff had balanced this with keeping the room safe. The home complies with environmental health and fire requirements. In this way service users live in an environment, which meets their individual preferences. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 19 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 People who use the service experience excellent quality outcomes in this area. EVIDENCE: The home is very well staffed. An emphasis is placed upon recreation time and staff reported having time to talk with the service users in addition to offering the care required. Service users said there were plenty of staff to carry out their duties without having to rush and that there was time to go out in the homes’ own transport in the afternoons, shopping or having a coffee in town. Staff are recruited according to policy and procedure and receive all required training. All staff on duty on the day of the site visit were spoken to. All said they received good support from management, and planned to develop their knowledge of care topics through internal and external training. Each had an individual training plan and this was discussed in supervision. Most staff have NVQ in care to at least Level 2 and others have Level 3. All said that the appointment of the recreational facilitator had been a very positive move as service users were more widely canvassed for their opinion and they were now more enabled to engage in stimulating and enjoyable pursuits. This member of staff was on duty and said: ’I am able to do some really great things with these people. Between us we Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 20 have some have fantastic ideas, I just help put them into practice. One member of staff said: ’I feel they value me as a person. I am doing more training and I think it is a lovely place to work.’ One service user said: ’All the staff are just wonderful. There isn’t one I wouldn’t want to look after me. They are so polite and helpful.’ Another wrote ‘Nothing is too much trouble’ A health care professional said: ‘Their observational skills are very good. They have an eagerness to learn.’ This approach to staffing levels, recruitment and the emphasis on good training ensures that service users needs and wishes are met. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 21 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 People who use the service experience excellent quality outcomes in this area. The management and administration of the home is based on openness and respect. Service users views and preferences underpin practice and they are protected by the health and safety procedures of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has NVQ level 4 in care and management. The home continues with a detailed and thorough quality assurance system based on regular questionnaires distributed to service users, friends, relatives Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 22 and all others coming into contact with the home. The proprietor and manager regularly carry out quality assurance audits. All information is collated and fed back to service users and staff in regular meetings. This information is used to draw up an annual development plan for the home. Service users also commented that they felt encouraged to mention any quality issue at any time and all concerns or comments were listened to and acted upon appropriately. The results of the quality assurance surveys are published and available for any interested party to examine. The home has a policy of continual self monitoring and has a proactive approach to improving the quality of service through consultation and regular review. A nurse who specialises in care of the dying said: ‘They recognise any areas where they need to improve. As a result of the end of life care pilot the home is sending two members of staff on a palliative care course to learn more.’ This approach ensures that care practice is based upon service users, staff and others views and that the manager learns from feedback received. The home does not handle the financial affairs of any service users. However, there are charges for some services, which are made clear in the contract. These are billed direct to the service user or a person who is acting on their behalf. Evidence was submitted on the pre inspection questionnaire that all relevant safety checks had been carried out. The home has comprehensive health and safety policies and procedures. This ensures service users are kept safe. Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 23 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 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x N/A x x 4 Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Alba Rose DS0000007625.V335003.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!