Inspection on 15/05/06 for Alder Close (20)

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alder Close (20) 27/11/08

Alder Close (20) 22/11/05

Alder Close (20) 05/07/05

Alder Close (20) 15/02/05

Alder Close (20) 10/08/04

Alder Close (20) 16/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Alder Close (20) 20 Alder Close March Cambridgeshire PE15 8PY Lead Inspector Andy Green Key Unannounced Inspection 15th May 2006 10:00 Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 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 Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 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. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alder Close (20) Address 20 Alder Close March Cambridgeshire PE15 8PY 01354 654146 01354 657905 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) Cambridgeshire County Council Margaret Hill Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability - for 5 service users receiving respite care only between the ages of 18 - 65 years. 22nd November 2005 Date of last inspection Brief Description of the Service: 20 Alder Close is a 5-bedded bungalow providing respite care for adults with a learning disability. The home was first registered in October 2003 and comprises five bedrooms, all with en suite facilities, a lounge, kitchen, two bathrooms, laundry and office. There are also extensive gardens around three sides of the bungalow incorporating seating and planted areas. The home is situated near to March town centre where service users have access to a variety of shops and facilities. The scale of charges range from £63 - £351 depending upon the individual’s financial assessment. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out by Andy Green, Regulation Inspector, on 15th May 2006. The inspector met with the operations manager in the absence of the registered manager and members of the care team. A variety of records were inspected including care plans, staff files, fire safety records and medication records. A tour of the building was undertaken and the inspector met two service users receiving respite care. Three requirements have been made. Most of the NMS have been met. What the service does well: What has improved since the last inspection? What they could do better: The staff files being stored in a locked cabinet in a bedroom whilst the home’s office is being re fitted. The Inspector was concerned that this compromised the service users privacy and dignity and that this cabinet must be moved to an appropriate area used by the staff. It was noted that staff files must include a recent photograph. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 6 It is recommended that staff files are stored in appropriate files to ensure that all documents are safely kept together. 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. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 7 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 Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: There has been a recent addition to the Statement of Purpose, which now gives clear guidance regarding the maximum length of stay for respite stays in the home. Six months is now the maximum length of stay. This has been agreed by the Operations and Area Manager to ensure that places are not blocked and that regular respite can be offered without risk of cancellation. The Operations Manager stated that most service users receive regular respite care for up to two weeks in length. A clear diary is kept showing when service users are booked in for respite stays in the home. All referrals are made through the local authority. The Operations Manager stated that both the Statement of Purpose and Service users Guide are reviewed as part of an ongoing process throughout the year. The manager has also implemented a set of clear guidelines for relatives and carers to ensure that service users bring appropriate amounts of personal items including medication, personal money, clothing, mobility aids and toiletries whilst they are receiving respite care. A copy of this document was supplied to the inspector. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 9 There are approximately 35 – 40 service users who access the service throughout the year. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The care and support provided at the home is of a good standard. Care plans are in place to ensure that staff have sufficient information to satisfactorily meet the service users assessed needs. EVIDENCE: Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 11 The Operations Manager stated that a level 2 assessment is received from the clients care manager prior to admission. A service user plan is generated from this information to provide the basis for the care to be delivered. The majority of service users have been known to the respite service for a number of years and appropriate assessment information is held on file. All service users have key workers who are involved in care planning and assisting with daily living skills as required. 4 service user plans were inspected and they were presented in a person centred format including appropriate risk assessments. They showed detailed evidence of the service user’s needs, which is contained in a document entitled ‘Continuity Guides’. These provide information about the service users life, activities, preferences, health, daily routines and personal care. Care plan reviews sheets have been implemented to ensure that any changes in the individuals care can be recorded appropriately. Regular reviews were documented. Relatives can be involved in the review process if they and the service user wish them to. The manager has also implemented a form, which all staff sign to evidence that they have read and are aware of the care plan regarding new service users to ensure that information and care needs are understood. Staff spoken to during the inspection confirmed this to be the case and that they were regularly involved in the care planning and review process. There were three services in residence during the inspection and two service users were coming later that day for a respite stay in the home. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users are assisted to have access to activities in the community appropriate to their needs and abilities. Service users have a choice of meals, which are prepared and served in a homely atmosphere. EVIDENCE: Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 13 Service users continue to be involved in programmes of organised day services during the week. Service users have regular access to the community with staff assistance to the local town and area including frequent visits made to local shops, garden centres, bowling alley, pubs and cinema. The improved availability of transport, which has enabled more day trips to the coastal resorts and nearby towns. There are also organised in-house activities including board games, cookery and craft sessions. There are television, video, DVD and music facilities available to service users. There are barbecues held in the garden during the summer months. Two service users were present during the inspection and they were busily involved in a craft session in the lounge. Both service users were complimentary about the care and support they received during their respite stays in the home. One service users stated that she particularly enjoyed the swimming sessions that she attends during her stay and the assistance she receives from staff during these sessions. During the day of inspection one of the care staff was assisting a service user with a shopping trip in the town Service users are also involved with menu planning and the preparation of meals with staff assistance where appropriate. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: Care staff continue to support service users with personal care where required and accompany service users to access out-patient appointments when necessary. Appropriate aids and equipment are in place. These are detailed in the daily notes in service users files The operations manager stated that if a service user is physically unwell they would not usually make use of their respite stay but would receive care from their own local GP practice. A variety of healthcare specialists are also available when required including speech therapists, occupational therapists, psychiatrist, community nurses and care managers. Records are kept of all medicines received, administered and disposed of. A medication policy is in place. Records of medication administered were inspected and found to be satisfactory. The Operations Manager that a new medication cabinet has been ordered to provide more adequate storage. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 15 Nursing care is not provided but the home has contact with a local GP practice that will provide medical support when required. The inspector registered his concern that the locked filing cabinet containing staff files was being kept in one of the occupied bedrooms whilst the office was being reorganised. Although the service user said that she did not have any objections the inspector felt that this was inappropriate and the Operations Manager stated that the cabinet would be removed to the office area that day. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a satisfactory complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. There are suitable arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: There have been no changes made to the complaints procedure since the last inspection. The home has not received any complaints since the last inspection. The home has a satisfactory policy in place, which is in line with local authority policies, to ensure that service users are protected from abuse. Care staff receive ongoing appropriate training to ensure they are aware of adult protection principles and procedures. Staff spoken to during the inspection confirmed that they had recently received POVA training. It was observed that care staff spoke to service users in a friendly and social manner appropriate to the individual’s needs. Comment cards received from service users, relatives and carers were complimentary regarding the care and support that is provided in the home. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The environment is homely and clean and suitable for the needs of those living in the home. EVIDENCE: The bedrooms and communal rooms are maintained to a good standard and they are presented in a bright and homely manner. Carpets in the communal areas and bedrooms are cleaned regularly. Carpets in the reception area and office have been replaced with laminate flooring. The home has been redecorated throughout since the last inspection as part of an ongoing maintenance programme. There is adequate equipment to meet the service user’s needs and individuals usually bring their own aids and adaptations where required. Service users are encouraged to bring personal items to make their stay more enjoyable. There are 5 single en-suite bedrooms two of which have overhead tracking in place. There are adequate furnishings in each bedroom. A new microwave, kettle, and toaster have recently been purchased for the kitchen. The garden is being redeveloped to incorporate more landscaped areas. Fundraising activities have raised money to provide more seating and planted Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 18 areas. A barbecue is being installed to provide a focus for social events during the summer months. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home’s recruitment policy and processes makes sure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver care to the service users they support. EVIDENCE: All staff receive a job description and copies are kept on file. All staff receive comprehensive training to update their skills to ensure an approach, which is knowledgeable and sensitive. Four staff spoken to during the inspection confirmed that they had received a wide variety of training including POVA, First Aid, Moving & Handling, Autism, Epilepsy, Communication and SCIP training. NVQ training continues to be undertaken by a number of staff in the home. They also confirmed that they were supported by the manager in the home and that they were receiving regular recorded supervision sessions approximately every six weeks. Staff also continue to receive an annual appraisal. There are thorough recruitment procedures to ensure that only appropriate people are employed. References and CRB checks are received prior to employment. Four staff files were inspected and they contained two Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 20 references, CRB checks and application forms. It was noted however that a recent photograph must be added to each of the staff files. The Operations Manager stated that there are vacancies for 1.5 whole time equivalent support workers and recruitment for these posts is underway. He also stated that there were regular relief and bank staff whoo are known to service users to ensure there is adequate and consistent cover provided. On the day of inspection there were three carers on duty and one administrator. There is one waking night staff and one staff member sleeping in each night to provide support when required. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42,43 The overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The manager provides support and guidance to staff to ensure that service users receive good quality care. EVIDENCE: The registered manager is working towards completing an NVQ level 4 in Management and Care to improve her skills and staff were complimentary regarding the support they received from her. They stated that they felt encouraged to raise issues and proactively participate in the development of the service. Although the required information is held in individual staff files, a more appropriate format needs to be in place so that information can be easily accessed regarding recruitment, induction, training and supervision. The cabinet storing the staff files must be stored in an appropriate area and be removed from its temporary site in a bedroom. The Operations Manager confirmed that this would be actioned that day. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 22 Fire safety records were seen during the inspection and they were recorded satisfactorily. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 23 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 3 3 X 2 2 X Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 24 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 YA18 Regulation 12 (4) (a) Requirement The registered person must ensure there are suitable arrangements to ensure that the privacy and dignity of service users is preserved at all times. Records must be stored appropriately in areas that are only for staff use. Staff files must include a recent photograph as detailed in Schedule 2 of the Care Homes Regulations 2001. Timescale for action 15/05/06 2 YA41 23 2 (l) 15/05/06 3 YA41 17 (3) (a) 31/07/06 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 YA41 Good Practice Recommendations It is recommended that staff files are stored in a appropriate files to ensure that all documents are safely kept together. Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 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 Alder Close (20) DS0000050387.V291787.R01.S.doc Version 5.1 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. 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