Inspection on 22/11/05 for Alder Close (20)

This inspection was carried out on 22nd November 2005.

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 2 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) 15/05/06

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 Unannounced Inspection 22nd November 2005 11:30 Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 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.V260215.R01.S.doc Version 5.0 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.V260215.R01.S.doc Version 5.0 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 Social Services Margaret Hill Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 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. 5th July 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. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Regulation Inspector, Andy Green on 22nd November 2005 and was the second inspection of the home for the year 2005/6. The inspector met with the operations 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 in residence. What the service does well: 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. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 6 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.V260215.R01.S.doc Version 5.0 Page 7 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 Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: There have been no additions or updates to either the Statement of Purpose or the Service Users Guide since the last inspection. The Operations Manager stated that both of these documents are reviewed as part of an ongoing process throughout the year. The home is currently compiling a set of clear guidelines for relatives and carers to ensure that service users bring appropriate amounts of personal items including medication, personal money and toiletries whilst they are receiving respite care. The home provides 5 beds for respite care for usually up to two weeks in length. All referrals are made through the local authority. There are approximately 35 service users who access the service throughout the year. However, there are three service users residing in the home who are currently awaiting long-term placements. This is causing a number of respite bookings to be cancelled, as there are only two spaces available. A maximum length of stay needs to be in place to ensure that longer-term stays in the home do not block regular respite placements. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 8 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 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: A service user plan is generated from a pre admission assessment from the clients social worker, which provides the basis for the care to be delivered. Many of the current service users have been known to the respite service and appropriate assessment information is held on file. All service users have key workers who continue to be involved in care planning and their daily living skills as much as possible. Service user plans are person centred and include risk assessments. Three sets of care plans were seen during the inspection. They contained a detailed account of the service user’s needs that are set out in a document known as ‘Continuity Guides’. These provided information about different areas of the service users life, e.g. health, daily routines, personal care etc. Care plan reviews sheets need to be implemented to ensure that any changes in the individuals care can be recorded appropriately. Records are kept securely and are in an accessible format. Relatives can be involved in the review process if they and the service user wish them to. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 9 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): 12,13,14,17 Staff provide appropriate support to ensure that service users have access to activities in the community, that are 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.V260215.R01.S.doc Version 5.0 Page 10 The majority of service users continue to be involved in organised day services during the week. The staff are actively involved with service users both in and outside the home. Service users, throughout the year, 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. There are also organised in-house activities including board games, cookery and craft sessions. There is a television, video, DVD and music facilities available to service users. There are barbecues held in the garden during the summer months. During the day of inspection one of the care staff was assisting a service user with a shopping trip in the town, three service users were attending college/day services and one service user was watching television in the communal lounge. Service users are involved with menu planning and the preparation of meals with staff assistance where appropriate. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 11 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 Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: Care staff support service users with personal care where needed and also to assist attending out patient appointments when required. Appropriate aids and equipment are in place. 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, psychiatrist, community nurses and care managers. The home uses a monitored dosage system of drug administration and all staff who administer medication receive appropriate training. Records are kept of all medicines received, administered and disposed of. A medication policy is in place and records of medication administered were inspected and found to be satisfactory. A pharmacist is available to provide advice and training as required. Nursing care is not provided but the home has contact with a local GP practice who provide medical support if required. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 12 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): 22,23 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: The home has a complaints procedure including agreed timescales to make sure that all complaints are fully investigated and actioned appropriately. 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 make sure 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 received POVA training. It was observed that care staff spoke to service users in a friendly and respectful manner appropriate to the individual’s needs. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 13 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): 24,25,27,30 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. Decoration is carried out as required 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 bedrooms, which are all en-suite. Two of the bedrooms have overhead tracking in place. There are adequate furnishings in each bedroom. A new oven has also recently been installed. The garden is being redeveloped to incorporate more defined seating areas. The garden will be further enhanced by a recently donated garden feature, which will be installed by the maintenance department. A new area of paving has been laid and a new flowerbed has been created. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 14 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): 31,32,34,35,36 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 which describes their role and copies are kept on file. All staff receive comprehensive training to update their skills to ensure an approach which is knowledgeable and sensitive. Staff spoken to during the inspection confirmed that they had received a wide variety of training including POVA, First Aid, Moving & Handling, Autism, Working With Families and SCIP training. NVQ training continues to be undertaken by a number of staff in the home. There are thorough recruitment procedures to ensure that only appropriate people are employed. References and CRB checks are received prior to employment. The operations manager stated that there are vacancies for two whole time equivalent support workers and recruitment for these posts is underway. Staff confirmed that they felt supported and that they were now receiving regular recorded supervision sessions and the manager has improved this aspect of the home to meet the requirments of this standard.. Evidence of recent supervision sessions was seen during the inspection . The staff have access to specialist input regarding sevice user needs as required. There is an Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 15 annual staff appraisal procedure in place and staff receive a copy of the home’s grievance and disciplinary procedure as part of their induction. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 16 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): 37,38,41,42 The manager provides support and guidance to staff to ensure that service users receive good quality care. EVIDENCE: The registered manager updates her knowledge and skills on an ongoing basis and she continues inworking towards completing an NVQ level 4 in Management and Care to improve her skills and she has a more confident management approach. The staff spoken to during the inspection confirmed that the manager isand supportive and encouraged them to raise issues and proactively participate in the development of the service. Staff training is given high priority in the home which is reflected in the well co-ordinated programme which is monitored by one of the senior carers. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 17 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. Fire safety records were seen during the inspection and although there have been some improvements records showed some gaps in the recording. The recording format for fire testing needs to be clear and new forms need to be implemented to show the appropriate intervals of testing for fire alarms and emergency lighting. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alder Close (20) Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 2 X DS0000050387.V260215.R01.S.doc Version 5.0 Page 19 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 2 Standard YA42 YA6 Regulation 23 4 (c) (v) 15 (2) (b) Timescale for action Weekly fire alarm tasting need to 22/11/05 be carried out with appropriate records kept. Service user plans need to be 31/01/05 reviewed at regular intervals. Requirement 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 YA2 Good Practice Recommendations A maximum length of stay should be in place to ensure that longer-term stays in the home do not block regular respite placements. Alder Close (20) DS0000050387.V260215.R01.S.doc Version 5.0 Page 20 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.V260215.R01.S.doc Version 5.0 Page 21 - 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. 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