Inspection on 05/07/05 for Alder Close (20)

This inspection was carried out on 5th July 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 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

Alder Close (20) 27/11/08

Alder Close (20) 15/05/06

Alder Close (20) 22/11/05

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 05 July 2005 @ 10:00 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 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 Stationary 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alder Close (20) Address 20 Alder Close, March, Cambridgeshire, PE15 8PY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01354 654146 01354 657905 na Cambridgeshire Social Services Margaret Hill Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 15/2/05 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. The home is situated one mile north of March town centre where service users have access to a variety of shops and leisure facilities. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 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 5th July 2005 and was the first inspection of the home for the year 2005/6. The inspector met with the manager and operations manager. 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 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 standard(s) 1,2,5 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 Manager stated that both of these documents are reviewed as part of an ongoing and developed so that information is more accessible to service users. A photo-board showing staff members is displayed in the corridor. The contract for service users has also been produced in a pictorial version to aid service users understanding of terms and conditions whilst they are receiving respite care services. The home provides 5 beds for respite care for usually up to two weeks in length. All referrals are made through Social Services. There are approximately 30 service users who are accessing the service throughout the year. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 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 standard(s) 6,7,9,10 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 9 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 for a number of years and their original assessment details are not on file but the manager stated that all new referrals have appropriate assessment information held on file. All service users have a key worker and they are involved in care planning and their daily living skills as much as possible. Service user plans are person centred and reviewed regularly along with 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. It was noted, however that some entries were not signed and dated. Care plan reviews sheets would give more space to record where changes in care or services have been made. Records are kept securely and are kept in an accessible format. Relatives can be involved in the review process if they and the service user wish them to. The manager and senior carer have received care planning training, which will be cascaded to the staff team. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 10 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 standard(s) 11,12,13,14,17, 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 11 The majority of service users are involved in organised day services during the week. Information regarding local activities and events are advertised and encouraged by staff. The staff are actively involved with service users both in and outside the home. 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. There are also organised in-house activities including board games, cookery and craft sessions. Three service users spoken to during the inspection confirmed that they had regular access to the local community and facilities as detailed with staff assistance. During the day of inspection one of the service users was assisting with cooking the evening meal with a member of staff and one service user was watching television in the communal lounge and another service user was listening to music in her bedroom. There is a television, video, DVD and music facilities available to service users. There are barbecues held in the garden during the summer months. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 12 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 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 registered 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, 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. Three service users spoken to were complimentary about the services and support they receive and they all stated that they looked forward to the occasions that they received respite care in the home. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 13 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 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 inspector was shown a letter from the parents of one service user complimenting the supportive services that had been received. 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 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 14 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 standard(s) 24,25,27,28,29,30 The environment is homely and clean and suitable for the needs of those living in the home. EVIDENCE: Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 15 The bedrooms and communal rooms are maintained to a good standard and they are presented in a bright and homely manner. 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. Due to the short nature of each placement it is difficult for rooms to be personalised to meet individual tastes but 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. New fencing has been erected to give greater definition to the garden areas. There are plans to create an entrance from the dining room, which will lead to a patio area including wheelchair access for service users. It was noted during the inspection that carpets in the hallway and entrance areas have become stained. The manager said that a contract cleaner visits the home to professionally clean all carpets and he was due to visit later in the week. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34,35,38 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, Epilepsy, Dealing With Challenging Behaviours, NVQ 2 & 3 and LDAFF. The home has thorough recruitment procedures to ensure that only appropriate people are employed. References and CRB checks are received prior to employment. Staff confirmed that they felt supported but were not receiving recorded supervision meetings. The manager stated that this was an area that would be improved to meet the requirments of this standard. The staff have access to specialist input regarding sevice user needs as required. There is an annual staff appraisal procedure in place and staff receive a copy of the home’s grievance and disciplinary procedure as part of the induction process. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42 The manager provides support and guidance to staff to ensure that service users receive good quality care. EVIDENCE: The registered manager has worked in the respite service for a number of years and updates her knowledge and skills on an ongoing basis and she is currently working towards completing an NVQ level 4 in Management and Care. The manager has improved her skills and she has a more confident management approach. She creates an open and supportive atmosphere and staff confirmed during the inspection that they felt supported and encouraged to raise issues and participate in the development of the service. Staff training is given high priority in the home which is reflected in the individual staff files and confirmed by staff during the day. 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. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 18 Fire safety records were seen during the inspection and improvements in weekly alarm testing need to be made as records showed gaps in a number of weeks over the last 6 months. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 19 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 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alder Close (20) Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 20 none 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. 3. Standard 6&9 36 42 Regulation 15(2)(b) 18(2) 23(4)9C0 (v) Requirement Service user plans and risk assessments must be reviewed to include signatures and dates. Care staf must recieve recorded supervisions on at least six occasions during the year Weekly testing of fire alarms must be carried out and appropriate records maintained Timescale for action 31st August 2005 31st August 2005 With immediate effect ie 5th July 2005 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 37 Good Practice Recommendations It is recommended that staff files are stored in a format to make information more accessible. Alder Close (20) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 21 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Canbridge 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) I53 I03 50387 ALDER CLOSE 20 V236358 050705 STAGE 4.doc Version 1.40 Page 22 - 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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