Inspection on 26/10/05 for Alderbank Community Care Centre

This inspection was carried out on 26th October 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

Alderbank Community Care Centre 10/02/09

Alderbank Community Care Centre 09/03/07

Alderbank Community Care Centre 22/02/06

Alderbank Community Care Centre 15/02/05

Alderbank Community Care Centre 16/09/04

Alderbank Community Care Centre 10/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Alderbank Community Care Centre Melville Road Kearsley Bolton Lancashire BL4 8JD Lead Inspector Stuart Horrocks Unannounced Inspection 26th October 2005 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 Alderbank Community Care Centre DS0000031354.V260281.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 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. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alderbank Community Care Centre Address Melville Road Kearsley Bolton Lancashire BL4 8JD 01204 337791 01204 337794 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) Bolton Metropolitan Borough Council Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission For Social Care Inspection. Staff numbers to be calculated in accordance with the Residential Forum Care Staffing Guidance (Older People) by 1 April 2004. Within the maximum registered number 26, there can be up to 26 (OP) Older People. 15th February 2005 Date of last inspection Brief Description of the Service: Alderbank is owned by Bolton Council and is run by the Social Services Department. At this time the home accommodates only one long stay older person with social care needs. The home is now, and will in the future only be admitting up to 21 older people for intermediate (rehabilitation) care on a short stay basis and four respite beds are also available. The home also provides a day care service for seven days a week. The intermediate care service at Alderbank is jointly provided by Social Services and the Primary Care Trust Aderbank is in a residential area of Bolton on Melville Road Kearsley about four miles from Bolton town centre. The building is one level and there are 26 single bedrooms. The home has four small lounge/dining rooms and there is also a large central dining/lounge area. The home has a central garden and patio area with seating and there is limited parking to the front of the building. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was started at 9.30am.It took place on one day and it lasted for about six and a half hours. The time was split between talking to senior staff and checking records, and looking around the home, watching what was happening and talking to residents, visitors and other staff. Five residents, four visitors and four staff were spoken with. What the service does well: What has improved since the last inspection? Some progress had been made by the staff to make sure that the things, which needed improving from the last inspection, had been done. The information guide for the residents now fully describes the sort of services that Alderbank provides although the section about the home’s management arrangements needs to be changed. The answers from resident’s satisfaction surveys have now been brought together in the form of a report, which makes it easier for the staff to see what is going well and also what may need some attention. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 6 Notices have been placed around the home so that should someone have any concerns they will now know how to go about getting such concerns dealt with. 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. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 6. The homes Statement of Purpose and the Service User Guide do generally give prospective residents and their relative’s useful information about the services that the home provides so that they can make an knowledgeable decision about coming to live at Alderbank. The home’s intermediate care service helps people independence so that they can return to live at home. EVIDENCE: A Statement of Purpose (what the home does) and Service User Guide (residents information guide) were seen to be available. A requirement of the last inspection was the home had to partly re-write these documents so that they fully described both that the Intermediate Care Service is the main function of the home and that they also described the home’s management arrangements. The inspector looked at the above documents to find that most of the required alterations had been made. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 9 to regain their However one area seems to be inaccurate; the above documents appear to refer to the home’s previous manager regarding things such as qualifications and amount of past experience and not to the present acting manager. This will need to be changed. The home’s Intermediate Care Service can accommodate up to 21 older people who need help to get back on their feet after they have been ill so that they can then return to their homes and live independently. This service is jointly provided by Social Services staff employed at Alderbank, and by employees of the Primary Care Trust. A specialist team of workers is available including physiotherapists, occupational therapists, nurses, therapy assistants, care staff, managerial staff, and ancillary staff. At the time of the inspection, there were 21 intermediate care places, four short-term care places, and only one long-term person in residence. . Needs assessments are undertaken and programmes of care are agreed. The rehabilitation programme usually covers for up to a six-week period. Special equipment is provided as necessary and a therapy room is available. The inspector saw that there were separate lounge/dining areas for use by the intermediate care residents. The residents’ progress is regularly reviewed. When residents are discharged from the rehabilitation programme a package of care is put together to make sure that they are supported when they get home. Those residents that the inspector spoke with said that they felt that the assistance that they were being given was “helpful”, that they had “got their confidence back” and that they “felt better” for the help provided. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Proper arrangements are in place that ensures the residents health care needs are monitored and met. Individual care plans and care programmes are in place, which were up to date, regularly reviewed and provided the staff with the information they needed to give a good standard of care. The home’s medication systems are generally satisfactory in ensuring that residents receive medication as prescribed. Care practices in the home ensure that the residents are treated with respect and their privacy and dignity is upheld. EVIDENCE: The inspector looked at the care file for the one long stay resident and also at three care files for residents receiving rehabilitation care. Each care file contained a care plan that described the health; personal and social care needs for the resident. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 11 The care plan for the long stay resident was up to date and it had been reviewed at the required monthly interval. This person’s care file also contained various risk assessments that also were up to date. The files of those residents receiving rehabilitative care contained a wide range of comprehensive assessments, a skills plan and goals plan, all of which are designed to assist the resident in regaining their independence. These are reviewed frequently and a full review of each resident’s progress is held weekly. The staff said that they knew each residents needs by reading the care files, which are readily available to them Talking to residents and the staff and looking at records showed that the resident’s health care needs are taken care of and that when necessary health workers such as doctors, nurses and opticians are called. A number of risk assessments are in place; all of these had been reviewed regularly with the information being up to date. Records also showed that the weight of the residents’ is also regularly checked. Suitable equipment is available for the treatment and prevention of pressure sores and the treatment and progress of pressure sores is correctly recorded. Medicines are properly and safely stored. All medicine when given is recorded on the residents’ drug sheets, these records were properly filled in and they were up to date. The prescription sheets for the giving of medicines are currently filled in handwritten by the home’s senior staff. The safety of this method relies on the staff making sure that the right name and amount of the medicine is written on the prescription sheet. In order to ensure that right details are entered two of the staff at the home usually check and witness the prescription, which they then both initial. In a few instances this had not been done, the staff must remember to do this checking whenever a prescription is made out. Those staff that give out medicines have been given the necessary training for this task. Personal support to residents is offered is such a way so as to promote and protect their privacy, dignity and independence and looking at the home’s satisfaction survey report showed that 100 of the people who were surveyed felt that their dignity was respected. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 12 This was confirmed by a number of residents who said that the staff treated them with respect and that their dignity is valued. Those residents spoken with said that the staff were “respectful”, “considerate”, “pleasant” and that “they (the staff) talk to us properly”. A letter from a family stated that the staff had shown “kindness and respect” to their relative. The staff were seen to deal with the residents in a friendly, comfortable and respectful way. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and15. The home offers some leisure activities, which help to keep the residents interested and stimulated. The visiting arrangements are flexible thus enabling residents to have good contact with family and friends as they please. Residents have choice about their daily routines (e.g. getting up and going to bed times, when to eat) thus they are able to spend much of their time as they wish. The meals at the home are good, offering choice and variety, and catering for individual dietary needs. EVIDENCE: The staff that look after the people who go to the home for day care usually provide some sort of daily recreational activity for them to take part in. These activities include bingo, dominoes, reminiscence sessions and gentle exercises. A basic programme of these activities is available with the day’s events being displayed on a notice board in a large lounge. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 14 Although those residents receiving rehabilitation care are often kept occupied by the care programme that they are following they are free to join in with the above activities. However Alderbank is a busy home and the staff are kept fully occupied with their work and they seem to have only limited time to become involved in providing the residents with social activities. The home must make sure that enough staff are available to provide meaningful activities for the residents on a daily basis. Residents said that they had choice about such things as going to bed and getting up times, which clothes to wear, which lounge they sat in and how they spent their day. They said that were comfortable living at the home and that the home was “relaxed” and “restful”. They are able to, and do bring personal items in to the home such as televisions, radios, photographs, pictures and mobile ‘phones. Discussion with residents and staff confirmed that the visiting arrangements are flexible with these being described in the resident’s information guide. Residents said that “we can see our visitors in our rooms” if they so wish. Visitors were seen to be coming and going from the home throughout the inspection. These people were made welcome and they confirmed that no restrictions on visiting were imposed. The home uses a four weekly menu that offers a choice of good attractive nourishing food. Warm food is always offered at midday and a warm choice is usually also available at teatime. The inspector saw that the midday meal was well presented and looked appetising. The residents were heard to say that the food was “good and warm” and they told the inspector that “there is plenty of it” and that they had “enjoyed the meal”. The home has four small dining rooms that are nicely furnished and they provide a comfortable and homely setting for the residents to eat in. The residents said that drinks and snacks are available at most times of the day and night. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Protection of vulnerable adults guidance is available and staff training in this topic ensures residents are protected from abuse. EVIDENCE: The home has a full copy of the Bolton area inter-agency adult protection policy that gives good, clear and sound guidance to the staff should an abuse situation arise. This document also advises the staff about “whistle-blowing” if they were to find themselves in such a situation. Discussion with the Care Supervisors showed that when such incidents arise they are dealt with quickly and properly. Staff members had received instruction in these topics during the Bolton Social Services induction to the job programme and also during NVQ training. The Authority also provides training on this subject through dedicated sessions. Although the home’s complaints procedure was assessed as being satisfactory at the time of the last inspection a recommendation was made that the home should raise the awareness of the complaints procedure to both residents and relatives. However discussion with residents and relatives at this inspection showed that they were not aware of the complaints process and looking at the home’s satisfaction survey report showed that only 64 of the people who were surveyed were aware of this procedure. However those people spoken with Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 16 said that if necessary they would complain and that they would “talk to the staff” if they had any concerns. The home does have complaints leaflets and details of the complaints procedure are given in the resident’s information guide (Service User Guide) a copy of which was seen in resident’s bedrooms. Following discussion with the Care Supervisors it was agreed that complaints notices would be displayed in various parts of the home in order to increase people’s awareness of the process. This was done during the inspection. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were not examined at this inspection. They will be checked at the next inspection. However the inspector did spend some time walking around the building whilst talking to residents and staff. The home is decorated and furnished to a good standard and it was seen to be well maintained to both the inside and the outside. It should also be noted that key standards 19 and 26 were assessed as being satisfactory at the time of the last inspection. EVIDENCE: Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30. Staffing levels must be reviewed therefore ensuing that the assessed needs of the residents can be met. The staff are properly trained to give the care that the residents need. EVIDENCE: Looking at staff rotas showed that staff are regularly available, although this has at times required that staff work overtime and also required the use of workers provided by staffing agencies. The Care Supervisors and other care staff said that in their opinion there wasn’t always enough staff on duty to do the work required of them. With the sort of service provided at Alderbank the numbers and dependency levels of the residents goes up and down all the time. The staff felt that when the home’s rehabilitation service is fully occupied (21 residents) and if some residents also needed a lot of care then staffing levels at that time are insufficient. They also felt that at times that the numbers of staff available at weekends was also insufficient. The inspector therefore requires that the staffing levels at the home be reviewed. The residents said that the staff were “brilliant”, “cheerful” and “caring” and a letter from a family stated that the “treatment was of the highest standard” and the “best I have ever seen”. A further letter said the care was a “credit to Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 19 you all” and that this family was “kept fully informed” of their relatives progress. Discussion with the staff and the Care Supervisors showed that there is a strong commitment to staff training within Bolton Local Authority. The staff gave examples of the wide range of training that they had done. This included induction to the job training, NVQ assessment, the giving out of medicines, safe moving and handling, fire safety, food hygiene and first aid. The provision of this training was confirmed when looking at staff training records. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 38. Due to the home’s acting manager being away from the home the outcome for this standard has not been able to be assessed (please see text below). The home consults residents about the way that the service is run so that both improvements are made and problems are dealt with. Procedures and practices within the home promote and safeguard the health, safety and welfare of the people living and working in the home. EVIDENCE: The home’s present acting manager is away from the home for personal reasons. The home is therefore currently being run by three Care Supervisors who have been given specific management duties to do until the manager returns, which may be early in 2006.This situation is presently being reviewed by the CSCI. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 21 From this inspection the home appears to be being running in a generally satisfactory manner with the staff saying that they felt supported by the above Care Supervisors who were described as being approachable and helpful. The home presently asks residents about what their experience is of using the home’s Intermediate Care Service. This information can then be used if necessary to bring about changes or improvements to the service. These people are therefore sent a detailed questionnaire shortly after they leave Alderbank, which they are asked to complete and to return to the home by post. A requirement of the previous inspection was that when these questionnaires are returned the answers are brought together in the form of a report so that both good and not so good comments are highlighted and steps could then be taken to deal with any issues. The inspector saw such a report for the month of September 2005 where the comments made were generally positive although some were slightly less so. The home is advised to continue to use this system and to also deal with any shortfall that may need attention. The checking of records and maintenance certificates showed that these were up to date apart from that for the safe working of the home’s small electrical appliances, which had expired. Looking at records and conversations with staff also showed that the necessary training had been provided so that they can work safely. The home is safely maintained with fire precautions tests done weekly and details of accidents are properly written down. Hot water temperatures at sinks are controlled in such a way as to prevent the danger of scalding and radiators are fitted with covers so that safety is ensured. Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 22 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 2 X X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 23 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. 1 Standard 1 Regulation 4 & 5. Timescale for action The Statement of Purpose and 30/11/05 the Service User Guide must be amended so that the current management arrangements of the home are described. Staffing levels must be reviewed 30/11/05 therefore ensuing that the assessed needs (including social needs) of the residents can be met. The certificate veryfying the 30/11/05 safety of the homes portable electrical appliances must be renewed thus ensuring safety. Requirement 2 12 & 27 18. 3 23 38 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 Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Alderbank Community Care Centre DS0000031354.V260281.R01.S.doc Version 5.0 Page 25 - 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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