Inspection on 09/03/07 for Alderbank Community Care Centre

This inspection was carried out on 9th March 2007.

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 22/02/06

Alderbank Community Care Centre 26/10/05

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 Sarah Tomlinson Unannounced Inspection 9th March 2007 07:30 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.V312829.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alderbank Community Care Centre Address Melville Road Kearsley Bolton Lancashire BL4 8JD 01204 337791 01204 337794 mandy.woods1@bolton.gov.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bolton Metropolitan Borough Council Mandy Woods 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.V312829.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users who can be accommodated is 26. Date of last inspection 22nd February 2006 Brief Description of the Service: Alderbank is owned by Bolton Council and is run by their Social Services department. It provides care for up to 26 older people. At the present time the home has 21 places for intermediate (rehabilitation) care (a 6 week maximum stay); 1 interim place (for an ‘intermediate care resident’ who needs longer than 6 weeks to recover); and 4 short stay/respite care places. The home also provides a day care service for older people seven days a week. Social Services and the Primary Care Trust jointly provide the intermediate care service at Alderbank. Care is provided to these residents by an onsite team of nursing, physiotherapy, occupational therapy, social workers, carers and specialist support staff. Alderbank is in a residential area of Kearlsey, about 4 miles from Bolton town centre. The home is purpose built, on one level ground floor. It has 26 single bedrooms, all with washing facilities. The home is divided into 3 care units (pink, blue and green), each with their own lounges and dining areas. There is also a large central dining/lounge area (shared with the day care service). There is a central, enclosed garden and a patio area with seating. Limited parking is available at the front of the building. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit, which the home was not told about beforehand, lasted ten hours. During this time we watched what was going on and talked to 7 residents, 1 visitor, 2 care supervisors, 6 carers, a receptionist, a cook, a domestic and the laundry assistant. (The manager was on leave. However, we later telephoned her to discuss our inspection findings). We also looked around parts of the building and at some of the home’s paperwork. Seven relatives and 3 residents had previously returned comment cards to us about the home, and their views are also included. Since the previous inspection visit, our pharmacy inspector had also visited the home. What the service does well: What has improved since the last inspection? Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 6 Changes to how medicines were looked after had made things safer for residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team worked hard to assess, prepare for and welcome new residents, thereby promoting the safety and well being of all the home’s residents. EVIDENCE: Due to the intermediate and respite care services provided, the home was always very busy; with a frequently changing resident population. New residents were initially welcomed and admitted by a care supervisor or an assistant practitioner before being taken to one of the care units, where they were then looked after and settled in by a carer. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 9 With regard to trial visits, intermediate care residents usually arrived at short notice, direct from hospital. However, a ‘respite resident’ confirmed they had been able to look around the home before deciding to come and stay. A copy of the home’s Service User’s Guide (brochure) was kept in each bedroom. Good practice was noted, as it was well presented, easy to read and written in large font size (as standard). Both this and the home’s Statement of Purpose will need to be updated to reflect the new manager (it also incorrectly stated that long term care was provided and referred to us as NCSC rather than CSCI). We advised the Statement of Purpose did not need to be displayed and was not meant for residents, as it was a ‘technical’ document, to be used for contract purposes etc. Three care files were examined (two from intermediate care and one from the respite care service). All had detailed assessment information received prior to admission. The pressure to take intermediate care admissions was discussed with the manager, who confirmed herself and her management team felt confident to refuse admissions when the prospective resident’s needs could not be safely and fully met (e.g. due to staffing/dependency levels). The manager said admissions were not limited to one per day; two were taken where it was felt safe and the home had capacity to do so. Occasional incidents of a prospective resident’s dependency levels and care needs being much greater and more complex on admission than described on referral were formally reported back to the hospital. Good practice was noted, as the home had previously worked with referring units so their staff could gain a better understanding of where patients were being discharged. We advised it maybe worthwhile now repeating this exercise. The specialised rehabilitation programme provided to ‘intermediate care residents’ aimed to help them regain their independence after a period of incapacity/illness and so return home. The programme included exercises, washing and dressing practice and home visits provided by a multidisciplinary team that included nurses, physiotherapists and occupational therapists. It was provided for a maximum of six weeks, with one interim care bed being available if longer than this was needed. In addition to going through the Service User’s Guide with new residents, an admission checklist had been introduced. Staff felt this new form was helpful and worked well. Good practice was noted, as care staff were very aware how overwhelming it could be for a new intermediate care resident and they worked hard to minimise this. Ways of developing this further were discussed, as we noticed residents who had been at the home a few days being unable to remember their room number or understand all the different uniforms. For example, the white boards used in dining areas as a memory aid for staff (regarding resident/room number/preferred drink etc), could be there for residents’ use too (we observed one resident telling another to refer to it to remember their room number). A brief reminder session could be held with Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 10 new residents a couple of days after admission where (some of) the ‘welcome’ information was repeated. Uniform boards/cards could be displayed to explain the different staff groups, plus the clarity and usefulness (for residents) of staff identity cards could be improved. Good practice was noted, as the manager had ordered different uniforms for domestic and laundry staff, who currently wore the same as carers (which caused confusion at times). Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care practices and generally satisfactory record keeping promoted residents’ health and wellbeing. EVIDENCE: Three care files were examined. Care information and risk assessments were in place and generally reviewed regularly. However, the risk assessment for a resident who was experiencing a high number of falls had not been reviewed recently and did not provide enough guidance (particularly for night staff) in how to manage this risk. Some care plans had not been dated or signed on completion and a pressure area risk assessment had not been completed for another resident. With regard to the intermediate care service, after an initial care plan summary was completed, a ‘skills plan’ was then used as the main care Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 12 document. This was a brief summary of the resident’s abilities and care needs, and was written in plain language. Care staff found both this and the risk assessments useful in informing them of residents’ care needs. The skills plan was produced by Primary Care Trust staff and reviewed at a weekly multidisciplinary team meeting, with an up to date copy displayed in the resident’s bedroom. All the intermediate care staff team also completed just one set of combined daily care notes. Although residents were not signing care plan summaries and skills plans, there was clear evidence of residents being involved in their care. The health care needs of intermediate care residents were monitored and met by the onsite nursing team and twice-weekly visits by medical staff. Residents receiving respite care used GP and district nurse services. The home had experienced two outbreaks of vomiting and diarrhoea over winter. Good practice was noted, as the community infection control nurse specialist praised the staff response on both occasions - “well done to …staff for their hard work in containing the infection”; “staff were prompt in identifying a problem”. The pharmacy inspector had visited the home in August 2006, resulting in several improvements being required and recommended. These were checked on this visit and had generally been made. The new medication policy was now in place and staff were starting to attend training about it. Levels of unwanted medicines were now being promptly returned to the pharmacist, with clear records kept. The handwritten medication administration records were now being signed, checked and countersigned. The recommendation to keep a list of signatures and initials of staff who were authorised to handle medication had not yet been implemented. Medicines were kept safely in two locked trolleys, which were secured in the medication room when not in use (the second trolley had recently been bought to improve efficiency). Stock levels of controlled drugs were checked and found to be correct. However, we advised a new controlled drug register was obtained, so records showed only one balance for each medicine held (the current system showed two (stock and current use). Photographs of residents were in place. Eye drops were being dated on first opening. Good practice was noted, as the Primary Care Trust pharmacist met all ‘intermediate care’ residents shortly after their admission to review their medication and to assess and support their ability to self-administrate. With regard to how staff treated and looked after residents, all residents spoken with were very positive (“the care is much better than I got in hospital”; “nothing is too much trouble”; “I felt very welcomed”; “perfect, I couldn’t fault it”; “I have nothing but praise for the care and attention I have received”). Staff were observed speaking to residents in a very warm, kind, caring and respectful manner. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Whilst visitors and meal times were welcomed part of daily life, satisfaction with the low level of social activities needs to be confirmed to ensure the needs of residents were being met. EVIDENCE: Residents had mixed views about the need for social activities to be provided. Generally, they were happy doing their rehabilitation exercises and then resting/seeing visitors. Others watched television. However, some said they had enjoyed group activities when provided and would like more. Residents were able to join in activities taking place with the day care service, but it was unclear whether residents felt able to do this and how often it actually happened. Within its quality assurance framework, the home could consider trialling different group activities and monitoring their success. Specific questions could also be asked in residents’ surveys. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 14 With regard to watching television, we advised the number of television remote controls needed reviewing (with a view to having more). They were not available for all the televisions and when a resident (with mobility difficulties) had used the call system to ask a carer to change the channel (as the remote control was not available), they had been told that this was an inappropriate use of the call system. As a reflection of the services provided, there were a high number of visitors. They felt they were made welcome, could see their relative in private and were kept informed of their health and welfare. One visitor said how they had been told to make themselves at home and felt very comfortable visiting. Another had commented after having three relatives stay at the home they had been “very pleased with all aspects of their care and the attention of staff”. Feedback from residents had been very positive about food, with one resident saying it was “excellent”. Apart from the teatime meal, residents ate in one of small lounge/dining areas, with a hot trolley serving each. These dining areas provided a pleasant setting, with table cloths, cups and saucers used. Cloth napkins were available, although they were often not used as carers said many residents preferred to use paper towels (we suggested the use of paper napkins could be considered). To promote a more social occasion, the evening teatime meal was served in the main dining area (used by day services during the day), with residents from all the individual units coming together. Good practice was noted, as this meal was usually hot (rather than just sandwiches), with a choice usually being available. A single choice menu was used for the main lunchtime meal. However, the cook confirmed an alternative was always made if requested. We advised the home should consider offering at least two vegetables with the lunchtime meal. Residents’ likes and dislikes and dietary needs were known by care staff and were also seen written in the kitchen. Good practice was noted, as the cook was aware to keep items in pureed meals separate (to maintain taste, texture and appearance). The home’s standard use of half fat milk was also discussed. We advised full fat milk should be considered because generally, residents’ nutritional needs would be better met. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for protecting residents from abuse or harm and for taking any concerns seriously were in place. EVIDENCE: A copy of the home’s complaints procedure continued to be displayed in the entrance and within the Service User’s Guide (it now needs updating with the new CSCI address). No complaints had been made to the home or to CSCI since the last inspection. The manager was planning to record more minor, informal issues that arose from the quality assurance surveys (to show they had been taken seriously and acted upon). We advised these could be recorded within one complaints record book (which contained both formal and informal complaints/concerns). This would enable any issues and patterns to be monitored over time, whilst also providing evidence of the home’s openness and its ability to put things right where necessary. Staff received abuse awareness training during their induction and when undertaking the NVQ award. Refresher training for any staff not undertaking the award should be considered. We also advised that general assistants, who carried out domestic and laundry duties, should also receive such training. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided residents with an attractive, comfortable, safe and homely place to live. EVIDENCE: Alderbank was bright and welcoming. There was a good standard of décor and furnishings, which were domestic in style. Good practice was noted, as wallpaper continued to be used in corridors, lounge/dining areas and bedrooms, helping the building appear more homely and comfortable. The building had been designed to provide more domestic, small group living environments, with the home divided into three units – pink, blue and green. Each had its own lounge/dining areas, bedrooms and washing facilities. The Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 17 green unit had two separate lounge/dining areas – one for residents receiving intermediate care and one for residents receiving respite care. A very good standard of hygiene was found throughout the home, with no malodour, which residents and visitors confirmed was usual. Liquid soap and paper towels were provided throughout. As noted previously, the community infection control nurse specialist had praised the domestic and care staff team in their efficient response to two outbreaks of vomiting and diarrhoea over the winter. An extensive range of aids and equipment was available. Whilst most was standard equipment (e.g. grab rails in corridors and toilets, commodes, raised toilet seats), following assessments from the onsite physiotherapists and occupational therapists, much was also provided on an individual basis, whereby after being trained to use it at Alderbank, the resident then took it home. Good practice was noted, as four new rise and fall beds had been purchased since the last inspection. The lack of dining room chairs with glide rails was discussed. The manager confirmed that funding had been secured for the refurbishment of the main dining room, which would include the provision of such chairs. We advised these should be provided throughout the home. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from good staffing levels, which were responsive to their needs and provided by an experienced, skilled and competent care team. EVIDENCE: On the day of the inspection enough staff were on duty to meet the needs of the residents. Good practice was noted, as whilst rotas indicated an acceptable level of staff, additional staff were being provided in response to the needs of residents. At the previous two inspections staff had felt staffing levels were sometimes insufficient. At this inspection staff generally felt they had enough time to care for residents without feeling rushed. However, staff did feel staffing levels in the green unit could be higher at times, as sometimes one staff member had to work across both lounges. We advised this situation must be monitored. Also, when a new admission arrived at meal times they felt it was difficult to manage the meal whilst also settling in the new resident. There was a low staff turnover with the staff team remaining stable. There were vacancies for two carers (2 x 17 hours), one general assistant (16 hours) and one kitchen assistant (16 hours). The manager was aware of the need to Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 19 fill these vacancies as soon as possible. There was some sickness within the management team, with two of the four care supervisors being off. Four carers were acting up to cover these absences. There had also been a vacancy for a receptionist (16 hours). Although the two existing receptionists tried to cover as much of the 7-day week, daytime rota as possible, inevitably there were gaps. This resulted in the care supervisor usually having to unlock the front door for visitors. We were concerned that Bolton Social Services had now withdrawn this vacancy. We advised that as Alderbank was such a busy home with a high number of visitors, a staffed reception seven days a week was essential during office and weekend daytime hours, and it was not acceptable to rely on care staff to fulfil this function. With regard to NVQ training, good practice was noted as the manager had confirmed 77 of the care staff had NVQ level 2 or above. We requested staff training records, however these were not routinely kept in the home. Some information was sent to us soon after, which confirmed that staff were receiving mandatory moving and handling and fire safety training. Although individual staff training records were held centrally by Bolton Social Services training department, we advised that this information also needs to be kept in the home (Schedule 4 (6) (g) of the Care Homes Regulations 2001). The manager recognised the system could be improved and intended to keep onsite individual training records. Good practice was noted, as staff were also attending additional courses (e.g. catheter care, infection control, continence awareness training) and domestic staff had received infection control training. Consideration could also be given to using the skills and knowledge within the onsite PCT staff team, by introducing in-house teaching sessions (e.g. orthopaedic care, oedema awareness, etc) (which would contribute towards meeting individual training targets). Further good practice was noted as we observed staff interactions with residents performed in a skilled and competent manner. We could not assess Standard 29 as recruitment records were held centrally by Bolton Social Services. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff benefited from a home that was well managed and well organised, with a manager who had created a culture of openness, involvement and respect. EVIDENCE: The acting manager, Ms Mandy Woods was about to be confirmed by us as the new Registered Manager (12 March 2007). Ms Woods had been in post as the acting manager since June 2005. She had then taken maternity leave before returning in February 2006. Ms Woods already had a management Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 21 qualification (NVQ level 4) and was about to complete a NVQ level 4 award in care. The open and inclusive atmosphere within the home impressed us. Staff were motivated, felt involved and listened to (e.g. as noted previously, staffing levels were increased when requested) and got to know what was going on in the home. “Staff work well together, we’re a good team…if we have any problems they get sorted out”; “I love it here, I’m always looking for improvements”; “it’s a good place to work”; “its not and us and them [regarding care staff and PCT staff], we work together”. Staff confirmed the manager was “very approachable and helpful”. Regular staff meetings were held. Staff were able to contribute to agendas and minutes were made available afterwards (displayed in the staff room). Staff confirmed they received regular, individual supervision. The home had an ongoing quality assurance programme, whereby surveys were posted to all residents after discharge. Results were collated on a monthly basis and displayed in the entrance (although these were in very small print). Good practice was noted, as the manager intended to show how any complaints or suggestions for improvements were followed up and acted upon. Cash balances were held on some residents’ behalf. These were being stored safely and securely, with appropriate records kept. Four balances were checked at random. Although two were correct, two were not (these were minor inaccuracies, one £2.00 too much, one £3.00 short). The manager was aware of the need for all balances to be correct. The manager had ‘inherited’ some unclaimed valuables left from previous residents. We advised the manager needed to try and trace the owners by advertising both in the home and in local newspapers. If this was unsuccessful, the items could be disposed of and the money raised donated to the home’s entertainment fund. Clear records should be kept of these transactions and further guidance sought if any item of high value was identified. The manager was aware there needed to be a clear recording system for any new valuables left with the home (as detailed in Schedule 4 (9) of the Care Homes Regulations 2001). From information provided by the manager and from records checked during the inspection, safety checks had been carried out on hoists, the gas boiler, the fire alarm and fire equipment and the electrical wiring (8/10/04 - valid for 5 years). The fire alarm was sounded weekly. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 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 3 X 3 X 3 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 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 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 OP1 Regulation 4 (1) (2), 5 (1) (2) Requirement The Service User’s Guide and the Statement of Purpose must be updated to ensure all prospective and new residents receive correct information about who manages the home and the type of care provided (with copies provided to CSCI). Timescale for action 30/07/07 2. OP8 14 (2) 3 OP27 18 (1) (a) Risk assessments must be kept 30/04/07 up to date to promote residents’ safety and ensure staff receive correct guidance regarding how to manage and/or reduce the risk. To ensure residents’ safety and 30/04/07 wellbeing are maintained, the staffing arrangements of the green unit’s two lounges must be monitored, with additional staff provided where necessary. Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 24 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 2 Refer to Standard OP1 OP9 Good Practice Recommendations Further ways of helping intermediate care residents settle into the home as quickly as possible should be developed. To continue improvements made with medication management, a signature list of staff authorised to handle medication should be maintained. Residents’ expectations and preferences about the provision of social activities should be researched. To provide residents with a real and meaningful choice, at least two vegetables should be served at lunchtime. To ensure residents receive practical support to maximise their independence, budget plans should be made for dining chairs with armrests and glide rails to be provided throughout the home. To ensure the reception can function effectively and appropriately, without relying on care staff, the receptionist vacancy should be reinstated and filled. In order to accurately monitor and respond to staff training needs, individual staff training records should be kept in the home. To demonstrate how feedback received from residents’ surveys was taken seriously, the manager should provide information of any action she takes in response. To improve accuracy and ensure residents’ monies are kept safe, the system of booking money in and out should be reviewed. 3 4 5 OP12 OP15 OP22 6 OP27 7 OP30 8 OP33 9 OP35 Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 25 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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alderbank Community Care Centre DS0000031354.V312829.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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