Inspection on 11/05/05 for Aldercar Care Home

This inspection was carried out on 11th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Aldercar Care Home 16/08/07

Aldercar Care Home 06/07/06

Aldercar Care Home 09/01/06

Aldercar Care Home 25/10/04

Aldercar Care Home 28/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Aldercar Care Home 36 Wood Lane Hucknall Nottingham NG15 6LR Lead Inspector Elaine Cray Unannounced 11 May 2005 09:00 th 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 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. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Aldercar Care Home Address 36 Wood Lane Hucknall Nottingham NG15 6LR 0115 963 7797 0115 956 6531 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) Mrs Amirchetty Anuradha Rao Mrs Amirchetty Anuradha Rao CRH 28 Category(ies) of OP Old Age - Both Male and Female - 28 places. registration, with number of places Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25th October 2004 Brief Description of the Service: Aldercar is 28 bedded home offering personal care to 28 older people. The home is located in a quiet residential area in Hucknall, a small town, which has local community facilites, shops and there is easy access to public transport. The home is set in attractive gardens, providing a pleasant outlook for the majority of bedrooms and communal areas. There are 2 double and 24 single bedrooms. The majoirty of the bedrooms are available on the ground floor and a stair lift provides access to the four single rooms available on the first floor of the home. There is a choice of lounge areas, including a conservatory. There is a variety of aids and adaptations throughout the home, including assisted bathing facilities. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 11th May 2005 over a period of 5 hours. The owner/manager was present for part of the visit and the deputy care manager and staff provided information throughout the visit. Twelve residents and one relative were spoken with and all expressed a high level of satisfaction with the care provided in the home. A team of District Nurses were present in home carrying out a six monthly continence assessment on several residents and their views on the home have contributed to this report. Four care plans and a variety of records were inspected and a partial tour of the building was made. What the service does well: Aldercar offers a homely and well maintained environment. The manager and staff encourage residents to be as independent as possible and to be part of the day to day running of the home. Residents are treated with a high level of dignity and respect and staff have an excellent understanding of the individual needs, preferences and personalities of each resident. There is a warm rapport between staff and residents. Residents presented as well groomed and there was lots of conversation and laughing between residents and the staff. Residents liked living at the home, they said they were happy, the staff were “wonderful” and several individuals stated that their emotional and physical well being had improved since living at the home. Care plans are comprehensive and form a good basis for an assessment of need and to provide the day to day support to enable residents to maintain their independence and be provided with appropriate care and support. Health care needs are well met and the staff at the home liaises well with health care and medical agencies. The manager and staff form a cohesive team, with good communication between themselves, with the residents and with other professionals. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 6 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. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 5 The home provides accurate information about the services available to prospective service users, relatives and representatives, who are able to visit the home to look around and meet the manager, residents and staff to discuss the prospective service user’s needs and to find out about the running of the home. EVIDENCE: The home has a Statement of Purpose which sets out the services available in the home and how the home is managed and staffed. There is a Service User Guide, which describes the facilities in the home, outlines terms and conditions and provides information about how the home is run, expectations of services and how to complain. Many of the staff and residents are from the local Hucknall community and were therefore familiar with the home and it’s existence within the local community prior to living or working there. The owner and manager provided a welcoming and sensitive approach to providing as much information and reassurance as possible to prospective residents and their families and/or representatives. The Service User Guide can be sent to prospective service users and is displayed in the entrance hall. The manager stated that a copy Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 9 will also be placed in each bedroom of the home. Residents confirmed that prospective residents and their families may visit as much as they wish before choosing to move into the home. Residents were particularly pleased with how helpful and reassuring the manager and staff were when they moved into the home. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. The health care and medical needs were identified, well met and promoted. The home had made very good progress in improving the policies and procedures for managing, giving out and recording most aspects of residents’ medication. However, some minor adjustments are still required. There is a warm and interactive rapport in the home and residents are treated with respect and dignity. EVIDENCE: Four care plans were viewed on this inspection. Medical histories, health assessments and how and who were involved in meeting these needs were comprehensively recorded in each plan. The manager and staff on duty at the time of this inspection provided a clear and detailed insight into the medical and health needs of the residents. Residents, relatives and visiting professionals were very pleased with the health care and support provided by the home. Several residents commented that their health has improved greatly since living at the home. A relative commented that the home communicates well about the health needs of her relative. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 11 On the day of this inspection, district nurses were carrying out a six monthly incontinence assessment for several service users. A district nurse stated that the health care needs of the residents are very well organised by the staff, who are always “on the ball” and aware of the medical conditions of residents. The district nurse also commented that staff are quick to identify, report and alert the medical professionals to any change in health. The regular visits and details of consultations made by doctors, district nurses, the optician, chiropodist and other medical professionals are recorded. Records provided evidence that the home liaises with relevant medical agencies to seek advice and further consultation when necessary. Some service users manage their own medication and these individuals have signed risk assessment records and have a lockable storage facility in their bedrooms. The lunchtime giving out of medication was observed on this inspection and the two members of staff demonstrated a thorough knowledge of the policies and procedures relating to managing medication. However, some medication had been placed in the medication trolley and whilst staff on duty knew what the medication was and who it was for, it was not labelled as it had been removed from the original box. On the whole, medication was well recorded, however, on one occasion the balance between the daily medication record, the controlled drugs book and the record for drugs returned to the pharmacy did not tally. There was a warm and respectful rapport between the staff and residents. Staff were observed to provide a sensitive level of care in terms of ensuring the privacy and dignity of residents is respected. The district nurse reinforced this by commenting that residents are always seen in their own room and whilst staff are always present to reassure the resident, the individual is always encouraged to give the nurse their own views and concerns. Residents said that staff were very polite and kind, knocking on bedroom doors and speaking to people with respect. Residents said that staff help with personal care and take their wishes around privacy into account. One resident commented that staff “have the knack of knowing just when to come in and help and then to leave so that I can still have my privacy and do my own bits”. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14 and 15 This home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents. There is a strong community network between the staff, residents and relatives as many individuals in the home originate from the local community and residents are encouraged and helped to maintain contact with family, friends and community networks. Catering arrangements were well managed and provide residents with regular and a well balanced choice of meals in a pleasant and social environment. EVIDENCE: Care plans documented the residents’ cultural, religious, social and family arrangements and preferences. Staff had an in depth and individualistic knowledge of the likes, dislikes and dispositions of all the residents living in the home. This knowledge was reflected in their personal approaches to residents, understanding who liked to be private and quiet, who liked to join in and have a joke and those individuals who were unable to fully communicate their needs and needed more guidance or help in expressing their wishes and views. All the residents spoken with on this visit happily commented on the warm and friendly approaches in the home, stating that they can choose how and when they do things; like getting up, where and who they sit with, joining in Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 13 activities, such as bingo and skittles and when and how they would like to go, or be helped to go, to bed. Some residents go out independently in the community, enjoying visits to the pub or to family and friends. The Visitors Book, residents and a relative confirmed that a variety of visitors arrive and are welcomed at the home. Residents confirmed that they can go to regular residents’ meeting, where they can talk about the running of the home, things they would like and express their views about the meals and menus. Residents also stated that they feel able to and are encouraged to maintain their own independence. For example one resident goes out as he pleases, another stated that she likes to have a lie down in the afternoon after managing her own medication, another enjoys helping out in the dining room and garden and on this inspection two ladies informed the inspector that they normally like one lounge as it is a bit quieter, but on this day took themselves off to another lounge as “it is more livelier”. The mealtime was a pleasant and social time, with well prepared food and residents chatting to each other and staff. Residents said that the cook asks them for their choice from the menu on a daily basis. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 and 18 The staff have a clear awareness of the need to provide a safe environment for residents. The procedures for the protection of residents from abuse are well managed by the home. Residents are confident that they are able to express any concerns to the owner, manager, staff and relatives and that these matters will be addressed. EVIDENCE: The home’s Protection from Abuse procedures are comprehensive and have been improved to include reference to the Nottinghamshire Adult Protection procedures and the role of the Commission for Social Care Inspection within the procedures. The manager and staff presented a good understanding of the vulnerability of older people living at the home, the need for consistent observation, individual assessment of risk and providing a safe environment. Risk assessments were well documented within the care planning format. The complaints procedure is displayed in the home and included in the Service User Guide. All residents spoken with on this inspection presented a clear confidence that they could discuss any concern with the owner, manager and staff in the home. They felt listened to and whilst many had no reason to complain, residents felt that every effort was made by the staff to rectify any concerns. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 15 The inspector experienced a group of residents who were able to say what they felt. The majority of residents queried who the inspector was and independently invited her to discuss the running of the home. There was a clear theme of empowerment running through the home. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24 and 26 The home presents as well maintained, homely, well decorated, comfortable and exceptionally clean. EVIDENCE: All lounges and the dining room were viewed and presented as clean, well decorated and very homely, with comfortable furnishings, lots of picture, ornaments, plants and flowers. Whilst a full tour of the home was not carried out, a number of bedrooms were viewed. Each bedroom presented its own individual style, dependent on the wishes and likes of the resident. All bedrooms were well furnished, safely maintained, well decorated and clean. Residents said they liked their bedrooms, the choice of lounges available and they were particularly complimentary about the well kept gardens and views from the majority of rooms in the home. Some minor damage to a carpet in one of the corridors was noticed on this inspection Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 The staffing arrangements in the home are well managed and staff working there are able to meet the needs of the residents. EVIDENCE: On the day of this inspection, the home was adequately staffed. The manager and many of the staff have worked at the home for an extensive period of time and provide a good level of experience. Regular training, including NVQ, is provided and the manager is developing a staff supervision system. All the residents spoken with on this visit gave positive comments about the staff, using terms such as “wonderful”, “they kill you with kindness”, “so hardworking and kind” and “can’t do enough for you”. All residents felt safe and well looked after, with staff encouraging them to be independent and providing support when needed and requested. Discussion with the manager and staff demonstrated that staff were knowledgeable about the needs of the residents, were aware of the policies and procedures of the home and the inspector observed appropriate care practices throughout the inspection. Care plans were well documented and staff were observed to be carrying out tasks according to information given in the care plan and District Nurse notes. The district nurse also spoke highly about the knowledge and caring commitment of the staff working at the home. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36 and 37 The management of the home was well organised, with clear lines of accountability, roles and responsibilities. Records were, on the whole, well maintained, accurate and up to date. EVIDENCE: The owner of the home is also the manager and delegates much of the care management to the deputy manager, who is known as the care manager. The manager was present for a period of time throughout this inspection. The care manager was present throughout the visit and had a thorough knowledge of the management and administration systems and the running of the home. The owner/manager is present at the home on a daily basis. The owner, care manager and staff were observed to maintain positive relationships. The majority of staff have worked together for an extensive period of time and the staff team provides positive and informal support to each other. The manager and staff reported that information about the needs of the residents and the Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 19 routines in the home are shared on a daily basis and this was evidenced by the inspector. The care manager has introduced a formal staff supervision system, which includes a recording format. These supervision sessions, whilst well handled, have not been as regular as required. Record keeping in the home was detailed, accurate and up to date. Policies and procedures had been updated, care plans were very comprehensive and practical for the day to day care for each resident and other required records were available in the home. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x 3 x 4 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x 2 3 x Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13.2 Requirement Ensure the recording of all drugs administered in the home is carried out accurately and consistently. Ensure medication remains in the relevant labelled box and not decanted into a communal container. Repair the damaged carpet in the corridor. Ensure that formal staff supervision is provided as recommended by the national minimum standard of at least 6 sessions per year. Timescale for action 30th June 2005 30th June 2005 30th June 2005 30th September 2005 2. 9 13.2 3. 4. 19 36 23.2 (b) 18.2 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 8 10 Good Practice Recommendations Bumpers to be used with bedrails. This recommendation is outstanding from the previous inspection. Facilities should be in place to enable residents with hearing difficulties to use the pay phone. This recommendation is outstanding from the previous inspection. The care manager reported that the telephone C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 22 Aldercar Care Home company had been contacted but could not provide the facility. Further research should be addressed. Aldercar Care Home C53 C03 S8615 Aldercar V225489 110505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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