Inspection on 09/01/06 for Aldercar Care Home

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11/05/05

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 Aldercar Care Home 36 Wood Lane Hucknall Nottingham NG15 6LR Lead Inspector Elaine Cray Unannounced Inspection 10:10 9 January 2006 th 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 Aldercar Care Home DS0000008615.V267886.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. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aldercar Care Home Address Aldercar Care Home 36 Wood Lane Hucknall Nottingham NG15 6LR 0115 9637797 0115 956 6531 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) Mrs Amirchetty Anuradha Rao Mrs Amirchetty Anuradha Rao Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: Aldercar is 28 bedded home offering personal care to older people. The home is located in a quiet residential area in Hucknall, a small town, which has local community facilities, 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 majority 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 DS0000008615.V267886.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 9th January 2006 over a period of 4.5 hours. The owner/manager was present for part of the visit and the deputy care manager and staff provided information throughout the visit. Five residents and the district nurse were spoken with and all expressed a high level of satisfaction with the care provided in the home. Three 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 were very complimentary about the home and the way they are treated by and care for by the staff. 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 liaise 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 DS0000008615.V267886.R01.S.doc Version 5.0 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 DS0000008615.V267886.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 Aldercar Care Home DS0000008615.V267886.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): 3 Arrangements for assessing the needs of residents are well managed. EVIDENCE: There is an assessment of need process, records are available and these are included each care plan. Discussion with the manager, the residents and relatives and inspection of care plans demonstrate that the resident, family members and representatives are included in the assessment process. Assessments of residents’ needs were thorough and well detailed. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 9 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, 10 and 11 Residents’ health care and medical needs were identified, well met and promoted. Procedures for storing, giving out and recording medication were well managed. There is a warm and interactive rapport in the home and residents are treated with respect and dignity. EVIDENCE: Three care plans were viewed on this inspection. Medical histories, health assessments and how and who are involved in meeting these needs are comprehensively recorded in each plan. The deputy 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 and/or relatives had not signed care plans. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 10 Residents, relatives and visiting professionals were very pleased with the health care and support provided by the home. Residents commented that their health has improved greatly since living at the home. A district nurse visiting the home on the day of this inspection was very positive about the home’s ability to promote and meet the health and medical needs of the residents. 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. Observation of the arrangements for storing, administering and recording medication and discussion with the manager and staff demonstrated that medication procedures are well managed in the home. Residents are treated with 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 were very complimentary about the home and the way they are treated by and care for by the staff. The manager and staff provided a clear commitment to caring for the residents at the home and provided a dedicated insight into caring for residents who become increasingly frail and supporting both residents and their families through the processes of death and bereavement. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 11 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): 13 and 14 The 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. 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. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 12 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 and joining in activities. One resident likes to, and is encouraged to, help out with domestic tasks. 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. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 13 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): 17 and 18 The staff have a clear awareness of the need to provide a safe environment for residents and to promote and protect the legal rights of the residents. EVIDENCE: 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, but were not signed by residents and/or a relative. The manager must ensure that risk assessments relating to the use of bed rails, should be recommended by the doctor or district nurse and be signed by the resident, a relative or a representative. The home’s Protection from Abuse procedures are comprehensive and include reference to the Nottinghamshire Adult Protection procedures and the role of the Commission for Social Care Inspection. All residents are on the electoral register. The manager confirmed that the residents who wish to visit the local polling station would be supported by staff, whilst other residents have postal votes arranged. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 14 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): 19, 24, 25 and 26 The home presents as well maintained, homely, well decorated, comfortable and 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. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 15 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, 29 and 30 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. All the residents spoken with on this visit gave positive comments about the staff and said they felt safe and well looked after, with staff encouraging them to be independent and providing support when needed and requested. Discussion with the deputy 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. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 16 The district nurse also spoke highly about the knowledge and caring commitment of the staff working at the home. Staff files were, on the whole, well organised with all the required information and background checks being in place, with the exception of one file which did not have the staff member’s references contained within. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 17 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): 32, 33, 35, 37 and 38 The management of the home was well organised, with clear lines of accountability, roles and responsibilities. Records were, well maintained, accurate and up to date and health and safety checks had been carried out. However, some attention to fire safety practices is required. EVIDENCE: The registered manager is present at the home on a daily basis, but delegates much of the day to day management of the residents needs to the deputy care manager. The staff reported positive working relationships throughout the home, with good communication and support. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 18 One of the owners of the home visits the home on a monthly basis to find out how the residents feel about the running of the home. Whilst these visits are documented, some were not signed and therefore did not verify who had carried out the visits. The manager stores and manages the spending money of some residents and individual records are maintained but receipts are not obtained for hairdressing. Fire safety checks had been regularly completed, but some doors were wedged open. The deputy manager reported that the fire officer had verified this practice as long as fire doors were closed during the evening and throughout the night. However, these practices had not been documented within a fire risk assessment and the manager is required to liaise with the fire officer and to carry out a fire risk assessment. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 19 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 3 X X X X 3 3 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X 2 X 3 2 Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP29 OP35 OP38 Regulation 19 Sch 2 16.2(l) 23.4 Requirement Ensure two references are maintained on staff files Provide receipts for all money spent on behalf of residents. Liaise with the fire safety officer regarding the practice of wedging open doors and document a fire risk assessment for the home Timescale for action 01/03/06 01/03/06 01/03/06 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 OP18 OP7 Good Practice Recommendations Ensure the resident and/or relative or a representative sign to verify the risk assessment relating to the use of bed rails. Encourage residents and/or relatives to sign care plans. Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Aldercar Care Home DS0000008615.V267886.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!