CARE HOMES FOR OLDER PEOPLE
Alderlea Care Home St Thomas Close Humberston Grimsby North East Lincs DN36 4HS Lead Inspector
George Skinn Unannounced Inspection 1st December 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 Alderlea Care Home DS0000002814.V262150.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. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Alderlea Care Home Address St Thomas Close Humberston Grimsby North East Lincs DN36 4HS 01472 812588 01472 816118 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) HICA Mrs Catherine Margaret Tyler Care Home 40 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (40) of places Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Alderlea is part of the HICA not for profit organisation providing residential care for up to forty people aged 65 and over, including thirty people who may have dementia; offering permanent residency, respite care and a small number of day care places. The home is a two storey building serviced by a passenger lift it has thirty single and five shared bedrooms. Communal space is well represented with five lounges, one of which is a designated smokers room and one a reminiscence room. One of the lounges is a light, airy, thoroughfare area with large windows and comfortable settees and chairs. The home has two dining rooms, a large room with individual tables to seat thirty-two people downstairs and a smaller room to seat eight people upstairs. There is also space for a small dining table at one end of the thoroughfare lounge. The home is well maintained with six bathrooms and ten single toilets throughout. There are pleasant gardens surrounding the home and ample car parking facilities. HICA have comprehensive policies and procedures and a well-established training department that supports the home. The home is close to the local church and village shop. It is on a bus route to Cleethorpes and Grimsby. The above description of the environment reflects the present facilities provided currently there is an extensive refurbishment program underway which is fazed over the next 3 years. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 3 hours. The home was looked at as were some records, and residents were spoken with. What the service does well: What has improved since the last inspection?
The home is currently undergoing an extensive refurbishment project and those areas which are finished have improved the appearance of the home a great deal. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 6 A significant amount of the rooms will have en-suite toilets and all will have more space as part of the improvements. A full refurbishment of all the toilets and bathrooms is also being planned to include specialist baths to assist the staff to care for the residents better. This will mean that the already good service offered at the home will be provided in an environment which reflects that quality of care. 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. Alderlea Care Home DS0000002814.V262150.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 Alderlea Care Home DS0000002814.V262150.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 All residents have their needs assessed prior to moving into the home, ensuring their needs can be met. EVIDENCE: Files were looked at and they indicted that residents are admitted to the home having undergone an assessment by either the Local Authority or senior staff from the home. The format of the home’s needs assessment covers all required areas; copies of completed assessments were detailed and appropriate. Copies of the Local Authority assessment and care plan are obtained prior to admission for those residents referred through the local Social Services care management teams. In addition to the pre admission assessment, the home undertakes a further assessment of strengths and needs once the resident has arrived. It is on the basis of both these assessments that the residents plan of care is formalised. Some of those residents interviewed knew the home kept information about them and said that they were involved in their care plans some commented on
Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 9 being involved with the reviews. One relative said “I’m always invited and it’s nice to think that the home take my mum’s care seriously”, however, due to the dependency levels of the majority of the residents many were unaware of this. The care plans did demonstrate that all the residents are involved in the process of care planning, or have someone acting on their behalf. Alderlea Care Home DS0000002814.V262150.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): 10 Residents feel they are treated with respect. EVIDENCE: Residents spoken with confirmed that privacy and dignity is respected whilst personal tasks are being undertaken. Assistance is always available but where possible independence is enabled. Medical examinations/treatment is conducted in the privacy of the resident’s own room. The preferred form of address is recorded on all case files. Residents are informed in the statement of purpose about their rights to have a private phone fitted in their bedroom. Residents can use the home’s payphone to make and receive calls. Alderlea Care Home DS0000002814.V262150.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): 12 & 14 The resident’s expectations are satisfied and their cultural and religious needs are met. Resident’s choice is maintained. EVIDENCE: Staff provide a variety of choice and flexibility in the daily lives of the residents, with care being given to ensure that it reflects the wishes of the resident. Care plans indicated how even small preferences were to be accommodated like the preference for putting slippers on before the residents feet touch the ground. Leisure and social activities are arranged both in-house and within the local community. Notices of forthcoming social events are displayed around the home. Resident’s interests are recorded in their individual care plans. Through discussion with residents, it was evident they choose when to get up, go to bed, spend time in company, time alone, etc. Whilst mealtimes are set, residents are able to make choices about where they wish to eat and there is some flexibility around the timing and what they would like to eat and times of going to bed and rising. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 13 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 & 26 Residents live in a well-maintained and hygienic environment. EVIDENCE: Currently the home is undergoing a major refurbishment and this is planned to be phased over the next 3-4 years. Each corridor is being done separately and some of the rooms are being upgraded to include en suite facilities. Those rooms which have been completed have been finished to very high standard. The building work is being carried out with little or no disruption to the residents, apart from the moving of rooms temporarily while it is being refurbished. One resident was very pleased with her new room and didn’t mind moving. The staff are doing a very good job at keeping the home clean and free from odours under the circumstances. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 14 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 The number and skill mix of the staff meet the needs of the residents. EVIDENCE: The National Care Standards Commission have been advised that recommended guidance should only be applied to new registrations. For homes registered prior to 1st April 2002 staffing levels must at least meet the minimum requirements of the previous regulatory authority. At the time of this inspection staffing numbers were found to meet those previous requirements. The home retains a copy of duty rosters. All staff employed by the home to care for residents are aged over 18 years and those staff left in charge are at least 21 years old. Dedicated domestic staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 15 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 & 35 The residents live in a home which is well managed and run in their best interest. EVIDENCE: The home has a quality assurance system in place, which seeks the views of all stakeholders. Residents confirmed that they are regularly consulted via questionnaires. The quality audit tool focuses monthly on areas such as the environment, complaints, individual care, etc. In addition to this, the home’s manager undertakes her own monthly monitoring. The company produces an annual development plan which looks at the organisation as a whole as well as each individual home. Residents who are able to manage their own finances are encouraged to do so; this was confirmed during the inspector’s discussions with them. For those who are not as able, finances are managed in varying degrees dependant on
Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 16 individual abilities and wishes. This has resulted in a number of residents taking care of their own personal allowance whilst others ask the home to keep monies in safekeeping. The home maintains a rigorous system for the safekeeping of monies, with individual details and receipts of any monies spent on their behalf. Hard copies of this account are printed off on a daily basis. This account, whilst being rigorous, does fall into the realms of a communal non-interest account, which is in conflict with the regulations. However, from discussions with residents and having read information provided to them, it is apparent that any decision to utilise this system has been made by the resident or their representative and is based on individual choice often for convenience. On the basis of these findings this system has been accepted. Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 17 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 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action 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 Alderlea Care Home DS0000002814.V262150.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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