CARE HOMES FOR OLDER PEOPLE
Alderlea Care Home St Thomas Close Humberston Grimsby DN36 4HS Lead Inspector
George Skinn Unannounced 6 September 2005 9:30 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. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Humberside Independent Care Association Mrs Catherine Margaret Tyler Care Home 40 Category(ies) of OP Old Age (40) registration, with number DE(E) Dementia - over 65 (30) of places Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 14/12/04 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. The home offers permanent residency for as long as needs can be met, respite care and a small number of day care places.The home is a two storey building serviced by a passenger lift. It is based in Humberston and close to the local church and village shop. It is on a bus route to Cleethorpes and Grimsby. There are pleasant gardens surrounding the home and ample car parking facilities.The home 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. On the day of the unannounced inspection this area was utilised by a large number of service users and relatives. 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 presented and maintained with six bathrooms and ten single toilets throughout. HICA have comprehensive policies and procedures and a well-established training department that supports the home. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 6 hours. The building was looked at and some records were inspected. The majority of the residents and two of the staff group were spoken with. The manager was also spoken with. This is the first visit to the home since the last inspection in December 2004. All those minimum standards inspected were met. What the service does well:
The home was found to be clean warm and welcoming. There were no malodours and the staff were working hard to meet the needs of the residents. The residents spoke positively about the home and their lives there commenting on how well the staff care for them. Relatives spoken with during the inspection were positive about the home and commented on the caring nature of the staff. The residents benefit from the homes record keeping as these are very well maintained and detailed instructing the staff in how to best care for the residents. These records contain a lot of detailed information which is relevant to the physical needs of the residents; likes, dislikes and other preferences are recorded which again help the staff to give a good service. The records are compiled with the involvement of the residents and their relatives if this is appropriate record’s confirmed this as did residents and relatives. Residents benefit from the staff being well trained and they were more than satisfied with the quality of care provided residents’ comments included “the staff are always happy to help you” “they are all very kind and caring”. The home provide basic induction training which is given to all new staff when they start working this provides the staff with the skills to care for the residents properly. The home also provides more specialised training in dementia etc to enable them to meet the more personal needs of individual residents. Residents live in a safe environment as staff are trained in all aspects of health and safety
Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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) EVIDENCE: Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9. Residents’ care records ensure personal care and health needs are well met by the staff group. Medication is handled safely and staff are appropriately trained. EVIDENCE: Each resident has a plan of care, which has been devised from the assessments; the resident or next of kin is involved in the formulation of these and subsequent reviews. Residents had signed their care plans as an indication of their involvement, A from is used which asks the resident where appropriate, or their relative to acknowledge that they are aware and agree with the contents of the care plan. Care plans set out in detail the action to be taken by staff; these are linked to individual risk assessments. Each care plan is reviewed on a daily, weekly and monthly basis. Risk assessments relating to falling, moving and handling are available. Residents’ health care needs are met and staff ensure they have access to health care services to meet their assessed needs. Equipment is available for the prevention of pressure sores. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 10 There was a policy and procedure in place for the management of medication and this included self-medication and homely remedies. There were no residents who were able to self-medicate. Staff members who are responsible for the administration of medication have attended the accredited medication course. The home used a nomad system delivered by a local pharmacy and evidence seen indicated that medication was signed for on receipt into the home and after administration. The home kept a record of any medication returned to the pharmacy; medication remains on the premises for seven days after the death of a resident as per procedures. There was evidence seen that medication was reviewed at regular intervals. Resident confirmed that they receive their medication one resident said, “I always get my tablets at the proper time”. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 standard(s) 13 & 15 The resident are able to have visitors at any reasonable time. Residents are provided with a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Visitors to the home were welcomed at any reasonable time. Relatives confirmed that they were always made welcome and could see their relatives in private if they chose to. Information regarding maintaining family contact and visiting arrangements is detailed in the Statement of Purpose and Service User Guide The quality of the meal was very good and the way in which it had been cooked had taken into account residents needs. The staff who are responsible for serving the meals know residents likes and dislikes. Residents spoke positively about the quality of the meals comments were: “the food is always nice” “You always get a good choice at every meal time”. Assistance is offered to residents with individual needs. Residents are offered a choice at each mealtime; the menu indicates that cooked alternatives are available at both lunchtime and teatime.
Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 12 Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 standard(s) 16 & 18 Both relatives and resident knew whom to complaint to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Residents and relatives all said they felt the management style of the home encouraged them to speak out and they were satisfied that they would be listened to and issues acted on, they would not hesitate in bringing such matters to the staffs attention. Residents are protected from abuse with robust procedures in place for responding to any suspicion. All staff receive formal training on abuse and the protection of vulnerable adults. The home does have a detailed system for the management of residents’ finances, which protects residents from financial abuse. The homes policies and procedures preclude staff from involvement in the making of wills or receiving gifts. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 standard(s) 26 Residents live in a home which is kept clean, hygienic and free from offensive odours. Systems are in place for the control of infection. EVIDENCE: The home is clean and tidy all areas both communal and private are well maintained and welcoming. There is an infection control policy in place to protect the residents from the risk of cross infection. Staff were seen to be using protective clothing again to eliminate the risk of cross infection for the residents. The home is currently undergoing a full refurbishment and this was a topic of conversation for residents who were looking forward to having their rooms redecorated. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 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 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) 29 The residents are protected by the homes recruitment and selection procedures EVIDENCE: The organisation has a detailed recruitment procedure. As part of this inspection six random staff files were seen. From these files it was evident that two references were sought. CRB checks are undertaken along with a health assessment. A copy of the General Social Care Code of Conduct is made available to staff. All staff are provided with written terms and conditions within 8 weeks of employment and copies of these are retained at headquarters. The organisations policy and procedures regarding the recruitment of volunteers outlines a thorough process, which includes the obtaining of references and a CRB check, the home does not currently have any volunteers. Those staff files seen did included a copy of passport and birth certificate. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 16 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) 38 Residents live in a home which is well managed and has effective administrative procedures to ensure that their health, safety and welfare is protected. EVIDENCE: The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 17 Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 18 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 19 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 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. 1. Refer to Standard Good Practice Recommendations Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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
© 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 Alderlea Care Home J54_s2814_Alderlea Care Home_v228720_060905_Stage 4.doc Version 1.40 Page 21 - 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!
