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Inspection on 16/08/05 for Alderson Resource Centre

Also see our care home review for Alderson Resource Centre for more information

This inspection was carried out on 16th August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provider offers a good level of structured dignified care to service users with dementia. The intermediate care and multi-disciplinary team work provided for service users who have suffered strokes is of a high standard. The staff are well trained and committed to the relevant service user group. The accommodation is well maintained

What has improved since the last inspection?

All the bedrooms are now for single use. A process has begun to replace the radiators in the home. Some new policies have been introduced.

What the care home could do better:

The service provider must fully inform relevant persons of the safety issues and restrictions to movement operated in the home. The recruitment process needs to improved to better protect service users.

CARE HOMES FOR OLDER PEOPLE Alderson Resource Centre Linnaeus Street Kingston upon Hull East Yorkshire HU3 2PD Lead Inspector John Gregory Unannounced 16 August 2005 @ 08.00 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. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alderson Resource Centre Address Linnaeus Street Kinston upon Hull East Yorkshire HU3 2PD 01482 585166 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) Kingston upon Hull City Council Ms Judith Lawtey Care Home 26 Category(ies) of DE(E) Dementia - over 65 (17) registration, with number PD(E) Physical Disability - over 65 (9) of places PD Physical Disabiltiy (9) Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th November 2005 Brief Description of the Service: Alderson resourse centre is a care home providing accomodation and personal care for 17 older persons who are subject to dementia and 9 persons with physical disability who recieve intermediate care. The building conists of two floors joined by a passenger lift. The accomodation for the individuals with physical disabilities is sited on the upper floor. All the rooms are single without en-suite facilities and there are a range of communal facilities. The enterprise is owned byHull City Council. The accopmodation is sited on Anlaby Road ajacent to the general hospital and a short distance from the centre of Hull. The accomodation has gardens to one side.a central courtyard area and a large car park to the front of the building. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one morning in August 2004.The process was one hour in preparation and six hours in fieldwork. The standards inspected were those that the CSCI determine are central to the care process. A sample of policies procedures and records were examined that were relevant to the standards inspected. Four staff and four service users were interviewed , two cases were case tracked. A brief tour of the accommodation was undertaken. The shift leaders for the residential and intermediate care units assisted the inspector. The inspector would like to thank the shift leaders, the staff and service users of the Alderson resource centre for their time cooperation and hospitality during the inspection. What the service does well: What has improved since the last inspection? All the bedrooms are now for single use. A process has begun to replace the radiators in the home. Some new policies have been introduced. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 6 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. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.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 Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.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) 1,3 &6 Relevant persons need to be more accurately informed the security and restraint mechanisms working in the home. The service users are subject to a preadmission assessment, which ensures that their needs can be met. The intermediate care facility operates to a high standard EVIDENCE: The Home is extensively fitted with security devises such as external video surveillance; digital locks to the inside of external doors. Internal door locks are in use throughout the home including staff locking service users doors when they are not in their rooms. These facilities are not described in the statement of purpose or service users guide or reasons given for their use and review for the information of prospective service users to inform their decision about admission. Service users are subject to care management assessment prior to their admission to the residential unit. Those admitted to the intermediate care unit are the subjects of multi disciplinary prior to admission. The processes ensure that the service users needs can be met in the home. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 9 The service users on the intermediate care unit are admitted following a stroke for a stay of approximately six weeks. The unit is separated from the main home and the staff are designated to the unit and receive special training in rehabilitative techniques. Specialist medical staffs such as physiotherapists, occupational therapists, speech therapists and nurses oversee the work and rehabilitation of the service users. Service users interviewed were pleased with the services on offer. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 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 &10 The service users receive good sensitive well-structured care within the home. The medical care on the intermediate care is of a high standard. That on the residential unit needs to be more systematically recorded. The medication system is sound and only minor attention is needed to an issue of recording. EVIDENCE: The care plans or goal plans of the service users were comprehensive and reviewed frequently in order to keep the care process relevant to their needs. A wide range of risk assessments existed on file. Staff confirmed that service users on both units receive care from the primary health care team and in the case of the intermediate care unit from the hospital to ensure that their health and rehabilitation needs are met. This information was not readily available on the files in the residential unit and needs further attention to ensure that all medical needs are met. The medication systems on both units were examined including that for controlled medication and was found to be satisfactory. In auditing the medication it was noted that the service provider has no stem for identifying the amounts of medication brought into the home ;or carried over ,on the MAR sheets. Making it difficult to reconcile the number of tablets given with those Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 11 remaining in stock. This needs rectifying to ensure the protection of service users. Service users were treated with dignity by staff with personal care being provided in their own rooms or in designated facilities. Transactions were seen to be positive and professional with service users dressed in their own clothing. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 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) 13&15 The service users have good family contact and enjoy a good varied diet which should be better recorded. EVIDENCE: Staff and service users were able to confirm good family contact. On the intermediate care unit it was clear from observed and verbal evidence that relatives and carers are actively encouraged to be involved in the service users care before their discharge home. The service users were happy with range and choice of food on offer. The breakfast was served as a moveable feast when the service users arose. The main meal was seen and was well served, and wholesome. Staff were discrete in encouraging service users to eat. The menu was examined and was seen not to include details of breakfast and the evening snacks available thus not confirming all the choices available to service users. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.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 The complaints procedure is sound but more attention needs paying to the process by which complaints may be received on the intermediate care unit. The service provider offers good protection to service users but needs to make explicit the extensive use of security or restraining mechanisms and support staff in the occasional need to restrain persons with organic brain disease. EVIDENCE: The Complaints procedure is clear and well understood by staff. There had been four complaints satisfactorily resolved within relevant time scales since the last inspection. Service users on the intermediate care unit were not clear about whom they would make any complaint to, should they wish. This needs to be made explicit in order that the procedure works effectively The service provider has a comprehensive procedure for the prevention of abuse to vulnerable adults and whistle blowing upon which the staff have received training; and expressed confidence in their ability to activate, should the need arise thus offering service users good protection. The service user makes extensive use of digital door locks to the inside if the premises. The building has locked doors through out and staff lock service users doors when the service user is not present. Several service users were seen to have bedsides fitted to their beds. In discussion with staff it was clear that they have to occasionally use physical restraint to deal with the behaviours of those with organic brain disease. These processes should be made explicit in a restraint procedure to protect service users rights and to offer clear guidance to staff in their care of a challenging service user group. The use of bedsides was risk assessed once in place but no risk assessments were seen of the reasons for the use of the sides, the arrangements to involve Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 14 stakeholders in the process nor arrangements for review. This needs to be addressed in order to protect service users rights. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 15 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&26 The service users live in a safe well-maintained clean and pleasant environment to which only minor attention is needed EVIDENCE: The accommodation is domestically furnished and decorated light and airy with good facilities. The carpet to the downstairs dining area that is badly stained and needs to be replaced. The home was clean and tidy and free of any offensive odours. The laundry is well equipped with commercial equipment and has and impervious floor and walls. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 16 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) 27,29&30 The home is well staffed by well-trained competent and committed staff. Attention is needed to the service providers recruitment processes to ensure that service users are fully protected. EVIDENCE: The rota was examined and confirmed a good level of care staff with support from domestic and catering staff. The manager is supernumery to the rota. Staff on interview impressed as being committed to their work and confirmed the recorded evidence of a wide range of training. The training involved the physical aspects of care and the detail of understanding of the conditions and needs of the specific service user group. This specialist training particularly stood out with staff of the intermediate care unit. These factors combine to ensure that the service users needs are met The service provider keeps a minimal amount of recruitment information in the home. An inspection of the central personnel function since the last inspection revealed that service users would be better protected if evidence of the identity of all staff was kept on record. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 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 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 The health and safety of staff and service users are protected by the homes health and safety practices to which only minor attention is needed. EVIDENCE: The fire protection equipment in routinely maintained and tests of the alarm system, emergency lighting and fire drills are undertaken at the necessary frequency. The mains utility systems are routinely tested. The temperatures at the hot water outlets exceeded safe limits on a number of occasions giving an increased risk of injury, The COSSH records were in order and there was a good policy procedure and records for health and safety issues. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.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 1 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x 2 Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 19 no 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. 2. OP 1 4 Schedule 1 19 Schedule 2 The servic provider must provide information in the statement of purpose of any specific theraputic tecniques used in the carehopme. The service provider must retain evidence of the identity of any person working in the care home 01/10/05 Standard Regulation Requirement Timescale for action 3. Op 29 01/11/05 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. 3. 4. 5. Refer to Standard OP8 OP 9 OP 15 OP 16 OP 18 Good Practice Recommendations The service provider should systematicallyrecord any medical treatment or consultation provided for a service user. All medication recieved into the home should be recorded on the MAR sheet for each service user All meals provided during the day should be stated on the menu The service provider should clearly identify the person(s) to whom complaints may be made on the intermediate care unit. The service provider should develop a procedure for the use of physical and mechanical restraint. 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 20 Alderson Resource Centre 6. 7. 8. OP 18 Op 19 Op 38 A full risk assessment should be undertaken on the use of bed sides to include relevant persons in the service users care and include arrangements for review. The carpet in the dining room on the residential unit should be replaced The service provider should ensurethat the hot water at all outlets is at a safe temperature. Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 Page 21 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 Alderson Resource Centre 20050816 Alderson Resource IR J54 v242181 s34408.doc Version 1.40 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. 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