Inspection on 05/11/08 for Alderwood Nursing Home

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Good service.

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.

Other inspections for this house

Alderwood Nursing Home 18/01/07

Alderwood Nursing Home 26/01/06

Alderwood Nursing Home 05/07/05

Alderwood Nursing Home 01/03/05

Alderwood Nursing Home 10/08/04

Alderwood Nursing Home 30/03/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alderwood Nursing Home Rectory Place Bensham Gateshead Tyne & Wear NE8 1XD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Suzanne McKean     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Alderwood Nursing Home Rectory Place Bensham Gateshead Tyne & Wear NE8 1XD 01914777833 01914783212 samgreenrmn@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Philip Samuel Green Type of registration: Number of places registered: Mental Health Concern care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home The local authority first built Alderwood nursing home in the late 1960s. In the 1990s it was leased by Mental Health Concern and registered to provide nursing and personal care for people with mental health needs and dementia-type illnesses. The home is divided into three units, with different statements of purpose. The downstairs unit provides nursing care for people who require long term care because of the nature of their mental health needs. The upstairs contains a unit for the long term nursing care of older people with dementia type illness. The other unit on this floor provides short break nursing care for older people with dementia type illnesses. Alderwood nursing home is in the Bensham area just off the main road leading to Gateshead. There are 5 9 Over 65 23 9 Care Homes for Older People Page 4 of 26 Brief description of the care home local shops and bus stops on this main road. The home stands on an elevated site and is surrounded by a mix of houses. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Summary This is an overview of what the inspector found during the inspection and how the inspection was carried out. Before the visit we looked at: Information we have received since the last visit on 18th January 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run, and the providers view of how well they care for people. The views of, people who use the service and their relatives, staff and other professionals. Care Homes for Older People Page 6 of 26 The visit was unannounced and was made on 5th November 2008 it was completed in approximately six hours. During the visit we: Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure that it was clean, safe and comfortable. Checked that improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good admission assessments and information gathered prior to the placement makes sure that the home is prepared for the person moving in and that the person can be confident that their needs will be met. Evidence: The home uses an assessment document specifically designed to give information about the needs of people who have dementia and younger adults with mental health needs. They are comprehensive tools, which assist the staff to find out allot about all aspects of peoples lives and needs. The staff continually review the document to make sure that it continues to be useful and the best way to carry out the assessment. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have their health and personal care needs met in a planned way, delivered in a respectful way and the care records show how this is to be achieved. Evidence: Each person living in the home has an individual care plan which is developed from the admission assessment and added to throughout their stay. These care plans show that the personal and health care needs of the resident are being met and how that is being achieved. Staff have ongoing training in the completion of the care plan documentation. The staff spoken to were knowledgeable about the contents of the care plans. They were able to describe the needs of the residents and were clear about the way that they had to record the care given and the need to report any relevant issues to senior staff. Care plans are in place around both the physical needs and the mental health needs of the people living in the home. Necessary risk assessments are completed for a Care Homes for Older People Page 12 of 26 Evidence: selection of areas including falls, nutrition and deterioration in skin condition. These were detailed, up to date, and easy for staff to follow, particularly in relation to their complex mental health needs. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home. The residents and their representatives are supported to take part in the review of their care. Plans had been signed by residents or relatives. A large number of the residents are registered with one general practitioner who visits the home routinely on Tuesdays and Thursdays allowing the staff to get advice without having to call out a GP. Residents who have kept their own General Practitioner are supported to get the medical care they need in the usual way. The consultant psychiatrist who is linked to the home visits once a month and the senior registrar working with his also visits once a month. This results in a specialist visit every 2 weeks. There is a small number of residents who have a different consultant and advice is sought from them as necessary. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. A number of residents were positive about the care they were being given and were complementary about the staff. An example of this was that they thought it was nice living here and that the staff were nice. Care was given in a discreet manner taking into account the individual residents previous lifestyles and the way they want to spend their time. Staff are knowledgeable about residents preferences and needs. They were being kind and polite with cheerful banter taking place throughout the day. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents medication and the records were up to date and in good order. The only exception to this was where a short course of medication was prescribed, where the records could have been more specific and detailed. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Specific routes of administration are followed and any omissions or changes to the way that the medications are given are recorded. Care Homes for Older People Page 13 of 26 Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are supported to live active and fulfilled lives in line with their choices, abilities and previous lifestyles. Evidence: The staff are knowledgeable about the social and recreational care needs of the service users. This was shown in the care plans and confirmed by residents. There are regular activities for the service users. One service user described some of the opportunities they had been offered and although they felt that this was enough they did not always want to take part. The home has a minibus, these offer the resident opportunities to travel to both local shops and attractions further away from the home. There are a number of staff who are able to drive this making it a more flexible service. Residents confirmed that they enjoy the activities organised for them, including visits to the home by local entertainers. The residents are supported to continue their religious practices and a resident who is from a minority religion is supported well to maintain his religious observance. There Care Homes for Older People Page 15 of 26 Evidence: are opportunities for residents to participate in services which are appropriate to their particular faith and beliefs. Service users confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. People living in the home are encouraged to re-learn skills such as cooking, budgeting and time management. This varies according to the specific needs and abilities of the residents and was being implemented in a sensitive way. The opportunities provided for those people who are not able to appreciate or participate in group or complex activities are being offered more one to one activities such as chatting and hand massage. The manager has introduced Dementia care mapping as a way of assessing peoples wellbeing and this is evident in the care plans and in the plans for further development of the social programmes. Relatives commented that they are aware of the activities that the staff organises for the service users. The home supports the relatives to make positive contribution to the care provided in the home. Alderwood operates a cook/chill method for providing meals. This means that meals are sent to the home prepared and the staff re-heat them. The home has a kitchen and now employs a kitchen assistant to assist with the preparation of the meals There is a rotational menu in operation in the home. Past menus indicate that the home provides wholesome and nutritious meals for the service users thus promoting good health. Service users were complimentary about the food. They confirmed that they are provided with choice and that there is always plenty of food for them. There is also sufficient food purchased outside of the contract for the meals which is prepared to give the residents alternatives. The staff have greater flexibility to provide people in the home an alternative should they feel unwell or that they wanted a particular food. The meal time was well organised and staff were sensitive when assisting the residents with their meals. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good policies and procedures in place which are followed by the staff to make sure that complaints are dealt with effectively and that residents are safeguarding from harm. Evidence: The complaints procedure is made available to residents and relatives through the service user guide. Relatives confirmed that the staff and the manager listened to their views and opinions. The manager and the deputies are committed to responding to any concerns raised, even those that are minor in nature. There is a good system for the management of complaints. Alderwood has an appropriate protection of vulnerable adults policy and follow Gateshead Social Service Department guidance. Staff were aware that any events effecting the welfare of the residents must be looked at with reference to the safeguarding guidance and CSCI need to be informed. The home have been involved in safeguarding procedures in the past and these have been manged well by the management. They worked well with the local authority to ensure the safety and wellbeing of the residents. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers accommodation which is clean and well maintained and has design features to help people of this client group and to promote their dignity, comfort and welfare. Evidence: The building was constructed by the local authority as a care home and it is sited within an area of Gateshead that is predominantly domestic housing although it is close to local shops and facilities. Access into and within it is good and meets the needs of those people who have mobility difficulties or have use of waling aids or wheelchairs.There are some challenges to the residents going out, particularly those who use wheelchairs as the home is sited on a hill, however staff were aware of this and support residents as necessary. There are specialist bathing facilities to promote independent use by those who are able to use them. And there are assisted bathing facilities for residents who have moving and handling needs. All bedrooms and toilets have suitable locks on the door to ensure privacy. This provides the opportunity for residents to remain independent and to enjoy good levels of privacy. There are sufficient numbers of communal areas for people living in the home to Care Homes for Older People Page 18 of 26 Evidence: choose from. These include a range of lounges, dining rooms and communal spaces that residents can use. The bedrooms are of varied shapes and sizes and they were well decorated, furnished and were personalised to the taste of the occupant. The home has a allocated Health and Safety co-ordinator who is responsible for facilitating good practices that safeguard the people living there. It is well decorated and furnished and there was no unpleasant odours anywhere in the home. There has been a change to the way that the regular maintenance is carried out and there is now a contract with a company who undertakes both the day to day repair and the regular inspection and certification of services and equipment. Safety checks are carried out in line with the homes policies. The home has a very pleasant outdoor area which has been improved by adding decking and a pond with a variety of plants. This is fully enclosed giving the people the opportunity to come and go safely and with little supervision. Ongoing improvements are planned as part of the general redecoration programme. The manager and staff are planning to use current guidance on improving the environment for those people with dementia. This is particularly important in the dementia care unit as it will give the opportunity to support the residents to live satisfied and fulfilled lives by living in an environment which is suitable. The staff are knowledgeable about control of infection procedures and were using these practices throughout the day to minimise the risk of cross infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are skilled, well trained, and competent staff employed in sufficient numbers to make sure that they can provide good care to the people living in the home. Evidence: The home maintains good staffing levels and on the day of the visit there was, the Manager Mr Sam Green, the deputies, two qualified nurses and seven care staff. The management structure gives good leadership and as well as the manager includes two deputies. There were sufficient numbers of domestic staff and a catering assistant. During the nigh there is one nurse and four care staff on duty. These levels are high and result in residents personal and health care being being fully met. Mental Health Concern has a dedicated training department. This provides staff with opportunities to go on a wide range of training. More than 75 of care staff have completed National Vocational Qualifications in care. The nurses and care staff are encouraged to go on a variety of courses including degrees. Plus secondment opportunities are provided for staff that wish to complete a nursing qualification. Staff records are kept centrally by these can be seen via an intranet link. These have been checked in the past and were well maintained. Any changes to legislation or guidance are implemented by the Human Resources department and the manager is Care Homes for Older People Page 20 of 26 Evidence: involved in the implementation. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in line with good health and safety practices and in the best interest of the residents, making sure that their needs are met and that the staff are supported in the roles they undertake. Evidence: The manager Mr Green is a very competent leader and has appropriate qualifications, experience and skills to make sure that the home is managed in the best interest of the people living there. He is also a registered nurse. The management team are skilled and provide good leadership within the home. Staff said that they felt well supported and were able to work toward relevant qualifications and that the manager would listen to any views they had about the home. Mental health concern has a comprehensive quality assurance systems, which are used to identify any necessary improvements. Residents and relatives are asked their views on the service provided. There is a service user group which meets at Buttress House, Care Homes for Older People Page 22 of 26 Evidence: a representative from the home is part of this. The home has coffee mornings for relatives and there are night out arranged for staff and relatives. Surveys are used to elicit the views of relatives and residents and these are analysed centrally with anonymous information given to the home so that they can make changes if necessary. A team of finance staff at the head quarters look after the personal allowance records. Residents and relatives are assisted on admission to arrange their finances and are then supported during the stay should they need it. Should they need information they can get it from the manager via the intranet system. Only small amounts of money are held on behalf of residents. Receipts are kept. If money collects in the accounts held at head quarters this is sent to the appointee or relative to put in peoples savings accounts. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 It is recommended that the recording of short course medication is reviewed to make sure that it is in sufficient detail and that staff sign for it appropriately. It is recommended that the plans to improve the environment in the home take into account best practices for people who have dementia. 2 19 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!