Inspection on 24/10/08 for Alex Wood House

This inspection was carried out on 24th October 2008.

CSCI found this care home to be providing an Adequate 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

Alex Wood House 31/10/06

Alex Wood House 25/10/05

Alex Wood House 26/04/05

Alex Wood House 24/10/04

Alex Wood House 08/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

CARE HOMES FOR OLDER PEOPLE Alex Wood House 3a Fortescue Road Cambridge CB4 2JS Lead Inspector Janie Buchanan Unannounced Inspection 24th October 2008 09:00 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 Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alex Wood House Address 3a Fortescue Road Cambridge CB4 2JS 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) 01223 578602 01223 578460 grace.willer@cambridgehs.org.uk Cambridge Housing Society Ltd Anne Owen Care Home 31 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (31), of places Physical disability (3) Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age range of two residents in the Physical Disability (PD) category is 60 - 65 years only. This age range applies to short stay placements only. One named resident under the age of 60 years with physical disabilities 31st October 2006 Date of last inspection Brief Description of the Service: Alexwood House is owned and managed by Cambridge Housing Society, a charitable housing association. The home is situated to the north of Cambridge City and is about 2 miles from the city centre. There are shops, a post office and a library nearby at Arbury Court. Alexwood House was purpose built for older people in 1988 and offers mostly permanent care. There is also a busy day centre. It is a pleasant modern building, built around a central courtyard. All bedrooms have ensuite facilities. Charges vary between £548 and £584 per week depending on residents’ needs. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. For this inspection we (The Commission for Social Care Inspection) looked at all the information that we have received. This included the annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. We also received 24 surveys from people living in the home, staff working there and from other people with an interest in the home. We spoke with four residents, four members of staff and the manager, and had lunch at the home so we could watch how staff interacted with, and helped residents. We looked at a range of policies and documents and undertook a brief tour of the home to check the environment and health and safety matters. What the service does well: What has improved since the last inspection? Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 6 The one requirement from the last inspection concerning fire doors being wedged open has been met, ensuring residents are protected in the event of a fire. New furniture has been bought for the dining rooms and new carpets have been laid throughout communal areas, giving the home a brighter, cleaner feel. The has been a restructuring of the kitchen staff’s working hours to provide a better service to residents at tea times. The teatime menu has been improved, as a result. 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. The summary of this inspection report can be made available in other formats on request. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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 Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. The home’s admission procedures are robust, ensuring that only residents whose needs can be fully met are admitted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an information pack for prospective residents. This pack is comprehensive and includes the home’s statement of purpose, its aims and objectives, its complaints procedure, a residents’ satisfaction questionnaire, photographs, details about charges and information about daily life in the home. It has been updated since the home’s last key inspection to include details of the new management team. Residents are invited to spend time at the home before moving in so they can meet staff, other residents and have lunch. All but one resident who completed the questionnaire responded that they had received enough information about the home before moving in; one stated ‘I came to have a good look’. All residents are issued with a ‘Licence to Occupy Residential Accommodation’ which clearly states the terms and conditions of their stay at the home. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 9 A senior member of staff assesses all residents before they are admitted to the home to ensure their needs can be met there. We checked the files for three recently admitted residents and there was good pre-admission information about them. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Residents’ health needs are met at the home but information in their care plans is poor and does not give staff adequate information as to how their needs are to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Every resident at the home has a care plan. We sat and went through one resident’s care plan with them. Nothing was recorded about her religious beliefs and terminal care needs even through she had strong views in both these areas. Some of the information in her plan was factually wrong such as the name of her chiropodist, that she didn’t like fruit and how she was actually helped by staff. The detail of how she was to be helped was very poor and did not ensure that staff assisted her in comprehensive and consistent way. There was very little about her interests, hobbies and previous life, even though she was very able to give this information to staff. In another plan it clearly stated that the resident could be aggressive towards staff and other residents, however no risk assessment had been completed and there was little guidance for staff in what triggered the behaviour and how to manage it if occurred. The same plan stated that the resident had dementia; however there was little Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 11 information about the type of dementia the person has and how it impacted on their daily living and functioning. Information about residents’ weights was also hard to find as the information had been recorded on a scrap of paper elsewhere in the home. Residents we spoke to told us they see a range of health care professionals and a chiropodist and optical health care company regularly visit the home. Mangers at the home meet with the district nurses every six weeks to discuss residents’ medical needs and this has proved valuable in monitoring residents’ health and building up good relations with the local surgery. Staff have received training in Huntington’s disease, monitoring blood sugar levels and testing urine for infection so that they are better able to support residents’ health. We checked medication storage and a sample of residents’ medication administration records (MAR). These were satisfactory, although there was a recording discrepancy found in relation to one resident’s tablets and a number of handwritten additions to the MAR sheets had not be signed or dated. The temperature of the drug storage area is not monitored and needs to be to ensure that medication is stored at the correct level. Residents who completed our surveys told us that they were happy with how staffed helped them, and that staff treated them well. One relative told us the home ‘provided respectful and individualised care, always treating residents with dignity’. However two residents told us that they would like to have more showers. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents enjoy a full and stimulating lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activities are afforded a high profile, with something happening every day at the home. There is a large activities board so that residents and visitors can see what activities and outings are to take place. On the day we visited there was bingo happening in the day centre which a number of residents were attending and another group of residents were sitting in the foyer playing board games with staff. There are also regular trips outside the home to garden centres, local pubs, the Grafton Centre and Bressingham gardens. There is a church service once a month and number of volunteers who visit the home on a regular basis, including a PAT dog who visits weekly and students who visit to engage with residents and play games and musical instruments. One relative told us: ‘there is a good variety of weekly activities-my mother in law complains that she hasn’t the time to settle to writing letters because they’re always collecting her for something, or bringing cups of tea. We all think this is great’. Relatives also told us that they were impressed by the Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 13 friendliness of the staff at the home and the welcome they got when they visited. Residents have a good choice of what they eat everyday, with at least three dishes on offer. We took lunch with the residents on the dementia care unit to see how staff interacted and helped them. One member of staff gave good support when feeding a resident, however the support from another member of staff was poor. The member of staff did not communicate with the resident at all, she gave little explanation to the resident about the food, or that it was lunch or what was on the fork. She fed the resident too quickly, not allowing the resident to swallow her food before she was given the next forkful. This was a poor piece of care and we discussed this with the manager who agreed to take immediate action to train the member of staff. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Residents are aware of how to complain and have their concerns taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Cambridge Housing Society has its own, comprehensive, complaints policy that has been viewed on previous visits. Details of how to complain are also included in the home’s information pack and in the entrance to the home. Residents who completed our survey stated that they knew how to make a complaint, and those we spoke to were confident that their concerns would be taken seriously. We checked the home’s records of complaints and recent complaints concerning the smell of urine, the cleanliness of a bedroom, and a resident who wandered outside the home had all been fully recorded, investigated and dealt with quickly. All staff receive regular training from Cambridgeshire County Council in protecting vulnerable adults so they have an understanding of the adult protection system in their local area and the part they have to play should the need arise. Senior staff have undertaken a more advanced course in adult protection. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,26 Quality in this outcome area is good. Residents live in a comfortable and wellmaintained home with a range of indoor and outdoor space available to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is purpose built for older people and has a variety of aids to assist residents such as hoists, bath chairs and grab rails. All bedrooms meet minimum size requirements and furnishings and fittings are of good quality. Since we last visited the home has purchased more dining room furniture and new carpet has been laid in all the communal areas. Disposable glove dispensers have been installed in all residents’ bedrooms, ensuring staff have easy access to them and improving infection control. The home was clean and free from strong smells when we visited. Residents who completed our survey told us that the home was always fresh and clean and one was particularly impressed that staff cleaned her walking frame every week without fail. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 16 There is additional communal space available and an attractive courtyard garden for residents to enjoy the fresh air and sun. One relative described the atmosphere of the home as ‘warm, friendly and accepting’. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staff are trained, skilled and in sufficient numbers to provide a good service to residents living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Training for staff is excellent, well over 50 of staff have an NVQ level 2 in care and many have an NVQ 3. In addition to all mandatory training staff at the home are also involved in a local training project for dementia which has increased their awareness of the disease and how it affects people suffering it. All staff receive training in equalities and diversity so they can better understand the varied needs of residents. Staffing levels at the home are good, with six care staff and a manager on duty throughout the day for 31 residents. This is a good ratio of staff to residents and ensures that there is enough staff on duty to provide a high level of care and also activities for residents. Residents told us that staff were available when needed and they only occasionally waited a long time for help. However the home does rely on agency staff a lot to cover vacant shifts. One relative commented; ‘my main complaint is lack of informing residents if there are staff changes, or sometimes agency staff. Sometimes we don’t know if new faces are permanent, but usually aren’t. It would be a good idea to tell the residents so they feel more secure’. A staff member reported ‘we can be short staffed a lot and end up with lots of agency which some residents don’t like’. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 18 Also two people told us that communicating with some staff was difficult. One commented: ‘the care home could not function without carers form overseas BUT communication with elderly residents is compromised- the residents sometimes just do not understand what is being said to them and likewise the care assistants are not able to elicit what is required form the resident’. One resident told us it was sometimes difficult to ‘tune into’ staff’s accents. There has been a turnover of these overseas staff who have either returned home or moved on to education. We visited the home’s head office to check staff personnel files. Although satisfactory references and POVA first checks are completed for all staff some staff are starting work at the home before their CRB has been received. Although DOH guidance states that this is allowed in exceptional circumstances only, it is not best practice to do so and puts residents at unnecessary risk. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34, 35, 36,38 Quality in this outcome area is good. Residents live in a home where their views are valued and their health and safety is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new manager has been appointed at the home since we last visited. She is experienced in caring for older people and was an assistant manager at the home for three years previously. She holds an NVQ level 4 in Health and Social care and has recently completed her Registered Manager’s Award, giving her the skills and knowledge to manage a residential home. There are two assistant managers, both of whom are undertaking their NVQ level 4 in care. The manager completed our AQAA (annual quality assessment). This was really detailed and gave us excellent information about the home. It showed us that the manager was very aware of what the home did well and what they Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 20 needed to improve on. It also showed us the many ways the home tries to promote equality and diversity for the residents living there. Staff told us they felt well supported and one commented: ‘since I took on a senior care role about 3 months ago, the time and support the manager has given me has exceeded my expectations and met my needs fully’. However one member of night staff had not received formal supervision as often as recommended by the minimum standards. There are regular and meaningful meetings where residents can raise concerns and where important issues such as food, activities, the home’s garden and health and safety matters are discussed. At a recent meeting a member of staff from Cambridge Housing Society’s head office came to discuss with residents the plans to improve their garden. One resident told us she found the meetings very useful and that every resident gets a copy of the minutes, which she used to take herself. The home holds cash for some residents and we checked their accounting procedures for this, which were satisfactory, with a clear record of all transactions maintained and receipts, kept. Health and safety is very good and records we viewed (including gas, fire, portable appliance testing, asbestos, hoist and lift servicing) showed that the home regularly maintains and checks its equipment and appliances. An audit of the home is completed every month that covers issues a range of health and safety issues. We checked the home’s kitchen that was clean and hygienic, with foodstuffs stored correctly. All the home’s cooks have achieved and NVQ 2 and two of the cooks have achieved their intermediate Food Hygiene certificate. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 21 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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 3 3 3 x 3 Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no 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 OP7 Regulation 15 Requirement Residents’ care plans must be much more detailed to ensure that staff know important information about them and ensure that they give consistent care Timescale for action 01/01/09 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 OP29 Good Practice Recommendations No member of staff should start working at the home until a full CRB check has been completed so that residents are protected. Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: 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 © 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 Alex Wood House DS0000015088.V372822.R01.S.doc Version 5.2 Page 24 - 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. 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