Inspection on 26/04/05 for Alex Wood House

This inspection was carried out on 26th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alex Wood House 24/10/08

Alex Wood House 31/10/06

Alex Wood House 25/10/05

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Alex Wood House 3a Fortescue Road Cambridge Cambridgeshire CB4 2JS Lead Inspector Janie Buchanan Announced 26 April 2005 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. Alex Wood House Version 1.10 Page 3 SERVICE INFORMATION Name of service Alexwood House Address 3a Fortescue Road, Cambridge, CB4 9ZR 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) 01223 578602 01223 578460 Cambridge Housing Society Ltd, Endurance House, Chivers Way, Histon, Cambridge CB4 9ZR Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (OP) 31, physical disability (PD) 3 of places Alex Wood House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of three residents in the Physical Disability (PD) category is 60-65 years only. This age range applies to short stay placements only. Date of last inspection 24/10/2004 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 although two rooms are available for short-term respite care. There is also a busy day centre. It is a pleasant modern building, built around a central courtyard. All bedrooms apart from one have ensuite facilities. Alex Wood House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first inspection for the year 2005/6. It was announced. The inspectors spent a combined total of 10 hours at the home and interviewed four residents, three members of staff and the manager. They also took lunch with the residents. The inspectors undertook a brief tour of the home, checked medication storage and viewed a range of documents. The inspectors also received 34 comment cards completed by residents and their relatives. What the service does well: What has improved since the last inspection? What they could do better: All prospective residents must be fully assessed before moving in so that both they and staff can be assured that their needs can be met at the home. Although care planning is generally very good, specific risk assessments for the prevention of falls should be undertaken for all residents. Residents must be given more opportunity for stimulation through leisure and recreational activities and specific activities should be developed for those residents with Alex Wood House Version 1.10 Page 6 sight and hearing loss. The continued use of agency staff must be reduced so that residents receive consistent care from staff who know them well. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alex Wood House Version 1.10 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 Alex Wood House Version 1.10 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) 1,2,3,4,5 The home’s Statement of Purpose and Service User Guide are excellent providing residents and prospective residents with details of the home’s services and enabling them to make an informed decision about where they live. However, pre-admission assessments must be completed to ensure that the home can meet the needs of prospective residents. 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 and information about daily life in the home, and the summary from the last inspection report. These documents should be developed into suitable formats for residents such as large print or audiotape. Each resident is issued with a ‘licence to occupy residential accommodation’ and this document includes all the information required by this standard. The inspector viewed three residents’ files in detail: each contained a licence Alex Wood House Version 1.10 Page 9 agreement signed by the resident themselves, or their advocate. Two of these files, however, did not contain a pre-admission assessment. Without this assessment, there is little assurance for residents that the home can meet their needs. Alex Wood House Version 1.10 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 health care needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. However, storage for some medications needs to be improved EVIDENCE: The inspector viewed three residents’ care plans. The information they contained was detailed and gave the reader a good understanding of the resident’s health and personal care needs. There was evidence that residents had been involved in drawing up the plan, and also of regular review. Residents’ health care needs are met at the home. All residents were registered with the GP of their choice; a chiropodist visits every six weeks; an optical healthcare company visit yearly or on request to conduct eye tests; nutritional screening is completed for all residents and all residents are weighed monthly. One resident had recently been discharged from hospital with a pressure sore: this sore was being closely monitored by district nursing staff and care staff at the home were regularly turning the resident. Appropriate risk assessments were in place for residents, although these could further be developed to include the prevention of falls. Alex Wood House Version 1.10 Page 11 The inspector checked the home’s medication storage and medication recording systems. These were generally satisfactory although the stock level for fortified drinks was excessive and hand-written changes or additions to medical administration records did not indicate who made the change or when. Controlled drugs were not stored satisfactorily and must be contained in a metal cupboard that complies with the Misuse of Drugs (Safe Custody) Regulations 1973. One care assistant told the inspector that she regularly picks up discarded tablets from the floor, despite staff having signed to say that they had witnessed residents taking these tablets. Residents spoken to confirmed that staff at the home respect their privacy and dignity well: one resident commented ‘the attitude of staff is good’. The inspectors observed staff knocking on residents’ doors, and not entering until invited to do so. Policies and procedures are in place for handling dying and death and residents terminal care wishes were clearly recorded in their care plans. Alex Wood House Version 1.10 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) 12,15 There is a lack of meaningful and regular activities in place to stimulate residents at the home and few opportunities to visit places outside the home. Meals are varied and well balanced and residents are offered good choice in what they need. However, staff must ensure that any specialist dietary requirements are met. EVIDENCE: There is no formalised activities schedule in place at the home and there have only been two outings for residents organised since the last inspection, 6 months ago. One relative commented ‘I feel there could be some light entertainment from time to time. Also for outings to take the old folk to places, Anglesey Abbey, backs of collages, museums etc.’ The manager is aware of this shortfall and already has plans in place to try and address it. The inspectors took lunch with the residents. This mealtime was relaxed and the food was plentiful and nutritious. Residents confirmed that they are always offered a choice of what they eat. One resident commented ‘they make sure I get a salad whenever there is something on the menu I don’t like, I can also ask for an omelette, ham or whatever’. However, one relative commented ‘the dietary needs of residents are apparently ignored by staff actually serving meals. Often there is a medical reason why certain ingredients or additives should be avoided’. The inspectors witnessed one resident being given dessert of apricot flam and cream, despite this resident being diabetic. The cook had Alex Wood House Version 1.10 Page 13 prepared a specific diabetic dessert for this resident but it had not been given to her. Alex Wood House Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home has a satisfactory complaints system in place and there is clear evidence that complaints are taken seriously by staff at the home. Staff have a good understanding of adult protection. EVIDENCE: Cambridge Housing Society has its own, comprehensive, complaints policy that the inspector has 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. The inspector viewed the details of the last formal complaint received by the home. This complaint had been investigated, and responded to appropriately. One relative wrote on a comment card ‘I feel confident any complaint I had would be taken seriously’. The manager has recently introduced a complaints book where she intends to record all complaints received, whatever their nature. The manager was uncertain if residents had been given the opportunity to register for postal votes, but did assure the inspector that any residents wishing to vote at the local polling booth would be helped to do so by staff on May 5th. Many staff have undergone training in the protection of vulnerable adults and showed good knowledge of the different types of abuse and reporting procedures. Alex Wood House Version 1.10 Page 15 Alex Wood House Version 1.10 Page 16 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) 19,20,21,23,26 The environment of the home provides residents with an attractive and homely place to live and the equipment they need to help their independence. However, time taken to address repairs can be slow and some areas of the home are in need of redecoration. EVIDENCE: The home is purpose built for older people and has physical aids to assist residents such as hoists, bath chairs and grab rails. All bedrooms meet minimum size requirements and there is a good range of additional communal space available for residents. The home appeared generally well maintained, although there were one or two areas that required attention. In bedroom no 9 there was damp smell and paint was loose and bubbling in the ensuite toilet; a number of courtyard lights were broken and had been covered with unsightly black bin bags, and paintwork in the staff area was scuffed and marked. A part-time handy person is employed who is responsible for testing fire and lighting equipment and carrying out minor repairs. He told the inspector that the response time to requests for repairs from the society’s property Alex Wood House Version 1.10 Page 17 department was often very slow. He showed the inspector a request that had been submitted on 27 April 2004 and was still outstanding. A number of general and domestic staff are undertaking NVQs in cleaning and the home was tidy and free from offensive smells on the day of inspection. One relative commented: ‘the home is always spotlessly clean’. The manager has recently introduced a number of procedures to further improve infection control within the home. Alex Wood House Version 1.10 Page 18 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) 27,28,29,30 The home’s recruitment and selections procedures are robust and ensure that residents are adequately protected. Training is good and residents are looked after by caring and competent staff. EVIDENCE: The inspector received many positive comments from residents about staff at the home including: ‘they are charming and well mannered’; ‘staff run around after you’ and ‘they take notice of you’. The home has a rigorous recruitment and selection procedure in place and all staff interviewed by the inspectors reported that they had been thoroughly interviewed and that references and CRB checks had been taken up. They also confirmed that they had received a job description and employment contract. Training for staff is excellent: more than 50 of staff hold an NVQ level 2 in care and staff also undertake additional training specific to the needs of older people such as Parkinson’s Disease, dementia care and the protection of vulnerable adults. However, the home continues to rely heavily on agency staff and, according to information supplied on the pre-inspection questionnaire, a total of 114 shifts had been covered by these staff in the previous 8 weeks. On the day of inspection itself, 2 agency staff were working in the home. Alex Wood House Version 1.10 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 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) 31,32,33,37,38 The manager is experienced and competent for her role and the home has detailed policies and procedures in place to guide staff. The home regularly reviews its performance by actively seeking the views of residents. EVIDENCE: The manager had only been in post for a few weeks before the inspection and an application to register her had not yet been submitted. Although new to this post, the manager has extensive experience of managing a variety of care services, including previous experience of managing a large residential home. She also holds formal social work and management qualifications. The manager already has a clear vision for the home, as well as a good understanding of the areas which need improving. The home is run in the best interests of residents and systems for consulting them are good. There are regular residents’ meetings and formal consultation exercises. One resident wrote on her comment card: ‘I consider the residents’ meetings provide us with a very good opportunity to discuss every aspect Alex Wood House Version 1.10 Page 20 concerning the facilities in this home. The manager and staff explain very clearly and fully the organisation, aims and what services we should enjoy. Suggestions we make are often taken up’. Communication systems within the home are generally satisfactory and there are regular handovers throughout the day to keep staff informed of what is going on. However, one member of staff reported that information given during afternoon handover was sometimes poor and on several occasions she had not been informed that a resident was out for the afternoon. Records viewed by the inspector were well maintained, up to date and accurate and the home’s policies and procedures were regularly reviewed. The inspector viewed no major health and safety hazards during the inspection. Alex Wood House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 2 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 x x 3 STAFFING Standard No Score 27 3 28 3 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 3 3 2 2 x x x x 3 3 Alex Wood House Version 1.10 Page 22 yes 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 3 Regulation 14 Requirement Timescale for action 26 April and ongoing 2. 9 13 (2) 3. 12 16(2)(m) 4. The registred person shall not provide accommodation to a service user unless the needs of the service user have been assessed by a suitably trained person. The registered person shall make 1 July 2005 arrangemensts for the safekeeping of medicines received into the care home. Controlled drugs must be contained in a metal cupboard that complies with the Misuse of Drugs (Safe Custody) Regulations 1973 The registred person must 1 July 2005 consult service users about their social interests and make arrangements for them to engage in local and community activties. Previous timescale of 1 January 2005 not met.. An application to register a 1 July 2005 manager must be submitted to the Commission for Social Care Inspection Alex Wood House Version 1.10 Page 23 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. 6. Refer to Standard 1 7 9 22 27 32 Good Practice Recommendations The homes Statement of Purpose and Service User Guide should be developed into more accessible formats such as audiotape Risk assessments for the prevention of falls should be completed for each resident. All handwritten additions to residents’ MAR sheets should be signed and dated. This is outstanding from the last inspection A loop system should be installed in all communal areas to help those residents who are hearing impaired The high use of agency staff should be significantlly reduced Information given during staff handovers, particulalry in the afternoon, should be more detailed. Alex Wood House Version 1.10 Page 24 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Alex Wood House Version 1.10 Page 25 - 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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