Inspection on 05/06/07 for Alexander Court

This inspection was carried out on 5th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Alexander Court 25/05/06

Alexander Court 17/11/05

Alexander Court 27/05/05

Alexander Court 15/10/04

Alexander Court 06/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Alexander Court Carnarvon Street Thatto Heath St Helens Merseyside WA9 5QN Lead Inspector Mrs Lynn Paterson Key Unannounced Inspection 10:00 5th June 2007 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 Alexander Court DS0000022398.V338692.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. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexander Court Address Carnarvon Street Thatto Heath St Helens Merseyside WA9 5QN 01744 818500 01744 811541 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) St Helens Housing Association Mrs Barbara Helen Morrison Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to Include up to 33 (OP) Date of last inspection 25th May 2006 Brief Description of the Service: Alexander Court Care home is situated in a residential area of St. Helens, close to shops and local amenities. The home is purpose built and comprises of seven separate cluster areas all of which accommodate small groups of six residents within. Most clusters provide single occupancy bedrooms, lounge and kitchen and bathroom and toilet facilities. 2 clusters have en suite facility. All accommodation is on ground floor level. The home provides a communal dinning room and conservatory/games room area and has large well maintained grounds, which are safe and accessible. Weekly fees charged are currently £371.00. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Alexander Court was carried out on 5th June 2007 and was undertaken on an unannounced basis. The inspector met with, the manager and senior carer, seven care staff members, cook, and district nursing staff, visitors and 22 of the 27 people currently living in the home. Records care files, policies procedures, questionnaires returned from representatives of people living in the home and other documentation was examined and a tour of the premises was carried out. Fieldwork included case tracking three people who were resident in the home, which involved reading all documentation relating to their daily living and speaking with them and the staff who were associated with their care. What the service does well: Comments received from people who live in the home and their representatives clearly identified that the manager is admired and respected as being a very good manager. Comments received included: “The manager is excellent. She has the great ability to utilise her staff to enable them to meet individual need, including the needs of the family”. “ The manager is very good. She knows what she is doing and makes sure that all the people living in the home are well looked after”. “The manager and staff work very hard to provide very good care for us all”. Staff revealed that they are very much supported by the manager and are provided with quality training to ensure they could provide needs led care to all the people living in the home. Comments included: “The manager gives us support and asks us if we need any training updates”, “The manager makes sure we are provided with all mandatory training and we have opportunities to go on other training if we wish to develop our skills”. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 6 Discussions with staff and observations of them carrying out their various duties revealed that they work well together as a team and provide quality services to all the people living in the home. People living in the home said staff were very good and treated them with respect and said the food and services provided were “first class”. What has improved since the last inspection? What they could do better: The home records and document management was seen to be maintained to a high standard. However it was noted that Criminal Records Bureaux (CRB) checks had not been updated and some were overdue for renewal. Discussions were held with the manager who immediately instigated action to be taken from The Human Resources Department of the organisation to ensure all CRB were updated as a matter of urgency. Whilst this has not been recorded as a requirement it is strongly recommended that the organisation arrange a system that will identify when future CRB updates are required. Please contact the provider for advice of actions taken in response to this Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 7 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. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 8 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 Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 9 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): 3. Quality in this outcome area is excellent. Pre admission assessments are clear and detail need and wishes of people who want to live in Alexander Court to enable the home to identify if need’s can be met within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records show that contracts are provided for all people who live in the home and these documents are signed for by the person themselves or by families or appointed representatives. Copies of these documents are held on file. Care files viewed held detailed information about pre - admission assessments carried out by the manager or senior care staff. The assessment process is undertaken prior to a placement being offered and the assessment document provides full details of need, capability, choice and general issues relating to Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 10 daily living. All pre assessments were clear and fully detailed what care the person would need if they were provided with a placement. The document took into account the facilities in the home to ensure all assessed need could be met. Representatives of people living in the home said they had been fully included in pre assessment interviews and felt the manager and senior care staff who carried out the assessments were very good at gaining full information to ensure that people who were offered accommodation at the home would have their full needs met. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 11 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): 7.8.9.10.11. Quality in this outcome area is excellent, Heath and personal care needs are clearly detailed in the individual plan of care and systems are in place to ensure all assessed needs are met. Staffs are respectful to all people living in the home and provided with full training to enable them to safely manage medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans viewed were very well organised and showed dates and times of the review of care and who was involved with the review. Care plans were detailed but easy to follow and identified what care was needed, when it was needed and how it was carried out. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 12 Staffs were most knowledgeable about care practices and the needs of people who lived in the home and observational practices showed they were “exceptional” with their interactions with residents and the provision of needs led care. Representatives of people living in the home said they felt staff, were very good at proving top class care for the people who resided at Alexander Court and also for their families. Comments included: “All staff are kind and caring” “The home provides total consistency of care carried out by people who are fully committed to caring and supporting everyone in the home” “We are consulted with at all times”, “The staff here have got us through our sadness with the death of our mum”, “The staff here are our friends” Observations of thank you cards and letters expressing deep gratitude for the care and support provided and for the understanding shown to relatives of people who had died revealed that staff treated everybody with dignity and respect. In discussion staff revealed that they had clear systems regarding the arranging of internal and external medical appointments. Examination of the systems identified that they clearly showed when appointments had been arranged; transport requests and staff who would be needed to accompany the resident to the appointment. Discussions held with District Nursing staff further confirmed that care staff supported the people living in the home to have full access to all health care needs. Medication records were well managed and staff advised that they had received refresher training in all aspects of medication management since the last inspection. Staff spoken with in respect of medication displayed sound knowledge of the homes policies and practices relating to medication. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 13 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): 12.12.14.15. Quality in this outcome area is excellent. Staffs ensure that residents are provided with a good quality of daily life and social activities, which meet, all assessed need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities programme held details to show that staff, arrange daily activities and interests to suit the needs of all the people who live at the home. People living in the home said they were informed of what was going on each day and asked if they wished to take part. Care plans detailed each person’s wishes, capacity, hobbies, interests and religious needs and staff said they had drawn up activities and interests programme using this information. Staff said they respect each person for their individuality and try to ensure that all diverse needs are discussed and arrangements made to meet individual needs wherever possible. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 14 The activity of the day was noted as hairdressing, bingo and “sitting in the sun” for those who wished to do so. The visitor’s book held details of the many people who visit the home and observational practices revealed that over twenty people visited people living in the home, either to take them out in the community or sit with them in their rooms. Visitors to the home said they were always made very welcome. Visitors also said that staff shared full information with them on a need to know basis and supported them when necessary. People living in the home said they were encouraged to have visitors and to go out and enjoy interests in the community if they wished. The cook and kitchen staff showed full knowledge of all resident’s dietary needs likes and dislikes and the ding room atmosphere and food organisation was seen to be commendable. People living in the home and their representatives said the food provision of the home was excellent. They said menus were varied, choices available, food was always well cooked and nicely presented. The inspector was given an invitation to join the residents for lunch and observed that everyone thoroughly enjoyed their meal including “the inspector”. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 15 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. Complaints policies are in place and people living in the home and their representatives know about the complaints system and are confident any complaints will be listened to and dealt with quickly. Staffs are trained and knowledgeable in all aspects of adult protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy identified the complaints process and people living in the home and their representatives advised that they knew how to complain if they wanted to. Resident’s and their representatives said that the home manager and staff were very approachable if they needed to discuss anything. The complaints book was viewed and it was noted that no official complaints had been recorded since the previous inspection. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 16 Staff spoken with, were clear in their understanding of what constituted adult abuse, and of what to do if they suspected abuse was taking place? Staff training records revealed that staff, were provided with ongoing adult protection training and staff said they found the training to be useful and informative. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 17 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): 19.26. Quality in this outcome area is good. The home ensures that residents live in a clean safe comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises revealed the home was clean, hygienic, and free from unpleasant smells at the time of the visit. The home manager advised that the home had recently benefited from some redecoration to the lounge and dining room areas. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 18 The manger advised that the home had a strict health and hygiene code and they updated all policies, procedures and practices in respect of health and safety to ensure wherever possible the residents lived in a clean and safe environment. Records show that the home has ramped access to all entrance and exit areas and aids and adaptations were provided as appropriate to ensure people living in the home were able to carry out their daily living in a safe environment. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 19 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. The home has clear recruitment policies to ensure that staff members who are appointed are carefully vetted prior to commencement. Staff, are well trained and provided in sufficient numbers and skill mix to ensure residents are safe and well treated. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rotas show that staffs are employed in sufficient numbers and skill mix to meet the assessed needs of all the people living in the home. Records show that whilst the home continues to use agency staff, the number used has fallen considerably since the last inspection. Staff said if agency staff were needed they would always be accompanied by a permanent member of staff to ensure they were fully aware of the policies and procedures of the home and of the individual needs of the people living in the home. Discussions with staff and observations of them carrying out their duties show that staff are very good at what they do and they are motivated and fully committed to the provision of quality care. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 20 People living in the home and their representatives said that staffs were always on hand to provide care and support and comments included: “Staff are always around to look after us”, “Staff always seem to know what we need and when we need it”, “The staff are very good and they really know what they are doing” Staff training records reveal that staffs receive ongoing mandatory training and they are offered additional training to enable them to continue with their personal development and update their skills. The homes recruitments and selection process is clear and the process involved shows that all relevant references and Criminal Records Bureau (CRB) checks are carried out prior to any offer of employment being made. However it was noted that the CRB checks are not being updated. Discussion were held with the manager and she immediately made contact with the company Human Resources Department to ensure that any outdated CRB checks were updated as a matter of urgency. Advice was given in respect of the company policy in their management of CRB information. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 21 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): 31.32.33.35.38. Quality in this outcome area is excellent. The home is very well managed and uses quality assurance methods to make sure that the views of the people who live in the home and their representatives as to the running of the home are recorded and addressed. The home employ maintenance staff and utilise clear health and safety policies and procedures which promote and safeguard the health, safety and welfare of the people using the service. This judgement has been made using available evidence including a visit to this service. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 22 EVIDENCE: In discussion it was noted that the manager constantly monitors and reviews policies and practices and it was revealed that she has amended care planning processes which were seen to be of a high standard. The manager demonstrated in discussion that she is very experienced in her management role and continues to develop her skills and attends meetings, training and development courses to ensure she has full knowledge and understanding of any changes in practice or legislation. Senior carers presented as skilled and experienced in the care of people who resided in the home were trained and knowledgeable in their role and together with the manager committed to the home management being focused on positive outcomes for the people who live in the home. Comments received from staff about the manager included: “ The manager is really great, she supports us and leads by example”; “We know we will always get support from the manager”, “The staffs work well together because the manager really knows how to manage”. Comments from representatives of people who live in the home included: “The manager is so very skilled at her job, she manages this home to perfection”; “The home is well managed for the people who live here and for their families”. Records show the manager has systems in place to ensure that all people who live in the home have their financial interests safeguarded. People who live in the home said that they are consulted with by staff about how they wish the home to be run and sometimes have residents meetings, in which they can “have their say”. Representatives of people living in the home said they were consulted with on a regular basis about their feelings about the way the home is run and made to feel very much a part of the home. Staff of Arena Options who are responsible for the home undertake monthly quality assurance visits and also carry out random audits in the home. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 23 Records show that staffs have received full training in all aspects of health and safety and the home employs the services of a maintenance person to ensure the health and safety of staff and residents is protected. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 24 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 X X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 X X 3 Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP29 Good Practice Recommendations It is strongly recommended that the responsible person put systems in place to ensure all CRB checks are updated as appropriate. Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Alexander Court DS0000022398.V338692.R01.S.doc Version 5.2 Page 27 - 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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