Inspection on 13/04/05 for Alexander Court Nursing Home

This inspection was carried out on 13th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alexander Court Nursing Home 07/04/08

Alexander Court Nursing Home 13/04/07

Alexander Court Nursing Home 25/04/06

Alexander Court Nursing Home 24/01/06

Alexander Court Nursing Home 04/08/04

Alexander Court Nursing Home 04/05/04

Alexander Court Nursing Home 19/12/03

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Alexander Court 2 Lydgate Court Crookes Sheffield S10 5FJ Lead Inspector Sue Turner Unannounced 13 April 2005 09:20 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. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Alexander Court Address 2 Lydgate Court Crookes Sheffield S10 5FJ 0114 268 2937 0114 268 2945 Not Available Southern Cross Healthcare Services Limited 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) Mrs Susan Hepke N Care Home with Nursing 60 Category(ies) of OP Old Age (60) registration, with number of places Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: One service user named on the application for Variation of Registration form dated 19 August 2003, who is in the category DE/E; Dementia for people 65 and over, may reside at the home. Date of last inspection 4 August 2004 Brief Description of the Service: Alexander Court is a purpose built home for older people, which provides 60 places for people with personal and nursing care needs. All bedrooms have an en-suite facility. It is in a residential area of Sheffield with good access to public services and amenities for example shops, pubs, and public transport. It is built on three levels serviced by a lift. The home has single and double rooms and a suitable number of lounges and dining rooms. The home has a car park and lawned areas. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day between 9.20am and 5.35pm. An inspection of most parts of the building and grounds was carried out. A number of records, relating to those living in the home and management paperwork were checked. Time was spent talking with groups of service users in communal areas and individually with three service users. Two relatives visiting the home were spoken to. The operations manager, acting manager and seven members of the staff team were also interviewed about various aspects of the service. What the service does well: What has improved since the last inspection? Management changes at the home had benefited service users, as staff morale was high and the new management team showed real enthusiasm and commitment to improving the service offered. Relatives said that the atmosphere within the home was one of friendliness and they were always made to feel welcome when they visited. Relatives and service users said that if they had any concerns they would feel comfortable in talking to the staff or the acting manager. Staff at the home had worked very hard to action the majority of requirements made at the previous inspection. Many areas of the home had been repainted and new carpets and furniture purchased. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 6 What they could do better: 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. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 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 Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 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) 3 4 and 5 Service users needs were assessed prior to admission to the home, which ensured all care needs could be met. Specialist medical and nursing staff were regularly consulting with the staff at the home and advising about good practice. Prospective service users and their relatives were encouraged to visit the home to check out and sample the facilities available. EVIDENCE: Copies of full needs assessments were contained in service user care plans. The information from the full needs assessment had been incorporated into the care plans. Details of medical/nurse specialists who had been consulted with regard to the service users care were recorded in the care plans this assisted staff in ensuring service users needs, were met. A number of service users spoken to said that prior to admission staff from the home visited them to assess their needs and give them information relating to the home. They were also encouraged to visit the home to meet people, see the facilities available and sample the hospitality. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 9 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 and 10 One care plan checked was satisfactory. The information in two care plans was inadequate to ensure that the service users health needs could be fully met. Information regarding medication not administered needed to be clear so that service users were not placed at possible risk or harm. Service users and relatives were satisfied with the care they were receiving they said that the staff were friendly, helpful and polite. EVIDENCE: Care plans set out in detail the service users needs and the action to be taken by the qualified and care staff at the home to ensure all these could be met. The care plans had been regularly reviewed by the staff. Service users and their relatives said they were involved in the drawing up and review of the plans. This helped to make the plans more accurate. Two care plans however were not satisfactory because relevant information was not recorded. Detailed records of pressure care were kept and staff were fully aware of pressure care treatments for individuals. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 10 Prescribed medications were checked for two service users. These were kept in lockable trolleys and administered by qualified staff. The majority of medications were dispensed from blister packs. Medication was signed for at the time of administration. The code ‘F’ was used when medication was not given, the reason why it wasn’t given was not clear. Relatives said they were very satisfied with the care delivered by staff. Staff closed doors before assisting service users with personal care, which protected and promoted their privacy and dignity. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 11 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 13 14 and 15 Service users had a choice of lifestyle within the home and they were able to maintain contact with family and friends. Meals served at the home were of a good quality and offered choice. Seating arrangements during meals could pose a health and safety risk to service users. EVIDENCE: Service users said that they could participate in a variety of activities. Activities were occurring during this inspection and activities planned for the next few weeks were displayed on the notice boards. Service users said that they were able to maintain contact with their family and friends. Relatives said they were always made to feel welcome when they visited. Service users said they chose when they got up and went to bed and meals were provided as requested. Enabling them to exercise choice and control over their daily lives. Service users said the quality of food served was good and ‘plentiful’. Menus offered a good choice of food and drinks were available throughout the day and night. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 12 The majority of service users remained in wheelchairs at the table. For some service users this meant they were not ‘sat up’ enough causing them difficulties in reaching their meal and drinks. This could potentially result in a choking or scalding incident. Movement from one chair to another would also promote pressure relief for those at risk of pressure sores. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Staff had an understanding of the procedures to be followed should they suspect any abuse at the home. Complaints procedures were in place to enable service users and relatives to feel confident that any concerns they voiced would be listened to. EVIDENCE: The home had a record of any complaint/concern raised by services users and/or their family. Service users and relatives said they felt confident that if they had any complaints or concerns the acting manager would deal with this appropriately. Service users were able to give examples of the action taken when they had raised issues and said they were satisfied with the outcome. Staff had received information on adult abuse and some staff had received some formal training. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 14 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 22 23 24 25 and 26 There was a marked improvement in the general appearance and cleanliness of the home. New carpets and furniture had been provided which pleased those service users who had received them. Service users said they were happy with their surroundings. EVIDENCE: All areas of the home were clean, tidy and well maintained. Lounge and dining areas were domestically furnished. Dining room chairs and tables on the first floor were scratched and damaged, resulting in the dining room looking unappealing and unwelcoming. Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Service users spoken to said that they had all they wanted in their rooms. A number of bedrooms had new carpets and some also had new furniture, which had enhanced the look of the rooms and delighted service users. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 15 To maintain the control of infection the laundry was sited away from food preparation and cooking areas. Hand washing facilities were provided. The home had appropriate sluicing facilities and washing machines. Service users said they were satisfied with the care of their clothing. All bedrooms had an en-suite facility and specialist equipment was provided to maximise independence. The ‘reception’ on the television in the ground floor lounge was poor making the picture difficult for service users to see. Service users sat in this lounge commented on how uncomfortably hot it was. One window was open, however the other had been screwed closed and could not be opened, reducing the natural ventilation within the room. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 and 30 Staff were employed in sufficient numbers to meet the needs of the service users. Service users felt well cared for at the home. The recruitment information obtained for new staff was not sufficient to adequately protect the welfare of service users who lived at the home. Communication difficulties could pose a risk to the health, safety and welfare of service users and staff. Staff were undertaking training, which enabled them to meet the needs of the service users in the home. EVIDENCE: The acting manager stated that agreed staffing levels were being maintained. Service users spoken to said that staff were busy but did get to them as quickly as possible. A newly recruited housekeeper meant that ancillary staffing levels were satisfactory and hygiene at the home had improved. Staff spoken to said that recruitment procedures were carried out prior to employment being offered. Three staff files were checked. Two were satisfactory, however one contained only one reference, which was not from the previous employer. Neither was there sufficient information to check any gaps in employment. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 17 Twenty-eight carers were employed at the home of which only one was NVQ qualified. All staff undertook an induction programme, which the acting manager stated, met the National Training Organisation (NTO) specifications. The skills and knowledge demonstrated by a number of staff was sufficient, to meet service users needs. Service users and relatives said that, although better than before they still had difficulties communicating with some of the overseas workers, who had a limited command of English. One member of staff was observed speaking inappropriately, to another member of staff whilst within earshot of service users. The inspector spoke to the member of staff and acting manager about this on the day. Staff said that there were frequent training opportunities available to them, which enabled them to feel competent to do their job. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 18 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 36 37 and 38 There was a positive style of management in the home and staff morale had improved which will ultimately benefit the health and welfare of the service users. Arrangements for fire safety checks and fire training were not satisfactory placing service users and themselves at a possible risk of harm. EVIDENCE: The acting manager was very positive about the inspection process and committed to improving the service offered at the home. He was familiar with the National Minimum Standards and Care Home Regulations. Service users, staff and relatives said that staff morale was high and had improved further since the change to the management team. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 19 Visits by the registered provider had been carried out; written records of these visits had been made. Copies of these visits have been forwarded to the CSCI. Staff said they did have management support but they were not receiving formal supervision on a regular basis. Records were securely stored, which protected the residents’ best interests and confidentiality. Risk assessments were seen on individual service user files, had been reviewed and updated as necessary. Electrical appliances displayed evidence of PAT testing in the last 12 months. At the time of inspection fire exits were unobstructed and window restraints were fitted at first floor windows to prevent falls. Staff were aware of the procedures to follow in the event of discovering a fire. Fire records confirmed that extinguishers and systems had been checked. Weekly fire checks and emergency lighting checks had not been completed. Not all staff had received fire practices and/or drills as required by the homes policy and procedures, placing all in the home at possible risk. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 20 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 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 2 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 2 3 2 Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 7, 8 9 15 Regulation 12 13 13 Requirement Full and accurate information must be kept on each care plan. The reason why medication has not been administered must be clearly recorded. Arrangements must be made to ensure that service users are sat comfortably and safely during mealtimes. The picture quality on the television must be improved so that it is clearly visible to the service users. Dining room tables and chairs must be renovated or replaced. The ground floor lounge must be adequately ventilated. Timescale for action 15 June 2005 15 June 2005 15 June 2005 15 June 2005 1 September 2005 Immediate as instructed on the day of the inspection. 13 April 2005 1 June 2005 4. 20 16 5. 6. 20 25 23 23 7. 28 18 8. 29 18 Action must be taken to ensure that service users and staff are able to communicate effectively. Action taken must be monitored and recorded. An investigation must take place in regard to the inappropriate J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc 1 June 2005 Page 22 Alexander Court Version 1.20 9. 29 19 behaviour displayed by one staff member. The outcome of the investigation must be recorded. Staff must not be employed until full and satisfactory information has been obtained. (Previous timescale of 1 Oct 2004 not met). Immediate as instructed on the day of the inspection. 13 April 2005 1 July 2005 Immediate as instructed on the day of the inspection. 13 April 2005 Immediate as instructed on the day of the inspection. 13 April 2005. 10. 11. 36 38 18 13 Care staff must receive formal supervision at least six times per year. All staff must undertake fire drills and practices as per the homes policy and procedures. 12. 38 13 Fire system and emergency lighting tests must take place as per the homes policy and procedures. 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 28 Good Practice Recommendations By 2005 there should be 50 of the care staff trained to NVQ Level 2. Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Alexander Court J55-J06 S21763 Alexander Court V187194 130405 UI Stage 4.doc Version 1.20 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. 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!