Inspection on 17/11/05 for Alexander House

This inspection was carried out on 17th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alexander House 04/07/06

Alexander House 06/04/05

Alexander House 27/08/04

Alexander House 04/05/04

Alexander House 16/02/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOME ADULTS 18-65 Alexander House 16 Tivoli Road The Park Cheltenham Glos GL50 2TG Lead Inspector Mr Paul Chapman Unannounced Inspection 17th November 2005 09:30 Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 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 House DS0000016359.V269478.R01.S.doc Version 5.0 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 Adults 18-65. 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 House DS0000016359.V269478.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alexander House Address 16 Tivoli Road The Park Cheltenham Glos GL50 2TG 01242 513525 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) Dr Ahmed Elbanna Mrs Lesley Elbanna Mrs Lesley Elbanna Care Home 9 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (3), Old of places age, not falling within any other category (1) Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th April 2005 Brief Description of the Service: Alexander House is a three storey period town house with accommodation for eight adults with a range of disabilities. The home is conveniently situated in Cheltenham, which enables service users to access local community facilities. Service users also have access to transport that is provided by the home and this enables them to access facilities in several other local towns. The home is staffed 24 hours a day, seven days a week. Family and friends are welcome to visit the home at any time and service users can meet them in private if they wish to. In general the service users organise their own activities, but sometimes the manager will organise trips or activities. Service users access a local College and Day Services. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. It is recommended for the reader to gain a more comprehensive overview of the service provided at the home that they read this report in conjunction with the announced inspection report dated 06/04/05 This inspection was completed over a period of 2 hours on a morning in November and focused on the home’s progress towards meeting the requirements of the previous report. When the inspector arrived the manager was out but returned during the inspection. The inspector spoke to 3 of the service users, 1 member of staff and the manager during the inspection. The inspector took the opportunity to speak to a service user who had recently moved into the home whilst also examining their assessments and care plans. A tour of the building was completed and the three service users who spoke to the inspector allowed them to see their bedrooms. What the service does well: The home provides the service users with a comfortable, homely environment with ample communal space. Service users commented on how much they liked living at the home and how good the staff and the food was. The last service user to move in was able to visit the home on a number of occasions before they moved in. They commented that they thought this was really good as they were able to get to know the staff and service users before they moved in. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 Prospective service users are given the opportunity to visit the home before they move in enabling them to make a decision based on their experiences rather than the home’s literature alone. The home completes assessments of prospective service users needs before they move into the home. EVIDENCE: Since the previous inspection a new service user has moved into the home. The inspector spoke to them at length about this process. They stated that they were given all the information they required to make a decision about moving into the home. In addition to this information they visited the home for 2 or 3 hours a day for a month where they were able to meet the other service users and see what the staff and the home were like. The service users file was examined and showed that an assessment had been completed by the service user’s care manager and by the manager of the home. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 Care plans are developed with service users empowering them to decide exactly what their care plan includes. Service users are supported to make decisions when required but are usually encouraged to make decisions for themselves. EVIDENCE: When speaking to the new service user they explained that they have a key worker and that they have been developing their care plan with them. Examination of the service user’s file showed that the care plan was being developed and requires finishing. As part of the service users probationary period weekly reviews are currently being completed. Other service users care plans were examined at the previous inspection and no shortfalls were identified. No restrictions to the service user’s choices were identified and evidence was available to show that staff were supporting them with some decisions where it was appropriate. The inspector spoke to a number of the other service users who all appeared happy with the care they were receiving and the interactions Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 10 witnessed between the staff and service users were seen to be positive and respectful. All records are stored securely in the office. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 16, 17 Staff support the service users appropriately to take part in leisure activities and personal development. The food served at the home is chosen by the service users and is healthy and nutritious. EVIDENCE: The new service user explained that since they have moved into the home they have had the opportunity for personal development. They explained that the staff at the home are supporting them to build up a network of friends and activities. They explained that they had visited a local social club and been supported to complete their shopping. In addition to this they are employed locally. As part of their programme to develop their independence skills staff are supporting them to cook meals three times a week. Conversations with the other service users gave examples of the other activities they are involved in. A recommendation of the previous inspection was for the staff to accurately record the food that is offered to the service users. Examination of the menu book on this occasion showed that this was being done and that the service Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 12 users are offered a choice. In conversation with the service users they stated they chose the meals and that the food was nice and if they wanted something else that was not on the menu for that day they could have something else. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were inspected on this occasion. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home’s complaints procedure enables the service users to make their views heard if they are unhappy. EVIDENCE: The service user who had recently moved in stated that she had not received a copy of the complaints procedure but she had read the version posted on the home’s notice board and understood what actions to take if she was unhappy. The manager must ensure that in future any person admitted to the home is issued with a copy of the complaints procedure and that where appropriate they explain the procedure to them. A requirement from the previous inspection was for the manager to go through the complaints procedure with each of the service users and ensure that each of them had a copy. This had not been achieved by this inspection and the requirement is carried over in this report. The manager and inspector spoke about disclosures made by service users. The inspector recommended that the manager records any future disclosures and stores them securely. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 The home is a comfortable and spacious and provides the service users with a safe environment. Bedrooms are personalised by the service users who are able to exercise choice as to their style and colour schemes. EVIDENCE: The home provides the service users with a homely comfortable environment with adequate communal space. At the time of this inspection the home was clean and tidy with no offensive odours. To the rear of the home is a large garden that is well maintained. During the good weather service users had barbeques. At the time of the inspection the home’s hard wiring was being replaced, this was a requirement of the previous inspection. Due to the work required to renew the home’s hard wiring a number of areas around the home will require some decoration and the manager said that this is planned on completion of the work. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 16 A tour of the premises was completed. The previous inspection report required that the manager replaced the floor covering in the entrance to the kitchen. This requirement had been met with a new floor covering now fitted. The new service user decorated their own bedroom choosing the colours and furniture they wanted. They told the inspector they really liked their bedroom. Some of the other service users allowed the inspector to see their bedrooms. The rooms seen were personalised their possessions and one spoke about the decorating they had done recently. The downstairs bathroom is in need of decoration, as it is looking a bit tired, this was brought to the attention of the manager. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 To minimise the risks to the service users all potential staff must be subject to a thorough recruitment procedure. EVIDENCE: A new staff member has been employed and the inspector examined the home’s recruitment procedure. The new worker is foreign and the manager has completed POVAfirst and CRB checks. But, the manager must also seek an equivalent CRB check from the worker’s country and request a reference from the worker’s previous employer in that country. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were inspected on this occasion. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 X Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alexander House Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000016359.V269478.R01.S.doc Version 5.0 Page 20 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. Standard YA22 Regulation 22 Requirement Timescale for action 03/03/06 2. 3. YA27 YA34 23(2) b 19 The manager must ensure that all of the service users have a copy of the homes complaints procedure. The manager must explain this process to each person to ensure they understand it fully. (Requirement from the previous report, timescale 17/06/05) The Downstairs bathroom must 14/04/06 be re-decorated. The manager must ensure the 03/02/06 recruitment issues identified in this report are addressed 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 YA23 Good Practice Recommendations The manager should record any future disclosures made by service users. Alexander House DS0000016359.V269478.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 House DS0000016359.V269478.R01.S.doc Version 5.0 Page 22 - 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. 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