Inspection on 10/01/07 for Alexander House (Palewell Park)

This inspection was carried out on 10th January 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 House (Palewell Park) 21/12/05

Alexander House (Palewell Park) 14/07/05

Alexander House (Palewell Park) 13/10/04

Alexander House (Palewell Park) 13/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Alexander House (Palewell Park) 1-3 Palewell Park East Sheen London SW14 8JQ Lead Inspector Sandy Patrick Unannounced Inspection 09:45 10 January 2007 th 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 House (Palewell Park) DS0000017353.V325889.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 House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexander House (Palewell Park) Address 1-3 Palewell Park East Sheen London SW14 8JQ 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) 020 8876 6927 020 8876 6927 Mr Rechade Goolam Mohidin Sau Kan Mohidin Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user under the age of sixty five years, who has dementia 21st December 2005 Date of last inspection Brief Description of the Service: Alexander House is a care home for up to sixteen older people. The home is owned and managed by a husband and wife team. The home caters for both people paying for their own care and those people whose placements are supported by the Local Authority. The home is in East Sheen, close to local amenities. Accommodation is provided on two floors, accessed by a passenger lift and stairways. Twelve bedrooms are for one person and two are shared. There is a large well maintained garden to the rear. There is a small parking area to the front of the home and roadside parking is available. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. The fees range from £520 to £600 per week. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 10th January 2007. The Inspector met with people living at the home, the Owners (one of the Owners is also the Registered Manager) and staff on duty. The Inspector was made welcome and spent time talking with different people and looking at records and the environment. Shortly before the inspection, the CSCI wrote to the people living at Alexander House, the staff, visitors and other professionals asking them what they felt about the home. 9 residents, 8 members of staff, 8 visitors and 9 professionals completed questionnaires. Information from the questionnaires has been used as evidence throughout the inspection report. The residents said that they were happy with the care and support that they received. Some of the comments people made were: ‘I am very happy here, it is very good.’ ‘I am very happy here and could not be better looked after. Everyone is very nice and helpful.’ ‘I have a lovely room.’ ‘The staff are very helpful and kind.’ ‘It is all first class.’ ‘I am very well looked after and lucky to be here.’ ‘I have lived here for many years and am very happy here. ‘I am very happy here. More than satisfied.’ ‘Wonderful care and support.’ ‘The home is well run and I am happy to be here.’ The staff said that they were happy working at the home and were well supported and trained. They were asked to comment on what they felt the home could change to improve the way it works. There were no suggestions. One person wrote, ‘I would not change a thing in this home since for me it is the perfect home for everyone’. The staff were asked to comment on things they felt the home did really well. Some of the things they said were: ‘Provides a comfortable place for residents.’ Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 6 I have never regretted a day of it and I am treated with respect by day and night staff.’ ‘All the staff and managers get along with each other.’ ‘There is a family atmosphere.’ ‘The residents are treated very well.’ ‘The Manager is very committed.’ ‘The home gives quality care with diversity, respect and dignity for the residents. They are happy living here.’ ‘It is not institutional and there is no set time for breakfast and when residents go to bed.’ ‘There is always a nice atmosphere.’ ‘The Manager is always here making sure everyone is happy and ok.’ Some of the things that friends and relatives said that the home did well were: ‘There is a caring atmosphere, a home from home.’ ‘Encouraging people to mix with others and keeping them happy.’ ‘The Owners lead by example, they are always cheerful, approachable and helpful. The staff follow suit. Visitors are made welcome at any time.’ ‘A lovely atmosphere, much kindness and attention to individual details and care.’ ‘Provides a home from home atmosphere.’ ‘The staff are very patient. The food always looks good.’ None of the friends or relatives had any suggestions for improvements. One person wrote, ‘improvements are always being made to the residents’ advantage’. Professionals said that they felt the staff communicated well and were knowledgeable. They said that they felt individual needs were always met and that the managers were open and caring. One professional who works with other care homes said that they felt Alexander House was a ‘far nicer place’ than other homes they worked with. One professional wrote, ‘the residents are treated as individual and the home is sensitive to changing needs.’ Everyone who spoke to the Inspector during the visit said that they were very happy at the home and that the Manager, Owner and staff were all very kind and supportive. What the service does well: Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 7 The people living at Alexander House are happy and feel well cared for. The staff are happy and well supported. The Owners are very committed and work alongside staff every day. The home has good links with the local community and local Churches. The staff work well with other professionals. There is a relaxing family atmosphere and visitors are made welcome. People are consulted about their care and about changes to the home. The Owners have an excellent knowledge of individual needs. The Manager works with other organisations to make sure she and the staff have up to date training and information. 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. The summary of this inspection report can be made available in other formats on request. Alexander House (Palewell Park) DS0000017353.V325889.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 House (Palewell Park) DS0000017353.V325889.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving to the home have a range of written information and are able to visit with friends and family. The Manager always visits new people in their home (or hospital) and gets as much information about them as possible to help make sure the home can meet their individual needs. People are supported to settle in and feel at ease when they move to Alexander House. EVIDENCE: There is a detailed Statement of Purpose and Service User Guide which include comments from the people living at the home. These are reviewed and updated as necessary. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 10 People completing questionnaires said that they had access to the home’s inspection reports. Everyone completing a questionnaire said that they had enough information to help them make the decision about moving to the home. Some of the comments people said were, ‘I received a brochure which was full of information and photographs. I was visited by the Manager while I was in hospital. After that I visited the home one morning. I liked the atmosphere which was very homely’, and: ‘This was the first home I visited and the one I liked out of many I looked at’. Everyone has the opportunity to visit the home before they make a decision to move there. There is a trial stay period and the new person or the home can make a decision that the home isn’t right for that person during this time. They have a review meeting at the end of this time to make sure the home is getting everything right for that person. Everyone who completed a questionnaire said that they had received a contract. Copies of these are kept by the home and given to individuals during their admission. The Manager makes an assessment of need for each potential resident and visits them at their own home or in hospital. The assessments include information from the person, their relatives, social workers and other professionals who work with them. The assessments are used to help develop a care plan. One person who spoke to the Inspector during the visit had recently moved to the home. They said that they had settled in well and were very happy. They said that the staff had really helped them. Another person who had moved to the home a few months before said that they had been really well supported with moving to the home and that they felt very comfortable there. The Inspector looked at the file for the newest person. This contained an assessment made by the Manager who had visited the person in hospital. The person had also visited the home and had brought a friend with them. The file contained information from the hospital, social worker and medical professionals. Alexander House (Palewell Park) DS0000017353.V325889.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. This judgement has been made using available evidence including a visit to this service. Each person has their own care plan and these are well designed and look at individual needs. There should be further work to look at how these can be made more meaningful to the person they are about. The staff work closely with other professionals to make sure health needs are monitored closely and met. This includes caring for people who are dying so that they can remain at the home. Medication is well managed. EVIDENCE: Everybody has a care plan which includes information on meeting their personal, social and medical needs. Care plans are reviewed monthly. They include individual long and short term aims. Care plans have been signed by Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 12 the person or their family. Annual review meetings to make sure the home is meeting the needs of each person are held. The care plans are well designed and give good information for staff. The Manager has a good awareness of individual needs and people are consulted about their care. However, the Manager needs to think about how care plans and other information can be presented in a way which is useful and meaningful for each individual. This may mean recording information in different formats, using different language, terminology and photographs. Each person should have a copy of their own care plan so that they know what is written about them. The Manager and some staff planned to take Person Centred Planning training shortly after the inspection. This will help them to think about different ways of recording information and involving people. The Manager said that some people have given information on their life histories. This is an area where there could be further work. The staff should work with the individual and their family to help build up a collection of information and photographs that would help them to get to know about the person’s life before they moved to Alexander House. Everyone who completed a questionnaire said that they received the support they needed, including medical support. The Manager said that new people had the opportunity to meet with the GP before they registered with the local surgery. One relative wrote, ‘Since my mother has been at Alexander House there has been a marked improvement in her mental and physical health. I am very happy with the home, they are very caring’. Another relative wrote, ‘Medical problems are addressed promptly and the GP is consulted’. One person wrote, ‘The doctor and district nurses come whenever necessary. Also the chiropodist and optician visit regularly.’ District nurses who visit the home said that the staff work well with them and that they always gave clear and appropriate information. They said that the staff were sensitive to changes in medical needs and made timely referrals to their service. They said that they had cared for some people at home before they moved to Alexander House and they had noted general improvements in their health. There is an appropriate medication procedure which is kept under review. This includes a homely remedy (non prescribed medication) procedure. The staff have had appropriate training. Medication is stored appropriately and records are accurate and well maintained. The Manager undertakes a regular audit of medication held. One person administers their own medication. There is a risk Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 13 assessment in place and the person has a lockable area to keep their medicines. There is information for staff on all the medications used in the home and possible side effects. Personal care needs are recorded in care plans and people said that they could have baths and showers whenever they wished. The Manager said that they aim to care for people at the home for as long as they can. Over the past year they have cared for some people at the end of their life with the support of palliative care nurses and district nurses. The Manager said that the health care teams had been very supportive and had provided verbal and written information to help staff give the right support and to cope with their own feelings at a time which can be hard for everyone. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a variety of organised activities and people are able to pursue their own interests. The staff support people to be in control of their own lives and to remain independent where possible. Families and friends are welcome at any time and feel involved and well informed. There is a varied menu and people generally enjoy the food. The Manager is looking at ways to improve the menu further to meet everybody’s needs. EVIDENCE: Everyone completing a questionnaire said that there were always or usually activities arranged by the home that they could take part in. One person said that they felt there should be more support for people to pursue individual interests if they could not do this on their own. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 15 On the day of the inspection visit, some people were relaxing in the lounge, others were busy doing craft activities or cross words and some were relaxing in their bedrooms. The Inspector spoke with almost everybody and they all said that they were happy and well supported. One person said that they were able to make their own bed and do basic household chores. The Manager said that people are supported to be as independent as they want and to continue to manage their own rooms as much as possible. One person spoke to the Inspector about going out. They said that they were able to go to the local shops and to visit places of interest. Regular activities include craftwork, quizzes, an exercise class and outings with a local group who visit the home and support people who want to join them. Some school children and other volunteers visit the home and spend time with individual people reading and chatting. The Manager and one other member of staff play the guitar. The Manager said that they regularly have sessions where they play and people can sing along if they want. The home is well stocked with quiz books, games, jigsaws, books, DVDs and other resources which people can use individually or together. Since the last inspection a cake baking group has started. People said that they really enjoyed this and the Manager said that it was a very popular activity. The Manager keeps a record of all the activities people participate in. Some of the comments people made about activities were: ‘There are church services and holy communion once a month. as handicrafts.’ ‘We do bingo and exercises once a week. Occasional trips to Kew Gardens are arranged. Individuals pursue different interests, such The hairdresser visits regularly.’ ‘There are good parties for special occasions.’ ‘If they wish residents are given a special tea party on their birthdays for all residents, friends and family to enjoy.’ All the people who live at the home who completed questionnaires stated that they were white British. They felt that their cultural needs were met. The staff who completed questionnaires said that they felt equality and diversity issues were recognised and managed effectively. Some of the comments they made were; ‘Everyone is treated equally and well respected regardless of race or colour.’ ‘Everyone is treated as an individual and has the same rights.’ ‘We have learned about this through our NVQ training.’ There is a regular church service at the home and members of the local church visit regularly and escort people to church. Some of the local church members completed questionnaires. They said that they felt individual cultural and spiritual needs were recognised and supported. People living at the home said that they had Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 16 really enjoyed the celebrations at Christmas time, which included a party, carol service and a traditional Christmas day. Relatives completing questionnaires said that they were made welcome at the home and that they were kept informed and able to continue to be involved in caring. Some of the things that they wrote were: ‘I visit the home daily and am always given information on my mother’s health and general well being.’ my mother.’ ‘I look ‘I am always made welcome at the home. to visiting and cannot compliment The the hospitality is very generous.’ ‘I am always informed of any situation relating to forward management and staff highly enough.’ Visitors are welcome at any time and many people visit daily. Relatives are able to be involved in caring if they wish and are invited to special meals and parties. They are able to take people out when ever they want and have a good relationship with the Owners and staff. People are able to make decisions about their own lives and their care. Those who spoke to the Inspector and completing questionnaires confirmed this. The ethos of the home is one of sharing information and looking at individual needs. Everyone said that the staff are polite and respectful and the Inspector witnessed this. Everyone completing questionnaires said that they always or usually liked the meals at the home. People who spoke to the Inspector during the visit said that they liked the food. The menu is varied and the Manager has started to look at introducing some new different dishes in response to a request from some people. Some of the comments people said about the food were: ‘I always look forward to meals.’ ‘I always enjoy my meals and have enough to eat.’ ‘The food is excellent and plenty of it.’ ‘Sometimes I find the meals quite plain.’ ‘I especially like the roast dinners. It would be nice to have a bit more variety.’ The Manager hopes that the new menu dishes will give some people the wider variety they want. She should regularly consult with these people to make sure they are happy. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 17 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, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to make complaints if they need to. There are procedures designed to help protect the vulnerable people who live at the home. EVIDENCE: There is a suitable complaints procedure. Everyone completing questionnaires said that they knew who to speak to if they were unhappy about anything and how to make a complaint. There have not been any complaints since the last inspection. Some of the comments people made were: ‘I do not wish to make any complaints as I am very happy and contented here and could not wish for anything better.’ ‘You can always approach any member of staff or the management with problems.’ ‘If I was unhappy about anything I would speak to the Manager and she would put it right.’ All residents have representatives external to the home. Everyone is on the electoral register and is supported to vote at elections. The home has agreed to the London Borough of Richmond protection of vulnerable adults procedure and has its own procedures on abuse and whistle blowing. The staff are all trained in this area. Criminal record checks are made on all staff. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is spacious, appropriately decorated, clean and well maintained. There are ongoing improvements to the building. EVIDENCE: The home is converted from three original buildings and is on two floors. The home is nicely decorated and there are flowers, ornaments, pictures and other personal touches throughout. There is a well maintained and attractive garden accessed by a ramp. There is a large dining room and two lounge areas. Two rooms are for two people and the others are single rooms. No one was sharing a room at the time of the inspection. Five bedrooms have en suite facilities. The Inspector was invited to see some people’s bedrooms. These Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 19 had been personalised with furniture and individual belongings, pictures and ornaments. People were relaxing in communal areas and their rooms throughout the inspection. Over the past few years the Owners have made improvements to the building and this is ongoing. The kitchen has been redeveloped, new bathrooms have been built and several rooms have been equipped with en suite facilities. This work continues and five bedrooms now have en suites. Some bedrooms have been redecorated and some have had new carpets. The Manager said that she plans for more redecoration over the next year. The building is equipped with hoists, call alarms systems, a stair lift, handrails and other equipment needed by the people who live there. Everyone completing questionnaires said that the home was always clean and fresh. One person said, ‘Any mess is cleaned up immediately and the home always smells fresh.’ Another said, ‘Everywhere is always very clean and welcoming.’ Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. People living at the home feel confident and well supported by staff who are appropriately recruited, trained and supported. EVIDENCE: The home is fully staffed and there have been no staff changes since the last inspection. One waking and one sleeping staff work at night. All the people living at the home who completed questionnaires said that the staff listened to them and acted on what they said. They said that staff were available when needed. The staff completing questionnaires felt that enough people were employed to provide a good service. They felt there was a good mix of skills within the staff team. The relatives, visitors and professionals said that they felt the staff demonstrated a good understanding of needs and communicated well. Some of the things people said about the staff were: ‘There is always someone here to help me if I need it.’ ‘I find the staff caring and supportive at all times. Alexander House (Palewell Park) They go out of their way to be helpful and DS0000017353.V325889.R01.S.doc Version 5.2 Page 21 considerate.’ ‘The staff are always kind and helpful. They are available at any time of the day and night.’ ensure her wellbeing.’ ‘I have always been impressed with the patient Much time is given to ‘The and caring respectful way the staff treat my mother. ‘The staff are kind, patient and well trained.’ Owners lead the team by their wonderful example. They are there everyday overseeing the care of the people who live there, providing an outstanding atmosphere of happiness which the carers follow.’ The staff completing questionnaires described thorough recruitment procedures, including a formal interview and checks. Staff files are complete and evidence thorough pre employment checks. The staff all said that they had been given a full induction into their role and the home. One person wrote, ‘I was given a full induction as soon as I started working here’. The staff all said that they were given relevant training and had regular team and individual meetings with the Manager. Meetings are recorded. The Manager uses these meetings to share information from the CSCI and other agencies. The staff can also contribute their ideas and opinions. The kitchen staff have recently updated their food hygiene training. The staff are supported to undertake NVQs in care. Some have completed these and some were undertaking them at the time of the inspection. The staff access training run by the local authority, Primary care Trust and other local training organisations. The Manager is a member of a group of care providers who work together to look at shared training needs and access these together. Recent training for staff includes stroke awareness, dementia, manual handling, fire protection, medication, communication and report writing. One of the Owners has updated fire risk assessment and health and safety training. The Manager and some of the staff are due to undertake person centred planning training. Some of the things staff said about training were: ‘I am doing my NVQ Level 2 and have nearly completed this.’ ‘I have completed my NVQ Level 2, dementia, safe handling of medication, abuse and manual handling training.’ ‘I am doing my NVQ Level 2 at the moment.’ Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 22 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, 34, 35, 36, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service is well managed and the Owners are committed to continuous improvement. They involved the residents, staff and others in development and regularly monitor and check how people feel that they are doing. EVIDENCE: The home is owned by a husband and wife. Both are qualified nurses and are qualified to NVQ Level 4. They took over the ownership and management of the home in 1997. Previous to this they owned and managed another home. Both partners are involved in the day-to-day management of the home and one is the Registered Manager. Both have consistently demonstrated an in depth knowledge of the service and the needs of the people who live there. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 23 The staff completing questionnaires said that they were well supported and were given opportunities to influence how the home was run and developed. One person said, ‘The managers are very committed – they are always here making sure everyone is happy’. Another member of staff said, ‘The Manager is really approachable. We are all well looked after.’ The Manager has an excellent knowledge of each individual. She knows people’s likes and dislikes, preferences and communication needs well. She genuinely cares about the people living at Alexander House. The Manager said that she tries to involve everyone in all aspects of the day to day running of the home, including choosing plants for the garden and planning menus and activities. The Manager is a member of local groups of care providers who meet to discuss common issues and share ideas and experiences. The group has invited representatives of the CSCI and London Borough of Richmond to offer support and information. The Manager keeps herself updated of changes in good practice and care through various organisations and publications. The Manager gives annual questionnaires about the service to the people who live at the home and their families. The majority of these had been returned at the end of 2006. The Manager has reviewed the information and had put in place an action plan to address any areas of concern raised. The Inspector saw the information from these. The majority of people rated the service as excellent in most areas, in particular staffing, choices and quality of care. Some people had some recommendations for changes to the menu. The Manager explained how she had spoken to individuals regarding menu choices and looked at ways to improve things for them, offering them alternatives if they wanted these. The Owners develop an annual business plan which looks at the needs of the service and proposed changes for the year. They keep this under review and record changes made. People who live at the home or their representatives manage their own finances. Any expenditure made on their behalf is processed by way of invoice. Copies of these are held on file. There are regular checks on health and safety, including fire safety. These are recorded. Since the last inspection a new fire panel has been installed. The Fire Officer and the Environmental Health Officer visited shortly before the inspection. Neither made any recommendations or requirements. The Environmental Health Officer was happy with the new kitchen and the food hazard analysis. The Owner has been on a course in this area and was able to demonstrate how he put his knowledge into practice at the home. Alexander House (Palewell Park) DS0000017353.V325889.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 4 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 4 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 4 4 4 3 3 3 3 4 Alexander House (Palewell Park) DS0000017353.V325889.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 OP7 Good Practice Recommendations The Manager and staff should look at how they can record information, including care plans and key procedures, in a more user friendly format, involving individuals in developing their life plans. Alexander House (Palewell Park) DS0000017353.V325889.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 House (Palewell Park) DS0000017353.V325889.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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