Inspection on 21/12/05 for Alexander House (Palewell Park)

This inspection was carried out on 21st December 2005.

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) 10/01/07

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 21st December 2005 10:00 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.V261190.R01.S.doc Version 5.1 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.V261190.R01.S.doc Version 5.1 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 Mrs 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.V261190.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user under the age of sixty five years, who has dementia 14th July 2005 Date of last inspection Brief Description of the Service: Alexander House is a Care Home providing accommodation and personal care for up to sixteen older people. The home is owned and managed by a husband and wife team. The home caters for both privately funded service users and those people whose placements are supported by the Local Authority. The home is situated in East Sheen, close to local amenities. Accommodation is provided on two floors, accessed by a passenger lift and stairways. Twelve bedrooms are for single occupancy 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. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 21st December 2005, and was unannounced. Both Owners were present throughout the inspection. The Inspector met with service users, staff on duty and visitors. A carol service and sherry and mince pie morning were taking place on the day of the inspection. There was a warm and happy atmosphere and service users were joining in carols led by visitors from the local church. The home was decorated for Christmas and service users spoke positively about the planned festive activities. Visitors from the church and the Inspector were made welcome. Many of the service users told the Inspector how much they liked living at the home and said that the Owners and staff were kind and caring. Several service users said that they could not find any fault with the home. Fourteen people were living at the home at the time of the inspection. What the service does well: What has improved since the last inspection? There is an ongoing programme of renovation and improvements to the building, which has taken place over the past year. Recent work includes Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 6 equipping three rooms with en suite facilities, relocating and refurbishing the kitchen and building new bathrooms and WCs. One new staff member has started work at the home and has been successfully inducted. The objectives of the business plan have been or are in the process of being met. Service users have enjoyed a variety of activities and spoke about some of these with the Inspector. 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 (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3 & 4 Prospective service users are able to visit the home and have access to a range of information on the service. There are appropriate procedures for assessment to determine whether the home is able to meet individual needs. Service users have agreed to the terms and conditions of residency. EVIDENCE: The home has produced a comprehensive Statement of Purpose and Service User Guide covering the required areas. These documents include a copy of the home’s complaints procedure and a plan of the house, including room sizes. The Service User Guide includes comments written by the current service user group. There has been no changes to these documents since the last inspection. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 9 Individual contracts are in place for all service users. These include a statement of terms and conditions, arrangements for payment of fees and are signed by service users or their representative. The Manager conducts her own assessment at the potential service user’s home or in hospital. Assessments incorporate information from the service user and their representatives and include assessments made by placing authorities. Service users are invited to visit the home before they make a decision to live there. All service users are admitted on a six week trial stay. At the end of this period of time, the service user, their representatives and the home decide whether their needs can be met and whether they wish to stay at the home. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Individual needs are appropriately recorded in care plans which the service users have agreed to. Health needs are assessed, monitored and recorded. There are appropriate procedures to make sure medication is stored, administered and recorded appropriately. EVIDENCE: Individual care plans are in place for all service users. These include information on meeting a range of needs. Service users have been involved in making these and have signed a record of their agreement. Care plans include risk assessments where necessary. Care plans focus on giving service users choices and promoting independence. Care plans include aims and objectives for individual service users, detailed information on specific care needs and life histories. There is a record of all accidents and incidents at the home. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 11 Health and personal care needs are appropriately recorded and monitored. All service users are registered with local GPs and other health care professionals as required. Health care professionals report that they work well with the home and staff are well informed about individual needs. There is an appropriate medication procedure and all staff are trained. Two staff have undertaken an advanced medication course and the Manager reported that they have shared their knowledge and experiences with other staff. Medication is stored securely and records are accurate. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Service users are able to join in with a range of organised activities and are supported to maintain their independence and organised their own activities if they wish. Visitors are made welcome at the home and families are able to continue to contribute to the care of relatives if they wish. EVIDENCE: There are links with local churches and activity providers, who visit the home and also support service users to access activities away from the home. Regular activities include music and movement, craft activities, bingo, quizzes and discussion groups. The home also organises visiting entertainers, parties and trips away from the home. Service users told the Inspector that they participated in trips and were supported to use local community facilities and shops when they wished to. A visiting library comes to the home monthly. The home has its own extensive selection of books, photo albums music tapes, videos and games. Church services are held at the home monthly and service users visit local churches and places of worship. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 13 Throughout December, a number of festive activities had been arranged. These included a Christmas party and visiting entertainers. Service users who spoke with the Inspector said that they had enjoyed these activities. One service user told the Inspector that relatives were invited to join them for the Christmas party. On the day of the inspection there was a carol service led by visitors from a local church at the home. This was enjoyed by service users and visitors alike. Some of the service users had made their own Christmas decorations and cards. These were on display at the home. Service users are supported to contribute to household tasks if they wish and are able. One service user told the Inspector that they liked to clean and tidy their own room. Visitors are made welcome at the home. At this and previous inspections, visitors have told the Inspector that the Owners and staff are always very friendly and that there is a nice atmosphere at the home. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There is an appropriate complaints procedure which is available to service users and their visitors. Procedures are in place in order to protect service users from harm and abuse. EVIDENCE: There is an appropriate complaints procedure, detailing timescales and how to contact the Commission for Social Care Inspection. All service users are issued with a copy of the procedure. There have been no complaints since the last inspection. The home has adopted the London Borough of Richmond Protection of Vulnerable Adults Procedure. There are additional procedures on abuse and whistle blowing. The Manager confirmed that all staff had received training in abuse. Appropriate checks, including criminal record checks, are made on all staff prior to employment. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Service users live in a well-maintained and suitable environment. Developments have been made to areas of the building and are on going. Communal and private areas are homely and personalised. The home is clean, pleasant and hygienic. EVIDENCE: There is accommodation on two floors, accessed by a stairway and passenger lift. The home is converted from three original buildings. The home is appropriately decorated throughout and flowers, plants and ornaments added to the general ambience. The home was decorated for Christmas, and some of the decorations had been made by service users. There is a well maintained, attractive garden to the rear accessible via a ramp. There is an ongoing programme of decoration and general improvements to the environment. Over the past year, toilet and bathroom facilities have been Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 16 improved, the kitchen has been relocated and refurbished and en suite facilities have been built for three bedrooms. The outside of the house was being painted at the time of the inspection. There are plans for further improvements in 2006. There are two lounge areas and a separate dining room. These are appropriately furnished and equipped. Service users were seen to spend time relaxing, socialising, pursuing activities and dining in these rooms. The home is equipped with specialist baths, hoists, a call alarm system and a stair lift. The Manager reported that specialist equipment needs are assessed by health care professionals and are appropriately met. The Inspector saw evidence of appropriate checks and servicing on equipment. Twelve bedrooms are for single occupancy and two are shared. Four bedrooms have en suite facilities. Bedrooms have been personalised by service users and are suitably equipped. The home is appropriately lit, heated and ventilated. The Inspector saw evidence of appropriate checks on water supply and heating installations. The home was clean throughout on the day of the inspection. There are appropriate procedure on infection control, clinical waste and Control of Substances Hazardous to Health. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Staff are employed in sufficient numbers and are suitably trained and supported. Recruitment practices are designed to protect service users. EVIDENCE: The home is appropriately staffed and the staff have job descriptions and information on their roles and responsibilities. Two members of staff have left the home since the last inspection. One new member of staff has been employed and they are due to start their NVQ Level 2 in January 2006. Then Inspector saw the recruitment records for the newly employed member of staff. There was evidence of thorough pre employment checks and a full induction to the home. The staff at the home have undertaken a range of training. Recent training includes medication, food hygiene, effective communication, health and safety and protection of vulnerable adults. Three staff have completed NVQ Level 2 and two more staff are due to start this in 2006. There is a record of monthly staff meetings, which include discussions on key procedures. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 38 The Owners are appropriately qualified and experienced and their management style is positive, open and inclusive. Regular checks are made on the environment and equipment to make sure people are not at risk. EVIDENCE: The home is owned by a husband and wife team. 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 service users. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 19 The Manager keeps herself updated in training and has recently undertaken training in prevention of falls and infection control. At this and previous inspections the service users and their visitors have praised the management style and approach. The staff report that they are well supported and have a good working relationship with the Owners. There are appropriate checks made on health and safety at the home, including checks on fire safety, water, gas and electrical safety. These are recorded. Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 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. 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 X X X X X 3 Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 21 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. Refer to Standard Good Practice Recommendations Alexander House (Palewell Park) DS0000017353.V261190.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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