Inspection on 18/11/05 for Alexandra Centre For Physical Disability &Sensory Impairment

This inspection was carried out on 18th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alexandra Centre For Physical... 11/09/06

Alexandra Centre For Physical... 27/06/05

Alexandra Centre For Physical... 10/03/05

Alexandra Centre For Physical... 19/08/04

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The Vicarage

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5 Seafield Road

Trevaylor Manor

Honeybourne House

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Stallcombe House

Stepping Stones

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

CARE HOME ADULTS 18-65 Alexandra Centre For Physical Disability &Sensory Impairment 23 Howard Road Queens Park Bournemouth Dorset BH8 9EA Lead Inspector Joanne Pasker Unannounced Inspection 18th November 2005 11:30 am Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 1 Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 2 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 Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 3 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. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Name of service Alexandra Centre For Physical Disability &Sensory Impairment 23 Howard Road Queens Park Bournemouth Dorset BH8 9EA 01202 528420 01202 528420 Address 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) Care Services (Bournemouth) Ltd trading as Alexandra Centre for Physical Disability Mrs Sylvia Jean Rundell Care Home 14 Category(ies) of Physical disability (14), Sensory impairment registration, with number (14) of places Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 5 SERVICE INFORMATION Conditions of registration: 1. 2. One named service user (name known to NCSC) in the category PD(E) residing at the Centre. Day care provision for a maximum of 5 service users in the category PD. 27th June 2005 Date of last inspection Brief Description of the Service: The Alexandra Centre for Physical Disability and Sensory Impairment is registered to accommodate up to 14 service users under the PH category. Two bedrooms are registered as doubles but only one used for shared occupancy. The home has been specially adapted to meet the needs of this group of younger service users. An attractive conservatory has been added affording extra communal space. Many of the occupational and leisure activities take place in this room. Alexandra Centre is fully equipped to ensure a totally inclusive environment for each individual. There is a garden which can be assessed via a ramp for wheelchair users. The home is located in a quiet residential area but close to all local amenities. Alexandra Centre offers both a caring yet busy and positive environment for the service users residing there. The Centre has it own bus which can accommodate up to four wheel chair users. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection had been conducted as part of the normal inspection process legally required. Mrs Rundell, the registered manager, was available throughout the inspection and Mr Nathoo, the proprietor, was present for part of the inspection. Both were helpful and available to answer questions and provide documentation as needed. Five residents were spoken to, two in private and the others in the communal lounge/conservatory. One visitor was also interviewed in private. Two staff files were inspected and two staff spoken to. A selection of bedrooms and the communal areas were seen during this inspection. The time taken on this inspection was 9 hours, three of which were spent in the home. The terms resident and service user used in this report are interchangeable. What the service does well: What has improved since the last inspection? What they could do better: Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 7 Pre-admission assessments would benefit from having more detail about how the information was gathered, including clear dates, where the assessment took place, who was present and gave the information. It is important to ensure that all staff files meet the employment and recruitment standards and contain up to date references and statutory checks. Staff supervision records and minutes of residents and staff meetings need to be kept up to date and provide the reader with a level of detail of any discussions which took place. 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. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 8 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 Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 9 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 • Pre-admission assessments are completed with a new resident prior to being admitted to the home, ensuring that a prospective resident’s individual needs and choices are met. EVIDENCE: The files of three residents were read on the day and showed that a good picture of the person’s needs was gathered prior to admission. The registered manager confirmed that visits to the home were arranged for prospective service users, their relatives and care managers prior to a possible admission. The registered manager would then visit the person to further assess the home’s ability to meet their needs and complete a pre-admission assessment. It would be beneficial if the date and where the assessment was completed, was documented on the pre-admission form and also whom the information was gathered from, for example, service user, relative, hospital, district nurse. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 10 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): 9 • Service users are safely enabled to lead an independent lifestyle by first assessing any risks taken, together with the home. EVIDENCE: Individual service user plans were evident in all files looked at and gave a clear account of each resident’s choice of lifestyle. Risk and safety issues were identified on care plans and individual risk assessments were also in place for individuals identified needs e.g. bed rails and falls. There was evidence that risk management strategies were in place and that these enabled service users to take responsible risks rather than restricting their activities. Residents told the inspector that they were supported to make their own decisions about their lives on a daily basis and take responsible risks e.g. freedom to attend appointments/activities in the community and use public/pre-arranged transport as appropriate. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.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): 12, 16 & 17 • Service users have opportunities for personal development and are able to take part in appropriate activities. • Service users are offered a healthy diet and mealtimes are flexible to suit services user’s lives. EVIDENCE: The home offers a variety of trips and activities to the residents and residents are able to choose what they wish to join in. Some residents prefer to stay in their own bedrooms and staff respect their wishes. Alexandra Centre employs two Activities Officers who work with either small groups of residents or on a one to one basis according to the resident’s needs and preferences. On the day of the inspection three residents with a visitor were playing dominoes in the conservatory; another was watching Test Match Cricket and others were observing what staff and other residents were doing. All residents and staff eat together and the main meal is in the evening. All residents are told what the menu is for that day and are then free to choose to have an alternative if they wish. All menus are kept however there was no record of the alternative dishes residents would have eaten. Menus are Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 12 regularly discussed at the resident’s meeting and healthy eating is encouraged. One resident confirmed how staff had helped and supported him to change his diet and as a result he was feeling much more positive about himself and his general health having changed his daily diet and intake. Evidence for these standards was obtained from discussions with residents, staff and the Registered manager. One resident spoke of having recently gone out independently to do their shopping and another of a trip to their family home. One resident described the meals as “ gorgeous” Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.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): 19 • Alexandra Centre provides a high level of flexible personal care and support to residents. The philosophy of openness means that any physical or emotional health needs are addressed as soon as the Manager or staff are aware of them. EVIDENCE: One resident said they could always talk to any member of the staff or manager at anytime and knows they will always listen to any worries and give good advice and support. Discussions with staff, the manager and residents confirmed that staff provide flexible personal care and support. One resident said that staff help with certain tasks but allows them to be independent with others. Two resident’s files were looked at on the day of inspection and health care needs were clearly set out, taking into account both physical and mental health needs. There was evidence that medical details were recorded and records showed service users had good access to healthcare professionals such as speech and language therapists, district nurses and dentists. Good records were kept of service users current medication and further information about specific health needs was available in the home. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 14 One resident’s file had a specific care plan regarding a particular medical condition and this was well documented. It contained clear information for staff, information about the condition and guidelines to follow regarding its management. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 15 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): These standards were assessed and met at the previous inspection. EVIDENCE: Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 16 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 • Alexandra Centre is decorated and furnished in a style that provides a comfortable and homely environment. The home offers a good complement of communal space. EVIDENCE: A tour of the premises demonstrated the Proprietors on going commitment to maintaining the home in good repair. Sine the last inspection new carpets have been fitted in all the downstairs communal areas and gradually the wooden window frames are being replaced with PVC windows. Bedrooms for wheel chair users have wide access and have sufficient room for ensuring staff can safely manage residents using their specialist equipment. The kitchen is fairly small and not accessible for residents. However, this is the only part of the premises, which residents cannot fully access. The large communal lounge and dining/conservatory provide sufficient space for activities and residents are free to access their bedrooms if they wish throughout the day. There is level access to all entrances/exits at Alexandra Centre and ample off road parking for the home’s specially adapted vehicles and visitors vehicles. One resident’s bedroom had a considerable number of handwritten staff instructions stuck on the wall, It recommended these should be kept more discreetly. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.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, 35 & 36 • Recruitment procedures need to be improved to ensure all residents are protected by robust employment standards. • Staff are clear about their roles and responsibilities and demonstrated a good understanding of the residents individual and collective needs. • Peer support at Alexandra Centre is positive and senior staff and the manager provides supervision. However, records of these sessions were not up to date. EVIDENCE: Staff spoken with during the inspection had a good understanding of their roles and of the home’s aims and values. They said they enjoyed working in the home and many staff members have worked at the home for several years. Observations throughout the inspection further demonstrated the excellent relationship, which has developed between staff and residents. Staff training is on going and the manager has now developed a comprehensive Training matrix which clearly indicates when staff have received and when they are due training. In addition to statutory training special interest training courses have been attend and include, continence training, Makaton workshop and Dysphasia awareness. A total of eight staff have completed NVQ s and a further two staff have commenced NVQ level 3. All staff are currently completing a distance learning Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 18 course provided by Poole & Bournemouth College in First Aid, Basic Food Handling and Administration of Medicines. One senior member of staff is completing a Management course. No specific training has been undertaken on Vulnerable Adults though the Manager stated all those staff completed/completing NVQs will have undertaken this compulsory modular. Issues have arisen with safe recruitment practise when it appears staff members have left the employment of Alexandra centre and then “rejoined” However, any person wishing to do this should be considered a new recruit and therefore all recruitment procedures and statutory checks and references must be completed. With reference to this two staff file were examined and found not to be complete. The manager said they had not appreciated this would be required and will rectify this comission. Staff supervision records were not up to date and whilst it is acceptable to undertake the occasional “group staff supervision” records of these sessions must be recorded and minutes of meetings must be recorded and not merely topics the agenda. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 19 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): 39 & 42 • Alexandra Centre has a formal quality assurance system. However on the day of the inspection the most recent report could not be found. • The manager and staff team ensure safe working practices to safeguard and protect the residents as far as practical in all aspects of daily living. EVIDENCE: From discussions and observations of staff and residents it is clear that the needs of the residents are paramount in the day to day running of Alexandra Centre. All those residents spoken with spoke well of all the staff and said it was “the best home”. The open atmosphere between all the staff and the residents ensures the wishes of the residents are heard and acted upon. In addition to this daily monitoring of resident’s views a set of questionnaires is circulated and then collated into a report, which is available to all residents and visitors. Unfortunately on the day of the inspection the most recent report and questionnaires could not be found. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 20 Detailed records of maintenance were examined and found to be satisfactory. A new remote call bell system has been installed and a new hoist specifically to suit a resident’s needs has been supplied. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 21 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 x Standard No 22 23 Score x x Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Standard No 3 x x x x x x Score x 31 32 33 34 35 36 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 x 16 3 17 x x x 1 3 1 CONDUCT AND MANAGEMENT OF THE HOME 3 Standard No 37 Score x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 x x 38 39 40 41 42 43 x 2 x x 3 x Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 22 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 YA34 Regulation 19 Requirement The registered manager must operate a thorough recruitment procedure and ensure all references and statutory checks are obtained before making an appointment. Staff must receive regular recorded supervision at least six times a year. Timescale for action 31/01/06 2 YA36 18 (2) 28/02/06 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 YA2 Good Practice Recommendations Pre admission assessments should be clearly dated and include more details of where the assessment was carried out and whom the information was gathered from. Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Alexandra Centre For Physical Disability &Sensory Impairment DS0000003909.V253766.R01.S.doc Version 5.0 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. 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