Inspection on 01/11/06 for Alexandra Court

This inspection was carried out on 1st November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Alexandra Court 21/01/10

Alexandra Court 10/12/08

Alexandra Court 14/03/06

Alexandra Court 06/12/05

Alexandra Court 02/02/05

Alexandra Court 19/10/04

Similar services:

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

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

CARE HOMES FOR OLDER PEOPLE Alexandra Court Howard Street Pemberton Wigan Lancashire WN5 8BD Lead Inspector Mike Murphy Unannounced Inspection 1st November 2006 09:30 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 Alexandra Court DS0000005666.V310280.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. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Court Address Howard Street Pemberton Wigan Lancashire WN5 8BD 01942 215555 01942 738753 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) Mr Keith Lowe Judith Melling Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (6) of places Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include:up to 40 service users in the category of OP (Older Persons) up to 6 service users in the category of PD (Physical Disabilities under 65 years of age) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th March 2006 2. Date of last inspection Brief Description of the Service: Alexandra Court is a care home situated within the Pemberton area and is close to local shops and other facilities nearby. Public transport is easily accessible. Access to the motorway network is also nearby. The home is purpose built and all personal accommodation is provided in single rooms each with an en suite facility. Accommodation is provided on two floors with a passenger lift allowing access to the upper floor. Alexandra Court provides Intermediate Care that has been commissioned by the Primary Care Trust and Social Services Department. Care arrangements can be used to facilitate earlier discharge from hospital following an acute episode of illness; alternatively, it can provide care to prevent admission to hospital for people who have a short term episode of ill health, which does not require specialist medical intervention. All admissions have a time-limited stay, maximum being six weeks. No fees are directly payable by patients for the intermediate care service provided at Alexander Court. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection visit took place over a period of seven hours. The inspection included discussion with some patients, relatives, consideration of responses in the pre-inspection comment card sent to patients and visiting professionals, a tour of the premises, inspection of care and other records maintained by the service and discussion with the registered manager and staff. Alexander Court was being appropriately managed and provided patients with a clean and comfortable environment in which to undertake their programme of rehabilitation. Patients were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. What the service does well: What has improved since the last inspection? Discussion with the manager revealed that the way the quality of the service provided by Alexander Court is monitored at the home is constantly being reviewed and improved on. As part of this process Alexander Court has applied for ‘Investors in people’ status. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 6 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. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 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 Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Potential patients are appropriately assessed prior to admission and are provided with an appropriate rehabilitation programme. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 9 EVIDENCE: The assessment system that is used is well organised, detailed and incorporates the National Service Framework single assessment process. All assessments are conducted by an appropriate health care professional and are reviewed by the manager of the home (a qualified nurse with many years experience). All assessments are documented appropriately. Alexander Court provides Intermediate Care for a maximum of forty male and female patients who need a period support and rehabilitation to enable them to return to their own home and live as independently as possible with the aid of appropriate support services. Alexander Court is appropriately equipped to allow skills assessments to take place. These include Occupational Therapy kitchen assessments and a Physiotherapy gymnasium to assess and maximise patient’s mobility. The service is staffed with Registered Nurses Occupational Therapists Physiotherapists and social workers that together with the care staff and visiting medical and other health care professionals form the multi disciplinary team. Multidisciplinary team meeting were held on the unit each Tuesday to the assess patients progress. The pre-admission assessments of six patients were inspected. These were detailed and well organised. Following admission appropriate assessments are made by the multi disciplinary team and individual goal settings agreed with the patient. The patient’s (and family) involvement in the planning, implementation and review of care is reflected in the care planning documentation. Patients confirmed that they had been involved in their assessment and were satisfied that their health and rehabilitation needs were being met by the staff team. Staff were aware of their objectives in supporting their patients to maximize their rehabilitation potential. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care Patients are provided with is suitable and is meeting their assessed needs. EVIDENCE: Alexandra Court provides Intermediate Care that has been commissioned by the Primary Care Trust and Social Services Department. These arrangements can be used to facilitate earlier discharge from hospital following an acute episode of illness; alternatively, it can provide care to prevent admission to hospital for people who have a short term episode of ill health, which does not require specialist medical intervention. All admissions have a time-limited stay, maximum being six weeks. Care is provided on 2 separate floors within the home. 6 patients care records were inspected – 3 from each floor. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 11 Care records were organised in a standard format throughout the home. All contained detailed pre and post admission assessments that clearly identified the care needs of patients. The care records are, maintained by the members of the multi-disciplinary team involved in the rehabilitation and support of patients. Care plans clearly identified how patient’s assessed needs were to be met by identifying exactly what actions and support needs to be provided to support them appropriately. Care plans were formally reviewed on a regular basis. Care plans were person centred and recognised the diverse needs of residents. Particular areas of risk are formally ‘risk assessed’ regularly to protect patient’s health and safety. Examples of such risk assessments included those completed in relation to preventing pressure sores, mobility, and moving and handling and nutrition (including regular weight monitoring). Medical care is provided by a designated responsible medical officer who visits Alexander Grange frequently and it was evident that all patients were enabled to access chiropodists, tissue viability and diabetic nurses and other specialist services that individual patient’s required. Relatives spoken to indicated they were kept informed of progress and were actively involved in the planning of their relatives discharge – preparation for discharge begins as early as possible in the rehabilitation process to ensure that patients return home at the appropriate time with an appropriate support package in place. The procedures for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. The nurses are responsible for all aspects of managing patient’s medicines in the home. Patients who are able to take responsibility for their own medicines are appropriately assessed and provided with a secure space in their rooms to keep their medication safely. Medicine records had been completed properly. Discussion with patients revealed that they are treated with respect and that their right to privacy is upheld. Comments made included; ‘ all the staff are very nice and they encourage me to do things for myself as much as possible but support me to do so’, ‘they have literally got me back on my feet since I came in here and have been very kind to me and my family’, ‘ I am kept fully informed and my opinions are regarded as important in all areas of my care’, ’the staff speak to you properly and knock on your door before they come into your room’ . During the inspection staff treated patients with respect, kindly, protected their dignity and assisted them properly. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Patients are actively encouraged to pursue their interests and maintain their family and social contacts whilst undergoing their period of rehabilitation. EVIDENCE: As the purpose of the service is to provide an intensive period of rehabilitation over a relatively short period of time a formally structured programme of leisure and recreational activities is not provided. However the health and social needs of patients are considered in the context of their present circumstances and those that will prevail when they are discharged. Patients confirmed that they were quite happy to pursue their own interests between the intensive therapy sessions. Patients are encouraged to maintain contact with their family and friends as well as accessing facilities in the local community. Service users are able to receive visitors and meet with them in private. There are no unreasonable restrictions on visiting patients at Alexander Court. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 13 Menus revealed that patients are provided with a varied and balanced diet. Meals are taken in the main dining areas. The general view was that the food was good and provided reasonable choice. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Patients spoken to felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards in place to protect the welfare of patients. EVIDENCE: The complaints procedure was prominently displayed and is also available in the ‘Service users guide’ that is provided for patient’s and their relative’s information. A record of complaints made to the home is maintained. Complaints and incidents appeared to be managed appropriately. Where necessary complaints are jointly managed with the other agencies involved in the provision of this service. Alexander Court operates protection of vulnerable adults and whistle blowing policies that seek to protect those using the service. In addition, a copy of Wigan’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was reflected in Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 15 training records maintained by the home) and were aware of the whistleblowing policy. Appropriate pre-employment checks are conducted on all staff to help ensure that residents are cared for by suitable staff. Discussions also indicated that the manager and her staff understood the needs of vulnerable people and had awareness that they can sometimes subjected to unfair treatment, which needed to be challenged. The home had a number of written policies covering such topics as harassment, bullying and anti racism. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,24,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Alexander Court appeared to be structurally well maintained throughout and provides a suitable and comfortable environment for the rehabilitation of patients. EVIDENCE: Alexander court was in a good state of repair and reasonably decorated throughout. Communal lounge and dining areas were clean, suitably heated, comfortably and appropriately furnished and provided a suitable environment for patients to be cared for and supported properly. Appropriate provision of televisions, music centres and other leisure equipment has been made. Patients are also able – when the weather is suitable - to access the pleasant garden areas within the grounds of the home. Appropriately adapted bathing/shower areas are provided. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 17 The home has been suitably adapted to meet the needs of patients in relation to specialist equipment. Individual patients specialist needs are met following referral of the individual to the relevant health care professional for assessment. Patient’s bedrooms that were inspected were very clean, suitably furnished and equipped. All bedrooms are provided with en-suite WC and washbasin. The home was very clean and free of malodour. Suitable arrangements and equipment were in place to manage the laundry requirements of patients at the home. And appropriate measures were being taken to minimise the potential spread of infection within the home. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 18 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. The recruitment and training of staff employed at the home are being managed appropriately. This is important to ensure that residents are being cared for adequately and appropriately by staff who are able to deliver this support safely and competently. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with the manager and other senior staff at the home indicated that they were of the view that current staffing levels at the home were appropriate to meet the assessed needs of patients. The following evidence was gathered during my recent inspection of Alexander Grange which although registered separately to Alexander Court is managed by the same registered manager and who manages her responsibilities for staff recruitment and training centrally. Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training and further training. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 19 NVQ 2, 3 and 4 training in health and social care is being provided for staff. At the time of inspection over 50 of care staff had achieved or were in the process of achieving the NVQ 2 qualification or above. Also a wide range of appropriate and ongoing training in moving and handling, abuse, basic food hygiene, fire safety and other relevant topics are provided to staff at the home. The home employs a senior person who manages the training needs of staff and quality assurance issues within the home. Discussion with this person revealed that training within the home has been reviewed and amended to comply with the new standards in respect of induction and further training recently introduced by the Skills Council. Training provided to individual staff is recorded in detail and reviewed at frequent intervals. Staff spoken to felt their training needs were being addressed. And many felt this not only made them more competent but also made them feel more valued in their work. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Alexander Court is well managed by the very experienced manger, a qualified registered nurse with many years of experience in general nursing and care of the elderly. EVIDENCE: The home manager is registered with the CSCI and is a very experienced registered nurse and has completed an NVQ4 in management. Discussion with patients, their relatives and staff employed at the home indicated that the manager is very accessible, approachable, provides excellent leadership, is Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 21 supportive and is very aware of what is happening in the home. She is supported in her role by her senior nursing and care staff. The following evidence was gathered during my recent inspection of Alexander Grange which although registered separately to Alexander Court is managed by the same registered manager and whose management and administration functions are centralised. A wide range of quality assurance systems are in place to ensure the home is run in the best interests of patients including regular care reviews, regular multidisciplinary meetings, staff meetings, internal audits, and regular satisfaction surveys. Patients and their relatives report that the manager and her senior staff operate an ‘open door’ policy that enables people to raise and discuss any areas of concern quickly and comfortably. Records in respect of fire safety equipment, fire drills, electrical safety, gas safety, safety of lifting equipment, clinical waste (including waste medicines) removal, and the regulation of water temperatures were inspected. These were found to be satisfactory. Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 22 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 X X 4 3 3 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 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 3 X 3 X 3 X X 3 Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 23 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 Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Alexandra Court DS0000005666.V310280.R01.S.doc Version 5.2 Page 25 - 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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