Inspection on 10/12/08 for Alexandra Court

This inspection was carried out on 10th December 2008.

CSCI found this care home to be providing an Excellent service.

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 01/11/06

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 16/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alexandra Court Howard Street Pemberton Wigan Lancashire WN5 8BD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Murphy     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Alexandra Court Howard Street Pemberton Wigan Lancashire WN5 8BD 01942215555 01942738753 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Judith Melling Type of registration: Number of places registered: Mr Keith Lowe care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 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. Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 25 Over 65 40 0 0 6 Brief description of the care home 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. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This inspection which included a site visit that the home did not know was going to take place was carried out over a seven hour period on the 10th of December 2008. The process of inspection included observing what went on in the home, talking to people using the service, staff, visiting health and social care professionals and the home manager, looking round the home, and examining some important records. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they Care Homes for Older People Page 6 of 25 did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form was completed well. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential users of the service are appropriately assessed before admission and are provided with a suitable programme of rehabilitation that seeks to maximize their independence. Evidence: All people who are admitted to the home have to be in need of specialist rehabilitation that is known as intermediate care. People are assessed for such rehabilitation whilst receiving care in hospital or the community. The assessment is very detailed and identifies what needs to be done to help and support each individual to return home and live as independently as possible. The assessment process was discussed with five people being rehabilitated. They all said the need for rehabilitation was explained to them, their agreement was obtained, they were involved in the process and were of the view their wishes were respected throughout. The home solely provides intermediate care and the maximum stay is about six weeks. Care Homes for Older People Page 10 of 25 Evidence: Appropriate space and equipment is provided. For example a physiotherapy gymnasium enables peoples mobility needs to be assessed and treated. Also an occupational therapy assessment kitchen is available. The home is staffed by qualified occupational therapists, physiotherapists and social workers who together with nursing, medical and other staff form a team who meet regularly to assess each individual persons progress. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal care, support and rehabilitation needs of people using the service were being met appropriately. Evidence: The care records of four people using the service were inspected. These all contained detailed information and care plans that detailed the care, support and rehabilitation needs people had and how these were being addressed. All records including care plans and risk assessments (that seek to keep people safe) were specifically developed for the individual concerned. Care records were well organised and up to date. They are completed by all the members of the rehabilitation team for example by nurses, doctors, physiotherapists and occupational therapists. This keeps all staff informed of the individual persons progress and ensures they are all following the same programme of rehabilitation. The care records also showed that people using the service were able to access health care services from chiropodists, dieticians and other specialists. This was confirmed in discussion with people using the service. They were of the view that their health and social care needs were being appropriately met. Care Homes for Older People Page 12 of 25 Evidence: Medicines were being safely managed at the home. The arrangements for medicines were secure and properly documented. The qualified nurses managed medicines at the home. Where appropriate, people being rehabilitated were encouraged to manage their own medicines. This was being assessed, recorded and monitored properly. Discussion with people using the service revealed that their privacy and dignity were respected. Comments made included they are all marvellous and have helped me enormously, I have been helped to walk again and I cant thank them enough and it has all been done in a kind and respectfull way, when they help you they make sure your dignity is kept, everybody has been caring and very nice, I have no complaints, all the staff have treated me well, they are decent and good natured people and respect your privacy, I have been very well looked after, they are very kind and well sorted me out and I have got my confidence back thanks to them. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are encouraged to maintain their family and social contacts and pursue their interests whilst undergoing their programme of rehabilitation. Evidence: The purpose of the service is to provide a programme of rehabilitation over a maximum period of about six weeks. Therefore there are no formal arrangements to provide a programme of social and leisure activities seen elsewhere in care homes. However discussion with people using the service revealed that the programme of rehabilitation kept them occupied and that they had enough to occupy them between therapy sessions. Bedrooms are all provided with a television. All lounge areas are provided with televisions, music centres and other recreational materials such as DVDs and books. People using the service also said they were able to have regular visitors to see them and were also encouraged to access activities in the local community. No unreasonable restrictions on visiting were reported by people using the service. The home does however politely request that visitors try to avoid mealtimes. Discussion with those using the service indicated that they were encouraged to make individual choices and stay as independent as possible. Each person goes through a programme of rehabilitation that is specific to them and which is developed in full consultation with Care Homes for Older People Page 14 of 25 Evidence: them and requires their full agreement. Comments made included I do feel that I am listened to and am able to make choices, I am in control and staff respect my views and decisions, I have been involved in all the decisions regarding my future and feel I have been listened to. Menus were prominently displayed, varied, balanced and provided choice. Lunch was served on the day of inspection. This was a hot substantial meal. Staff served and assisted people appropriately and sensitively. The two dining rooms provided pleasant areas to take meals. Those spoken to said food was of a high quality, was sufficient, and meal times were reasonable. Hot and cold drinks were provided regularly and snacks were available at all times. Those spoken to had no complaints concerns regarding the food and drink provided. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of people using the service. Evidence: The complaints procedure was prominently displayed and is also supplied to all people staying at the home. Those spoken to said they had been given information about how to make a complaint when they were admitted. They also said they understood how to make a complaint and were clear what would happen if a complaint was made. The home keeps a full record of complaints made and this includes details of the investigation and actions taken. Unless there are exceptional circumstances the manager responds within the agreed timescale. The home learns from complaints and it is rare that a complaint about the same issue is made twice. The home operates safeguarding and whistle blowing policies that seek to protect people. In addition a copy of Wigans interagency protection plan is also used. Staff spoken to confirmed they have been provided with safeguarding training (this was also reflected in staff training records maintained at the home) and were aware of the whistle blowing policy. Appropriate pre-employment checks are conducted to ensure all staff are suitable to provide care and support to those using the service. Care Homes for Older People Page 16 of 25 Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home environment provided a suitable environment for people to be cared for, supported and rehabilitated appropriately. Evidence: The home has been completely refurbished since the last inspection. The lounges and dining areas were clean, warm, suitably and comfortably furnished and suitably adapted and equipped. People being rehabilitated said the home environment was very comfortable and always clean. Suitable aids and adaptations had been provided throughout the building including in bathrooms, shower rooms and individual bedrooms. Four bedrooms were inspected on this occasion. These were clean,warm, suitably ventilated, well lit and decorated and comfortably furnished (including provision of a TV). All bedrooms are provided with an ensuite WC and washbasin. People using the service were satisfied with the laundry arrangements. Appropriate arrangements have also been made to minimize the spread of infection within the home. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment, provision and training of staff employed at the home are being managed appropriately. This is important to ensure that people using the service are cared for adequately and appropriately by staff able to deliver this support safely and competently. Evidence: People using the service said they were being properly supported by nurses, carers, occupational therapists and other staff. They also stated they were helped in a kindly and timely way. The staff team were working together to ensure each individuals rehabilitation, care and support needs were being met. However discussion with the manager revealed that there had been recent difficulties (due to changes in personnel) in providing three nurses during the day and three at night (meaning that at times there were two and one on duty respectively). However we have been informed that this has been addressed by the recruitment of qualified nurses due to start working at the home in early 2009. It is also noted that when the numbers of nurses were reduced extra care staff were on duty, the registered manager (herself a qualified nurse) was available on call at all times, and nursing staff were available in case of emergency at Alexandra Grange care home that is on the same site as Alexandra Court. The home continues to make progress in the provision of training leading to a nationally recognised qualification in care, National Vocational Qualification (NVQ), Care Homes for Older People Page 19 of 25 Evidence: level 2 and 3 training. At the time of inspection in excess of 80 of the care staff had received such training. 3 staff recruitment files were inspected on this occasion. They contained evidence of criminal records checks, 2 written references, criminal convictions declarations, proof of identity and completed application forms which included a detailed work history and a declaration relating to the prospective employees health status. Checks were made and recorded in respect of the status of registered nurses with their registered body. Training records and discussion with staff indicated that they were provided with induction training on starting employment. There was also documentary evidence that staff had been provided with training in moving and handling, safeguarding, fire safety and basic food hygiene and other relevant topics. There is a strong commitment to training at the home. The registered manager is supported by a senior member of staff who is responsible for organising and monitoring all staff training at the home. A very detailed training plan has been developed. Individual staff training records were very detailed and indicated that staff have been provided with a very wide range of relevant training. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager was managing Alexander Court very effectively in the interests of residents. Evidence: The registered manager has the qualifications (she is a qualified nurse and holds a management qualification) and experience to run the home properly. She is particularly experienced in managing the type of rehabilitation service (known as intermediate care) the home provides. She works very closely with the local health and social services organisations to ensure the service provided is well organised and effective. People using the service and staff working at the home tell us that the registered manager shows strong leadership, is very supportive, makes herself available and is approachable, listens to people and is responsive. The home was being run in the best interests of those using the service. The programme of rehabilitation provided to each person is specifically designed for that individual. Those spoken to confirmed they were involved in all decisions relating to Care Homes for Older People Page 21 of 25 Evidence: their rehabilitation and felt that they were retaining control of their own lives and what happens to them. The home actively seek the views of people using the service throughout their rehabilitation as one of the ways they measure how good and effective the service provided is. This helps the registered manager identify any issues and take the appropriate action. There is also a system in place where the registered manager and senior members of her staff team carry out checks (audits) on how things are run in the home. For example, the standard of care records, the environment and catering. These actions are all important in helping to assure peoples confidence in the the quality of the service provided. The registered manager informed us that people using the service or their relatives (or other supporters) manage all personal monies - none are managed by the home. People using the service all have a lockable space. They are advised not to bring valuables into the home as their stay is for a limited period of rehabilitation. The health, safety and welfare of people using the service were being promoted and protected. Staff had been provided with training in moving and handling techniques, fire safety, first aid, basic food hygiene and how to minimize the spread of infection. All training was being updated periodically. Gas, electrical and fire safety equipment had been regularly inspected and serviced. Hazardous substances (such as cleaning fluids) were being securely stored. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!