Inspection on 06/12/05 for Alexandra Court

This inspection was carried out on 6th December 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alexandra Court 21/01/10

Alexandra Court 10/12/08

Alexandra Court 01/11/06

Alexandra Court 14/03/06

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 Bernard Tracey Unannounced Inspection 6th December 2005 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.V257932.R01.S.doc Version 5.0 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.V257932.R01.S.doc Version 5.0 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.V257932.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maxium 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 Comission for Social Care Inspection. 2nd February 2005 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. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a four-hour period. The home was not notified that the inspection was going to take place. The following records were read; residents’ records relating to how the care of residents was planned and carried out, medication records, complaints records, staff rosters, accident records, training records and staff files. The Inspector spoke to numerous staff members, the manager and two visitors. The Inspector spoke at length to five residents and more during the tour of the home. All of the residents spoken with said they had no concerns. All had been recently discharged from hospital and said they were benefiting from the care and treatment they were receiving in Alexandra Court. They said that the staff were “very helpful and prompt to give assistance”. They said that “the home is comfortable and the food very good, well presented, and served to their table”. They said that they had been given a welcome pack on arrival, which gave them all the information they needed about the services provided in the home. Residents said that they were pleased with their bedrooms and ensuites. What the service does well: Alexandra Court has been commissioned to support people to return home, following rehabilitation in a homely setting, after a stay in hospital. There is a well-established partnership between health and social services staff with good communication systems in place to ensure that admissions, ongoing support, and discharges, are managed with residents’ welfare as a priority. Residents have access to specialist health services and a visiting G.P. The home works within the remit of a rehabilitation service and periods of stay over six weeks, are extended only if this is in the resident’s best interests. The assessment and ongoing review of care is thorough, which makes sure that the residents’ care needs are being met. The care plans are well written and contain details of any specific intervention required. All care plans are reviewed monthly or more frequently if there are changes to the needs of the residents. Residents spoken to said that they were involved in any decisions that affected their care and daily living. A good level of staff training was in evidence and required staffing levels are Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 6 consistently maintained. A high level of in-house expertise is available to the residents to support their recovery to good health and mobility. A number of residents were spoken to during the course of the morning, comments were;‘Food excellent, staff kind, cannot fault them in anyway’ ‘staff very good and kind, food alright, I sometimes eat in the dining room’ and ‘I was happy with my transfer here and all the staff seem nice’. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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.V257932.R01.S.doc Version 5.0 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): 3 6. A member of the PCT assesses residents before admission to the home to ensure the placement in a rehabilitation unit is appropriate to their needs. Residents are provided with clear information regarding the admission and assessment procedures to ensure they are informed how their care needs are to be met. EVIDENCE: Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 9 The assessment documents in place are very detailed using the National Service Framework single assessment process, and the information contained within these assessments exceed the requirements of this Standard. The home provides Intermediate Care facilities for up to forty male and female residents who require a period of short - term support and rehabilitation to enable the individual to return home and live independently or with the appropriate support services in place. The home is adequately equipped to enable skills assessments to take place, including Occupational Therapy kitchen assessments and a Physiotherapy gymnasium to assess and treat mobility. The home is staffed with Registered Nurses Occupational Therapists Physiotherapists and social workers that together with the nursing staff form the multi disciplinary team. The assessments of three residents examined were detailed and accurate. It was identified that the intermediate care assessor, which forms the single point of access to the service, had undertaken a detailed assessment prior to the individual being referred to the home. Following admission appropriate assessments are made by the multi disciplinary team and individual goal settings agreed with the resident. The residents’ involvement in the planning, implementation and review of care is evident in the care planning documentation. Multidisciplinary team meeting were held on the unit each Tuesday to the assess residents’ progress. Residents confirmed that they had been involved in their assessment and were happy that their needs were being met by the home. The staff spoken to were well aware of the care needs of the individual residents and this was confirmed during the inspection through observations of the care practices being carried out. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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 Resident’s welfare is closely monitored to ensure that all health needs were met. EVIDENCE: Individual care plans are in place for each service user. The care plans of three service users were inspected. The care plans were detailed and included the assessments of the service users health, personal and social care needs identified in Standard 3 of this report. Detailed care actions were in place. The care plans that were examined on the inspection were evaluated and reviewed by the multi disciplinary team on a weekly basis detailing the progress of the service user and actions needed to ensure the rehabilitative process was maintained. There was documentary evidence that service users and their representatives, where appropriate, were involved in the planning and review of their care. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 11 Service users spoken with at the inspection were able to describe the process and events that led to their admission to the home, were clear regarding the purpose of the home and were involved in their individual treatment programmes of care. There is a protocol for the residents to be assessed by the community pharmacist, with a view to taking responsibility for their own medication. The resident, following assessment as able to self administer medication, has a lockable space in which to store medication to which designated staff may have access with the resident’s permission. All members of staff receive instruction and training in preserving the privacy and dignity of service users on induction, and a signed form indicates acceptance that the training has been given and received. Medical examination and personal treatment is provided in the privacy of the resident’ s own room or in the home’s treatment rooms. Relatives and friends are encouraged to visit as often as possible and the home operates an open visiting policy, which is referred to in the Statement of Purpose and confirmed in discussion with residents. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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): None of the key standards were examined on this inspection. EVIDENCE: The key standards were not inspected on this occasion but will be inspected at the next inspection. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 13 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 Procedures for dealing with complaints and reporting abuse were satisfactory ensuring people are adequately protected. . EVIDENCE: The complaints procedure is easy to understand and gives an assurance that complaints will be responded to within 28 days. . Residents spoken with were aware of this document. The complaints procedure is displayed in the reception area and a copy is attached to the Service User Guide. A record is kept of all complaints made and any necessary action taken within the timescales described. Information is also available throughout the home providing details of advocacy services along with the contact numbers and addresses. As the home is an Intermediate Care facility the residents retain control over their personal finance and retain their legal rights in relation to their affairs. The resident will therefore remain on the electoral register detailed prior to coming to the home. If the individual was in the home at the time of a local or general election it would the individual’s responsibility to make arrangements for postal balloting, but the care staff would be available to support the resident in arranging the delivery of the necessary forms. Policies and procedures regarding the protection of the vulnerable adult are robust and ensure residents are protected at all times. Induction and foundation training ensures staff are aware of their responsibilities to protect Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 14 vulnerable adults in their care. A discussion with members of staff demonstrated an awareness of the procedure to follow in the event of an allegation of abuse. Positive comments have been received from residents and relatives in relation to the care received during their stay within the home. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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 21 22 23 24 25 26 The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely and safe environment. EVIDENCE: A programme of routine maintenance and a programme of renewal of the fabric and decoration within the home were made available at the inspection. The garden area, to the rear of the home, provides a well maintained and safe environment for the service users and their visitors. There are ample car parking spaces available. There are four lounges including a designated smoking area. Smoking is not allowed in the dining rooms or bedrooms. The communal areas provide comfortable and domestic style furnishings. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 16 There are accessible toilets for the service users, clearly marked, close to the lounge and dining areas and each service user has an en suite facility as part of their private accommodation. The en suite facilities provide accessibility to service users who may use wheelchairs, or other aids to their mobility. There are adequate numbers of assisted baths as well as bathrooms providing the option for service users to be assessed using bath facilities of a domestic type in readiness for their return home. The premises have been professionally assessed by a qualified occupational therapist. The manager stated that equipment required is provided to meet the assessed needs of individual service users. Specialist equipment is provided through the Physiotherapist and Occupational Therapist who work within the home. A dedicated therapy and assessment facility is provided and personal accommodation is designated and arranged as far as possible, to mirror the service users own home. There is a lift within the home and all communal areas are accessible. Grab rails are fitted to toilets and showers and baths are assisted. Nurse call bells were seen to be available and accessible. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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 well trained to ensure they have the competencies to meet residents needs. There is sufficient staff to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: The Inspector examined three staff files and found that they contained all the information required, confirming that the recruitment procedures had been followed. The Inspector examined the rotas and found that the staffing levels were sufficient for the number of residents in the home and to meet their needs. Training is very high on the agenda and very comprehensive records are kept of the training undertaken by staff, competently overseen by the Quality and Training Co-Ordinator. Staff spoken to informed the Inspector of the training that they had done. They stated that they are encouraged to attend courses and given the time and support to do this. The Inspector observed the positive manner of the coordinator and her skill and enthusiasm in obtaining training opportunities for the home. Staff spoken to said that they were clear about their role and work Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 18 well as a team to ensure the individual and collective needs of the residents are met. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 19 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): None of the standards were examined on this occasion. EVIDENCE: The key standards were not inspected on this occasion but will be inspected at the next inspection. Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 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 X X 4 X X 3 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 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Alexandra Court DS0000005666.V257932.R01.S.doc Version 5.0 Page 21 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. 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.V257932.R01.S.doc Version 5.0 Page 22 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: 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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