Inspection on 08/01/09 for Alexandra Court

This inspection was carried out on 8th January 2009.

CSCI found this care home to be providing an Good 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 18/01/07

Alexandra Court 07/03/06

Alexandra Court 18/08/05

Alexandra Court 16/09/04

Alexandra Court 11/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alexandra Court 333 Spen Lane West Park Leeds LS16 5BS     The quality rating for this care home is:   two star good 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: Paul Newman     Date: 0 8 0 1 2 0 0 9 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 28 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 28 Information about the care home Name of care home: Address: Alexandra Court 333 Spen Lane West Park Leeds LS16 5BS 01132743661 01132179555 courtalexandra@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacinta Jackson Type of registration: Number of places registered: Mr Charles Wray Nelson care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Alexandra Court is a privately owned care home with 24 registered places for older people. Personal care only is provided with any nursing support provided by the district nursing service. The accommodation is provided over two floors with the first floor being reached by a passenger lift. An extension to the original building has bedrooms with en suite facilities. There is ample provision of communal sanitary facilities throughout the home. Lounge and dining rooms are situated on the ground floor. There are raised patio areas to the rear of the building. The home is situated close to the ring road and is easily accessible by car or public transport. There are numerous community facilities close by including churches, GP, dentists, opticians, shops and a library. Information about the home and the services provided is available to prospective residents in the form of a Statement if Purpose and service user guide that are available at the home. The current range of fees is four hundred and twenty pounds for a single room to four hundred and thirty five per week for a single room Care Homes for Older People Page 4 of 28 0 Over 65 24 Brief description of the care home with en suite facilities. The provider gave this information in January 2009 but the fees are usbject to annual review. Care Homes for Older People Page 5 of 28 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: two star good 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: This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means that the people who use the service experience good quality outcomes. The accumulated evidence in this report has included, the previous key inspection, information we have received from the provider since the last inspection, what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement, relevant information from other organisations and information from people living at the home, relatives, staff and other health care professionals. Care Homes for Older People Page 6 of 28 One inspector made an unannounced visit to the home that lasted six hours on 8 January 2009. Before the inspection visit, we asked the manager to complete an Annual Quality Assurance Assessment (AQAA). This is a self assessment that if completed thoroughly, should tell us how the home is meeting National Minimum Standards, where we can find the evidence for this, what improvements have been made since we last inspected and what improvements are planned in the next year. The AQAA that was returned was adequate and could have provided more detail and this was discussed with the manager but gave enough information for us to plan for the inspection visit. During the visit a number of pre selected documents were looked at and most areas of the home used by people living there were inspected, including some bedrooms. Apart from spending time with the manager, a good proportion of time was spent speaking with staff, visitors including a chiropodist and advocate from Age Concern and people living in the home. Time was spent in communal areas watching what was going on and checking how the staff cared for and supported people. Surveys were sent out prior to the inspection to a proportion of people living at the home, their relatives, staff and health care professionals. Feedback was provided to the manager at the end of the inspection visit including an analysis of the survey results. What the care home does well: What has improved since the last inspection? What they could do better: No requirements are made and three good practice recommendations are made. To continue the development of care plans, the home should include more person centered detail in care plans to fully evidence that peoples lifestyle preferences and choices are known. Care Homes for Older People Page 8 of 28 Serious consideration should be given to employing an activity organiser to extend the range of opportunities and experiences for people on a regular basis. Staff personnel files should be better organised and the records of when Protection of Vulnerable Adults list and Criminal Records Bureau checks were sent and received kept at one source. This will make things easier to find. 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 9 of 28 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 10 of 28 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. People can decide to live at the home based on up to date and accurate written information that is available and visits to the home so they have a clear picture of the services and facilities provided. People are properly assessed before admission so all concerned can be sure the home can meet their needs. Evidence: The home has a service user guide and statement of purpose on display in the reception area. These accurately reflect the services and facilities provided at the home. A number of people and relatives spoken with during the day said that they had been recommended the home and had visted before they made a decision to live there. Care Homes for Older People Page 11 of 28 Evidence: The home uses an electronic data base for its care planning documentation. This was introduced about a year ago and all staff were given training on using the system. As part of the pre admission process, paper copies of easy care documentation and the homes own pre admission paperwork are kept. This information is then transferred to the data base. Three peoples care plans were looked at, including the newest admission, to see that pre admission assessments had been carried out and the home had got the right and accurate information to make a judgment that the home could meet the persons needs. The records showed that the person and or their relative had been involved in giving the information as well as professionals who may be involved. The quality and detail of information on the newest admission was better than the other two checked, but this was because the information about these two that had been put onto the system at the time it was introduced and not all of the original pre admission detail had been added. Essential care needs were there, but it was the more personal information about likes and dislikes that had been missed out. This was to some extent understandable, for the inputting of information at the outset was a huge task. Discussions with staff showed that despite this, they knew the people they care for, very well indeed. Care Homes for Older People Page 12 of 28 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. People get the care they need and the care plans provide sufficient information and guidance to staff on how to meet peoples needs. People get the support and treatment of specialist health care professionals when they need it. People are treated with respect and live in a dignified way. Evidence: The three care plans that were checked showed that information from the pre admission assessment had been accurately used to complete a care plan. The home uses an electronic data base to record information. This is a comprehensive tool and automatically schedules reviews that appear on a diary to prompt key workers and the manager that an evaluation is needed so they are not missed. The plans addressed individual health, personal and social care needs and are supported by a range of risk assessments. The written guidance for staff to follow was clear. Nutritional screening is Care Homes for Older People Page 13 of 28 Evidence: done and there was evidence of monthly weight checks or more often if necessary. Although it was clear from conversations with staff that they know peoples lifestyle preferences well, more detail could be included in the records particularly in the daily living plan. This detail will continue the development of care plans in a person centered way and show the personal lifestyle preferences and choices that make each persons quality of life and living experience at the home as good as possible. There was evidence of good liaison with health care professionals and three surveys returned by community nurses who visit the home made comments like: Care is tailored to the individual. Residents privacy and dignity is always treated as a priority. Very good communication between staff and district nursing team. Advice always acted upon and feedback given. Provides a homely environment. Treats people as individuals. Assess their needs and aims to meet those needs taking account of gender, ethnicity, beliefs, disability and promotes independence when possible. A chiropodist was treating some people on the day of the visit. She felt that the home was thoroughly professional, really cared about people, referred problems at the right time and acted upon advice. She said that she traveled a long distance to the home and continued to do this because she enjoyed the visits to the home and the professional way it operated. One relative spoken with said her husband, a GP with a long association with the home, said that they should look for no other home for her Mother and was full of praise for the care provided, the communication between staff and relatives and the caring qualities of all the staff at the home. Some written comments made in surveys that were returned echoed what the relative and her Mother had said: The care and support is wonderful. My Mum tells me every time I visit how much she loves living there and how nothing is too much for the staff. The staff treat her just like she is their own Mum. My mind is completely at rest knowing Mum is being cared for in such a wonderful place. The home has a policy on the safe handling, storage, disposal and administration of medication. These were discussed with staff on duty and observations made of practice and checks made of the records. These were safe. All staff who are involved in handling or administering medication are properly trained. There was good attention by staff throughout the day to make sure that people were happy and comfortable and they made sure that people were treated in a sensitive and dignified way. They knocked on doors before entering and made sure doors were closed at times when personal care was being given. People looked well cared for and Care Homes for Older People Page 14 of 28 Evidence: were positive about all aspects of home life. The home has been fully involved in initiatives to plan for end of life care and works with doctors, nurses, relatives and people to make sure peoples wishes are known and taken account of and acted upon. Care Homes for Older People Page 15 of 28 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 are able to lead their chosen lifestyles and have opportunities to make the most of their abilities and interests. Families and friends are encouraged to visit and they are made welcome. People have nutritious meals and eat healthily and can make suggestions about the menus. Evidence: One of the most positive features of the day was the warmth of the relationships between staff and the people they care for. This also extended to relatives who consistently used the word wonderful to describe aspects of home life. There were regular visitors during the inspection visit, all of whom said they felt welcome in the home. Peoples interests are recorded on the data base but there is no daily activities plan and the manager acknowledged that this was something they could do better, although people did not grumble in conversations and appeared very happy with home life. There are exercise activities, quizzes and reminiscence sessions using material loaned from the library on a regular basis. The home has its own vehicle and when staffing permits, trips out are arranged to cafes, shops and other local attractions. Care Homes for Older People Page 16 of 28 Evidence: People also attend a local Church coffee morning where there are quizzes and talks arranged and local clergy also visit in a pastoral capacity and to give communion. The home uses a befriending scheme for one person who has no relatives this is good practice. Age Concern are also involved in an advocacy role with two people and the advocate was visiting and expressed very positive views about the home and caring qualities of staff. To extend the range of activities and opportunities for stimulation, the home should consider employing an activities organiser. Positive comments were made about the food provided. People said they had good choice and enjoyed the meals and were able to discuss food at the regular residents meetings. One written comment made in a survey said: My Mother enjoys all her meals and is always given plenty of choice. The home has regular meetings about meals and the menus can change depending on residents wishes. It was noted in the minutes of one meeting that people had been disappointed that the supplier of pink wafer biscuits that they all enjoyed had stopped delivering these, so at their request, an alternative supplier was found much to their satisfaction. Regular weight checks are made and nutritional assessments made. The chef is experienced in catering for the elderly. People looked well cared for and the written comments in surveys and conversations during the day indicate they are treated as individuals with routines like getting up, going to bed or how they spend their time set as they prefer. One lady said, sometimes I just feel like a lay in, so I do. Care Homes for Older People Page 17 of 28 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. 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 home safeguards people from abuse and neglect and takes actions to follow up any allegations. Evidence: The home has a formal complaints procedure that is displayed in the reception area and is included in the service user guide. People and relatives spoken with said that they felt comfortable in raising issues. Regular residents meetings are held where they can air their views and make suggestions. People and relatives are encouraged to raise matters straight away so that things can be sorted out quickly, but where the formal complaints procedure is used, there are good records kept to show what the problem was, what actions were taken and how things were resolved. Staff spoken with and the training records seen showed that training is provided in recognising abuse and actions that must be taken if abuse is suspected. There are policies and procedures to support this. Other checks made during the inspection visit on recruitment, medication and money held for safekeeping all met requirements. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 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. People live in a safe and well maintained home that is homely, clean, pleasant and hygienic. Evidence: A tour of the premises was made and things were found to be clean, well maintained and to the credit of the housekeeping staff, free from unpleasant odours. Surveys and conversations during the day indicate this is always the case. Bedrooms were comfortable and personalised and there is a rolling programme of redecoration and refurbishment. In addition to the rolling programme, the last year has seen improvements have been made to the laundry room where the floor space has been increased and a new drier installed. The carpet on the first floor corridor has been replaced. There are plans to convert into a bedroom, a small lounge that is out of the hub of activity and not used. To maintain the communal space lost a small extension to the dining room/lounge will be built. Generally the home presents as homely and comfortable. There is good attention to infection control and staff confirmed there is always a plentiful supply of protective clothing and they have been involved in a programme of hand washing training to Care Homes for Older People Page 20 of 28 Evidence: further reduce the risk of cross infection. Care Homes for Older People Page 21 of 28 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. People have safe and good support from staff who are competent and well trained. Staff go through a thorough recruitment process that includes checks to make sure they are suitable to care for them. Peoples care needs are met by staff whose training is kept up to date and are well supported and supervised by the manager. Evidence: The surveys that were returned and the conversations during the day give a clear indication that people, relatives and professional visitors think there are enough staff on duty and that they are well trained and competent. The home is good at retaining staff and the conversations with staff showed that they had a good team spirit and like working with each other. The personnel files for three staff were checked to make sure the home carries out good recruitment procedures. All staff had application forms, job descriptions, induction checklists, a contract of employment, two references (one being from the last employer) and the necessary checks with the Criminal Records Bureau had been made. This makes sure that people are protected from staff who may not be suitable to work in the care industry. The staff files could be better organised and a recommendation was also made to improve the way that checks with the Protection of Vulnerable Adults list (POVA) and Criminal Records Bureau (CRB) are recorded. Care Homes for Older People Page 22 of 28 Evidence: There is a training programme and the records seen and conversations with staff showed that they are up to date with safe working practice training that includes fire safety, food hygiene, moving and handling, infection control, the control of hazardous substances, protection of vulnerable adults and for those staff involved in medication, the safe handling of medication. The home exceeds targets for the numbers of care staff who should gain a National Vocational Qualification (NVQ). From what was seen during the visit, people look well cared for, have good and warm relationships with staff and there is a good friendly atmosphere in the home. Visitors also have good relaxed relationships with staff. Care Homes for Older People Page 23 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People get the right support because the manager is clear about how the home should be run, has an open approach to staff, people and visitors and makes them feel valued and respected. People are safeguarded because the home has clear financial and accounting procedures, keeps records properly and makes sure that staff are supported, understand and follow the way things should be done. Safety checks on facilities and equipment make sure the home is a safe place to live and work. Evidence: The manager is experienced and holds a relevant qualification. She is a qualified nurse and maintains her registration with the National Midwifery Council (NMC). Some of the surveys that were returned made specific reference to the good leadership and Care Homes for Older People Page 24 of 28 Evidence: support. This was echoed in the conversations with relatives and staff during the day. These showed that she was approachable and people felt comfortable with her and they felt she had a clear vision of the standards she wanted at the home. In relation to quality assurance, the home conducts its own satisfaction surveys, holds regular meetings with people and relatives and encourages open communication and feedback about the standards of care in the home. The new data base automatically signposts when evaluations of risk assessments and care plans are needed. There are a range of policies and procedures that give staff appropriate advice and guidance to make sure care is delivered in a safe way. Some money is held for safekeeping for some people. The methods of recording were discussed and a specific check made of one persons account and a reconciliation made with the cash held. This showed that peoples money is properly accounted for, backed up by receipts and their cash held safely and securely. The conversations with staff, checks made of training completed showed that they are up to date with safe working practice training. Checks were of fire safety and these were up to date. The AQAA that was returned showed that regular checks are made of other equipment and facilities. Care Homes for Older People Page 25 of 28 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 26 of 28 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 1 7 To continue the development of care plans, the home should include more person centred detail in care plans to fully evidence that peoples lifestyle preferences and choices are known. Serious consideration should be given to employing an activity organiser to extend the range of opportunities and experiences for people on a regular basis. Staff personnel files should be better organised and the records of when POVA and CRB checks were sent and received kept at one source. This will make things easier to find. 2 12 3 29 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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!