Inspection on 15/05/06 for Alexandra House

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alexandra House 05/09/07

Alexandra House 02/11/05

Alexandra House 01/08/05

Alexandra House 11/02/05

Alexandra House 22/07/04

Alexandra House 04/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Alexandra House 1 Narborough Road Huncote Leicestershire LE9 3AN Lead Inspector Keith Charlton Unannounced Inspection 15th May 2006 09:35 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 House DS0000049312.V294250.R01.S.doc Version 5.1 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 House DS0000049312.V294250.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alexandra House Address 1 Narborough Road Huncote Leicestershire LE9 3AN 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) 0116 2753669 Mrs Jacqueline Ann Skubala Mr Albert Konrad Skubala Mrs Jacqueline Ann Skubala Care Home 17 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (17), Physical disability over 65 of places years of age (7) Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To be able to admit the named person of category DE named variation application number V000000223 dated 10/12/03. Named Person To be able to admit the person of category SI (E) named in variation application No. V27292 dated 15 November 2005 2/11/2005 Date of last inspection Brief Description of the Service: This is a registered home for Older People. It is situated in the village of Huncote. There are local facilities nearby. Service users all enjoy the benefit of a single bedroom with toilet en suite. There is a choice of lounge/dining rooms and a good size garden to the rear. The home has a friendly Labrador dog who provides companionship to service users. The weekly fees range from £400 to £600 - this information was provided on the day of the Inspection. There are additional costs for individual expenditure such as hairdressing, toiletries, etc. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager, Deputy Manager and Registered Provider were present. Planning for the Inspection included checking notifications of significant events sent to the Commission for Social Care Inspection by the home and following up the requirements from the last Inspection Report. There have been no complaints received by the Commission for Social Care Inspection regarding the home in the past year. The Inspection took place between 09.35 and 13.35 and included looking at facilities, inspection of records and indirect observation of care practices. The Inspector spoke with seven residents, one member of staff, the Registered Manager, Registered Provider and the Deputy Manager. What the service does well: Service users felt that they were central to the running of the service - they said that staff and management were friendly and caring, food was good and plentiful and that they are given a choice for each mealtime, that they could approach staff or management if they had a concern and were confident it would be sorted out, activities are organised, and visitors are made welcome – this was also confirmed by a visitor. Service users again said they liked their bedrooms and they could bring in their own things and they liked the garden. They said that they are encouraged to retain their independence – one service user said that he was growing his own vegetables - and are supplied with equipment to assist them. Staff and management were again observed to be friendly and respectful towards service users. Staff said that they are asked to read service users Care Plans and the Policies and Procedures of the home so that they aware of service users needs and are Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 6 consistent in their work. Staff were aware of the whistle blowing procedure in case of abuse. Care Plans are comprehensive to assist staff to deliver care that fits individual service users care needs, there is a checklist of Policies and Procedures for staff to ensure that they are read, and staff records contain essential statutory checks to protect service users from unsuitable staff. Service users are encouraged to continue to be independent and follow their hobbies, e.g. baking, going to outside clubs and to church etc. Facilities are kept in a clean and tidy condition and decoration is of a high standard. What has improved since the last inspection? What they could do better: There were a small number of issues that would further enhance the service provided - staff supervision needs to take place on a recorded and regular basis to ensure that all relevant issues can be discussed to enhance performance and give support to staff in their job. To ensure that a newly admitted service user is assessed and a minor variation for the service user is swiftly applied for if outside the registration category of the home, that serious issues appertaining to the welfare of service users are reported to the Commission for Social Care Inspection so that the service’s performance can be monitored, to ensure that water temperatures from all outlets are kept to the National Standard of close to 43c to prevent possible scalding, and not to alter the usage of facilities without checking with the Commission first to ensure that all essential facilities are kept in place. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 7 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 House DS0000049312.V294250.R01.S.doc Version 5.1 Page 8 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 House DS0000049312.V294250.R01.S.doc Version 5.1 Page 9 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 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is generally well managed and service uses receive a satisfactory assessment, thereby ensuring that their health and welfare needs are being met. EVIDENCE: A service user said that she could recall being asked questions about what care she needed before coming into the home. The assessment form mirrors that of the National Standard, which means all essential issues of care are covered. One of the service users who was case tracked was assessed by management to have confusion, though it had not been determined from a medical authority whether this condition was dementia. The Registered Provider is to medically refer the service user so that this issue can be determined. If the diagnosis is dementia then the Registered Providers need to ensure that a minor variation is applied for as this is outside the home’s legal registration category, to legalise this situation. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 10 The service does not offer intermediate care facilities. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 11 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 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well looked after in respect of their health and personal care. EVIDENCE: A service user said that she had not heard of a Care Plan. The Registered Provider said he would remind service users that they all had a Care Plan and they could see it if they chose. Care Plans seen by the inspector contained information as to the physical, social and medical needs and interests and hobbies of service users. Service users again said when they felt ill the Home would swiftly summon medical assistance - service users contacts with medical personnel were documented in Care Plans. Care staff members spoken to said that they were encouraged by management to read all service users Care Plans. Service users said that if they were unwell and wanted to see a GP staff would arrange this. There was ample evidence on service users files as to medical Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 12 appointments being arranged and a staff member was observed to remind a service user as to a medical appointment. The Registered Provider acknowledged that some serious welfare issues – service users needing hospital treatment, service users passing away etc had not been reported to the Commission for Social Care Inspection (so that the service performance can be monitored) and said this would be carried out in future. Some service users said that they were taking care of some of their own medication, which helped them feel independent. Others said they were glad that staff kept it and gave it to them. The Registered Provider said that staff issuing medication had had training in the administration of medication. Manager issuing records were checked and found to be of a generally good standard with a small number of issues to be followed up. Service users thought staff carried out personal care in a way that respected their privacy and dignity. Staff were observed to be friendly and respectful to service users. The visitor also highly praised staff for their friendly care and welcoming attitude when she visited the home. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 13 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): 12,13,14,15 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and management work hard to ensure that service users experience a relaxed, homely lifestyle. EVIDENCE: Service users spoken to said that they thought that the current level of activities was generally good and they were looking forward to having outings this summer. Some service users said they would like to have speakers on issues of interest coming to the home. The Registered Provider said this was currently being arranged. Service users said there were a number of activities – games, music, baking, staff speaking to service users etc. Records confirmed service users participation in activities. A service user spoken with said she could go out to attend clubs if she wanted and that she went to Church every week. Another service user said that he had his own vegetables in the garden and obviously was pleased to be able to carry out this task. He was seen to go out to get his own paper from a local shop. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 14 Service users said that there were no rules and they could please themselves about things – getting up and going to bed times (one service user said she often got up late and was still given breakfast) and that staff encouraged them to retain their independence. All service users spoken with confirmed that all meals were of a good quality and were enjoyed. The Registered Provider said that a cooked breakfast was available once a week though service users could request eggs at other times and he would remind service users of this choice. The Inspector sampled the mid-day meal. The quality of the food was good, a three course meal was provided which were home cooked and there were three choices of main meal. The Registered Provider said that a choice was offered if service users did not want the main meal. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 15 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 Quality of this outcome area is excellent.This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are sound with good staff training provided, resulting in protection of service users rights. EVIDENCE: Service users again said that they would have no hesitation about going to management if they had a problem and were confident it would be properly sorted out. There is a detailed Complaints Procedure displayed on the Notice Board. The Registered Provider said there had been no complaints received since the last inspection and the Commission for Social Care Inspection has also not received any complaints. There is no central complaints book to record information at present – the Registered Provider said this would be followed up. The staff member spoken to knew to take concerns further if abuse was suspected and was aware of outside Agencies to go to if no action was taken by the service. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality of this outcome area is good.This judgement has been made using available evidence including a visit to this service. A comfortable, clean and homely standard of accommodation is provided for service users. EVIDENCE: Service users all said that they liked their bedrooms and they could bring in their own furniture. Facilities were found to be clean and odour free. Service users said that this was always the case and that rooms were hoovered every day. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 17 Some bedrooms were inspected and found to be homely with great deal of service users own possessions in them, and organised the way they wanted. Lounges were also homely and attractive. The Registered Providers have installed a loop system to assist service users with hearing impairment. The inspector found that some facilities had been altered – a lounge divided to make a visitors room and office and a WC changed to store the medication cabinet. The Registered Provider was made aware that the Commission for Social Care Inspection needs to be informed before there are alterations to the use of facilities so that essential facilities are maintained. He is to write to the Commission seeking approval for these changes. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality of this outcome area is good.This judgement has been made using available evidence including a visit to this service. At the time of inspection staff at the home were sufficient in numbers, and there are staff training and recruitment procedures in place to meet the service users needs. EVIDENCE: There were comments from service users that staff were often busy but no one thought they had long waits for their care needs. Staffing levels meet the Requirements of the Commission for Social Care Inspection in that there are three care staff for early shifts and two care staff for late shifts. Some staff records were inspected. They were found to contain all statutory checks needed to ensure protection for service users. A staff member said that training was provided although there had been no training in dementia care. The Registered Provider said that he was going to order a comprehensive training package - the Deputy Manager who is a trained nurse would then deliver this training. Records showed staff have received training regarding essential care issues. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 19 A staff member said she was encouraged to enrol on National Vocational Qualification level 2 course. A record showed that another staff member had completed the National Vocational Qualification level 2 award. The Registered Provider stated that when the aim of the service is to achieve the National Minimum Standard of 50 of staff with this training. The staff records inspected were found to be generally satisfactory with references (one was being sought as it has been temporarily misplaced) and Criminal Records Bureau/ Protection of Vulnerable Adults checks in place. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality of this outcome area is good.This judgement has been made using available evidence including a visit to this service. The management team generally effectively manages the home to protect the rights and needs of service users. EVIDENCE: Service users said that they thought the home was well managed and staff were good at their jobs. In terms of Quality Assurance, the inspector was given a quality questionnaire that had been devised, which is to be supplied to service users and other interested parties – relatives, GPs, District Nurses, Social Workers etc to determine how the service is operating. The survey results are to be published in the Statement of Purpose. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 21 The Registered Provider stated that there were no service user monies records as service users or their relatives dealt with this issue. Fire records had been entered into the home’s general diary as the fire book had gone missing. This showed that essential tests – fire alarms etc had been carried out. Fire doors now have approved enclosures fitted so that doors can be kept open whilst at the same time preserving fire safety. The water temperature was taken in a first floor bathroom, which measured 51c from the bath, the National Standard being close to 43c. This had been identified earlier in the day by staff and measures put in place for this to be rectified. The Registered Providers are aware that water temperatures must ensure service users are not at risk of scalding. The inspector saw risk Assessments for safe working practices – these are maintained to ensure that risk is managed and service users welfare protected. Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alexandra House DS0000049312.V294250.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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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