Inspection on 17/06/08 for Alexandra House

This inspection was carried out on 17th June 2008.

CSCI found this care home to be providing an Adequate 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 House 19/06/07

Alexandra House 28/07/06

Alexandra House 15/11/05

Alexandra House 08/06/05

Alexandra House 06/01/05

Alexandra House 09/08/04

Alexandra House 10/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Alexandra House Masons Court Hillborough Road Solihull West Midlands B27 6PF Lead Inspector Martin Brown Key Unannounced Inspection 17th June 2008 08:15 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 DS0000004516.V366274.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Address Masons Court Hillborough Road Solihull West Midlands B27 6PF 0121 245 1081 0121 707 1090 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) www.sjmt.org.uk Sir Josiah Mason’s Trust Mrs Hilary Lloyd Care Home 36 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (36) of places Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th June 2007 Brief Description of the Service: Alexandra House is a registered care home for older people. The home is located on the outskirts of Solihull, in a residential area, close to local amenities and a bus service, which provides access to surrounding areas. The home is a single storey building, registered for thirty-six beds; all rooms are for single occupancy. The home has two lounges; two areas for dining and a conservatory, there are four assisted bathrooms and one walk in shower room available plus toilets within close proximity to communal areas, these meet the needs of residents living at the home. There is level access for wheelchair users to the front entrance and throughout the home. Corridors are wide and spacious and allow residents to move around the home freely and safely. The home has hoisting equipment available for residents who have decreased mobility. There is an accessible, well-maintained garden area with a pond. The home is approached through security gates where there is parking for visitors, alternatively there is off road parking. The organisation’s head office is on site; the complex also provides sheltered housing and domiciliary care from separate facilities. Inside the home, the reception area has notice boards, which display information about forthcoming events and other articles that may be of interest, including current the inspection report.. The current charge for living at the home is £357 per week. Additional charges include chiropody, hairdressing, newspapers and phone rental. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. The inspection visit was unannounced and took place on 17 June 2008, between 8.15am and 3.15pm. During the inspection, people living at the home were seen and spoken with. The manager was not available during this inspection, but was spoken with by phone the following day. Staff on duty, including the senior carer, were spoken with, and interactions with residents were observed. Visiting relatives of a number of residents were spoken with during the inspection. The Annual Quality Assurance Assessment, completed and returned by the manager, also informed the inspection. This gave a summary and self assessment of the home’s achievements, how it benefited users of the service, and how it could improve in the future. Policies and procedures and care records were examined, and four service users were ‘case tracked’, that is, their experience of the service provided by the home was looked at in detail. This was done by examining their care files, talking to staff involved in their care, talking to them or their relatives, and observing interactions and care. A meal was taken with residents. Staff and users of the service were welcoming and helpful throughout the inspection. What the service does well: Residents at Alexandra house benefit from a light, airy, well-maintained environment, and the attentions of a well-motivated and consistent staff team, who are familiar with the residents and their needs. The staff team has remained largely unchanged for a number of years, giving consistency in its approach. Relatives and residents were positive in the comments: “it’s great here”, “The staff are always attentive” “they all know what to do” were typical comments. Staff are confident and good-humoured, but respectful and thoughtful in all their contacts with residents. “ I haven’t a worry here” was another comment. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 6 Care plans detail care needs, and professional help is sought when necessary, and relatives kept informed of any developments or concerns. “They always phone with any problem” was another comment from a relative. 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. The summary of this inspection report can be made available in other formats on request. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents make positive informed choices to come to this home. An improved assessment form will help the service to clearly record more detailed written information regarding individual needs prior to their admission. EVIDENCE: We looked at the care plan for one of the people most recently admitted. The person concerned was also spoken with. She said she chose this home after viewing a number of others, and deciding that Alexandra House was the best one. She said she thought its food was better, it was in a ‘better condition’ and that the staff were ‘helpful and kind’. She said it compared much more favourably with the other homes looked at, and added that, so far, her favourable view of the service had not changed. Her one reservation was that she ‘wished her room was a little bigger.’ Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 9 The initial assessment for this person gave details of her needs. These were sufficient to give an outline of the needs that the service would need to meet, but were rather brief. The senior staff advised that fuller assessments are completed by the service after a person has ‘settled in’. This person had been at the home for three weeks. A ‘social history’ for this person, giving details of her life and interests up to this point, had not yet been completed. Other files looked at showed full assessments, as well as initial assessments, and ‘social histories’ in place. Other residents and relatives spoken with about coming to Alexandra House said they had chosen the home above others and had no regrets about doing so. Staff advised that an updated, more detailed assessment form is to be used for future admissions. A copy of the prototype for this was seen. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements in the recording and storage of all medications are needed to give greater confidence to residents that medication is being managed safely and effectively at all times. Medication aside, residents can be confident that their health and care needs are documented and attended to, and that they are treated with respect by a staff who are familiar with their needs and how to meet them, and with whom they are familiar and comfortable with. EVIDENCE: A sample of four care plans were looked at. These included all necessary care details, and concentrated on areas of need, so that, for example, one person with vulnerable skin had a pressure risk assessment and relevant guidelines in the care plan, including turning in bed. The care plan also guided staff to taking heed of individual choices. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 11 Care plans are reviewed monthly, and all looked at, bar one, contained ‘social history’ giving background information on that person’s life and interests up to the point of admission, helping to inform staff in responding to individual wishes. In the case where one person had no details relating to ‘life history’ staff advised that this person was unable to give details, and relatives had not yet provided clear details. Care plans do not have photographs of individual residents on them. Photographs are on individual Medication Administration Record Sheets. Staff advised that, because they are all so familiar with the residents, they do not need a photo to readily identify residents on their files. Staff agreed that any new staff taken on would benefit from such photos. Staff showed themselves to be knowledgeable on individual care needs, and were familiar with individual day-to–day needs, offering support as needed. Relatives were very complimentary regarding the care. Evidence was seen of the involvement of health professionals whenever needed. A small number of residents have diabetes. Care and kitchen staff were aware of these people and how to meet their needs. Medication was looked at. Controlled medication was administered and recorded appropriately. The majority of medication is administered by an efficient ‘blister’ pack system, supplied by the local chemist. All Medication Administration Record Sheets had accompanying photos of residents, helping to minimise the chance of errors. ‘Non-blistered’ medication was checked. In two instances amounts left did not tally with original quantities minus what had been recorded as given. Closer examination showed that this was not necessarily because correct medications had not been given, but because initial starting amounts were not clear, because medication may have been carried forward. In the absence of any clear and definitive starting amount, or of any daily ‘countdown’ of individual medications, it was not clear if a medication error had occurred, and if so, when. The staff member agreed that not knowing clearly and exactly how many of a particular tablet there are at the start of the month, and being able to identify how many tablets there are left on any particular day, leads to potentially unsafe situation. She agreed that having a clear daily countdown, similar to that used in the controlled medication, and a transparent record of any medication ‘transferred’ over from the previous month, would enable any errors to be identified, and rectified, promptly. There is a section at the top of the Medication Administration Record Sheets that states the named person has any allergies. Staff informed me that one person had an allergy to penicillin, but was marked as ‘none known’. Staff advised that the pharmacist who recorded this may not have been aware of this, and that they would inform them. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 12 One relative expressed concern over cleanliness or absence of items on several occasions. They may make this the subject of a complaint if they are not satisfied in this respect in future. But this was, it was stressed, in the context of this person being very happy and settled and well-regarded. Evidence was seen in the relevant care plan of these matters being addressed. This person, like all others seen during this inspection, was clean, wellgroomed and well-presented. Staff were observed to be treating residents with respect and dignity, although this did not stop them frequently enjoying a laugh with residents. There was a lot of laughing and good-natured ‘chat’. Several residents enjoyed private time in their own rooms, while others enjoyed being in the central lounge, ‘making sure they didn’t miss anything’ as one staff put it. Residents commented that staff were ‘very good’ and that they were always there if and when needed. The call bells were answered promptly when they sounded. ‘Staff are very good to me,’ commented one resident. A ‘key worker’ system operates, with staff having specific responsibilities for particular residents. Staff showed a good knowledge of the needs of all residents. Staff were observed transferring a lady from a wheelchair to a lounge chair. This was done unhurriedly, with the appropriate equipment, and with calm reassurance and clear explanation. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a variety of activities that they enjoy, although some may benefit from greater opportunities to get out. Visitors are made welcome, and residents are helped to maintain choice and control over their lives. They enjoy a healthy, varied diet, although a different spacing of mealtimes may be beneficial to some. EVIDENCE: There is an activities organiser who invited residents to ‘in house’ activities in the morning and afternoon. Some were encouraged to take part, others needed little encouragement, while others declined. Residents spoken with all expressed satisfaction with the level of activity, although some said they wished they could get out more. Staff echoed this, regretting that staffing numbers and availability were not readily sufficient to support more outings in the minibus belonging to the organisation. Tuesday is a day when staffing overlaps allow individual staff to help individual residents go to the local shops. Two did so during the inspection, enjoying making some small purchases. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 14 The activity organiser advised that she is aware of those that do not wish to take part in activities as organised, tries to make time to talk to and involve people individually, and keeps a log book of activities and interests. The activity organiser spoke of the variety of activities that took place in the home, and of trips organised outside the home, the most recent being to an open day at a nearby spot just outside Birmingham. Residents spoke positively of visiting entertainers, notably musicians. It was good to hear residents, and staff, occasionally bursting into song! One person said they enjoyed the quizzes, and also enjoyed having a cake, and a fuss, made on her birthday. A poster on the wall advised of regular religious services in the home. Residents confirmed that these take place: ‘a lady priest comes into the home’ said one person. Four relatives visiting residents during the inspection were spoken with. They all said they were made welcome at any time and were kept informed of any problems. Tea and coffee making facilities are provided for visitors. the home also has regular coffee mornings to wish people in other parts of the complex are invited. Residents have various parts of the home to relax in. Many preferred the main lounge, by the television; others liked the quieter, sunnier, conservatory. Others spent time in their rooms. There is also a smaller lounge, more frequently used, staff advised, when visitors and residents want some privacy. Breakfast was seen to be a relaxed time enjoyed by residents at around 9am. Some staff remarked that breakfast appeared to be people’s favourite meal of the day. All residents spoken with said that the food was good, without naming specific meals. The only complaint was from one person who felt that portions were too big. Dinner was taken with residents, and, although it was freshly prepared, well-presented, and tasty, many left a good proportion of their meal. There were suggestions, from staff as well as some residents, that dinner, at 12.30, followed on too soon from breakfast. Tea is at 5.30pm, followed by an optional supper in the evening. Regular ‘tea rounds’ were noted between meals. The kitchen was clean, and airy, thanks to a high ceiling, and was clean and hygienic, with records showing fridge/freezer temperatures maintained at safe limits. A menu, displayed in the dining room, showed the menu for the week. Staff advised that they offer choices for dinner to residents at breakfast time, but are aware that a small number may wish to choose, or change their mind, at dinner time itself. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and other interested parties can be confident that concerns will be listened to and acted upon. Residents are protected from abuse by the policies and procedures and by the positive ethos in the home, which emphasises openness and a respect for residents’ dignity and well-being. EVIDENCE: There is a complaints procedure available, and a ‘grumbles’ book, principally for residents, as a well as a complaints book, principally, but not exclusively, for relatives. The most recent complaint was recorded in November 2007. The ‘grumbles’ book enables residents to bring up relatively straightforward problems, such as a television not working, and get them rectified swiftly. Both books briefly detail actions taken in response, and outcome. The concerns expressed about items being dirty or missing, as mentioned earlier in this report, although not recorded at present as a complaint, have been noted and responded to by the service, and staff were aware of them. We have received no complaints about this service in this past year. Residents and relatives spoken with said they felt confident in raising any issues of concern. Relatives all said the manager and staff were very approachable. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 16 There are residents’ meetings, one of which had taken place the previous week. Minutes of this were not yet available. Staff spoken with showed a good awareness of what to do in the event of abusive practices being witnessed, suspected, or alleged. They advised that they had been on abuse awareness training. Observation and discussion with staff, residents and relatives, showed a calm and respectful ethos operating within the home that denies abusive practices the climate to flourish. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a light and airy, clean and well-maintained environment. They may further benefit from some features being made more ‘homely’. EVIDENCE: The home is a light airy building with plenty of communal space, added to by a conservatory, which several residents enjoyed as halfway to being ‘outdoors’. Residents have choice of several different communal areas, although most preferred the central lounge. The manager included in the Annual Quality Assurance Assessment details of on-going maintenance and refurbishment. Residents and relatives commented positively on the pleasant environment. There is also a pleasant garden area. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 18 Bedrooms have hand washbasins, but no en-suite bathrooms or toilets. Staff, and some residents, said commodes were preferred as they were easier and safer at night. These are portable commodes, used in bedrooms only at night, which then leaves a storage problem in the day. At present, they are stored in one of the three bathrooms that are next to each other. Two bedrooms have non-carpeted, non-slip flooring, to meet specific needs. The flooring was installed after discussion with residents and families. Staff advised that there were no further plans to introduce this flooring in other rooms. Wheelchairs are stored in a less obtrusive spot than previously, behind a pillar on alcove. Hoists, are stored in a storage room, and can be readily accessed when needed. Bedrooms are personalised according to individual wishes. Although one person wished her room was bigger, most said they were pleased with their rooms. Many chose to have their doors open, which was enabled by alarm activated closure devices. Doors are numbered with large numbers that bear no apparent relation to a thirty six bedded home, with numbers 216 and 219 being noted. Below the numbers are very small name plates. In one instance, a resident has had their name printed on a piece of paper which has been stuck to the door. Staff explained that this was because this person could not readily locate her room. Staff agreed that personalising doors with a larger name or picture of the resident’s choice might help residents identify rooms more easily. At present, it appears that the doors are identified for the organisation’s convenience, rather than the residents’. Bathrooms and toilets are large, giving people plenty of room to manoeuvre. They were clean and generally well-maintained, with suitable equipment to assist people to have baths and showers as preferred. One bathroom had missing neon light cover, and a broken fascia. The manager was advised of this and pledged to have this rectified swiftly. She also agreed that the bathrooms, while clean, were a little clinical, and could be made more homely and inviting, particularly in view of the fact that there were some residents who were reluctant to bathe. There is a hairdressing facility, located in one of the bathrooms, next to a toilet. Staff agreed that it would be nicer for residents if there were a dedicated room for hairdressing alone. There are good facilities for maintaining good hygiene, with an efficient laundry and sufficient sluice rooms. Cleanliness was maintained throughout the home, and there were no unpleasant odours noted during the inspection. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 19 Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a consistent and stable staff team who are familiar with their needs and how to meet them, and do so in a warm and positive way. Staff are deployed in sufficient numbers and receive appropriate training to fulfil their roles. EVIDENCE: The rota showed sufficient deployment of staff to meet residents’ needs. On the day of the inspection, there were extra staff on duty following a training session, enabling additional activities with residents. Kitchen, cleaning, laundry and care staff all worked together well within their defined roles. Staff spoken with were all positive about their role and work within the home. Residents were all complimentary concerning staff. ‘Very good staff ‘was a typical comment. Relatives too, were complimentary about staff, although one person raised concerns about the management of personal care issues, discussed elsewhere in this report. As the manager was not present, recruitment files were not accessible. These were examined on inspection last year and seen to be satisfactory. The manager later advised by phone that there have been no new recruits since the last inspection. Staff comments confirmed that the home benefits from a stable staff team. Where extra cover is needed, to cover sickness, leave or Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 21 training, a number of bank staff are able to be called upon. Very occasionally, agency staff are used. The Annual Quality Assurance Assessment returned by the manager detailed training, including a high percentage of staff holding National Vocational Qualification at various levels. Staff were clear that they had completed all mandatory training and receive refresher training, including health and safety, and moving and handling. Observation showed appropriate moving and handling and use of equipment taking place. Staff talked of the training they had received in areas such as Parkinson’s disease, dementia, falls prevention, and tissue viability. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-run home in which their well-being is promoted and protected. EVIDENCE: The manager was not present during the inspection, but was spoken to by phone the following day. She has managed the service for many years. Feedback from residents, relatives and staff concerning the running of the home was positive. ‘Hilary’s really on the ball’ was a comment from one relative. In her absence, the senior care person on each shift is in charge. The senior care was most helpful throughout the inspection. Some items, such as recruitment records, she was unable to access, other items, such as previous Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 23 surveys, and minutes of meetings, she located with some difficulty, owing, she advised, to a recent move from one office to another. The Annual Quality Assurance Assessment returned by the manager detailed all appropriate health and safety checks. Records of fridge and freezer temperatures, and hot water temperatures, were up to date and satisfactory. Servicing of specialist equipment was up-to-date. Records showed regular fire alarm tests, and staff spoken with were clear what to do in the event of the alarms sounding. The service keeps personal monies on behalf of residents, for minor personal expenditure, such as hairdressing and shopping trips. This is all recorded and receipted, and audited regularly by the manager. Samples showed one to be accurate, and one to be out by twenty pence. This was later found under the desk. Accurate counting is hindered by monies being kept in small brown paper cash bags, liable to split and rip, especially when crammed with receipts as well as money. The staff member agreed receipts would be better kept separately, and monies better kept in small plastic cash bags. The home now has the services of a Quality Assurance advisor, who is assisting them in getting useful feedback from residents and relatives, and who is now undertaking regular ‘regulation 26’ visits, in which aspects of the service, and how well it is doing, is looked at. Staff spoken with said he is helping them improve systems in order to provide a better service. Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 24 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 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 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 DS0000004516.V366274.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP9 Regulation 13(2) Requirement Medication recording of all nonblistered medication must clearly show accurate amounts being dispensed and remaining, so that residents can be confident that their medicines are being properly and safely administered. The missing neon light cover and broken fascia in one bathroom must be replaced. Timescale for action 25/07/09 2. OP21 23(2)(b) 25/07/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Photographs of each resident on their care files would help any new staff in familiarising themselves with new residents. Having breakfast and dinner slightly further apart might help some residents to build up more of an appetite for the DS0000004516.V366274.R01.S.doc Version 5.2 Page 26 2. OP15 Alexandra House second meal. 3. 4. 5. OP19 OP21 OP24 Residents might appreciate a dedicated hair salon, rather than one that shares with a bathroom, adjacent to a toilet. Residents may appreciate the bath/shower rooms and toilets being made more ‘homely’. Having resident’s names, or personal features, on their own bedroom doors, as clear as the current numbers, would help personalise the rooms for residents. Better individual storage for residents’ personal monies would minimise the chance of errors in handling these. 6. OP34 Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alexandra House DS0000004516.V366274.R01.S.doc Version 5.2 Page 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. 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