Inspection on 18/04/07 for Alexandra House

This inspection was carried out on 18th April 2007.

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 02/06/09

Alexandra House 26/10/05

Alexandra House 10/05/05

Alexandra House 02/11/04

Alexandra House 11/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Alexandra House 1 Poyner Road Ludlow Shropshire SY8 1QT Lead Inspector Mike Moloney Key Unannounced Inspection 18th April 2007 09:00 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 DS0000020637.V333891.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 DS0000020637.V333891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Address 1 Poyner Road Ludlow Shropshire SY8 1QT 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) 01584 872412 01584 879561 alexres.home@btconnect.com Mrs Susan Grehan Mrs Julie Daley, Mr Christopher Gifford, Mrs Nichola Price, Miss Jane Alexandra Gifford Mrs Susan Grehan Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Alexandra House is a privately owned care home registered to offer care and support to a maximum of 22 elderly people. The proprietors, Mrs S Grehan, Mrs J Daley, Mrs N Price, Ms A Gifford and Mr C Gifford are all related and, as a group, have been running the home successfully since 1996. The home is 2 storey building situated in a residential area within walking distance of the town centre of Ludlow. There are gardens to front and rear and these are well maintained and provide pleasant seating areas. The home offers accommodation in 18 single and 2 double bedrooms. The ground floor provides rooms for dining and sitting - including a reception hall that serves as an additional informal seating area. All facilities and shops are within reasonable walking distance. There is a railway station near by and a regular bus service passes on the road next to the home. Ludlow is a busy historic market town in the South of Shropshire and has plenty to offer by way of activities, entertainment and areas of interests. Further information is available in the home’s service user guide that can be made available in a number of formats. The fees currently range from £415 to £425 per week. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service What the service does well: 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 DS0000020637.V333891.R01.S.doc Version 5.2 Page 6 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 DS0000020637.V333891.R01.S.doc Version 5.2 Page 7 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): 1 and 3 Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home that will meet their needs They have their needs assessed and a service user guide which clearly tells them about the service they will receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two of the service users were looked at. The records contained assessments which staff confirmed had been carried out prior to or shortly after admission. The documents used by the home for the assessment were seen to contain information about the individuals needs and included enough to ensure that a care plan could be developed that met that persons needs. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 8 Risk assessments had also been carried out at this point and these included those about moving and handling and nutrition. The home’s service user guide was looked at and this was seen to have been recently reviewed by the management team. The manager explained that this was also being made available in alternative formats such as audio tape for people with a visual impairment. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is excellent. The home ensures that any new medical need is brought to the attention of appropriate healthcare professionals promptly and previously identified needs are carefully monitored and any directions given by those healthcare professionals are followed ensuring that the healthcare needs of the service users are met. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of three service users looked at and these were seen to contain formal care plans. The manager and the staff confirmed that these were reviewed each month. They contained information about the likes, dislikes and preferences about how that person’s care should be delivered. Manual handling risk assessments had also been carried out around the tasks identified within these documents. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 10 The documents also showed and staff confirmed that medical professionals such as GPs and District Nurses visited on a regular basis. This was further confirmed as a GP and a District Nurse visited during the course of the inspection. The records contained the staffs’ observations of the residents’ conditions as background information for such people. The records maintained by the home clearly relayed the instructions left for the staff to follow after such visits. Medication storage and management systems were also looked at. Both the storage and administration procedures were seen to be appropriate. When talking with a group of service users one said, “This is a care home; they definitely care for us”. The others in the group agreed enthusiastically. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is excellent. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking to a number of the service users it was clear that they felt that the town centre location of the home suited their needs. One person explained that as soon as he was ready in the morning he was able to make his way to a number of places of interest to him and, having told the staff that he was going out, he could return at any time during the day. Another resident talked about how she liked going for walks in the area immediately around the homes as she considered there to be plenty of interest to see but the pavements were safe. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 12 During the inspection conversations were overheard between the staff and the residents where the staff were arranging to take less independent individuals out for similar walks. A minibus was seen to be available for use by residents for trips further afield. Various records showed that that the home has regular visits from residents’ families, hairdressers etc and on the day of the inspection a number of family visitors were seen around the home. Those relatives spoken to confirmed that they had been made welcome by the managers and the staff. Peoples’ likes and dislikes were seen to be catered for in a variety of ways. They were addressed by their preferred name, preferred drinks were known by the staff as were their preferences at meal times. Although the cooks had a varied but traditional ‘British’ menu to work from this was in keeping with the ethnic mix of the service user group and they had a lengthy list of peoples likes and dislikes available to them so that they could be sure to offer an acceptable alternative if requested. They also had the information available that ensured that they were able to cope with any special diets that were required for medical reasons. All of the service users spoken to were complimentary about the food that they were offered at the home. The minted lamb being served on the day of the inspection looked and smelled very appealing and the portions were of a good size. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been one complaint received by the home since the last inspection. This was seen to have been recorded appropriately in the complaints book as had the outcome. Speaking to the complainant she said that it had been resolved to her satisfaction. All of the residents spoken to said that they feel able to talk to any of the management or staff team if they had a complaint. The procedure followed had been clearly laid down in the home’s complaints procedure that was seen to contain all of the information laid down by law. The manager explained and it was seen that alternative formats would be developed to suit the needs of individual residents. The home was seen to have a copy of the local policies and procedures for the protection of vulnerable adults. The records showed and the staff confirmed that they had received training in such matters. There had been no referrals into those procedures from the home. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 14 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 and 26 Quality in this outcome area is good. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated close to the centre of the town giving easy access to all of then facilities located there. Communal rooms are well equipped and are homely and welcoming. Bedrooms are personalised and meet individual needs and the front gardens and grounds are attractive, well maintained and accessible to residents and their visitors. The home has an appropriately equipped laundry and the records showed that the staff have received training in infection control. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 15 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, 29 and 30 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Documents were seen that showed that the home’s training plan was being developed. The records showed what training had been undertaken by the staff and what would be needed over the next twelve months. It showed who would need to continue their NVQ training and showed that over 50 of the staff had already achieved NVQ2 or above in care and that three of the management team had already achieved their Registered Managers Awards which is the qualification that is considered appropriate for someone managing a service of this kind. The training that the staff received had been sourced from a number of places and these included the local college, a local providers consortium as well as internally as in the case of the manual handling instruction where one of the management team is qualified to carry out such training. The records of a number of staff recently recruited by the home were also looked at. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 16 These showed that the home has recruitment procedures that are safe and transparent and contain all of the checks required to ensure that those people who are looking to work with vulnerable people are fit to do so. The records also showed that those people also undergo a proper induction training process early on in their employment. On the day of the inspection there appeared to be appropriate numbers of staff on duty to meet the needs of the service users. Talking with the staff and the residents confirmed that this was also their view and that these were the staffing levels at which the home normally worked. Further chatting with the staff both individually and as a group demonstrated that they were focussed on the needs of the service users. Listening to them talk to the service users further confirmed this. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 17 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, 36 and 38 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that she has achieved the Registered Managers Award as had others in her senior management team. This is a qualification that is recognised as being appropriate for someone who is managing a service such as this. She explained that one of the proprietors is responsible for quality assurance and to carry out this function she organises the annual distribution of service Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 18 user and relatives questionnaires. Part of this process is to follow up with personal interviews with the individuals concerned. She then formulates a report that is presented to the rest of the proprietors for consideration. A copy of the last report was seen during the inspection. A second way in which that particular proprietor is involved is in that she undertakes and records all of the professional supervision of the staff team. Records of this process were also seen and from these it could be seen that these sessions happen at appropriate intervals. Various other records were also looked at. From these it could be established that a variety of safety checks take place on a regular basis. These included such things as fire safety checks, electrical checks on portable electrical appliances, the shaft lift and other lifting equipment, gas equipment, fridges and freezers as well as the bath water temperatures. The risk assessment and storage of hazardous substances was looked at and this was found to be appropriate. As mentioned elsewhere in this report a full range of safety training had been undertaken by the staff and risk assessments were available for a range of activities. Accident records were available for inspection and these were completed appropriately. The home does not hold cash on behalf of the service users. Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 19 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 3 x 3 Alexandra House DS0000020637.V333891.R01.S.doc Version 5.2 Page 20 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 DS0000020637.V333891.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 DS0000020637.V333891.R01.S.doc Version 5.2 Page 22 - 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!