Inspection on 28/04/08 for Alexandra House

This inspection was carried out on 28th April 2008.

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 House 13/10/09

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Alexandra House Havelock Terrace Gateshead Tyne & Wear NE8 1QU Lead Inspector Karena M.Reed Key Unannounced Inspection 28th April 2008 11:00 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 DS0000071024.V363919.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 DS0000071024.V363919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Address Havelock Terrace Gateshead Tyne & Wear NE8 1QU 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) 0191 477 5117 0191 477 4879 alexandragateshead@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd Mrs Ann Thorogood Care Home 40 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (40) of places Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 40 2. Dementia - Code DE, maximum number of places 40 The maximum number of service users who can be accommodated is: 40 N/A Date of last inspection Brief Description of the Service: Alexandra House is a large, purpose built home in Gateshead, close to the town centre. It is built on the site of an old social club, well known in the area. It is surrounded by houses and is close to Coatsworth Road, a main shopping area. There are good transport links to the home. The home is registered to provide personal care to forty adults over the age of sixty- five years, some whom may have memory loss. The home does not provide nursing care. All bedrooms are en-suite and for single occupancy. There are five lounges and two dining rooms over the two floors of the home. The home is equipped with aids and adaptations to help more physically dependent people in the home. A Statement of Purpose and service user guide are available at the home. The guides describe the services and facilities provided by the home and how staff are trained to meet service users’ care and support needs. CSCI Inspection reports are also available at the home detailing the quality of care provided. Fees payable for living at the home at the time of inspection in April 2008 vary between £394-£424. Additional charges are payable for personal newspapers, private chiropody, toiletries and hairdressing. Alexandra House DS0000071024.V363919.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 2 stars. This means the people who use this service experience good quality outcomes. How the inspection was carried out This is the first inspection of the service since change of ownership of the home. We looked at: • • • • • Information we have received since the change of ownership of the home. How the service dealt with any complaints and concerns since the change of ownership. Any changes to how the home is run. The provider’s view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit • An unannounced visit was made on April 28th 2008 During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the provider what we found. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: More activities and the provision of a therapeutic environment for people with memory loss must be provided to help them remain stimulated and relaxed. More opportunities must be provided for people with memory loss to help them make a choice and keep them involved in daily decision-making. More effective odour control is required in identified areas of the building in the interests of health and comfort. Ceiling tiles on the ground floor corridor must be replaced in the interests of fire safety. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 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 DS0000071024.V363919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5. People who use the service experience good quality in this outcome area. We have made this judgement using a range of evidence including a visit to this service. There are good procedures in place to ensure that prospective residents are making an informed choice about the home and that the home can meet their needs. EVIDENCE: The Home’s Statement of Purpose and service user guide were examined. They contained the necessary information as required by the Care Homes Regulations 2001. Records for five people who live at the home showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. The person living at the home and relevant people who knew them were involved in the initial assessment. The assessment form Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 10 encourages staff to explore issues relating to equality and diversity as it refers to gender, cultural, religious/spirituality, educational and social histories, preferred daily routine and preferences. It also looks at mood, speech, behaviour, mental health, risks, sexuality and living skills. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. The information was transferred into care plans to help any new staff provide the correct amount of care and support to the people who use the service. A married couple who had recently moved to the home said they had been involved in their care assessment. Staff receive training so that they know how to meet the needs of the residents. Staff have received the necessary statutory training: Fire Training, Food Hygiene, Moving and assisting, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; infection control, risk assessment, challenging behaviour, dementia awareness, visual impairment, diabetes, care planning, health and safety and supervision and appraisal. Residents have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People who use the service experience good quality in this outcome area. We have made this judgement using a range of evidence including a visit to this service. There are good arrangements in place to ensure that residents’ health and social care needs are met. EVIDENCE: There are detailed assessments in residents’ care plans. Personal support needs are well documented and give clear instructions to staff on how to support people in tasks such as washing, bathing, dressing and remaining mobile, in order to help retain some independence. Care plans are used as tools breaking down the care needs of residents to show the amount of care and support staff need to provide. There is a system of reviewing the changing care needs of residents. Moving and handling assessments are in place. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 12 Technical aids and equipment are available for residents. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Records show district nurses visit the home as required and residents are helped to use chiropody and optical services at least annually or as often as required. Medication records looked at for two residents were correctly recorded and signed by staff. No resident administers their own medication currently, although a system is in place if anyone was to do this. A monitored dosage system is used in the home; it is made up and delivered weekly by the community pharmacist, which reduces the amount of handling of medication by staff. Risk assessments are in place for the necessary areas e.g. moving and assisting, falling. Care records, conversation with staff and observation showed the privacy of residents was respected. All of those residents spoken to said that they were treated well by the staff and are well cared for. Alexandra House DS0000071024.V363919.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 and 15. People who use the service experience adequate quality in this outcome area. We have made this judgement using a range of evidence including a visit to this service Most residents are supported to have a good quality of life, although those with memory problems do not receive sufficient and appropriate stimulation. EVIDENCE: Two members of staff share responsibility for arranging activities and outings. Residents are supported and encouraged to follow their own interests and hobbies. Some residents were watching television, reading or listening to music in the communal areas. Some residents were spending time in their bedrooms. A programme of activities is in place for residents which includes: videos, sing-a-long, manicurist, dominoes, skittles, bingo, quizzes, crafts and hairdressing. Musical and theatrical entertainers also visit the home. Various seasonal parties are also arranged, which are well supported by relatives. The home shares transport with another home and has use of a mini bus monthly. Trips are arranged to the Metro Centre, to the coast for fish and chips and other places of interest. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 14 Church services can be arranged to take place within the home and a Roman Catholic priest also visits to give Communion to some residents. Relatives spoken to at the time of inspection spoke very highly of the care and support provided by staff. Fewer activities appeared to be available for people on the top floor who have memory loss although the manager did talk of plans to provide a more stimulating and therapeutic environment for these residents. Residents have the opportunity to go out with relatives or with staff into the local community. The home is establishing relations with a local school so residents may enjoy the company of groups of children who may visit the home. Staff support residents to keep in touch with relatives. Staff ask each resident about their wishes, interests and choices. Further work is required to engage with residents with memory loss to help them exercise choice and to maintain some control over their daily decision making. Residents and their families also receive questionnaires to complete as part of the home’s quality assurance. Residents’ spoken to said that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. All were very complimentary about the staff and the support they receive. The home’s menu is made up of the known likes and dislikes of the residents. Residents are also asked daily what they wish to eat from the menu selection. At least two hot meals are provided daily and an alternative is available Residents were very positive about the food: “Meals are very good.” On the day of inspection the lunch served was beef stew and dumplings or toad in the hole, mashed potatoes and vegetables. Residents enjoy home baking and special diets are catered for. Alexandra House DS0000071024.V363919.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. The home has a good, clear, user-friendly complaints and protections system and residents’ views are listened to and acted upon. EVIDENCE: The home’s complaints procedure is given to new residents as they move into the home. The procedure assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. There is a complaints procedure on display within the home for the use of residents and their relatives. The home keeps a record of complaints. There has been one safe guarding issue. Twelve complaints have been received by the home. These were investigated and seven were upheld and satisfactorily resolved. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 16 The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. Staff have received training about Protection of Vulnerable adults. Staff have also received training about behaviour that may be difficult to work with as part of a dementia awareness course. Alexandra House DS0000071024.V363919.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, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Most areas in the home provide a comfortable and safe environment for those living there and most areas are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and mostly well maintained, apart from some ceiling tiles were missing on the ground floor corridor. The home is accessible and is placed in the centre of a local community surrounded by houses and shops. It is designed so residents have the benefit Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 18 of being able to see from window and garden areas and almost being part of the local community. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place, including a visitor’s lounge. Service users can also see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in very good condition. Room sizes meet the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Bedrooms are personalized with residents’ own belongings. Service users’ bedrooms all have en-suite facilities. The rooms are centrally heated and the heating levels can be controlled within each bedroom. Married couples are provided with extra accommodation to use as a sitting room if they wish. There was emergency lighting throughout the home. Much of the home was clean, but there were some areas where there were strong odours. This was discussed with the manager at the inspection. The laundry facilities are well organised. The washing machines have the specified programme to meet disinfection standards. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff ,who are appropriately recruited and well trained, to meet the needs of the residents. EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 7.45 am- 9.15pm 9.00pm- 8. 00 am 6 staff 3 staff These numbers do not include the manager. There is a senior staff member on each shift. All the staff were over 18 years of age and those left in charge were at least 21. There are no staff vacancies currently. Other staff members are employed for duties such as food preparation, maintenance and cleaning. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 20 Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. A stable committed staff team has been created. The necessary checks are being carried out prior to the workers being appointed. Two written references were available on the staff files examined from the most recent employers. An application form had been completed for each staff member. CRB checks are carried out before a person is appointed. Staff receive Skills for Care induction. Training needs of staff are identified in supervision and appraisal sessions. Over 75 of the care staff team have now achieved National Vocational Qualifications at level 2 and 3. Staff and their records showed that they also receive advice and /or training in other areas such as Fire Training, Moving & Assisting, Food Hygiene, Safe Handling of Medication, Infection Control, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; visual impairment, memory loss, diabetes management, falls awareness, stress management, dementia care, care planning, performance appraisal and supervision, mental health and Equality and Diversity. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 21 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): 31,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ live in a home that is well run and managed for the benefit of residents and where the welfare of all is promoted. EVIDENCE: The manager has many years experience in senior management. She has the necessary skills and qualifications needed to manage the home. Staff spoken to were clear about their duties and responsibilities. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 22 Lockable facilities are available for residents to keep their own money if they wish. If a resident does not wish to keep control of their own money, the home is able to provide the facility to hold a small amount of money on behalf of the resident for everyday living. Individual records show the home has a suitable system for accounting any monies held on behalf of a resident. There was plenty of evidence of personal spending. Receipts are kept of any money spent on behalf of residents. All records as required by the Care Homes Regulations 2001 were well documented and completed. The organisation has developed a range of policies and procedures which have been linked to the National Minimum Standards. There is a health and safety policy and range of associated procedures. Staff receive training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. Accident reporting was suitably recorded and analysis of accidents is carried out. Staff files showed staff are supervised regularly. Staff meetings take place regularly. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 23 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 3 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 3 2 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 3 3 3 3 3 Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP12 Regulation 16(n) Requirement More appropriate activities and a therapeutic environment must be provided for residents with memory loss. The missing ceiling tiles must be replaced in the interests of health and safety. There must be more effective odour control. Timescale for action 30/06/08 2 3 OP19 OP26 13(4) c 16(2)(k) 30/05/08 30/05/08 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 OP14 Good Practice Recommendations More opportunities should be provided to encourage residents’ with memory loss to make choices about every day living. Alexandra House DS0000071024.V363919.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000071024.V363919.R01.S.doc Version 5.2 Page 26 - 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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