Inspection on 03/08/05 for Alexandra House

This inspection was carried out on 3rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 01/03/10

Alexandra House 19/01/09

Alexandra House 29/03/07

Alexandra House 01/03/06

Alexandra House 04/01/05

Alexandra House 03/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Alexandra House 2 - 4 Lord Street Southport Merseyside PR8 1QD Lead Inspector Claire Lee Unannounced 3 August 2005 rd 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 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 F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alexandra House Address 2 - 4 Lord Street Southport Merseyside PR8 1QD 01704 543715 01704 543828 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BEN - Motor & Allied Trade Benevelont Fund Mrs Sharon Watson Care Home 56 Category(ies) of OP - Old Age registration, with number PD - Physical Disability of places TI - Terminally Ill Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 56 OP and up to 5 TI and up to 6 PD 2. Maximum no. of registered - 56, of which a maximum of 28 PC (personal care) and up to maximum of 28 N (nursing) 3. The service should employ a suitably qualified and experienced manager who is registerd with the CSCI. 4. Room 208 to be temporarily registered as a nursing bed Date of last inspection 4th January 2005 Brief Description of the Service: Alexandra House (BEN – Motor and Allied Trades Benevolent Fund) is a registered care home run by a charitable organisation. The registered manager is Mrs Sharon Watson. The home provides 56 places for nursing, residential and palliative (terminal) care residents. Inluded in this number the home can accommodate up to 6 young physically disabled. Respite care is offered for up to 5-6 non residents a week. The home is situated in the town centre close to local amenities including shops, churches, cinema, pubs, restaurants and public transport. Alexandra House is a large 4-floor building and consists of 3 units. The nursing unit has 28 beds (inlcuding 6 for the young phsyically disabled), the residential unit has 28 beds and palliative care unit 5 beds. There are 52 single rooms and 2 double rooms; there are no en-suite facilities. 6 of the residential rooms on the top floor are small flats. They have cooking facilities and as the needs of the residents change, the rooms will be converted in to standard residential rooms. All areas of the home are accessible by the use of a lift, stairs, chairlift on the residential unit and ramp for wheelchairs at the main front entrance. The home has suitably adapted bathrooms and a very good standard of equipment to assit those who are less independent. Residents benefit from a therapy room, haidressing salon, their own laundry room and a chapel to worship. A call system with an alarm facility operates throughout the building and the home is subject to an ongoing programme of maintenance and redecoration. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 2 days for a duration of 12 hours. It was an unannounced visit conducted by 2 inspectors and was carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. A visit was undertaken in February 2005 in response to a complaint from a resident. This was resolved to the satisfaction of all parties. A partial tour of the home was conducted. Care records and other nursing and general home records were inspected. Discussion took place with the registered manager, care manager of the residential unit, 2 registered nurses, 2 care staff, 2 domestics, 10 residents and 2 visitors. Their views were obtained of the home and satisfaction cards were also given to the manager to hand out to residents and relatives. Comments received have been good. What the service does well: The home had a very friendly atmosphere and visitors were observed being greeted warmly by a receptionist during the mornings. The home receives many visitors and they are asked whether they would like to have lunch with their family member. The service user guide and statement of purpose provide detailed information on the home. These documents were displayed in the main hall along with the most recent inspections reports. New residents to the home are given a copy of the service user guide in their room. Residents and/or their family member are fully involved with the initial assessment, which is completed prior to admission to the home. The assessments are detailed to ensure staff can meet their needs. A resident who has recently arrived said, “I am fine, settling in well and the staff have arranged everything for me.” Following on from the assessment residents have an individual plan of care, which includes key areas, for example, mobility, washing and dressing, nutrition, skin condition and social background. A number of care files viewed had records of specific health needs with information from other health professionals. Instructions to staff on care delivery were noted and staff interviewed were very knowledgeable regarding individual resident needs. Care staff spoke enthusiastically regarding the benefits of the team leader role (extra responsibilities assigned to senior staff) and the input they have. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 6 Residents commented on the courteous and helpful nature of the staff and this was observed when they were assisting with personal care and also chatting with residents. The philosophy of the home is to focus on the needs of the residents and they are asked regularly what they think of the home and what could be improved. Resident meetings are held and satisfaction cards are also sent out to access their views. Management are quick to act on any ideas and suggestions they feel would be beneficial. This was discussed with residents in relation to food surveys and social arrangements. Many of the staff have worked at Alexandra House for a long time and the home presents with a stable, enthusiastic, well trained team. Residents were complimentary regarding the good standard of care and professionalism of staff. The manager arranges a good training programme and staff are provided with the necessary skills to enable them to deliver care and support the residents. The home is an accredited centre for NVQ studies and each registered nurse has developed a specialist role, for example diabetes, wound and palliative care. Staff confirmed that the manager has an ‘open’ door policy and is very supportive and approachable. A resident stated, “the overall management of the home is very good indeed, nothing is too much trouble for Sharon (manager).” Staffing levels were seen to be good and extra care staff are brought in to help when needed. The home is subject to an ongoing programme of decoration and refurbishment and this has improved the overall environment. The size and décor of the recreational areas contribute to providing a good quality of life for the residents. The ‘quiet’ lounge and dining room have been decorated to a very good standard and residents also have the use of a lounge with tea/coffee making facilities on the residential and palliative care unit. New colours schemes in bedrooms are based around residents’ wishes and are cheerful and bright. Residents confirmed that the home offers a good choice of food served in very pleasant surroundings. The menu is varied and provides nutritious wellbalanced meals. Residents were being asked what they would like for tea and their views are regularly sought to ensure the meals are to their liking. The catering manager spends time with the residents to obtain their views and any special requests are catered for. Waitress service is provided for lunch and tea and the dining room tables were attractively laid for both meals. The residents were observed to have their lunch in a pleasant, relaxed atmosphere. Positive comments were received from residents regarding the food including “the food is wonderful, we get so much choice”. A relative of a resident being admitted was offered to stay and have lunch to settle his mother into the home. The home has its own therapy department and staff offer a varied programme of activities and rehabilitation programmes. It is very well equipped and open Monday to Friday. Residents provided positive comments on the activities and expressed that they look forward to them. The department has its own staff and they spend time with residents planning activities to suit individual needs. One to one treatments are also given. Keep fit was organised for the morning Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 7 of the inspection and a quiz for the afternoon. The home has a minibus, which is used for trips out and a relaxation room for holistic treatments. The home has it’s own chapel, which is available for use by the residents. Staff support is also available to enable them to attend church services of their choice. What has improved since the last inspection? What they could do better: In Room 207 window restrictors are required to maintain the safety of the residents. The rolling programme of decoration for all bedrooms affected by general wear and tear should continue and this is to include respite Room 208 to raise the standard. One staff file viewed only had a Criminal Record Bureau (CRB) disclosure at standard level. Recruitment procedures must include a CRB disclosure at Enhanced Level for all staff employed. This helps to ensure protection to people living in the home. Environmental health records for the kitchen must include the temperature of the fridge, freezers and hot food. These had not been recorded the week of the inspection and this has the potential to put residents at risk. Medication records have improved since the last inspection, however it was recommended that sample signatures on the residential unit are put into place Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 8 for all staff who administer medication and that all receipts/returns are countersigned. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 9 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 Standards Statutory Requirements Identified During the Inspection Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 Residents are provided with a contract that states terms and condition of the home. There was a good standard of assessments enabling the home to be sure of meeting residents’ care needs. EVIDENCE: The service user guide and statement of purpose were not viewed on this occasion however they were on display in the main hall for everyone to see. Residents are issued with a contract and this includes terms and conditions of residency. Contracts seen had been dated and signed by the resident and/or relative. Individual care records are kept for each resident and the managers from their respective unit complete the assessments. The assessment is carried out by prior to admission to ensure staff can meet residents’ needs in full. New assessment documentation has been introduced and an assessment of a resident who had recently been admitted was completed in good detail. There was also supporting documentation from hospital regarding current treatment Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 11 to assist staff when drawing up the plan of care. The resident stated that he was settling in very well and the staff had been very kind and thoughtful. A resident spoken with on the residential unit said that she had been to look around the home prior to admission and is “very happy with the care and support provided. The staff are all very nice.” Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11 It was clear that that the health, personal and social care needs of residents were understood and set out in an individual plan of care. Medicines were administered according to the home’s policy and procedure for safe administration. General and palliative care was provided in a sensitive and respectful manner thus maintaining the privacy and dignity of the residents. EVIDENCE: Residents have an individual plan of care and the content of the care files has greatly improved since the last inspection. A number of care files were viewed from the residential, nursing and palliative care unit. The care plans were structured, clearly written and gave instructions to staff on how to meet individual care needs. All care plans involve the residents and/or their relatives who sign on their agreement. Key areas identified included, skin, nutrition, personal hygiene, pressure area care, mobility and social background. Care plans viewed had been reviewed monthly and the information recorded was accurate and up to date. This was confirmed when talking with residents and staff. Residents and/or their relative are approached kept fully involved with any changes made. Supporting care documentation included risk assessments for manual handling, bed rails, nutrition and Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 13 pressure relief. Residents are also weighed regularly and the dietician is called in when needed. One file viewed evidenced wound care management and the progress of current treatment. A resident with diabetes was having her condition carefully monitored and a resident who requires a lot of assistance and general support stated that staff were knowledgeable regarding his condition and the home had all the necessary equipment. Staff had liaised with external health professionals prior to admission to ensure everything was in place when he arrived. Residents are able to transfer between the units according to their needs and placement arrangements. This was discussed in relation to a resident who had been transferred to the palliative unit. Having the 3 units greatly benefits the residents, as they do not have to move to another home. Residents spoken with who live in the ‘semi – independent’ units commented that they are happy to receive monitoring care and support, “I like to try and manage myself as long as I can.” “It’s like having my own place with someone there if I need them.” When a reassessment is required they have the choice to transfer to a residential unit. Residents can see their own GP at any time and appointments to health care professionals; for example, dietician and physiotherapist were evidenced in care files viewed. The home’s physiotherapist was visiting at the time of the inspection to give advice and she also completes manual handling assessments. A number of medicine sheets were viewed on the residential and nursing unit. These evidenced staff signatures following administration. Medicines are now being disposed of according to the most recent guidelines given to care homes. Residents are able to self medicate and sign a self-medication agreement for this practice. This is also recorded in the plan of care. Medication records have improved since the last inspection, however it was recommended that sample signatures on the residential unit are put into place for all staff who administer medication and that all receipts/returns are countersigned. Discussion with residents confirmed that staff offer a good standard of privacy and are respectful of their individual wishes especially around personal care. A resident said, “staff are always polite.” “Staff always help me with my washing and dressing and are never pushy.” Staff were seen knocking on private doors before entering and assisting residents with walking and meals. There were 3 residents currently receiving care on the palliative unit. A care file viewed had a good record of all general care needs, palliative care and family involvement. Staff were seen spending time with the residents and they displayed a sensitive approach. Good staffing levels ensure residents receive one to one care. The atmosphere in the unit was relaxed and calm. A chapel is available to use for funerals should this be the resident’s wish. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 There was a friendly relaxed atmosphere and residents were enjoying the company of staff, visitors and taking part in social activities. The daily routine was based around the residents’ wishes and provided daily variation. Lunchtime was a social occasion where residents got together and enjoyed a nutritious well-balanced meal. EVIDENCE: Residents spoke positively about living at Alexandra House, comments included, “it is the best home I have lived in” and “the staff make it really good and a nice place to live in.” Residents interviewed were happy with the routine, for example, the times meals are served, time of going to bed and getting up in the morning. The home offers a day care service for nonresidents; this includes bathing and taking part in the home’s social activities. The therapy department is open Monday to Friday and the excellent range of activities contribute to residents enjoying life at the home. The department has its own staff and residents are able to take part in a varied social programme to suit individual wishes. The programme includes, music, dancing, relaxation, massage, games, quizzes, baking, keep fit and trips out. Parties are arranged regularly and a resident was spending time with his dog who had been brought in during the morning. Residents are encouraged to take part in celebrations for BEN events and one to one sessions are arranged for residents who are unable to attend the department or who wish to stay in their rooms. A resident Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 15 stated, “ the staff encourage me to take part in everything and I really enjoy it.” Each resident has an activities programme and this is updated by the therapy staff. The department has a good standard of rehabilitation equipment and this includes a couch for physiotherapy instruction. Residents were seen going out during the day and they are asked to sign out and in to ensure staff are made aware of their whereabouts. Many residents on the residential unit are very independent and staff encourage this. Support is available to take residents out. The home has an ‘outings book’, which records where the residents have been and which staff member accompanied them. The home offers a very good standard of meals. The menu was seen and this is based over 4 weeks. It offered a good choice of hot and cold meals and there was a good supply of fresh produce. Special diets are catered for and pureed meals presented in a way in which to preserve colour and taste. A dietician has reviewed the menu to ensure it is well balanced. The main meal of the day is served at lunchtime and the majority of residents attend the dining room. There are 2 sittings for lunch and staff were observed assisting residents with their meals in an unhurried manner. The dining room tables were attractively laid and waitress service provided. It was evident that the residents enjoyed this time together. Some residents prefer to receive meals in their room and this wish is respected. Comments from residents included, “very good choice”, “the quality is always good”, “ times of meals are fine”, “sauces and gravy served separately” and “staff serve the food properly”. A resident commented that she would like more ‘home cooked puddings’. This was passed onto the manager who acknowledged the comment. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a clear and accessible complaint procedure. Complaints received had been handled promptly and efficiently and residents were confident that their concerns would be listened to and acted upon. Staff understand the concept of abuse and what action to take should an allegation occur EVIDENCE: The home has a complaint procedure that is on display and residents spoken with were aware that they are able to speak to the manager or other staff members at any time. Residents said, “I have no complaints at all and if I did I would speak to Sharon (manager) and it would be sorted” and “if I wasn’t happy I would tell them.” The Commission were involved in a complaint earlier this year and this was resolved to the satisfaction of all parties involved. The manager stated that no other complaints have been received. The use of ‘grumbles’ book was discussed with the care manager on the residential unit and she agreed that this would be beneficial for recording minor incidences. A copy of the new complaint procedure has been placed in the service user guide. The concept of abuse is discussed during the induction of all new staff and formal training is also arranged. The home has a policy and procedure on abuse, a whistle blowing document and Sefton’s local guide. A member of staff discussed abuse awareness, which she had studied when undertaking an NVQ course. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 17 Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 25 and 26 Alexandra House provides comfortable accommodation and all areas of the home are subject to an ongoing programme of redecoration. Window restrictors are required in Room 207 as this has the potential to comprise the safety of the residents. The home was clean and hygienic. EVIDENCE: Alexandra House is a large house comprising of 3 units. The residential unit is on the second and top floor, nursing unit on the first floor and palliative care unit on ground. The home is spacious and is well maintained. Residents confirmed that the home has a ‘good feel’ to it and feels like a real home. A rolling programme of decoration and refurbishment is in place with emphasis on the bedrooms on the nursing and residential units. This programme should continue as many of these rooms need painting. This is particularly so for Room 208, which the manager confirmed is next in line to be decorated. Improvement to this room should also include a new carpet and door strip. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 19 New colour schemes in other bedrooms are very pleasant and the rooms look brighter and fresher. The facilities manager carries out general maintenance work and residents spoken with were pleased with the upkeep of the home. A comment from a resident regarding a request for a larger room was brought to the manager’s attention. When touring the building it was noted that a window restrictor in Room 207 was broken and the window could be opened fully. This was brought to the care manager’s attention and must be rectified to ensure the window opens to a safe width. The manager confirmed that a new window is also being fitted. The home has 2 lounges and a large dining room on the ground floor. These rooms are very attractive and offer comfortable furniture and fittings. The dining room tables are laid for each meal with tablecloths and flower arrangements. One lounge is used as a ‘quiet’ room for meeting visitors in private. The palliative care unit has a separate lounge for visitors and they are able to stay overnight if they wish. The home also has a special room for light therapy, holistic treatments and relaxation. The residential unit has a small lounge and this is used for cosy television and video evenings. Small kitchens are on all floors for residents’ and staff use; the flats on the top floor have their own cooking facilities. A therapy room is situated in the basement where specially trained staff provide therapeutic treamtments and organise activities. Residents have access to a haidressing salon and their own laundry room. The home also has a chapel and services are held regularly. The home does not have a garden however chairs and a gazebo are placed outside during the warm weather. There is some car parking space to the front and side of the building. CCTV cameras are being installed this month and these will be placed at entrance areas for security purposes. Bathrooms were not inspected on this occasion however the temperature of the hot water to the baths and showers had been checked and recorded. Temperatures seen were satisfactory. There are currently some domestic vacancies however the home appeared clean and tidy. It is apparent that staff work had to maintain this standard. A resident interviewed stated that her room was cleaned every day and that the laundry service was fine. Staff have access to infection control policies, gloves and aprons. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Sufficient numbers of well-trained staff were deployed to meet the needs of the residents. Staff receive training to ensure competency in their role. Recruitment of staff must include a Criminal Record Bureau (CRB) check at Enhanced Level to help ensure protection to people living in the home. EVIDENCE: The staffing rota for the nursing and residential unit was viewed and this evidenced a good number of staff on duty. The manager has increased the staffing levels during the day to meet resident needs. This demonstrates good practice. Residents commented positively on the staff employed. “The staff are always around to help.” “The staff are brilliant.” “The home has excellent staff.” In the mornings the nursing unit has 6 care staff, the residential unit 5 care staff and palliative care unit 4. Agency or bank staff are used to cover any shortfalls and staff interviewed said that the manager always ensures the home has the correct number of staff on duty. During the day 2 cooks are employed, 2 kitchen staff and 2 waitresses assist them. There are currently vacancies for domestic, kitchen and night care staff however these posts have been advertised and the manager has had a good response. Residents were complimentary regarding the care and made reference to the kind attitude of staff, for example, spending time sorting out summer and winter wardrobes for the ladies. A member of staff said, “everyone pulls together as a team” and this was evident during the inspection. 3 staff files were viewed and one did not evidence a CRB check at enhanced level. The home must ensure the necessary recruitment checks have been Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 21 undertaken to ensure protection of residents. This includes a CRB disclosure at enhanced level. Protection of Vulnerable Adult (POVA) checks are being obtained with the CRB’s for new staff. They are supervised until a full satisfactory check has been obtained. Staff files evidenced completed job application forms and 2 written references that are obtained prior to employment. Health checks are undertaken by head office and the manager advised of anything relevant. Staff have access to courses in safe working practice areas and all have recently undertaken manual handling and fire awareness. The manager teaches infection control and health and safety and the majority of staff have completed first aid and food hygiene. The home has a rolling programme though it is recommended training files be updated to record the most recent courses attended. Some training certificates are on file. The induction for new staff is detailed and they also attend a training event held locally for this purpose. Staff are supervised during the first 6 weeks of employment. A member of staff interviewed stated that training is always available and the manager encourages everyone to take part. Registered nurses provide talks on their clinical speciality. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 General safety records of the home were in date to protect the welfare of the residents however environmental health checks of kitchen had not been recorded. This has the potential to put residents at risk. EVIDENCE: Whilst touring the kitchen it was noted that fridge, freezer and hot food temperatures had not been recorded for the week. This was brought to the chef’s attention and must be rectified. Safety certificates and contracts were seen for gas, electric, portable appliances, lift and manual handling equipment. The gas certificate has expired however a date has been sent for this inspection next month. The fire logbook evidenced regular testing of fire prevention equipment, fire drills and fire awareness training. The manager and facilities manager are fire wardens and a qualified engineer inspects all fire prevention equipment. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 4 x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 24 NO Are there any outstanding requirements from the last inspection? 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. 2. 3. 4. Standard 25 29 38 Regulation 13/23 19 13 Requirement Window restrictor to be placed on the window in Room 207. To ensure staff employed have a CRB disclosure at Enhanced Level To record the temperatue of the fridge, freezers and hot food Timescale for action 31.8.05 ongoing ongoing 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. 2. 3. 4. Refer to Standard 7 9 19 30 Good Practice Recommendations To ensure key worker records are completed by staff Sample signatures on the residential unit are put into place for all staff who administer medication and that all receipts/returns are countersigned To continue with the programme of redecoation of bedrooms, to include Room 208. Staff files to be udpated to evidence most recent training. Alexandra House F53 F03 S17218 Alexandra House V241704 030805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Burlington House, 2nd Floor, South Wing Crosby Road North Waterloo, Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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