Inspection on 08/11/05 for Alexandra House [Poole]

This inspection was carried out on 8th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 [Poole] 08/07/08

Alexandra House [Poole] 04/12/06

Alexandra House [Poole] 07/06/05

Alexandra House [Poole] 04/01/05

Alexandra House [Poole] 14/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Alexandra House Alexandra Road Parkstone Poole Dorset BH14 9EW Lead Inspector Trevor Julian Unannounced Inspection 10:40 8 & 12 November 2005 th th 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 DS0000004036.V265155.R01.S.doc Version 5.0 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 DS0000004036.V265155.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alexandra House Address Alexandra Road Parkstone Poole Dorset BH14 9EW 01202 746640 01202 743627 alexandra@dorsettrust.co.uk 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) Care South Mrs Christine Trinder Care Home 39 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (39) of places Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 39 in the category OP (Old Age) including up to 20 in the category DE(E). 7th June 2005 Date of last inspection Brief Description of the Service: The home is situated just south of the Ashley Road in Parkstone, Poole. Ashley Road is a busy shopping centre and has a range of facilities including banks, a post office, supermarket, public houses, local public transport, etc. Alexandra House was a purpose built home, erected in 1965 and which transferred from the control of Dorset County Council to Care South in the early 1990s. The Borough of Poole currently own and lease the property. Accommodation is provided on both the ground and first floors, both have their own lounge/dining areas and a small kitchen, which is used for preparing drinks, breakfasts and light snacks. On the ground floor there is the main lounge and dining room with a central kitchen used for preparation of all meals. Toilet and bathroom facilities are to be found in various locations throughout the home. Staff have office accommodation along on the ground floor corridor. Alexandra House is registered with the Commission for Social Care Inspection to accommodate 39 residents. Including up to 20 places for those who are diagnosed with dementia. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection began at 10:40 on 8th November and was concluded on Saturday 12th November 2005. A total of 6.5 hours were spent on site. The total inspection took 18 hours including preparation, travelling time, inspection and report writing. During the visit discussion took place with residents, visitors, community nurses, care manager, staff and manager. Further information was gathered through examination of records, a tour of the premises and observation. This was the second of two statutory visits for key standards not covered in this report please refer to the previous report dated 7th June 2005. What the service does well: Staff said that they were responsive to the rights of the residents, some people had said they preferred to have their personal care carried out by female members of staff and this was respected, residents confirmed this to be the case. All the residents and visitors spoken with described the staff as considerate and helpful. Several commented that there was a lot of humour in the home and they enjoyed the banter with the staff. Visitors said they were always welcomed in the home and they were normally offered refreshments. People in the home found the range and variety of activities very good. They added there was to pressure to join in. Most people liked the food, there was a good choice and the food served was of a good standard. Most people took their meals in the main dining room or in the first floor dining rooms but they could opt to take meals in their own rooms. The home’s call alarm system allowed the staff to prioritise their responses, people said the calls were answered promptly but there could be delays at busier times of the day. New staff were encouraged to take NVQ level 2 in care to help ensure the staff are competent. The organisation provided a comprehensive training programme to allow staff to develop their skills and knowledge. The manager and senior staff have the skills and experience to manage the home. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The fabric of the building was showing the need for maintenance and repair. In one bedroom visited the window did not close fully in another the window restrictor was loose and would have failed if put under any pressure. The painting on the window frames in both rooms was flaking. Several rooms were wallpapered which was dated; other rooms seen had been emulsioned giving a lighter and more modern appearance. The ground floor and main stairwell had been redecorated to a good standard. However, the lift area on the first floor was in a poor state of repair giving that part of the home a neglected feel. The floor covering main areas of the home were carpet tiles, some were loose and could become a tripping hazard; others were worn and marked. None of the radiators and most of the hot water pipes in residents’ rooms were not covered resulting in possible risk of burns. The risk assessments relating to hot surface temperatures should be updated to include the topics identified by the Health and Safety Executive. It was noted during the visit that there was a bolt on the main front door. This was referred to a Fire Safety officer of Dorset Fire and Rescue Services who gave advice to the organisation to ensure fire safety procedures were not compromised. Please contact the provider for advice of actions taken in response to this Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 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 DS0000004036.V265155.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Intermediate care is not offered at the home and was therefore not applicable Not assessed during this inspection. Please refer to the previous inspection report. EVIDENCE: Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9, 10 Medication systems had been reviewed to reduce the risk of errors. Residents’ dignity and privacy was considered by the staff to ensure that the residents’ basic rights were respected. EVIDENCE: A check of medication records showed that transcription entries were verified by a second person. The records held photographs of the residents in order to assist staff when administering medication. There were lists in the medication storage room giving details of any allergic reactions the residents had to medication. It is recommended that the information on allergies is included on the individual record sheets supplied by the pharmacist. The residents and visitors said they were treated well by the staff, visitors said they were offered refreshments and there was an invitation for visitors to join the residents for lunch subject to a nominal charge. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 11 Residents said that the staff knock on their doors before entering their bedrooms, this was also observed during the visit. One person, who was poorly sighted, said the staff were normally very careful to return the furniture to its usual position helping her to navigate around her room. Several residents commented that they were asked their preferences for either male or female carers when providing personal care. Staff also confirmed that they respected individual wishes in this matter. A resident said she recalled being asked for her preferred term of address and had said she preferred to be known by her first name. Several comment cards had identified the laundry returns as poor. During the visit four people said there had been a great improvement over the last few months this was since a new laundry assistant had been employed. Staff said there remained problems when items were put out for laundry without identification marks. During the visit a care manager was in the building to complete a care review on a recently admitted resident and had brought the resident’s next of kin to attend the review. The home’s deputy manager also attended the review. The resident said she had settled well and the staff were kind and helpful, if she had concerns she would talk to her next of kin or members of staff depending on the circumstances. She described the food as good with good variety offered. The care manager had another resident at the home and always found the home well run and had no concerns. The next of kin also said the home was friendly and welcoming and she was offered refreshments during her visits. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 Activities and entertainment provide the residents with the opportunity to follow their preferred pastimes and to feel part of the community. Residents are encouraged to make decisions about their daily lives in order to maintain their involvement. The choice and variety of the meals provided in the home encouraged the residents to maintain a good diet. EVIDENCE: The activity organiser continued to provide a variety of activities and pastimes for the residents; during the afternoon of the inspection most of the residents congregated in the main lounge and were enjoying a sing-along session. All the residents and visitors said the activity organiser worked hard to provide appropriate entertainment. There were timetables of activities posted around the home. There were fortnightly church services in the home. One resident who had been very active in her local church appreciated the visits from members of the church. The activity organiser carried out hand-care, the visitors and residents seen said they appreciated this service. Residents said that the activities were optional and they were able to choose to attend. One Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 13 person said she preferred her own company and enjoyed the selection of books offered by the visiting library service. The staff did not manage the finances of any of the residents. Most residents did deposit petty cash with the home for personal expenditure e.g. hairdressing, chiropody, etc. A sample check showed that the balances matched the transaction records; there were internal checks in place to verify the records. None of the residents had asked to look at their personal records but several felt they could ask if they needed to. Several visitors said the home did contact them when there had been changes in need. All the residents spoken to were supported by members of their family but they felt if they needed they could talk to the senior staff. Most residents said there was a good variety of food provided and that the chef came to see what their preferences for the following day were, at the same time asking for feedback about the previous meal. The chef said she was advised, prior to admission, of any food allergies and preferences. One person had recently requested Bovril and this had been supplied. The home had a number of people with diabetes and the chef took this into account when planning the meals. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed during this inspection. Please refer to the previous report. EVIDENCE: Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 The home provides a generally safe and comfortable environment although some aspects would benefit from attention. The home was warm and comfortable but there could be a risk of burns from hot surfaces. EVIDENCE: The ground floor and the stairwell had been redecorated creating a bright and welcoming entrance to the home. The first floor lift area and first floor corridor had not been redecorated giving a neglected feel to that area. Some of the rooms visited were wallpapered which again showed signs of wear and tear. Other rooms had emulsion on the walls creating a bright and warm environment. One room had a window which would not close fully and would be draughty for the occupant, the paintwork was also flaking. Another room had a loose window opening restrictor which could possibly fail placing the residents at risk. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 16 Heating in bedrooms was achieved by large bore pipe at low level and radiators. None of the radiators were covered but some pipes had been covered following individual risk assessments. The Health and Safety Executive have issued guidance on areas to be considered in these risk assessments. (http:/www.hse.gov.uk/lau/lacs/79-4.htm) One person said that her bed was uncomfortable, the deputy manager agreed to look at alternative mattress covers as a possible solution. During the visit a bolt was noted on the main door way. The matter was referred Dorset Fire and Rescue Services to advise the home if the device compromised fire safety. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Staffing levels were appropriate for the level of care provided. Staff training was accessible and of a good standard helping to ensure that the staff were competent. EVIDENCE: Since the last inspection the home had success in recruiting additional care staff and had as a result there had been a reduction in reliance on agency staff to cover vacant shifts, down from 29 in June 2005 down to 16 . Recruitment was continuing to fill the remaining 1.5 care post vacancies. Two of the residents said that the staffing had improved at weekends as there were more of the home’s own staff on duty. They added that call bells were promptly responded to, but recognised there could be delays at the busier times of day. One person said she rarely used the alarm and when she did the response was very good and the staff were always positive and did not give the impression that they were being interrupted from their other tasks. During the Saturday afternoon shift there were 2 carers and the Care Team Manager from Care South and the remaining 3 carers were from an agency. The agency staff said they regularly covered shifts at the home and were aware of the tasks and routines. Staff felt the shifts were manageable and also that their had been changes to some shifts which had improved the situation. The call alarm system informed the staff where the call had Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 18 originated, allowing them to prioritise their response. There was a clear procedure for staff to follow if alarms were not from their unit. During both visits it was noted that the call bells were answered promptly. Nine of the care staff had completed NVQ 2, 3 or 4 in Care. Four were nominated to start NVQ 2 or 3 and a further six were to be nominated once they had completed their trial period. Two new members of staff said they were both new to care and had found the induction programme very helpful and informative; they had also both attended a training course on Dementia awareness. Staff also said they were trained in fire safety procedures and safe moving and handling. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38. The manager has the experience and qualifications to run the care home in the best interest of the residents. The views of residents and other interested parties had been regularly sought in order to identify and prioritise improvement. The organisation has systems and procedures in place to help provide a generally safe environment for residents and staff. EVIDENCE: The manager had managed the home for a number of years and had completed the Registered Managers’ Award. The organisation had a system of monthly visits by head office staff in order monitor standards in the home; Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 20 reports of the visit were provided to the Commission and the registered manager. Residents and visitors said they were able to raise concerns with the senior staff. The organisation had completed a quality assurance survey for Alexandra House, information was gathered through the residents, relatives, staff, healthcare professionals. The results were discussed during supervision meetings. The home should formalise the results and produce an annual development plan based on the results of the survey. Fire safety system checks and staff training were in place. Records showed that the staff training was up to date this was also confirmed by the staff spoken to. Several mechanical hoists seen had all been serviced and tested by contractors. Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23 (4) b Requirement The home must take appropriate action to comply with Dorset Fire and Rescue Services guidance. Timescale for action 30/11/05 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 Refer to Standard OP9 OP33 OP19 Good Practice Recommendations Any medical allergies should be recorded on the individuals’ medication charts. The results of the consultation exercise should be used to produce an improvement plan for the service. An audit of the premises should be completed to ensure the home is kept in good order particularly: Damaged paintwork redecorated. Windows should close properly. Window restrictors should function correctly. Flooring material should be fixed to reduce the risk of falls. Risk assessments of hot surfaces should be updated to include topics recommended by the Health and Safety Executive. 4 OP25 Alexandra House DS0000004036.V265155.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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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