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Inspection on 18/01/06 for Alexandra Nursing Home

Also see our care home review for Alexandra Nursing Home for more information

This inspection was carried out on 18th January 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents of the Alexandra are well looked after. The care staff work well as a team and show a good understanding of the needs of the people living at the home. Care documentation is well written and comprehensive. The owner of the home has a good knowledge of the service. He is actively involved in ensuring that the service is running well. The home provides an attractive setting for people to live in. The house was well furnished and had many of the original decorative features. Some of the residents said that this added to their feeling of wellbeing. The views from the front of the building were exceptional. The home also has 7 beds registered to care for service users with dementia. A specialised unit with separate facilities and staffing is available for this purpose and staff have had specialist training in caring for people with this condition. The home has a residents committee and meetings are held to arrange activities and outings for service users. Almost all of the residents spoken to said that the food was very good and that they looked forward to mealtimes. The home had a number of `housekeeping` staff that kept the home clean and free from unpleasant odours.

What has improved since the last inspection?

There have been several training events that helped to add to the skills of the care staff. Most of the care staff now hold a nationally recognised care qualification. An activities programme has been devised for those who have dementia.

What the care home could do better:

This was a home that has attained all of National Minimum Standards.

CARE HOMES FOR OLDER PEOPLE Alexandra Nursing Home Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU Lead Inspector Christopher Bond Unannounced Inspection 18th January 2006 10:30 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 Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 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 Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alexandra Nursing Home Address Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU 01253 893313 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) Alexandra Nursing Home Limited Ms Sandra Jean Cohen Care Home 40 Category(ies) of Dementia (7), Old age, not falling within any registration, with number other category (33) of places Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 40 service users to include up to 33 service users in the category OP (older persons 65 and over ) and up to 7 service users in the category DE (Dementia) 9th August 2005 Date of last inspection Brief Description of the Service: The Alexandra is a listed building and stands in its own grounds on the outskirts of Poulton-le-Fylde. The main building is most attractive and contains many of its original features, including wall and ceiling paintings, stained glass windows and a broad open staircase leading up from the hallway. The gardens are well managed and there are lots of places for residents to sit out in good weather. The main railway station is quite close and bus services run from close by. There are plenty of parking spaces close to the home and within its grounds. There are local shops not far from the home as well as places of worship and other amenities. The building has a lift and some of the bedrooms are en-suite. The home is registered for 40 residents, there are 7 residents who have dementia and a specific area has been set -aside for this purpose. Other residents have general health problems or physical disabilities and trained staff are available at all times to assist with their needs. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took 3.5 hours. Two inspectors were involved in the inspection process. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. The homeowner gave a tour of the home. Staff and training records were also looked at. What the service does well: What has improved since the last inspection? Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 6 There have been several training events that helped to add to the skills of the care staff. Most of the care staff now hold a nationally recognised care qualification. An activities programme has been devised for those who have dementia. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed during this inspection. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Health and care needs were addressed correctly through good care planning, ensuring that the residents were looked after properly. Residents were treated with respect and their dignity was well maintained by understanding care staff. EVIDENCE: All of the residents living at the home had a plan of care where important information was recorded, and where the health of the residents is monitored. Notes were kept of the outcome of any visits by the District Nurse or the Doctor, which showed that individual health care needs were met. There was lots of information about the general care needs of each resident. All of the plans were reviewed on a regular basis to make sure that the information was always current and that the care staff knew the latest condition of a resident. A number of residents were spoken to and they all felt that they were treated with respect by the care staff, and that their dignity was maintained. None of the residents within the home were able to handle their own medication. There were good procedures and policies for the staff to follow when they were administering prescriptions and the medication was stored safely and Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 10 appropriately. This helped to ensure that residents were not put at any risk when medication was being given out. There were lots of good examples seen by the inspector of care staff being polite, courteous and caring when attending to residents’ needs. The visitors that were spoken to during the inspection also said that they were really pleased with the way that the staff cared for their relatives and friends. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Residents enjoy planned and stimulating activities. EVIDENCE: It was good to see that the residents within the home who had dementia had their own specific activities that were particular to their condition. A special box had been obtained from the local library and this was full of curios and objects that were popular in the early 20th Century when most of the residents would have been young. By discussing what the objects were for staff would help the residents’ reminisce about their lives and help their memory. Those residents who were spoken to who did not have dementia said that there was always a lot to do and that activities were regularly organised. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 12 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): EVIDENCE: This section was not assessed during this inspection. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 13 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, 20, 21, 22, 23, 24, 25 and 26 Residents live in a clean, well-maintained home. Residents’ bedrooms are attractive and homely. EVIDENCE: The home was attractively set in its own grounds and there were areas where the residents could enjoy the gardens around the house. The hallway and lounge areas were decorated with ceiling and wall paintings from the last century. There were quiet areas for residents to sit and enjoy the views of the garden. It was clear that the residents had the specialist equipment that they needed to make their stay within the home more comfortable. There were hoists available for people who found it difficult to get around. This meant that they could be helped by the care staff to get around safely. There was a lift to help people get to their rooms on the first floor. There were several bathrooms within the home. All of them were in easy reach of the rooms and communal areas. There is a need to ensure that when people have a bath that it is a nice, Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 14 relaxing experience. The bathrooms were a little austere and clinical. Surroundings are important when people are relaxing. All of the rooms were quite large and there were lots of personal possessions around that made them more homely. All of the residents that were spoken to said that they liked their rooms, and there were some nice views from the rooms at the front of the house. The home was very clean and there were no unpleasant smells. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Good training and proper recruitment ensures that the home provides a good quality of care. This also helps to ensure that residents are safer. EVIDENCE: There were lots of staff on duty during the inspection. The residents and their visitors confirmed that there were always plenty of care staff to look after the needs of the people who lived there. There had been several training events since the last inspection to help ensure that skills were being improved and updated. Over half of the care staff had a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). This was good because it meant that the staff were better qualified to do their jobs correctly. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 16 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, 32, 36 and 38. Service users benefit from a well run home. EVIDENCE: Care staff had been trained in ensuring the safety of residents. This included learning how to move people safely and ensuring that food was prepared and served hygienically. Good records were being kept of safety checks within the home. These showed that tradesmen were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. The manager was well qualified to manage the home. The care staff that were spoken to during the inspection confirmed that the manager was always approachable and was responsive to the needs of the residents. Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 17 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 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 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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. Extracts may not be used or reproduced without the express permission of CSCI Alexandra Nursing Home DS0000064333.V283203.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!