Inspection on 31/08/06 for Alexandra Nursing Home

This inspection was carried out on 31st August 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.

Other inspections for this house

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 Nursing Home 71-75 Queens Road Oldham Lancashire OL8 2BA Lead Inspector Mrs Fiona Bryan Unannounced Inspection 31st August 2006 09:30 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 DS0000066180.V310343.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 Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Nursing Home Address 71-75 Queens Road Oldham Lancashire OL8 2BA 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) 0161 627 2970 0161 627 2015 Cherry Garden Properties Limited Sarah Jane Beswick Care Home 35 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (1), Mental disorder, excluding learning of places disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (1), Old age, not falling within any other category (15), Physical disability (20), Physical disability over 65 years of age (20) Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 35 service users to include: *up to 15 service users in the category of OP (old age not falling within any other category). *up to 20 service users in the category of PD (Physical disability under 65 years of age). *up to 20 services users in the category of PD(E) (Physical disability over 65 years of age). *up to 1 service user in the category of DE (Dementia under 65 years of age). *up to 1 service user in the category of DE(E) (Dementia over 65 years of age). *up to 1 service user in the category of MD (Mental disorder excluding learning disability or dementia under 65 years of age). *up to 1 service user in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). No service user under the age of 55 years to be admitted into the establishment. A Registered Nurse must be on duty in the home at all times. No more than 23 places can be used for nursing care. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. A suitably qualified person must be employed by the home undertake the clinical supervision of nursing staff. 9th January 2006 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: The Alexandra Nursing Home is situated on Queens Road, less than half a mile from Oldham town centre. The home has a total of 35 beds and provides nursing care for up to 23 service users, aged 55 years and over. The home may also provide personal care and care for service users with mild forms of dementia, as long as they do not require the input of psychiatric nurses. The home is owned by Cherry Garden Properties Limited, which is a private company. A registered manager is responsible for the day to day running of the home. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 5 Fees for accommodation and care at the home range from £313.88 to £449.26 per week. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. Accommodation at the home is provided over three floors, all served by a passenger lift. There are a total of 25 single rooms, with ten of these having en-suite facilities, and a further five double rooms for service users wishing to share. In addition, the home provides three lounges, three dining rooms and assisted bathing and toileting facilities. The home is located in the Alexandra Park district of Oldham and is well served by local bus services. It directly overlooks the park offering lovely views from the garden. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on Thursday 31st August 2006. Time was spent talking to residents and staff and observing the home’s routine and staff interaction with residents. Three residents were looked at in detail, looking at their experience of the home from their admission to the present day. A partial tour of the building was conducted and a selection of staff and residents’ records was examined including records of care, medication records, employment and training records and staff duty rotas. Since the last inspection the home has been sold to a new provider who has been registered with the CSCI. The assistant manager for the previous owner was registered as the new manager at the same time. What the service does well: The internal and external appearance of the home provides a pleasant, comfortable environment for residents to live in. Residents’ bedrooms are cosy and personalised with ornaments and mementos. Some residents have brought items of furniture into the home. The atmosphere in the home is relaxed and informal and residents said there were no strict routines and they were able to choose for themselves how to spend their day. Residents said that staff were very kind and looked after them well. One resident said, “the staff are lovely – they are very sympathetic”. Another resident said, “the staff are great; (the home) is 5 star, top class”. Visitors said that they were made to feel welcome and staff were friendly. Staff interaction with residents was patient and caring. Staff seemed enthusiastic and everyone worked well as a team. The new manager has quickly settled into the role and staff and relatives said she was approachable and competent. Over 75 of care staff are trained to at least NVQ level 2 and the home has accessed training in a variety of topics to ensure staff have the skills and knowledge to care for the residents. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: As the home’s statement of purpose and service user guide were written by the previous owner, these documents need to be updated so they give accurate information about the new owner and the services he will provide at the home. Although assessments had been undertaken for all new residents before they came into the home, which were generally quite good in providing details about the residents’ physical needs, they tended to be very limited in information about their social, cultural and spiritual needs. This type of information helps staff to recognise each resident as an individual with differing interests and preferences, and can be used in planning how to meet those needs. Also a number of residents were from different ethnic backgrounds and staff need to have clear information about their specific cultural needs and beliefs and be aware of how the resident wishes these to be addressed. Opinions were varied about the meals provided by the home. It was reported that the menus were being revised at the time of the site visit; more thought needs to be given to the presentation and choice of meals. More rigour is needed to ensure that references are obtained for all new employees before they start work at the home. Although the home used to hold regular residents meetings, none have taken place so far this year. The manager is in daily contact with residents and relatives around the home, but should ensure that more formal opportunities are also provided for residents to offer their views about how the home is run. Annual checks of the fire alarm system and emergency lighting need to be arranged and fire drills must be carried out to ensure that all staff are fully familiar with the procedures in the event of fire. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 8 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 DS0000066180.V310343.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 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 the following standard(s): 1, 2 and 3 Quality in this outcome area is adequate. The statement of purpose and service user guide does not give entirely accurate information; therefore prospective residents may not be able to make an informed decision about choosing to come and live at the home. Residents receive sufficient written information regarding the terms and conditions of their stay; therefore residents are clear about their rights and obligations. Assessments had been undertaken prior to a prospective resident entering the home; more thought needs to be given as to how the assessments can reflect individual preferences and social requirements so the home can be sure it can meet peoples’ diverse needs. This judgement has been made using available evidence including a visit to this service. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 11 EVIDENCE: The home has a statement of purpose and service user guide. However, the manager stated that these documents needed to be reviewed and updated as the home is now under new ownership. On admission to the home all residents or their representatives are given a copy of the terms and conditions of their residency, which includes details of the fees payable, the services not covered by the fees and the notice period required. Three residents were case tracked. Two of the residents had assessments from Social Services on file whilst the other resident was self funding and had therefore had an assessment of needs completed by the home. This assessment had not been signed or dated so it was not possible to determine when it had been completed. Two of the assessments generally contained detailed information about the residents’ physical needs but were less informative about the residents’ social needs. The third assessment also contained little information about the resident’s social contacts and was more limited in respect of other information as well, for example there was no detail about the residents’ past medical history and it was difficult to establish from the information provided why the resident had been admitted to the home. Care files for three other residents who potentially had diverse needs due to their different ethnic backgrounds, were also examined. The information provided could have been expanded on, as there were no details as to whether the residents maintained contact with relatives or friends in their country of birth and if they did, if they required assistance to continue doing so. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Care plans and risk assessments were generally successful in identifying and addressing residents’ physical and health care needs; more consideration should be given as to how residents’ social, emotional and more diverse needs are recognised and recorded. Procedures for dealing with medicines in the home are generally satisfactory; some minor improvements are needed. Personal support within the home is offered in such a way as to promote residents’ privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents were case tracked. Care plans in 2 of the files were person centred and had been reviewed monthly and updated accordingly. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 13 The care plan for the third resident had not been updated as well and had no information about the bereavement they had suffered since coming into the home, still stating the deceased person as their next of kin. The inspector only learnt of this information in conversation with the resident. Care files for three residents with more diverse needs were also examined. Two of the care files referred to the fact that English was not the residents’ first language and advised staff on how to address this. A personal profile had only been completed for one of the residents and this contained no details about her early life and provided no insight into her cultural customs and beliefs. Several care plans had been written for this resident regarding her well being and sense of identity, which stated that staff must develop an understanding of her culture by conversing with her family and friends. However, no specific information was available regarding the resident’s cultural needs and routines; the care plans were written in a very broad and generalised way. Risk assessments for moving and handling, pressure sores and nutrition had been undertaken for all residents and usually reviewed monthly. Care files provided evidence that other health care professionals such as the optician, podiatrist, dietician, wound care specialist and GP had been accessed for residents. Prior to the site visit comments cards were sent to a number of GP’s who visit the home to attend patients. Of these 2 responded. Positive feedback was received from both. Staff were very knowledgeable about the care needs of each resident and were able to describe residents’ preferences and daily routines. Examination of the medicine administration records of the residents that were case tracked indicated that medicines had been received, stored, administered and disposed of correctly. Examination of the controlled drugs records proved satisfactory. The medicines fridge did not have a usable lock, as the key had been lost; a suitable lock should be attached to the fridge. Oxygen cylinders were kept in 2 residents’ rooms. Appropriate safety signage should be placed on the doors to these rooms. A daily record of the temperature of the treatment room had been maintained. The record showed that the temperature of the room had regularly exceeded 25ºC during the month of July 2006 although the temperature was satisfactory on the day of the site visit. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 14 All the residents spoken to said that staff were very kind. One resident said that she was upset when she first came into the home as she was having to sell her own home, but staff had helped her through that period and she felt more settled. Staff were able to give examples of how they promoted residents’ privacy and dignity. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 15 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, 14 and 15 Quality in this outcome area is adequate. Although efforts are made to provide social stimulation, lack of consultation with residents and poor information gathering about their lifestyle preferences means that some residents’ social, cultural and recreational needs may not be met. Visitors are encouraged and welcomed into the home. Routines are fairly flexible so residents are able to make some choices about their lives. Meals were generally acceptable but further consideration is needed regarding the provision of choice for residents. The presentation of food and the dining experience could also be improved. This judgement has been made using available evidence including a visit to this service. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 16 EVIDENCE: An activities’ organiser is employed who works five days per week from 11am until 4pm. The manager stated that there was no set activity programme; residents tended to be asked on a daily basis what they would like to do. Carers complete a social activity record each day for each resident. However the file on the first floor did not record a wide range of activities on offer – most residents seemed to spend large part of days in lounge watching TV, chatting to residents and staff or sometimes having a sing along. One resident said there had not been as many organised trips out of the home as in previous summers. Residents said they had done some cake making the previous week and on the day of the inspection they were making bread in the afternoon. Some of the more independent and mobile residents seemed to enjoy a wider range of social opportunities but the manager acknowledged that the provision of social stimulation and leisure pursuits was an area that needed development. Memory diaries had been created for some residents and some were really good with lots of details and interesting information about the resident’s early life and individual interests. However some residents did not have these. More thorough care planning for the residents’ social needs and the development of the key worker system could help in creating person centred social activities tailored to individuals’ preferences. Residents confirmed that they were able to receive visitors at any reasonable time and that their visitors were made welcome. Residents also stated that daily routines within the home were fairly flexible and they were able to decide when to get up and go to bed. Residents had mixed views about the food provided. Some said the standard of the meals was variable and the majority were uncertain as to whether there was any choice of meal on offer. Most residents said they did not know what was for lunch or tea until it was served, although the menu for the day was displayed outside each dining room (no choice was apparent on that). One resident said the staff in the kitchen knew his likes and dislikes and automatically provided an alternative for him if they knew the main option would not be to his liking. The manager stated that the menus were being reviewed. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 17 Lunch was roast beef, cabbage, carrots, roast and mashed potatoes and Yorkshire pudding. The meal smelled appetising but many of the residents were served their meals on side plates, which were far too small. This detracted from the presentation of the meals and made it more difficult for the residents to eat as the food was piled up on the plates. When the inspector asked, no good reason could be offered as to why the meals were served in this way. Also none of the residents were taken to sit at the dining tables but were left in their armchairs and served their meal on bedside tables. This routine had changed from the last inspection, as at that time most residents sat down at the dining tables. When asked about this a carer said she thought residents preferred to stay where they were. However, encouraging residents to move to the dining tables would provide pressure relief for less mobile residents and would create a more social occasion. Several residents said that staff always made a cake when a resident was celebrating a birthday and all the residents spoken to confirmed that they were offered plenty of hot and cold drinks between meals. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 18 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): 16 and 18 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed prominently around the home and gives timescales by which a complainant can expect a response and contact details for the CSCI. A record of complaints had been maintained since the last inspection. The record of complaints included details of any investigation that had been undertaken and the outcome. Residents said that they would speak to the manager if they had any concerns and felt confident that she would deal with it appropriately. The majority of staff have received training in the protection of vulnerable adults. Staff when questioned, were aware of the procedures to follow regarding complaints and in the event of suspected abuse. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 19 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, 22 and 26 Quality in this outcome area is good. The standard of the environment within the home is good, providing residents with an attractive and homely place to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises found that the home was clean, tidy and in a good state of repair. The ground floor lounge was in the process of being redecorated as part of the general maintenance programme and the manager reported that decking was planned for the front garden so that the surface is more even for residents to walk on. There was no nurse call lead in the lounge on the top floor of the home; thus the 2 residents that were sat in the room had no means of accessing help if they required it. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 20 A nurse call lead was also not provided in one of the residents’ rooms although his care plan stated that he required access to the call system. Residents liked their rooms and said they had been encouraged to personalize them with photographs, ornaments and mementos. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 21 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, 29 and 30 Quality in this outcome area is adequate. Staffing levels are satisfactory the majority of the time. The home exceeds the standards for the percentage of care staff who have completed NVQ training and a comprehensive training programme ensures staff have the skills and knowledge to care for the residents. Recruitment procedures do not protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of the staff duty rotas from the week commencing 29/8/06 to the week commencing 25/9/06 indicated that staffing levels were usually maintained to at least the minimum levels imposed by the previous registering authority. Of 13 care staff, 10 have successfully obtained NVQ level 2. This figure exceeds the target set by this standard. Examination of 2 staff personnel files indicated that the application form only requested details of the applicant’s last 2 employers. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 22 If the candidate had only worked for a limited time for the previous 2 employers, these details may not provide a sufficiently long employment history to accurately assess if they are suitable to work at the home. One of the files only contained one reference. Examination of the staff training file indicated that staff had attended a variety of study days, ranging from Falls Prevention Awareness, Diabetes Awareness and Understanding Parkinson’s Disease to the Management of Incontinence, Prevention of Pressure Sores and the Management of Leg Ulcers. A foot ulcer study day had been planned and also training in Dysphagia Awareness. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 23 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, 35 and 38 Quality in this outcome area is good. The manager is supported well by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. There are limited systems in place to enable residents to offer opinions about how the home is being run; these need to be expanded. Residents’ financial interests are safeguarded via the home’s procedures. Some improvements must be made to health and safety procedures to ensure staff and residents are protected. This judgement has been made using available evidence including a visit to this service. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager is registered with the CSCI and has successfully completed an NVQ level 4 in management. Staff and residents said the manager was accessible and approachable and they had confidence in her ability to manage the home. Minutes were available from 2 staff meetings that had taken place since the last inspection. At one of the meetings the manager had discussed the findings from the previous inspection and had also informed her staff about the new changes to how the home would be inspected as a result of Inspecting For Better Lives. Minutes of the meetings highlighted that staff were enthusiastic and willing to take on additional responsibilities; however they also expressed a wish to meet with the new owner, as they had not yet had an opportunity to do so. The CSCI has received reports of the Regulation 26 visits undertaken on behalf of the owner, by his company secretary; staff said that they had not been involved in those visits. No residents/relatives meetings or satisfaction surveys have been undertaken since the last inspection. However the manager is well known to all the residents who described her as approachable and easy to talk to. The home is responsible for the administration of a very small number of residents’ personal allowances. The allowance is paid into the home’s business account but on the same day the manager reimburses the residents in cash that is then held for them in the safe for their use as they wish. Written records are kept of all transactions. The home has had a Health and Safety inspection and an Environmental Health inspection within the last 2 months. A small number of requirements and recommendations were made at these visits, which the manager stated were being addressed. During a tour of the premises a chemical store on the ground floor was found to be unlocked, which contained cleaning products – such products should always be stored in a locked cupboard. Some residents had suffered accidents, which had necessitated hospital assessment and treatment. Although accident reports had been written for all the incidences, the reports were not later updated to state if the resident had sustained an actual injury. Records were maintained of weekly fire alarm checks and monthly nurse call system checks. The service file was up to date for lifts, hoists, bath hoists and gas safety. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 25 The annual fire alarm and emergency lighting test certificates were out of date. There were no up to date records of fire drills having taken place. Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 26 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 2 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 27 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 OP3 Regulation 14 Requirement The registered person must ensure that comprehensive assessments are undertaken for all residents that include all the details stated in NMS 3.3 The registered person must ensure that residents have access to the nurse call bell. The registered person must ensure that two references are obtained for all new employees prior to their employment. The registered person must ensure that the fire alarm system and emergency lighting within the home are checked and serviced annually. The registered person must ensure that fire drills are carried out at suitable intervals. Timescale for action 31/10/06 2 3 OP22 OP29 16 19 31/10/06 31/10/06 4 OP38 23 31/10/06 5 OP38 23 31/10/06 Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 28 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 5 6 7 8 9 10 Refer to Standard OP1 OP7 OP9 OP9 OP9 OP12 OP15 OP15 OP29 OP33 Good Practice Recommendations The registered person should ensure that the statement of purpose and service user guide are reviewed and updated. The registered person should ensure that care plans are person centred and contain clear information about how staff can meet residents’ more diverse needs. The registered person should ensure that the medicines fridge is kept locked at all times. The registered person should ensure that appropriate signage is placed on the doors of all rooms in which oxygen is stored. The registered person should ensure that all medication retained within the home is stored at the appropriate temperature. The registered person should expand and develop the key worker system to maximise person centred care and assist in meeting residents’ social, cultural and spiritual needs. The registered person should ensure that food is served on appropriately sized plates to enhance the presentation. The registered person should consider the seating arrangements at meal times, to ensure that a pleasant and social dining experience is facilitated for residents. The registered person should ensure that application forms for new employees request sufficient information about the candidate’s employment history. The registered person should ensure that residents and relatives have the opportunity to offer their views on the running of the home through residents/representatives’ meetings and satisfaction surveys etc. The registered person should ensure that any person undertaking visits on his behalf to assess the standard of care being provided by the home, takes the opportunity to speak with staff and residents to gain their opinions. The registered person should ensure that all hazardous materials are stored safely. The registered person should ensure that accident forms contain details of any injury sustained by residents. 11 OP33 12 13 OP38 OP38 Alexandra Nursing Home DS0000066180.V310343.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 DS0000066180.V310343.R01.S.doc Version 5.2 Page 30 - 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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