Inspection on 09/08/05 for Alexandra Nursing Home

This inspection was carried out on 9th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alexandra Nursing Home 05/06/09

Alexandra Nursing Home 29/09/06

Alexandra Nursing Home 18/01/06

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

CARE HOMES FOR OLDER PEOPLE Alexandra Nursing Home Moorland Road Poulton-le-Fylde Blackpool FY6 7EU Lead Inspector Chris Bond Announced 8th & 9th August 2005 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 Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 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 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 Cohen Care home with nursing 40 Category(ies) of OP Old age (33) registration, with number DE Dementia (7) of places Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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). Date of last inspection 19th October 2004 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 aswell as places of worship and other ammenities. 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 F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over eight hours. The inspector spoke to a number of residents during the inspection. Five visitors were also spoken to. The manager and the owner of the home gave the inspector a tour of the building. Staff and care records were also examined. What the service does well: What has improved since the last inspection? Several of the rooms have had new carpet fitted, which added to the appearance of the home. Nine of the care staff are trained up to National Vocational Qualification level 2 or 3. There are five carers working towards achieving this. This will mean that by December 2005 most of the care staff will be trained to the required level. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 6 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 F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4 and 5 All new residents have a full assessment completed prior to moving into the home, ensuring that the home can meet their needs. EVIDENCE: Five residents’ personal files were looked at which included all of the people who had most recently been admitted to the home. It was clear that the manager of the home was carrying out detailed needs assessments prior to new residents being admitted. This would clearly help when planning what care the resident would need within the home. The manager confirmed that good assessment was a priority to ensure that the home would be able to care for the residents successfully. Information about the home is given to residents before they come to live there. This information clearly states the purpose of the home, and explains the criteria needed to be accepted as a resident. Relatives and residents confirmed during the inspection that they were offered the opportunity to look round the home before making a decision to stay there. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Promotion of health was taken seriously. Resident’s welfare was closely monitored and health needs were met. EVIDENCE: All of the residents living at the home had a plan of care where important information was recorded. Notes were kept of the outcome of any visits or healthcare professional input, providing evidence that individual health care needs were met. All of the plans were reviewed on a regular basis. There were lots of comments from residents about the care that they received. One lady said, “this is a lovely home, and the girls are so nice”. All of the ladies that were spoken to were very complementary about the way that their needs were met and all of them felt that they were treated with respect. None of the residents were responsible for their own medication. Systems were in place that ensured that medication was handled correctly and professionally. The records of all the people who received medication were seen and there were no concerns. Each resident had a photograph attached to their record sheet to help prevent mistakes. Only trained staff gave out the medication. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 10 There was evidence that the pharmacist visited the home to advise on medication issues and a report had been produced of his findings. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15 Meals are nutritional and a varied diet is provided to residents ensuring they receive meals that promote their health. Visitors are welcome at any time ensuring personal relationships are maintained. Social activities were adequate but could be improved to provide a more fulfilling lifestyle for those residents with dementia. EVIDENCE: The likes and dislikes of the residents were recorded on their care plans and the chef showed the inspector the menus that were currently being used. Local food suppliers were used and there were plenty of fresh vegetables on the menu. The dining room overlooked the garden at the front of the building and was decorated with the original wall and ceiling paintings from when the home was a private house. The Inspector was able to sample the lunchtime meal and found it appealing and wholesome. There were several visitors to the home during the inspection. Those that were spoken to said that they were always made very welcome and privacy and refreshments were always offered. One visitor commented, “If anything happened to me I’d love to come and live here, its so lovely.” Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 12 Four residents were spoken to and all said that there were sufficient activities and pastimes available within the home. The home also had a separate unit for residents who had dementia. The home needs to research and explore ways of providing specialist activities for those with dementia. New activities and therapies should be developed in line with current good practice to ensure that the home is able to specialise in the care of those with this condition. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 13 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 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The complaints procedure was available in the Service User Guide and Statement of Purpose and the procedure was available to residents and visitors in the main part of the home. The carers on duty were aware of the procedure regarding helping residents and their relatives to complain if they wished to do so. Training had been accessed regarding the recognition of abuse, and staff were aware of what action to take should abuse be suspected. The home had good procedures and guidance for staff, as well as a ‘whistle blowing’ policy that protected staff when voicing their worries. There were no concerns regarding care practices within the home. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 14 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, 22, 23, 24 and 25 Residents live in a clean, well-maintained home. Residents’ bedrooms are attractive and homely. EVIDENCE: The manager and the homeowner gave the inspector a tour of the home. 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. One visitor said, “ The home is quite lovely, this is a remarkable place.” The residents’ bedrooms were all individual, reflecting their preferences and contained personal possessions. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 15 The home was very clean throughout. There were no unpleasant smells. The housekeeper was spoken to and she confirmed that the home is cleaned on a daily basis and thorough practices are used in dealing with issues around incontinence. The bathroom facilities were adequate, although they were a little stark, and more could be done to ensure that bathing is a pleasant and relaxing experience. Several of the bedrooms had en-suite facilities. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 16 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 Staffing levels are appropriate to meet the needs of the people accommodated. Staff are well trained to ensure they have the competencies to meet residents needs. EVIDENCE: The staffing rotas for the home were looked at and there were no concerns regarding the amount of care staff on duty. It was clear to see that the needs of the residents were being attended to and that people were being treated with respect and dignity. It was found that over 50 of staff had a achieved NVQ level 2 which is a nationally recognised qualification. There was evidence to show that care staff had received training in Dementia awareness and how to deal with challenging behaviour. There had also been recent training in moving and handling to help ensure that residents and care staff are safe when moving takes place. The training room within the home is accessed by a large caring organisation (BUPA) to provide training for their own staff and as part of this agreement care staff from the Alexandra also access this training. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 17 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) 31 and 32 Service users benefit from a well run home. EVIDENCE: The registered manager has achieved the management element of NVQ level 4 which is a nationally recognised qualification. The Registered Manager was competent, respected and experienced in her running of the Alexandra. There were clear lines of responsibility within the home. It was clear that all staff were being supported to do their jobs effectively. Records of individual supervision were available. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 18 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 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 19 yes 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. 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. 1. Refer to Standard 12 Good Practice Recommendations Appropriate activities for those residents who have dementia should be introduced. Alexandra Nursing Home F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway 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 F57 F09 S64333 Alexandra Nursing Home V234829 080805 Stage 4.doc Version 1.40 Page 21 - 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. 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