Inspection on 21/05/07 for Alexandra Park Home

This inspection was carried out on 21st May 2007.

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 Park Home 10/06/08

Alexandra Park Home 11/04/06

Alexandra Park Home 12/12/05

Alexandra Park Home 16/05/05

Alexandra Park Home 13/09/04

Alexandra Park Home 04/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Alexandra Park Home 2 Methuen Park Muswell Hill London N10 2JS Lead Inspector Margaret Flaws Key Unannounced Inspection 21st May 2007 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 Park Home DS0000010757.V336476.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 Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Park Home Address 2 Methuen Park Muswell Hill London N10 2JS 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) 020 8883 5212 020 8343 7459 Mr David Weston Mr David Weston Care Home 15 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (15), Old age, of places not falling within any other category (15), Physical disability over 65 years of age (8) Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Limited to 15 people of either gender who fall into the category of old age (OP) and of whom no more than 8 people may be accommodated on the ground floor may also have a physical disability (PD(E)) One specified service user who has dementia may remain accommodated in the home. The home must advise the regulating authority at such times as the specified service user vacates the home. 11th April 2006 Date of last inspection Brief Description of the Service: Alexandra Park Home is a care home for fifteen older people some of whom may have mental health problems, up to eight people may be accommodated on the ground floor may also have a physical disability and one specified service user who has dementia. There are nine single bedrooms and three shared rooms. No bedrooms have en suite facilities, although there are a number of toilets plus two bathrooms. Alexandra Park Home is not purpose built and comprises of a large converted house with an extension on the ground floor. The home is situated in a quiet residential area of Muswell Hill and is not far from local shops, other amenities and Alexandra Park. Transport links are very good. The home’s stated aim includes that ‘residents’ rights are at the top of our care philosophy. We will advance these rights in all aspects of the home and encourage our residents to take part fully in decision-making’. Inspection reports produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. The current scales of charges are from £400 to £600 per week. Other additional charges include, hairdressing, chiropody, newspapers and magazines. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The Inspector was assisted by and spoke to the Registered Person and four staff. I also spoke to several people living in the home and one relative. The remainder of the inspection comprised inspection of home and service user records and policies and procedures, a tour of the building and observation of staff with the service users. What the service does well: What has improved since the last inspection? What they could do better: A total of ten requirements were made at this inspection. Four requirements are restated from the past two inspections: The adult protection policy and procedure needs updating and needs to be synchronised with the local Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 6 authority’s policies and procedures. An environmental risk assessment must be updated. The inspection control policy and procedure must also be bought up to date, along with the Statement of Purpose and Service User Guide. The following new requirements are made: Staff must be trained in infection control, medication and adult protection. They must also be trained in fire safety. Staff have regular supervision but supervision recording must improve. The quality assurance system must be implemented regularly to formally obtain the views of the people living in the home and their significant others. 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. The summary of this inspection report can be made available in other formats on request. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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 Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a good assessment process for prospective residents but still needs to provide more information to them about what is offered. EVIDENCE: Two pre-admission assessments for new people living in the home were checked. These contained sufficient detail about their needs. Assessments are done by the placing authority and by the Registered Manager. The London Boroughs of Camden and Haringey fund most people living in the home. Annual social work reviews of people’s placements by these boroughs were mostly up to date. All admissions checked on the previous random visit were found to be within the home’s categories of registration. Many people have lived in the home for a number of years. Some work has been done on improving the quality of information available to prospective residents, including producing an information brochure, with interim information to prospective service users. The Statement of Purpose Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 9 and Service User Guide still require some work and a previous requirement is restated. The home has updated their Equalities Policies and Procedures and is checking these against recent legislation. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recording in the home has improved to better meet the needs of people living there. People’s health care and social needs, including their mental health needs, are assessed and regularly reviewed. The home has safe medication policies and procedures, which are put into practice. EVIDENCE: Three files for people living in the home were checked and found in to be in good order. They contained very good care plans and excellent information on the psychological health status and the needs of the residents. All care plans were up to date and the daily notes were clear. Health care checks are done regularly and documented - there is a good monitoring procedure in place. Care plans are now signed and dated on review and photographs are on file. People spoken to were very positive about how their privacy and dignity is respected. They said that they felt safe, comfortable and treated with respect. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 11 Staff were observed knocking on people’s bedroom doors before entering and they were able to describe the steps they take to protect the service users’ rights. Manual handling risk assessments are done and regularly updated. Two service users need some moving and handling support. One person needs to be assisted using a hoist with the support of two care staff, and one other person, a wheelchair user, is able to do most things for herself. Staff were able to describe the way they support these residents and were competent in moving and handling practice. The hoist was in good working order and had been certified safe in its six monthly inspection. Accident and incident records were in order. The medication arrangements were inspected. All MAR sheets checked and were in order, with no gaps in the record of administration. The pharmacist does a regular audit for the home. One staff member has been trained by the District Nurse to give insulin to a diabetic person. Some staff, however, had not had medication training and a requirement is made under Standard Thirty. People’s preferences in event of death have ascertained and recorded. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities offered in the home are reasonable and appropriate for the people living there. Family contact is encouraged and meals are of good quality and varied. EVIDENCE: There are good choices of leisure, social and cultural activities offered to the people living in the home. Activities are facilitated by an activity person, for example, physical activities by an exercise coordinator, or by a staff member on duty, and then recorded in the activities record. An entertainer visits the home regularly. Some people go out into the community daily. People spoken to described activities they enjoyed and were positive about what was on offer. These included painting, gardening, music, quizzes and board games. The people I spoke to were very positive about living in the home. For example, one person said, “I was very lucky coming here when I got out of hospital. The staff are very good and (the Registered Manager) is an angel”. Family involvement is supported and encouraged and home has a policy on family involvement. This was confirmed by checking the visitors’ book. One relative said he was a regular visitor. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 13 I spoke to the cook in the kitchen. The home has purchased a new fridge/freezer. There was good selection of fresh fruit, vegetables and other fresh food available on the day of the inspection. Kitchen temperatures are monitored and recorded daily. Menus showed good rotation and variety. On the day or the inspection, the choice was sausage and mash, or lamb or fish followed by dessert at lunchtime and fish and chips for dinner. The home always offers a cooked breakfast to anyone who would like one. People said that they liked the food and that the cooks were very responsive to their requests. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The complaints policy and procedure has improved over the last year. People living in the home are protected from abuse but the policy and staff training improvements are needed. EVIDENCE: The complaints policy and procedure was checked. It had recently been updated. There were three complaints in pat twelve months and all had been appropriately dealt with. People living in the home said they would always speak to the Registered Manager if they had an issue. The home still needs to update its adult protection policy and procedure to ensure that it is in line with the policies and procedures of the local authority. The home must obtain a copy of the local authority’s adult protection procedures and then update its own process accordingly. A requirement made at the previous inspection is restated. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical environment is pleasant and homely for people to live in. Maintenance has improved over the past year. EVIDENCE: I toured the building with the Registered Manager. Some redecoration has been done since the last inspection, for example, the upstairs corridor has been painted and one room has been refurbished. The boiler was repaired recently. A key pad for the front door has been removed because it was no longer needed. The home was very clean and tidy and felt homely. The garden has been tidied up since the last inspection. The home has a contract for the removal of hazardous waste. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 16 Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a reasonable staffing mix and level to meet people’s needs. Staff training needs some improvement. EVIDENCE: I checked three staff records. These were all in order and all pre-employment checks had been done appropriately. There was one staff vacancy but no new staff at the time of the inspection. In discussion with the Registered Manager, it was clear that staff turnover is low. He said that team morale is good and staff interviewed confirmed this. Staff also said that they worked well together as a team and that their colleagues were easy to work with. I checked the staff rota. There were sufficient staff on duty to meet the needs of the people living in the home. Service users said that staff were always on hand when needed. Staff are making progress with NVQ achievement. Training records contained certificates for course completed but the home would benefit from a training matrix showing all training delivered to whom. A recommendation is made. Staff need training updates in adult protection, medication and requirements are given. Staff also must have training in infection control. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 18 Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Health and safety and financial systems in the home are generally good but improvements are needed in fire safety training to better protect those living and working there. Staff receive regular supervision. Quality assurance is adequate but needs to be better implemented. EVIDENCE: All staff and people living in the home were very positive about the Registered Manager and about the way the home is run. The Registered Manager is supported by a Deputy and by senior care staff. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 20 The home has good system for managing the personal allowances of those people living in the home who need support. Cashboxes, receipts and spreadsheets are reconciled weekly. The quality assurance process involves an annual survey. There is also a more informal mechanism in place where key workers monitor the views of the people living in the home. However, the Registered Manager said that the home has not done this survey for some time. A requirement is made that the home implements its quality assurance system at least annually to ascertain the views and wishes of the people living in the home and their significant others. The Registered Manager is gradually updating the policies and procedures, acting on a requirement from the last inspection. Staff said that they received individual clinical supervision. However, supervision recording needs to improve and a requirement is given. At the last inspection, a requirement was given to update the current environmental risk assessment and to include a section on access to the garden. This requirement is restated. Fire drills are held four times per year and recorded. The records include the outcomes of the fire drill any actions needed to improve the practice. The Registered Manager said that the outside emergency lighting is currently in need of refurbishment. Fire equipment checks had been carried out. However, fire training is not up to date and a requirement is given that all staff undertake this training. Hot water temperatures are checked weekly. Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 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 3 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4&5 Sch 1 Requirement The registered person must amend and ensure that the home’s Statement of Purpose and Service Users’ Guide cover all the elements as specified in Regulations 4 & 5 and Schedule 1 of the Care Homes Regulations 2001. (Previous timescales of 20/05/06 and 30/01/07 not met) The registered person must ensure that the abuse/adult protection policy is updated and is in line with the local authority’s procedures. (Previous timescales of 30/05/06 and 30/01/07 not met) Timescale for action 30/08/07 2. OP18 13(6) 30/08/07 3. OP38 13(4) 30/08/07 The registered person must update the current environmental risk assessment. This must include a section relating to access to the garden areas and the comfortableness of the chairs for service users. (Previous timescales of 30/06/06 and 30/01/07 not met.) Alexandra Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 23 4 OP30 18(1) 5 OP30 18(1) 6 OP30 18(1) 7 8 OP30 OP30 18(1) 18(1) 9 10 OP36 18(2) 24 (1-3) OP33 The Registered Person must ensure that the home’s infection control policy and procedure is updated in line with current legislation and practice. Previous timescales of 30/06/06 and 30/01/07 not met.) The Registered Person must ensure that staff are trained and regularly updated in infection control. The Registered Person must ensure that staff are trained and regularly updated in medication handling. The Registered Person must ensure that staff are trained and regularly updated in fire safety. The Registered Person must ensure that staff are trained and regularly updated in adult protection. The Registered Person must ensure that supervision is recorded systematically. The Registered Person must ensure that quality assurance measures are regularly implemented. 30/08/07 30/09/07 30/09/07 30/09/07 30/09/07 30/09/07 30/09/07 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 Park Home DS0000010757.V336476.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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