Inspection on 09/05/07 for Alexandra Rose Residential Care Home

This inspection was carried out on 9th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alexandra Rose Residential Care... 14/11/06

Alexandra Rose Residential Care... 04/01/06

Alexandra Rose Residential Care... 12/07/05

Alexandra Rose Residential Care... 04/03/05

Alexandra Rose Residential Care... 16/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Alexandra Rose Residential Care Home 358 Havant Road Farlington Portsmouth Hampshire PO6 1NE Lead Inspector Nick Morrison Key Unannounced Inspection 09:30 9th May 2007 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 Rose Residential Care Home DS0000055562.V336172.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 Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Rose Residential Care Home Address 358 Havant Road Farlington Portsmouth Hampshire PO6 1NE 023 9238 2944 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) Riva Limited Mrs Tammy Denise Durrant Care Home 32 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (32) of places Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may admit people under the age of 65 years in the OP and DE category. 14th November 2006 Date of last inspection Brief Description of the Service: Alexandra Rose Care Home is a residential home that is registered to accommodate 32 service users over the age of 65 years. The home is situated in the Farlington area of Portsmouth and is close to shops and transport links to the city of Portsmouth. The home fits well into its residential surroundings. The building is set out over two floors and has a shaft lift to enable service users access to the first floor. Fees at the home range from £450 - £645 per week and service users are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 9th May 2007 and lasted six hours. During this time the Inspector toured the premises, looked six service users’ files and met with people living in the home and some of their relatives. The Inspector also met with the Registered Manager and the Provider and spoke to three members of staff. All records and relevant documentation referred to in the report were seen on the day of inspection. Observation throughout the day showed that all service users appeared to be happy with the service they were receiving. What the service does well: What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 6 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 Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 7 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Examination of service users files showed that each person living in the home had had an assessment of their needs prior to admission. Families of service users spoken with during the inspection visit confirmed that they had been consulted during the assessment process. The home liaised with health and social care professionals during the assessment process. Service users had the benefit of trial periods in the home before deciding to move in permanently. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 8 The Manager actively manages admissions to ensure that the home can clearly meet the needs of prospective residents and to ensure, as far as possible, compatibility with people already living in the home. A family member spoken with said the home responded very well and very quickly to her initial enquiry for a service for her mother. The home does not provide intermediate care. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the home’s medication policies and procedures and are treated with dignity and respect. EVIDENCE: There had been a requirement from the previous inspection that care plans must be amended to ensure that there is clear information for staff so that they have all the information they need to give the right support for service users. Since then care plans had all been re-written in a new format that is clear, detailed and informative. This requirement has now been met. Examination of files showed that there were care plans in place for each service user. The plans had clearly been written in response to those needs identified in the pre-admission assessment, as well as to those needs identified as staff in the home got to know service users better. Staff spoken with said that the plans were accessible at all times and that they understood the care Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 10 plans for each person living in the home. The plans were all reviewed on a monthly basis and changes made where necessary. Changes were also made to the plans in-between the monthly reviews if it was clear that needs had changed. Family members spoken with said they were consulted about care arrangements and were kept fully informed of any changes. This was further confirmed through feedback from families in the home’s quality assurance questionnaires. The healthcare needs of service users were monitored daily and formally monitored on a monthly basis. Records were kept to demonstrate any changes in the person’s health and staff in the home liaised with other healthcare professionals whenever necessary. Family members spoken with confirmed that staff in the home were attentive to the health needs of people living there and responded to any concerns and that they involved external healthcare professionals when necessary. There had been two requirements from the previous inspection that the home must draw up a protocol and procedure and a risk assessment for staff to follow with regard to the pen injection of insulin for one service user at the home and that appropriate training for staff must to be provided. The care plan for this person and the training records showed that these requirements had now been met. There were also two recommendations that a specifically identified code be used on the MAR sheets for drugs that are prescribed on a PRN basis and are not needed and that medication being stored in the cupboard for service users who are in hospital be returned to the pharmacy to avoid confusion when the service user returns home with 28 days supply of medication from the hospital. Examination of the medication records showed that these two recommendations had now been addressed. Medication in the home was well managed. There was a clear medication policy and staff spoken with understood it fully. Staff involved in administering medication had all received training. All medication was stored safely and securely in the home and good records were kept of all medication administered. Records were also kept of all medication coming into and going out of the home. Observation throughout the inspection visit showed that staff understood how to respect the privacy and dignity of service users. Staff were courteous at all times to all service users and this was confirmed by family members spoken with. All service users seen and spoken with on the day of inspection were well-presented and, where necessary, had support from staff to maintain their appearance. The induction training for staff provided them with guidance on the rights of service users and on ways to actively demonstrate respect and maintain peoples dignity. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good approach from the home to their nutritional needs. EVIDENCE: Staff had received training in communicating with people who have dementia and were skilled in communicating with people living at the home. Service users’ methods of communication were recorded and there was close liaison with families over the needs, choices and wishes of each service user. Families spoken with confirmed that all the staff in the home were very good at communicating effectively with their relatives and that they were respectful of the choices they made. Observation of staff on the day of the inspection visit showed that they gave time and consideration to all service users and attempted to respond to their wishes at all times. They spent time listening to people and engaging them in conversations. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 12 The home provides a variety of activities. Records were kept of all activities. Activities included videos, music, discussions and books. In addition to the actual activities offered, staff were mindful throughout the day of the need to ensure that service users were receiving sufficient stimulation. There was a lot of interaction with service users throughout the day. There is one member of staff at the home who has specific responsibility for organising activities. Service users’ families had commented that the home provided good stimulation for people. On the day of the inspection visit there was an entertainer in the home who sang for the people living in the home. Staff were involved in the activity and made efforts to ensure that all service users were as involved as they wanted to be with the singing. The Manager of the home is planning to increase the opportunity for people living in the home to go out, especially during the summer months. She is planning to take small groups of people out for a drive and to visit places in the local community. Visitors were encouraged to come to the home at any time and all those visitors spoken with confirmed that they felt able to visit whenever they wanted to. Families spoken with said they were always made to feel very welcome in the home and that staff made it easy for them to visit and spend time with their relative. They said it was a very friendly and homely atmosphere and that they always felt welcome. Information was available within the reception area for visitors and this included the Statement of Purpose, Service User Guide and a copy of the last report from the Commission for Social Care Inspection. The home had a very positive attitude to supporting service users to maintain contact with their friends and families. The home also had a very positive attitude to addressing the nutritional needs of service users. On admission each service user had an assessment of their nutritional needs and individual nutritional care plans and risk assessments were devised in response to any issues highlighted in the assessment. Food was always served in the best way for each service user to consume it and staff were available to provide support for people who needed it. Fresh fruit was available for people. The meal seen on the day of the inspection visit corresponded with the menu for the day and people spoken with said they enjoyed the food in the home. Feedback from family members described the food as excellent. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear and effective complaints procedure and are protected by the home’s adult protection procedures and practices. EVIDENCE: The home has a clear and effective complaints policy in place. The policy is made available to service users and their families on admission and a copy is also available in the front entrance of the building. Families of service users spoken with were aware of the complaints policy and how to use it, but those spoken with said they had never had to make a complaint. There had been no complaints since the previous inspection. The home has a system in place for recording and responding to any complaints that may be made. Discussion with staff and examination of training records showed that all staff had received training in adult protection issues and were aware of their responsibilities within the adult protection procedures. The manager was clear about the reporting procedures and how to use them. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 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. 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. Service users benefit from living in clean, safe, well-maintained environment. EVIDENCE: All parts of the building were kept very clean, but the home retained a homely and comfortable appearance. The Manager said that the owner of the home was very good in responding to requests for necessary expenditure on the building, but usually initiated improvements himself before they were requested. A recent extension had been made to the home and all parts of the building were well decorated. The furniture in the home was of very good quality and was replaced whenever necessary. There was also a programme of routine maintenance and records were kept to demonstrate that maintenance issues were responded to swiftly. The home Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 15 employs a maintenance person to deal with day to day maintenance issues. The home also employs adequate numbers of domestic staff to maintain the appearance of the building. There were comprehensive cleaning rotas in place and these were checked regularly by the Manager to ensure that all cleaning was undertaken to the necessary standard. Infection control policies were in place and were posted in places throughout the building to ensure that staff were able to refer to them throughout their work. The home had a very positive approach to infection control, including a hand rub available to staff and visitors so that people did not pass on any infection. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: There had been a recommendation form the previous inspection that a copy of the application form for any management position applied for, be maintained in the recruitment file for that person. This had been addressed. The home employs sufficient numbers of staff to meet the needs of service users. Rotas showed that, in addition to the Registered Manager there were five care staff on each shift throughout the morning and four throughout the afternoon. Staff and families of service users spoken with confirmed this. In addition to this there were domestic staff including cleaners and a cook. The numbers of staff on duty meant that service users were able to have their care needs met and were also supported to be involved in leisure activities and were stimulated throughout the day. All staff had very comprehensive induction training when they first began working in the home and clear records were kept of this. The ongoing training for staff was provided through a comprehensive training package and most training was delivered by the Manager. Staff spoken with Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 17 said they had good access to all the training they wanted and were encouraged and supported to undertake as much training as possible. Families of service users said all the staff appeared to be very well trained and were competent in their roles. All staff in the home had, or were undertaking, NVQ level two or equivalent. All staff received regular support and supervision sessions with a member of the management team. Records were kept of all sessions and issues were followed through from one session to the next. All staff spoken with said that they were well supported by the Manager of the home. Examination of recruitment records showed that the home ensured that all necessary pre-employment checks were in place for all staff before they began working in the home. All staff were interviewed before being offered a job and clear records were kept of all interviews. Family members spoken with said every member of staff was always very supportive and was always able to answer any questions or concerns they had. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s financial procedures and by the management of health and safety issues. They benefit from living in a service that is well managed and focussed on their best interests. EVIDENCE: Service users in the home have their finances managed by family members or by other representatives outside the home. The home does look after small amounts of spending money for some service users and has a policy and procedures in place to govern this. Access to the money is currently limited to times when the administrative person is present in the home. The Provider Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 19 explained that this was to cut down the number of staff who had access to the money. The issue of people living in the home having access to their money whenever they wanted to was discussed and the Provider is planning to alter the Service User Guide so that people are informed, before entering the home, of the arrangements regarding the money the home looks after on behalf of them. Clear and accurate records are kept of all transactions, along with receipts. Health and safety was well managed in the home. Comprehensive workplace risk assessments were in place and these were monitored and reviewed on a regular basis. The manager was clear about health and safety legislation and specific regulations were accounted for within the home’s health and safety policies. Procedures for safe working practices were posted around the building and were covered in staff induction training. Staff spoken with were clear about the need for ensuring the health and safety of themselves, their colleagues and service users in all the work they undertook. Any incidents or accidents were recorded clearly and these records were regularly reviewed to ensure that practices were changed where necessary. All staff received regular training and updates in health and safety issues. The quality assurance system in place in the home was comprehensive and focussed on outcomes for service users. There were regular questionnaires for service users and family members about the service provided and the results of these were considered and acted upon where necessary. The amount of positive feedback received through the consultation process was good. People completing the questionnaires had been most positive about the management of the home, the approach of staff, the environment and the way they were involved with and consulted about care arrangements. The Registered Manager had been in post for six months, but had previously been a Registered Manager elsewhere. She has demonstrated that she has the necessary skills and qualifications to manage the service. Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 20 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 X 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 3 3 X X X X X X 3 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 3 X 3 X 3 X X 3 Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 21 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 Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Alexandra Rose Residential Care Home DS0000055562.V336172.R01.S.doc Version 5.2 Page 23 - 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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