Inspection on 26/04/06 for Alfrace

This inspection was carried out on 26th April 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

Alfrace 03/07/07

Alfrace 19/12/05

Alfrace 14/07/05

Alfrace 09/02/05

Alfrace 29/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Alfrace Newton Lane Wigston Leicestershire LE18 3SH Lead Inspector Kim Cowley Unannounced Inspection 26th April 2006 03:00 Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 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 Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alfrace Address Newton Lane Wigston Leicestershire LE18 3SH 0116 2883352 0116 2449013 residentialcare@alfracehouse.wanadoo.co.uk 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) Mr Richard Morgan Mrs Rita Morgan Mrs Rita Morgan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 19th December 2005 Brief Description of the Service: Alfrace is registered to provide care for six adults with learning disabilities. It is a small family-run home situated on the outskirts of Wigston. It is mainly staffed by the two Providers (one of whom is the Registered Manager) who also live in the home. The residents’ accommodation consists of five ground floor single bedrooms, all with ensuite facilities, a large lounge/dining room and a smaller lounge with a television. The home has nearly an acre of gardens with a summerhouse, aviary, lawns, and a terrace. The Providers grow organic fruit and vegetables helped by the residents. Fees range from £1,269 to £1,328 per month. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home, and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looks at the care provided all the residents living at the home by talking with the residents themselves; talking with the Providers who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other areas relating to the running of the home, including health and safety and management practices, were also inspected. The quality and cleanliness of the accommodation was commended. What the service does well: Alfrace is a family-run home, which has been open for 20 years (initially as part of the Adult Placement scheme). Most of the residents have been in the home for between 10 and 20 years. All the residents praised the Providers and said they were happy with the way the home is run. Comments included, ‘It suits me here. I like the people who run it – nothing’s too much trouble for them’, and, ‘Dick and Rita aren’t strict and they don’t tell us what to do. They are fantastic people.’ The Providers promote healthy eating and healthy living, and the residents are proud of their lifestyles. One resident commented, ‘We all look healthy thanks to Rita and Dick.’ One of the Providers said, ‘If they’re (the residents) happy, then we’re happy, and if they’re healthy, we’re happy.’ All residents attend day services or work placements and have a range of leisure activities. One resident said, ‘We’re going on holiday to the seaside on a coach. We’re staying in a hotel with Dick and Rita’, and, ‘Dick and Rita take us out to the club and everyone knows us there.’ Residents are encouraged to help in the home and to have at least one area of responsibility each, for example washing up or sorting out the lunchboxes. The Providers are committed to healthy eating and mostly organic fresh food is served. They grow their own organic vegetables. All food is home cooked and purchased locally from farm shops and local supermarkets. Convenience foods are not used. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 6 Alfrace is decorated, furnished and cleaned to a high standard and provides spacious comfortable accommodation to the residents. Residents’ bedrooms are homely and personalised. One resident commented, ‘My room’s lovely, it’s fantastic.’ All of the residents currently accommodated made many positive comments about the home including, ‘I like it here. I like the residents and Dick and Rita’, ‘I like the peace and quiet’, and ‘This is my home and I don’t ever want to leave.’ What has improved since the last inspection? What they could do better: The Providers said they do not keep menu records. They told the inspector they can demonstrate in other ways that they offer a variety of wholesome food. Although menu records should be kept, it is recognised that this is a small home where residents live as a family, and administrative systems are kept to a minimum. The inspector currently has so concerns about the quality of the residents’ diet. Four of the residents said they knew what to do if the fire alarm went off, but one was unsure. This was discussed with the Providers who said this resident had been told on a number of occasions but might have forgotten. They said they regularly reminded him of the procedure, and would alert him immediately if the alarm went off. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 7 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. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. Residents’ needs are adequately assessed prior to moving into the home. EVIDENCE: All residents currently accommodated at Alfrace were placed by social workers who carried out comprehensive assessments of their needs. The assessments were then discussed with the Providers, and a decision made that the home could provide suitable care. All residents were involved in this process, as were their families/friends. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents care needs are met. EVIDENCE: All residents have appropriate records in place including care plans and risk assessments. The Providers regularly review these, and they are also externally reviewed by social services staff. Since the last inspection one of the Providers has attended a training event on Person Centred Planning. She has since re-written care plans to include residents’ input in the following areas: Daily routines Important people in my lie Like and dislikes What I must have in my life What I would love to do Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 11 Things that make me happy My fears Residents are encouraged to make choices about all aspects of their lives. They get up and go to bed when they want. Most said they like to have a lie-in at weekends. Risks are carefully managed and residents are aware of potential areas of risk. One commented, ‘Some of us have kettles in our rooms but we don’t all have them as they can be dangerous.’ Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents lead full and active lives. EVIDENCE: All residents attend day services or work placements. Leisure activities include: • • • • • Evening classes A visit to a local social club every Saturday for drinks, skittles, and pool A weekly shopping trip/café visit Trips out A summer holiday The Providers provide transport, where necessary. Alternatively, community transport is used. Residents’ comments about their lifestyles included: Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 13 ‘In the morning I fetch the post and set the table.’ ‘I help look after the garden. I rake the grass.’ ‘We’re going on holiday to the seaside on a coach. We’re staying in a hotel with Dick and Rita.’ ‘Dick and Rita take us out to the club and everyone knows us there.’ Residents are encouraged to help in the home and to have at least one area of responsibility each, for example washing up or sorting out the lunchboxes. Residents’ finances are properly managed with records kept. At present the residents have no identified religious needs. Male and female residents mix well and have respect for each other. All residents socialise in the wider community supported by the Providers. The Providers are committed to healthy eating and mostly organic fresh food is served. They grow their own organic vegetables. All food is home cooked and purchased locally from farm shops and local supermarkets. Convenience foods are not used. A meal served during the inspection consisted of organic pork chops, and home grown carrots, swede and potatoes, served with gravy. Pudding was fresh fruit. All residents said they were very happy with the food and the following comments were made ‘Dick’s a good cook.’ ‘We had lamb chops today and they were nice.’ ‘We have pasta at weekends – my favourite.’ ‘We like healthy eating.’ The Providers said they do not keep menu records. They told the inspector they can demonstrate in other ways that they offer a variety of wholesome food. Although menu records should be kept, it is recognised that this is a small home where residents live as a family, and administrative systems are kept to a minimum. The inspector currently has so concerns about the quality of the residents’ diet. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health and personal care needs of residents are satisfactorily met. EVIDENCE: Residents need some assistance and support with their personal care and this has been agreed with the residents themselves. The Providers encourage them to be independent where possible, prompt them to care for themselves, and give active help where necessary. All residents are registered with local GPs, and have regular eye, hearing, and dental checks. One of the residents sees a chiropodist and the others have their nails cared for by one of the Providers. Two of the residents have a weekly appointment at a local hairdressers, the others have their hair cut by one of the Providers. The Providers promote healthy eating and healthy living, and the residents are proud of their healthy lifestyles. One commented, ‘We all look healthy thanks to Rita and Dick.’ None are overweight, although some had been when they Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 15 first came to the home. The Providers said that not one of the residents had a cold during the previous winter. Only one of the residents is on medication and they self-medicate, supported by one of the Providers. The Providers know how to keep appropriate medication records, and have facilities for secure storage should it be needed in the future. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents feel able to talk to management about concerns. EVIDENCE: All residents told the inspector they were very happy in the home and had no complaints. They said that is there was anything wrong they would tell the Providers. One of the Providers said, ‘They know they can come to me. If they ever look down we talk to them to find out what’s wrong. Sometimes it takes a while but we always get to the bottom of things and sort them out.’ Since the last inspection the Providers have acquainted themselves with the vulnerable adults procedure. They are now clear about their responsibilities in this area and know who to contact and what to do should an issue arise. They demonstrated an awareness of their residents’ vulnerability, and understood the type of support they need to live safely and independently. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents live in a comfortable and well-maintained environment. EVIDENCE: Alfrace is an extended detached house in a rural area on the outskirts of Wigston. Bedrooms are on the ground floor and are single with ensuite facilities. One resident commented, ‘My room’s lovely, it’s fantastic.’ Residents have the use of a large lounge/dining room and a smaller lounge with a television. The Providers live on the first floor and all residents have call bells if they need to call for assistance during the night. The home has nearly an acre of gardens with a summerhouse, aviary, lawns, and a terrace. The Providers grow organic fruit and vegetables helped by the residents. The home has a new shower room and the kitchen is in the process of being refurbished. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 18 The home is decorated, furnished and cleaned to a high standard and provides spacious comfortable accommodation to the residents. One of the Providers does the maintenance of the property and the other is responsible for the cleaning, helped by the residents where appropriate. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Friendly and professional staff meets residents’ needs. . EVIDENCE: Although the Providers have no formal care qualifications they have extensive experience of working with people with learning disabilities. A family member does the home’s record keeping. An experienced carer and family friend looks after the residents on the rare occasions the Providers are away. All who help in the home have satisfactory CRB checks in place. Since the last inspection one of the Providers has attended a Person Centred Care training event, and has used what she learnt to update and improve care plans. One of the Providers is booked to renew his First Aid certificate this year, and the other to renew her Food Hygiene Certificate. The Providers read a national care journal, which helps to keep them up to date with advances in leaning disability care. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 20 The Providers are committed to the residents. For example when one resident was in hospital one of the Providers stayed all night with them, and made sure she was there when they came round from the anaesthetic. One resident commented, ‘If I need Rita and Dick in the night I pull the cord in my bedroom’, and, ‘Dick and Rita are very good to us.’ Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a well managed home where staff take account of their views. EVIDENCE: The Providers have run Alfrace for nearly 20 years, initially as an adult placement setting, and then as a registered home. Most of the residents have been in the home for between 10 and 20 years. All the residents praised the Providers and said they were happy with the way the home is run. Comments included, ‘It suits me here. I like the people who run it – nothing’s too much trouble for them’, and, ‘Dick and Rita aren’t strict and they don’t tell us what to do. They are fantastic people.’ As the home is small residents spend time with the Providers every day and influence the running of the home by giving their views and making choices. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 22 One of the Providers oversees health and safety in the home. A contractor maintains the fire safety systems, which are regularly tested by the Providers. Call bells are fitted throughout the home. The Providers said the Environmental Health Officer visits the home annually to ensure standards are met. Four of the residents said they knew what to do if the fire alarm went off, but one was unsure. This was discussed with the Providers who said this resident had been told on a number of occasions but might have forgotten. They said they regularly reminded him of the procedure, and would alert him immediately if the alarm went off. Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 24 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 Alfrace DS0000001669.V290733.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. 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