Inspection on 03/07/07 for Alfrace

This inspection was carried out on 3rd July 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

Alfrace 26/04/06

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 Bhavna Keane-Rao Key Unannounced Inspection 3rd July 2007 10:30 Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 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.V340379.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 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.V340379.R01.S.doc Version 5.2 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.V340379.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 26th April 2006 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, about four miles away from the city of Leicester and about a mile from the town of Wigston, in Leicestershire. The home is a large detached farmhouse, which has been upgraded and modernised. It is staffed by both of the Providers (one of whom is the Registered Manager) who also live on the premises. The residents’ accommodation consists of six ground floor single bedrooms, one with an en-suit facility, a large lounge/dining room and a smaller lounge with a television. The home has nearly one and half acre of gardens with a summerhouse, aviary, lawns, and a terrace. The Providers grow organic fruit and vegetables helped by the residents. On 3rd July 2007 the registered providers confirmed the Fees for the service provided at the home were £340 per week per person. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process consisted of pre-planning the inspection, which included viewing the last Inspection Report, reviewing of the pre-inspection questionnaire, the service history of significant events since the last inspection and Comment Cards sent to residents from the Commission for Social Care Inspection. The unannounced site visit commenced on the 3rd July 2007 and lasted six hours. The focus of the inspection is based upon the outcomes for the residents. Which means, for example, do the residents feel happy with the service they get and do they feel involved in decisions made about their lives. The method of inspection was ‘case tracking’. This method involves identifying individuals who currently live at the home and tracking the experiences of the care and support they received during the time they have lived there. Since there are four residents who live at this home, they were all selected and discussions were held with all of them. The method of case tracking included the review of residents’ individual care records, discussions with both the providers with various responsibilities within the home and reviewing the records that were available. The inspection was also used to check that information provided by the manager matched the individual experiences of residents. This was achieved by speaking with residents and both provider and provider/ manager who were on duty whilst observing day to day care practice. Commission for Social Care Inspection (CSCI) sent out four Comment Cards called “Have your Say about…” to residents and also to their relatives. This is a way of collecting views from people who use the services. The cards were sent to both the residents and their relatives. These were actually received by the home on the day of the site visit and had not been returned to us at the time of writing this report. Also three comment cards were also sent out to resident’s relatives/advocate. However these had not been returned to us at the time of writing this report. l What the service does well: This a very small family run home with emphasis on informality and homeliness. Care provided is totally individualised. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 6 Both the providers and the residents have been at the home for a number of years and this has created a very relaxed stable environment, which is mutually beneficial for the residents and the providers. Residents who were spoken with were extremely positive about the home, the service provided, the providers and the quality of their lives at this home. 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. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 7 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.V340379.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner/manager ensures that new residents needs and aspirations are assessed before admission to the home, to meet their individual care needs. EVIDENCE: Residents have access to a Statement of Purpose, which outlines the role of the care home, providing additional information as to the home’s aims and objectives, information for relatives, policy on referral and admission, services offered, the accommodation and information on other policies and procedures. There have not been any new admissions to this home for a number of years. However there is s set admissions procedure, which is followed. At the point of admission residents are given all relevant information. The statement of Purpose has been reviewed in April 2005 with a review date of April 2006. This document had not been reviewed but the manager has stated it will be done so by the end of July 2007. A statement of Purpose was viewed during the visit. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 9 This means that people have all the information about the service provided by this home and how much it will cost Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s independence is promoted, whilst they are supported to make decisions affecting all aspects of their lives. EVIDENCE: On the day of the inspection the manager initially stated that she did not keep any daily records for residents and that all the information she required was on the calendar on the kitchen wall. However after an interval the manager was able to provide dairies kept from previous years. These had not been completed since January 2007. Following a discussion with the manager as to why there was need to keep regular records. This was seem to be a good practice by the manager and immediately started to complete these diaries. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 11 Before the last Key inspection, 26 April 2006, the person who deals with formatting and producing templates for care records, attended a training course on Person Cantered Planning and this has been almost completed for one resident. The manager was able to see that if these were completed then they would provide information such as daily routines, important people in the resident’s life, likes and dislikes etc to enable the home to provide a consistent individualised approach to support residents in the provision of care. Care plans are completed at review stage and are drawn up by the Social Workers after the review. Discussion was held with the manager who stated that there were not changes to the plan and that she was aware of all the residents care needs, as it was such a small informal setting. However following the discussion these were to be reviewed by the end of the week and dated even if there were no changes. During discussions with residents during the visit, it following comments were made: “I can do what I want and Rita and Dick (owners) help me if I need their help” “ I can make hot drink at night as I have a kettle in my bedroom. I like coffee before bed.” “We have a lot of parties which are nice.” “X and I danced at the party last weekend until 2 am.” Please note ‘X’ here is used to replace the name of the resident. At the time of writing this report comment cards from residents and their relatives had not been received. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices about how they wish to lead their live and activities they participate in and what food they eat, which gives them control over their lives. EVIDENCE: Residents spoken with were very positive about the care they received and confirmed that all their needs were met and that they were very able to express opinion if their needs were not met. On the day of the inspection all the residents had attended structured day care. There are various day care activities provided five days weeks from 9 am to 3 pm. These are: Two people attend Age Concern day care One person attends Four West One person attends Greenhouse Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 13 Every Sunday evening the residents go out for a skittles night. Three residents stated that they like to have a pint when they go out and one person stated they prefer a coke. Residents stated that they did not like to have a conventional menu planned before hand, they preferred “to be surprised” everyday when they got back from their daily activities. One person stated that the “ food is really nice and most of the vegetables are from the garden here.” Everyone stated that all their favourite food was provided for them on regular basis. The interaction between the residents and the providers was very positive. The atmosphere was very relaxed. Residents were observed helping around the home, setting the table washing, drying, cleaning and vacuuming. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health, emotional and personal care needs are met in line with their individual wishes. EVIDENCE: At present only one person is on medication. This person looks after their own medication. Records, which were viewed, including calendar and the diary, demonstrated that resident’s health care needs were met. All appointments to any health care professionals were noted. There is a procedure in place in case the home has to manage anyone’s medication. Residents have a choice as to who provides them with personal support. The manager is female and the other provider is a male to ensure that the gender choice is available should a resident wish for this. Upon discussions with residents it was obvious that the felt very familiar and comfortable with both the providers. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safe and protected from abuse. EVIDENCE: The statement of purpose has a complaints policy and procedure, which is made available to residents and their families. There have not been any complaints made to the home or CSCI. Residents who were spoken with stated they felt very safe and comfortable at the home. Mrs Morgan was aware of safe guarding policy and procedure. However has not undertaken any up dated formal training she stated that the last training she had undertaken was in 1996 on Prevention of Abuse and Responding to an allegation of abuse. Discussion was held with Mrs Morgan and she aware of her responsibility to ensure she had updated policies and procedures on safe guarding vulnerable adults and that she was familiar with these. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 27, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: The providers/manager pride themselves on the informal setting with emphasis on homeliness at this home. Communal areas are decorated to a high standard, bright and well ventilated. Communal areas including lounges/dining area, the hallway, the bathroom and the kitchen, newly fitted, were found to be clean and tidy. The bedrooms are located on the ground floor, which have all been recently redecorated. Residents were very proud of their “beautiful” bedrooms. The providers live on premises, they occupy the first floor. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 17 All the bedrooms had new wooden floors fitted. The bedrooms were highly personalised and showed individual tastes and interests. All bedrooms had a call bell system in case of an emergency. They all had a hot drink making facilities. Although formal risk assessment had not been carried out, residents were very aware of the risks of spillage, hot water and the need to be careful. Residents were observed moving around the home without restrictions. A new hot tub has been installed in the large back garden, which the residents were looking forward to using. Resident’s clothes are washed in the garage where the washing machine is situated. This service is provided by the home. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff to ensure that residents’ care and social needs are individually, collectively and safely met. EVIDENCE: Mr and Mrs Morgan work at the home full time. They also live on the premises and are on call during the night. There is one family member who provides administration support for the providers. This person has been checked for any criminal convictions to ensure residents are protected at all time. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a committed registered provider/manager who understands the needs of individual residents. EVIDENCE: There are no formal residents meetings are held- however regular ‘chats’ are held collectively and individually. Residents who were spoken with stated that they felt they were involved in the running of the home. Mr and Mrs Morgan have a very ‘hands on approach’, which residents were observed to respond to positively. There was light banter and singing on the day of the visit. Although residents did state that occasionally there is also Irish dancing provided by Mr Morgan. Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 20 The manager has recently undertaken a review of the quality of the service, which is provided by the home. A questionnaire was sent out to residents and their relatives. This is still being analysed. Mr Morgan is a trained First Aider Mrs Morgan has been trained in Basic Food and Hygiene. Residents are independent and mobile and do not require and specialities aids or adaptations. Alfrace DS0000001669.V340379.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 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 3 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 3 25 3 26 3 27 3 28 X 29 3 30 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X 3 3 X X 3 X Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 22 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. 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.V340379.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Alfrace DS0000001669.V340379.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!