Inspection on 19/01/06 for Alfred House Residential Care Home

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Alfred House Residential Care... 27/04/07

Alfred House Residential Care... 31/08/05

Alfred House Residential Care... 10/02/05

Alfred House Residential Care... 03/08/04

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

CARE HOME ADULTS 18-65 Alfred House Residential Care Home 29 - 31 Horne Street Bury Lancs BL9 9BW Lead Inspector Sue Evans Unannounced Inspection 19th January 2006 09:30 Alfred House Residential Care Home DS0000008420.V278902.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 Alfred House Residential Care Home DS0000008420.V278902.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. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alfred House Residential Care Home Address 29 - 31 Horne Street Bury Lancs BL9 9BW 0161 764 2442 0161 764 2442 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) Mrs Margaret Ann Partridge Mrs Margaret Ann Partridge Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Alfred House is a small, privately owned care home that provides support for up to 8 adults with mental health needs. The home consists of 2 adjoining terraced properties that have been adapted to form 1 house. The house is situated just outside Bury town centre, close to bus routes, shops, and other local amenities. The house is similar to other properties in the area and it is not distinguishable as a care home. It has a no smoking lounge, a smoking lounge, a dining room, a kitchen, and a laundry room. All bedrooms are single. Outside there is a garden at the front and a paved area at the back, with garden furniture, where people can sit out. The owner is also the manager. She is a qualified mental health nurse with many years experience in supporting people with mental health needs. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took 5½ hours. Most of this time was spent watching what went on in the home, talking to 6 of the 8 residents and a visiting health worker, and interviewing 2 staff members and the manager. The inspector also looked round some parts of the house, looked at some key records, and ate lunch with some of the residents. This inspection was the second to take place in the current inspection year. In order to gain a fuller picture of the home, this report needs to be read in conjunction with the report of the previous inspection of August 2005. A further visit is planned by the Pharmacist Inspector to look at the home’s medication procedures. Her findings will be sent to the home in a separate letter. The letter will not be published but will be available, on request, to members of the public if they wish to see it. What the service does well: Alfred House is a well managed home and the manager and staff strive to achieve good standards. Residents benefit from the open, inclusive, forward thinking atmosphere. They feel that they can talk to the manager about anything they wish. During the inspection they had no hesitation in approaching her if they wanted to talk to her. She is skilled, experienced and well qualified. Residents were pleased with the home and the support provided. They said that they had choices about their daily routines and that they were happy with the way the manager and staff treated them, and the way they spoke with them. One said, “Staff are great”. They gave examples of how their privacy was respected, for example no one went in to their room without invitation. A visiting health worker felt that the home was good at promoting independence and encouraging residents to lead fulfilling lifestyles. Residents are encouraged and supported to take part in community activities. Staff members said that they received the support and direction that they needed to do their jobs. Regular, individual meetings with the manager or deputy help them to develop professionally and provide a good service to residents. They are also encouraged to undertake projects that will help the service to further develop and improve. The commitment to staff training is impressive with all but one of the team trained to at least NVQ level 3. Two staff members also have NVQ 4 in management as well as their NVQ level 3. This commitment to training has equipped staff with the knowledge and skills that they need to provide a good service to residents. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 6 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. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 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 Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None None of the above standards were assessed this time. EVIDENCE: Standard 2 was assessed in August 2005. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 9 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): 7 Residents are able to make choices about their lifestyles, with help from staff if needed, to exercise their right to autonomy and individuality. EVIDENCE: Standards 6 and 9 were assessed in August 2005. Some of the residents were seen, throughout the inspection, coming and going from the home. They said that they could choose how they spent their time. Records and discussions showed that the staff team helped and encouraged people to make appropriate choices, for example when considering leisure or educational opportunities. Two residents had made use of local independent advocacy services. Where any restrictions on personal choice were necessary, for example for health and safety reasons, this was done only in the person’s best interests, and it was discussed and agreed with the resident and other significant people in their life, and recorded. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 10 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, 14, 16 and 17 Residents choose how they spend their time, taking part in appropriate activities that they enjoy doing. Practices in the home respect residents’ rights to privacy, dignity, independence and choice. Residents enjoy the meals and are encouraged to eat healthily. EVIDENCE: Standards 12, 13, 15 and 16 were assessed in August 2005. It was clear from discussions that residents were encouraged to participate in fulfilling activities, with staff support as necessary. Staff members said that some residents were reluctant to take part in outside activities but they continued to encourage participation in the community. At the time of the August inspection, the home had organised swimming groups, and residents and staff had started going swimming at the local leisure centre. However, interest in this had since dwindled. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 11 Staff said that staff rotas were flexibly arranged to accommodate residents who did want to take part in community activities and who needed staff support to do so. Residents described some of the things they were involved in. One attended a college course and an art group. One was closely involved with a local Church. One person had a part time job. Residents said that they sometimes went out to the cinema, drives in the country, pub lunches, and shopping. They talked about an event at Heaton Park that they had enjoyed. Residents are supported to take an annual holiday. Last year they went to Centre Parcs and this year they are planning to go to Spain. On the day of the inspection, one resident had an appointment to look at suitable college courses. Another was assisted by a visiting health worker to shop for, and cook, his own lunch. Residents said that they had choices about their daily routines, for example what time they went to bed, or what they did throughout the day. They gave examples of the ways in which staff members encouraged them to do things for themselves, for example cooking, washing up, doing their own laundry, or feeding the dog. Residents said that they were happy with the way that the manager and staff treated them, and the way they spoke with them. One said, “Staff are great”. During the inspection, it was observed that the manager and staff spoke with residents in a natural way. Residents’ personal information was kept locked away. Staff members understood the confidentiality procedures, and were aware that they must not discuss residents’ personal information in front of others, or outside the home. Residents were satisfied that their privacy was respected, for example nobody entered their bedrooms without knocking. Locks were fitted to bedroom doors. Mail was given to them unopened and there was a portable telephone so that calls could be taken in private. A visiting health worker felt that the home was good at promoting independence and encouraging people to lead fulfilling lifestyles. The inspector enjoyed a pleasant lunch with two of the residents. Residents said that they enjoyed the meals, and they gave examples of some of the dishes provided. They said that they had enough to eat. It was observed that they made themselves a drink throughout the day whenever they wanted to. A staff member said that residents were consulted about menu plans. Another staff member said that staff tried to encourage healthy eating. Mealtimes were fairly flexible depending, for example upon what time people got up, or the activities that they might be taking part in. Although staff took responsibility for most of the cooking, residents were encouraged to get involved. For example, they said that they made their own lunches on Fridays. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 12 Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 13 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 Most residents attend to their own personal needs, with prompt and encouragement if needed. Privacy and dignity is maintained. EVIDENCE: Standard 19 was assessed in August 2005. Standard 20 is to be assessed by the Pharmacist Inspector during a separate visit. In respect of personal needs, most residents were very independent and able to manage for themselves. Staff said that sometimes prompt and encouragement was needed. It was evident, from discussions with staff members, that where supervision with personal care was needed, support was provided discreetly, and privacy and dignity was maintained. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 14 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): 23 Staff members understand their responsibilities in reporting any suspicion or allegation of abuse. EVIDENCE: Standards 22 and 23 were assessed in August 2005. Staff members understood their responsibilities in protection and whistle blowing. They said that they had seen the written procedures. One said that the topic had been covered on the NVQ course, and that it had been discussed at team meetings. As was the case at the time of the last inspection, the inspector was satisfied that the outcome for this standard was being met. However, it was recommended last time that the manager try to find out about any local training in protection might be available. She had not been able to find anything so far, and this therefore remains a recommendation. In the meantime, the manager is advised to regularly include adult protection responsibilities in agendas for team meetings and 1 to 1 supervision meetings. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 15 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 Alfred House provides a homely, comfortable environment for residents, suited to their lifestyles. EVIDENCE: Standards 24, 28 and 30 were assessed in August 2005. The home is situated in a residential area of Bury, just outside the town centre. It is close to bus routes, local shops, and other local amenities. The home consists of two adjoining terraced houses that have been adapted to form one house. The house is similar to other properties in the area and it is not distinguishable as a care home. All bedrooms are single. The home has two lounges, one of which is the designated smoking area, and a dining room, giving residents some choice about where they spend their time. There is also a domestic style kitchen, two bathrooms, and a laundry room. Outside there is a garden at the front, and a paved area at the back where people can sit out. The home had a comfortable, homely atmosphere. The pet dog added to the homeliness. Residents were pleased with the home. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 16 As required at the time of the last inspection, the home has produced an improvement plan which includes upgrading the men’s bathroom and the smoking lounge. This work had already commenced with the provision of an extractor fan in the smoking room, and a new door. It will also be redecorated. The manager said that the builder was due to visit the following week in connection with the men’s bathroom and it was expected that this would be completed by the end of February. The inspector was satisfied with the home’s ongoing work to maintain satisfactory standards. The environment will be looked at in more depth next time. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 17 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 and 36 The home is committed to providing staff training opportunities, including NVQ training, in order to equip the team with the knowledge and skills that they need to meet the needs of the residents. Pre-employment checks are carried out in order to protect residents. Staff members are appropriately supported and supervised to help them to develop professionally and provide a good service. EVIDENCE: Standards 32, 34 and 35 were assessed in August 2005. From observations and discussions, it was evident that the staff team understood the needs of the residents and had the skills and knowledge to meet those needs. The level of commitment to staff training in NVQ was excellent. All staff members except the most recent recruit were trained to at least NVQ level 3. In addition to NVQ 3, two staff members had also completed the NVQ level 4 in management, and they had been given opportunities to assist the manager with developmental work. The manager had also done NVQ level 4 in management. One of the staff members who were spoken with said that she was doing a degree in social work. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 18 The manager is an approved practice teacher, and social work students are regularly provided with placements in the home. Staff members gave examples of some of the ongoing training that was provided, including first aid and food hygiene. The majority had done sign language to specifically improve communication with one of the residents. Evidence of training, including induction records, was seen on the staff file that was looked at. The staff member had only recently done food hygiene training so the certificate had not yet been received. Staff recruitment records, in respect of the most recent recruit, were looked at. They contained an employment history, CRB (Criminal Records Bureau) disclosure, evidence of the checking of the POVA (Protection of Vulnerable Adults) list, and 2 written references. Also, as required at the time of the last inspection, the home had obtained a photograph of the staff member, and a declaration from her that she was physically and mentally fit to carry out her duties. Records, and discussions with staff members, showed that staff had regular 1 to 1 supervision meetings with the manager or the deputy manager when they discussed topics such as training needs, problems, and work issues. They said that they were given feedback about their practice. Staff members said that they were also supported informally and could approach managers at any time for advice. They also said that regular staff meetings were held. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Residents benefit from a well run home and they are able to openly express their wishes and opinions. Residents, and others, have contributed to a quality audit, to identify any areas for improvement. EVIDENCE: Standards 38 and 42 were assessed in August 2005. The manager is registered with the CSCI. She has been owner/manager of Alfred House since 1995. Prior to that, she had worked for 13 years on an acute mental health unit, and for 2 years as a CPN (Community Psychiatric Nurse). She has the RMN (Registered Mental Nurse) qualification, and is an approved social work practice teacher. She has completed NVQ level 4 in management and is now doing the RMA (Registered Manager’s Award). Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 20 The manager and staff strive to meet, and often exceed, national minimum standards. Staff members are encouraged to participate in development work, for example a staff member recently took responsibility for the quality audit. From observations and discussions, it was evident that the manager encouraged an open, inclusive atmosphere within the home. Residents and staff said that they found her to be very approachable and that she listened to them. During the inspection, it was observed that residents and staff had no hesitation in approaching the manager if they wanted to talk to her about anything. Staff members felt that the home was well run, and that the manager operated in an open, inclusive way. They said that she communicated well and gave them appropriate direction. Since the last inspection, a new quality audit had been completed. It included the use of satisfaction questionnaires that residents, families, carers and social workers were invited to complete. The outcomes had been summarised into a report, a copy of which had been sent to the CSCI before this inspection. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 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 X 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 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 4 X 3 X X X X Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 22 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. 1. Refer to Standard YA23 Good Practice Recommendations The manager is advised to look at options for staff training courses in adult protection, and to regularly check out staff members’ understanding of their adult protection responsibilities. Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alfred House Residential Care Home DS0000008420.V278902.R01.S.doc Version 5.1 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. 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