CARE HOME ADULTS 18-65
Alfred Minto House Care Home 26-28 Zulu Road New Basford Nottingham NG7 7DR Lead Inspector
Fiona Stephenson Unannounced Inspection 19th January 2006 10:10 Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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 Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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 Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Alfred Minto House Care Home Address 26-28 Zulu Road New Basford Nottingham NG7 7DR 0115 978 3826 0115 978 0717 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) Turning Point Limited Ms Gaye Flounders Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26/04/06 Brief Description of the Service: Alfred Minto House is located in a residential area close to a range of public amenities and good public transport links. It is a specialist mental health service for men that aims to assist people make the transition from hospital and secure care, to more independent accommodation in the community. It is a non-secure facility with close monitoring and supervision. The home offers nine places comprising of eight single rooms and one self-contained flat, with communal facilities including two lounges (one non-smoking), a kitchen/dining area; and a laundry room. There is a back garden for residents’ use. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Thursday 19th January 2006 from 10:10am to 1.00pm, and was conducted by one inspector. The inspection was the second statutory inspection for the home for the year 20052006 and as such the inspector focused on the care standards that were not checked during the previous inspection. The inspector used a ‘case tracking’ system to look at the care needs of two residents. This means their care notes were checked, staff working with them were spoken with, and the staff records of their primary carers were checked. Two residents were spoken with during the inspection. What the service does well: What has improved since the last inspection?
All staff have attended training on the administration and management of medication and now have a clearer understanding of the issues relating to administration. The shower rooms now have shower curtains and extractor fans and are a safer environment for residents. The Statement of Purpose now provides residents with written information about restrictions that may be imposed on them, if there are concerns about risk. The insulin containers are now being disposed of appropriately, and a record is being maintained of the fridge temperature. The contact details of the local CSCI office have been made clearer in the information booklet for residents to enable them to access the CSCI if they wish. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 6 Consultation has taken place with residents about the use of the garden as a car park for staff vehicles and a decision has been reached which is satisfactory to residents. 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 Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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 Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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): Not checked on this occasion. EVIDENCE: Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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): Not checked on this occasion. EVIDENCE: Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 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): 15,16,17 Residents are given good encouragement to live independently and to exercise choice where appropriate. EVIDENCE: The inspector checked the records of two residents and found that the staff encouraged residents to have family and personal relationships where appropriate. The inspector saw records demonstrating that resident’s rights are respected and observed that staff only entered bedrooms with the resident’s permission. Staff were observed talking to residents in the communal lounge, and it was also noted that residents choose when to be alone or in company. The responsibility for housekeeping tasks is set out in each residents care plan and in the service users guide. Residents are supported in shopping and in preparing nutritious meals, particularly in the first few weeks of stay, although their own preferences are also respected. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 11 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): 19,20. Residents physical and emotional health needs are met. EVIDENCE: The care records checked demonstrate that staff have a clear understanding of residents emotional and physical health needs. Staff work well with residents and other professionals in supporting their care, and reviews are regularly made. Medication is appropriately administered and recorded. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 12 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. Residents are protected from abuse, neglect and self-harm. EVIDENCE: Staff have a good understanding of the Protection of Vulnerable Adult (POVA) procedures, and receive mandatory training from the Turning Point organisation to support their understanding. The POVA procedures are also covered in staff induction. Staff are also experienced in dealing with challenging behaviour, and are expected to have had at least one year’s experience of working in the mental health field, and with challenging clients, prior to working at Alfred Minto. The address of the local CSCI office is now provided in the literature. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 13 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): 24,25,26,27,28,30 Generally, residents live in a homely and comfortable environment, however some areas of the home give cause for concern. EVIDENCE: The inspector noted that the communal areas were well furnished and bedrooms reflected the needs and personalities of the residents using them. The home was in a satisfactory state of hygiene and cleanliness. Two residents showed the inspector rotting window frames where in one case, the glass was sitting outside the frame. They demonstrated how difficult it was to open some windows as the decorators had painted over the woodwork in the summer, and left the paint to dry when the windows were closed, thus sealing the windows together. They informed the inspector how this left the room with limited ventilation. They showed the inspector the downstairs toilet, which they said was often getting blocked, and demonstrated how the whole unit ‘wobbled’ when touched. The inspector was also shown a significant sized crack in the hallway, which was mirrored in the adjoining laundry room, and extended along the laundry ceiling – this gave cause for concern. The residents informed the inspector that the windows are so rotten in their room that the wind from outside can blow their curtains, they rattle, and let the noise of the street in. Staff informed the inspector that they have repeatedly asked the landlord of the premises to undertake these tasks but little has been done.
Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 14 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): 33,35. Staff are provided with good training to support residents living at the home. EVIDENCE: The inspector looked at the training files of staff that are the primary workers to the resident’s case tracked and found evidence that good training opportunities had been made available to them. The induction training programme is to TOPSS standards and Turning Point provide an additional training package also. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 15 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): 39,42 Residents are encouraged to express their views about life at the home. EVIDENCE: The inspector noted an atmosphere of openness in the home where residents are encouraged to talk about their concerns. Staff were aware of issues that affected residents and these were incorporated into care plans and daily records. There is also a resident survey questionnaire to provide staff with further opportunities to find out how residents view life at the home. Staff have received training in health and safety training including First Aid, Moving and Handling, Food Hygiene, and Control of Substances Hazardous to Health (COSHH). Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X x X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 2 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Alfred Minto House Care Home Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 X DS0000002228.V272339.R01.S.doc Version 5.0 Page 17 None 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. 1 Standard YA24 Regulation 23 Requirement Provide an action plan demonstrating how and when remedial work will be carried out to the window frames identified in the inspection; the downstairs toilet; the laundry room wall and ceiling; and the kitchen doorframe. Timescale for action 09/02/06 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. 2. 3. Refer to Standard YA20 YA20 YA22 Good Practice Recommendations The Royal Pharmaceutical Society guidance entitled: The Administration and Management of Medicines in the Care Home should be applied in practice. Defrost the medication fridge. Explain to residents the reason why there are delays in acting on agreed improvements. Alfred Minto House Care Home DS0000002228.V272339.R01.S.doc Version 5.0 Page 18 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
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