Inspection on 26/04/05 for Alfred Minto House Care Home

This inspection was carried out on 26th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alfred Minto House Care Home 20/07/06

Alfred Minto House Care Home 19/01/06

Alfred Minto House Care Home 09/09/04

Alfred Minto House Care Home 27/05/04

Alfred Minto House Care Home 24/07/03

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

St Matthews Unit

Brain Injury Services, 51 The Drive

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

CARE HOME ADULTS 18-65 Alfred Minto House Care Home 26-28 Zulu Road New Basford Nottingham NG7 7DR Lead Inspector Sharon Rosenfeld Unannounced 26 April 2005, 09:15 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 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 Stationary 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 C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 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 Ltd Ms Gaye Flounders Care home 9 Category(ies) of Mental Disorder x 9 registration, with number of places Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/09/04 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 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. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours and was carried out as part of the routine inspection process. A partial tour of the premises took place. Three residents and four staff were spoken with. Three support plans were examined. What the service does well: What has improved since the last inspection? Some of the accommodation has been re-decorated and new carpets have been fitted. The permanent staff have received training in the administration of medication. The manager has implemented the majority of the requirements made at the last inspection. All staff vacancies have now been filled. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 6 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 C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5. Prospective resident’s needs are comprehensively assessed prior to admission. The information provided generally enables them to make an informed choice about whether or not the home can meet their individual needs. EVIDENCE: One resident confirmed that they had received a comprehensive induction prior to moving to the home. The staff had visited him at his place of residence and he also had opportunities to visit the home. The records examined contained detailed multi-disciplinary assessments. The person spoken with stated he had expected to have greater freedoms whilst at the home, the multi-disciplinary records kept explained the basis upon which decisions to restrict his liberty had been made. The resident confirmed that he attended multi disciplinary review forums where he had been consulted about the restrictions placed upon his time away from the home as part of his programme of rehabilitation. One resident stated that he wanted a private telephone line and access to the Internet from his private room using his own computer. He had been informed that this would not be possible. It was not absolutely clear how this decision had been reached. All resident’s can use a computer owned by Turning Point to access the Internet. The Statement of Purpose does not include information about restricted Internet use. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9. The care plans are clear and comprehensive. Opportunities are available for residents to be involved in all aspects of decision making within the home. The care plans generally contain sufficient information for staff to provide consistent support. The majority of areas of risk are considered appropriately. However staff do not always adopt the same approach to all aspects of risk assessment and management, particularly where the issues in question are more complex. EVIDENCE: One of the residents’ spoken with confirmed that he meets with his support worker on a weekly basis to review his support plan. Staff acknowledged that one person has made suggestions that have influenced positive changes for residents at the home. Two people stated that residents meetings are held regularly. Both people stated that they are informed about and where possible consulted about any changes at the home. As previously mentioned, one resident stated that he wanted to access the Internet from his private room. He had been informed that this would not be Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 10 possible. It was not clear how this decision had been reached and no appropriate risk assessments were available regarding this more complex issue. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 11 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 standard(s) 11, 12, 13, 14. The residents are encouraged to access a wide variety of appropriate resources available in the community that will assist in their personal development. EVIDENCE: A number of residents were out using community facilities at the time of the inspection. Additional staff, from a domiciliary care service were at Alfred Minto House providing extra support to enable one resident to access community resources. The staff stated this service is available three times each week. One person stated that he had attended a number of college courses which he hopes will help his future career prospects. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18, 20. The residents personal support needs are met according to their individual preferences. People are given the opportunity to self medicate which encourages independence. All permanent staff have received training in the administration of medication, however the relief staff have not completed appropriate medication training and the medication policy is not written in line with current good practice and procedures for the recording of medication administered are not followed consistently. These shortfalls could potentially put residents at risk. EVIDENCE: None of the current residents require assistance with personal care. Residents spoken with believe that their rights to privacy and dignity are promoted and upheld and the regimes within the home are flexible to meet their individual lifestyles. One resident said that he administers his own medication. The staff confirmed this is common practice at the home and the majority of people participate, at some level in a self- medication programme. The relief staff are also responsible for the administration of medication. One relief staff member confirmed he had not completed appropriate training. The medication procedure viewed does not meet the current good practice guidelines issued by Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 13 the Royal Pharmaceutical Society of Great Britain. One medication administration record had not been appropriately completed at the time the medication was administered. The medication fridge contained used Insulin administration equipment. The medication in the fridge must be stored at a recommended temperature. However no records were kept about this. The medication fridge required de-frosting. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 standard(s) 22 Resident’s believe there are opportunities for them to influence decisionmaking, on occasions they perceive staff to be slow to act upon agreements reached. This can cause unnecessary frustration and could potential hinder relationships and deter people from making further suggestions. EVIDENCE: One resident felt that staff do listen to his views but he finds the delay in implementing any agreed changes frustrating and unnecessary. The staff could not give an adequate explanation as to why one such delay had occurred. The complaints procedure was seen on the resident’s notice board. It did not contain the contact details of the local Commission for Social Care Inspection office. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 standard(s) 24, 27, 28, 30. The standard of the accommodation is generally good however, the newly refurbished showers in the bathrooms cannot be used safely. A maintenance plan is required for the kitchen with consultation from the Environmental Health Office. The residents do not have access to all parts of their garden and some garden furniture is unsafe for use. EVIDENCE: The resident’s accommodation has recently been improved by re-decoration and the provision of new carpets. A resident showed the inspector the newly re-furbished bathrooms. Showers were fitted over the baths but there were no shower curtains. Consequently, the floor was wet creating a potential sliphazard. The extractor fans in the bathrooms were not working. The main areas of the home are generally kept clean. The residents stated they are happy with the standard of their individual accommodation. Some residents had not kept their kitchen clean and this was causing conflict between a few people. One person stated that he is frustrated that some residents do not clean up after themselves in the kitchen. He would prefer the staff to offer more support and encouragement with this. Some parts of the kitchen are in a poor state of repair with flaking plaster work and damp patches. Advice from the Environmental Health Department to determine the improvements needed Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 16 to the residents kitchen is required. The garden space is limited and is being used as a staff car park and to store unwanted items such as a cooker. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The registered managers role at the home is compromised because she is used regularly to maintain minimum staffing levels. This was a requirement from the previous inspection on 9th September 2004. EVIDENCE: The staff rota indicates that five of ten shifts worked by the registered manager since 28th March 2005 have been used to maintain minimum staffing levels. Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) X These standards were not assessed on this inspection. EVIDENCE: Alfred Minto House Care Home C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 19 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 2 4 4 4 3 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 4 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x 2 2 x 2 Standard No 11 12 13 14 15 16 17 4 4 4 4 x x x Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alfred Minto House Care Home Score 4 x 1 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 20 Yes 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 1 Regulation 4 Requirement The Statement of Purpose must include information about restrictions, freedom to make choices and decisions and liberty of movement. A record justifying the decision to restrict one resident from accessing the Internet from his private room must be made. All staff who have responsibility for the administration or management of medication must receive appropriate training. The used Insulin containers in the medication fridge must be disposed of appropriately. Maintain a record of the medication fridge temperature. The complaints procedure must include the contact details of the local CSCI office. Provide and fit shower curtains. Repair or replace the extractor fans in the bathrooms. Consultation must take place with the residents about the use of their garden as a car park for staff vehicles. This must be reviewed regularly. Evidence that the residents C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Timescale for action 30th June 2005 2. 9 17 31st May 2005 31st May 2005 31st May 2005 31st May 2005 31st May 2005 31st May 2005 30th June 2005 31st May 2005 3. 20 13 4. 5. 6. 7. 8. 9. 20 20 22 27 27 28 13 13 22 13 23 23 10. 30 13 31st May Page 21 Alfred Minto House Care Home Version 1.30 11. 33 18 kitchen meets the standards expected by the Environmental Health . The registered managers hours must not be used to cover staff absences except in an emergency. (Previous immediate requirement of 9th September 2004 remains unmet). 2005 15th May 2005 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. 4. Refer to Standard 20 20 22 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 C53 C03 S2228 Alfred Minto House V223754 260405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham. NG2 1RT 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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