Inspection on 13/03/07 for Allison House

This inspection was carried out on 13th March 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

Allison House 25/11/08

Allison House 20/10/05

Allison House 18/08/05

Allison House 02/12/04

Allison House 01/06/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Allison House Swan Lane Sandy Bedfordshire SG19 1NE Lead Inspector Leonie Milton Unannounced Inspection 10.15 13 March 2007 th X10015.doc Version 1.40 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 Allison House DS0000014875.V323946.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 Older People. 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. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allison House Address Swan Lane Sandy Bedfordshire SG19 1NE 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) 01767 682998 01767 690982 BUPA Care Homes (Bedfordshire) Ltd Mr G Michel Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Learning registration, with number disability over 65 years of age (42), Old age, not of places falling within any other category (42), Physical disability over 65 years of age (42) Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Alison House was opened in 1984 by Bedfordshire County Council and transferred to Care First Bedfordshire Ltd, part of BUPA Partnership Homes, in July 1998. The house is a purpose built residential home for 42 frail, elderly residents including those with dementia and learning disabilities. The home provides respite care for 2 service users and permanent care for 40. The home is a two-storey building and has two units on the upper floor and three on the ground floor. Each unit has a lounge, dining, and kitchenette area. All the bedrooms are single and the service users are encouraged to bring in their personal belongings to make their rooms as homely as possible. The home has a pay phone, a hairdressing salon and a mobile library that comes to the home once a week. The home has a pleasant garden with a patio area. The home is situated in a residential area in Sandy, near Bedford; the A1 trunk road allows easy access for those travelling to the home from a distance. Car parking facilities are also available on site for both visitors and staff. The shops and a bus stop are within walking distance of the home. Weekly fees for accommodation were between £383 and £510 Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report sets out the significant evidence that has been collated by the Commission for Social Care (CSCI) since the last visit to and public report on, the home’s service provision in October 2005. Reports from the home, other statutory agencies, and information gathered at the site visit to the home, which was carried out on 13th February 2007 were taken into account. The visit to the home included a review of the case files for three service users, conversations with six service users, four members of staff and the manager. Much of the time was spent with service users in three lounges, where the daily lifestyle was observed. A partial tour of the building was carried out and other records were reviewed. The CSCI circulated a service user survey prior to the inspection. Responses have been taken into account and some are detailed in this report. What the service does well: Service users had been well cared for by an experienced team in spacious, comfortable surroundings that had been suitably designed for the care of frail older people. The home had been purpose built and was designed on the principles of small group living. The building was set out in five units that provided distinct living areas, all of which had achieved a homely feel. Service users could also come together for parties and activities for large groups in a large club/activity room. The staff team was well established. The majority of personnel had worked in the home for a considerable time and were thoroughly conversant with service users’ needs and the daily routines of the home. Personnel had benefited from guidance and support from a qualified senior team and had undertaken satisfactory training to carry out their roles. Service users and staff were observed to be on friendly terms. Indeed, many favourable comments were passed by service users about the standard of care they had received and the skills of the staff. The home was well managed for the benefit of those who lived and worked at the home. There were systems in place to ensure that daily routines operated smoothly but these had not detracted from the homely atmosphere that was prevalent throughout the day of the inspection. The lifestyle experienced by service users was seen to proceed at an unhurried pace and in a calm and Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 6 restful atmosphere. Activities were available for stimulation and entertainment but those who did not wish to participate were able to sit in quiet places throughout the home with their visitors or alone in their rooms, if this was their wish. Strategies were in place to enable service users to voice their opinions about the home though a formal annual questionnaire and also at quarterly service user meetings. Service users also commented that they could readily talk to members of staff and the manager. 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. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had ensured that it had the capability to meet service users’ needs by obtaining and carrying out thorough pre-admission assessments of need. EVIDENCE: The home’s statement of purpose had been updated to reflect the current operation of the service. Three service users case files were assessed. Each contained detailed preadmission assessments of need as specified by the National Minimum Standards. Assessments had included an evaluation of service users’ abilities as well as their needs. Placing authorities had also provided assessments of needs carried whilst service users had lived in their own homes or when they had been in hospital. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 9 The home reserved two places for respite care. An intermediate care service, as detailed by the National Minimum Standards was not provided Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had been supported to properly care for service users’ personal and healthcare needs. Sufficient written guidance to each service user’s needs were in place, as were robust medication procedures. EVIDENCE: The case files seen at this inspection contained detailed care plans for each service user. The plans predominantly outlined personal and healthcare needs and showed how these would be met. The plans would benefit from references to service users’ preferences for the provision of such care. The pre-inspection survey carried out by the CSCI showed that service users or their representative were predominantly satisfied with the care provided by the home. “The staff are very kind and caring for my relative as they are very deaf and very poorly sighted”, “Generally very pleased with the care…keep up the good work”, “I am fine and content”. A concern was expressed about Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 11 times waiting for responses to call bells but given the numbers of people living in the home, the inspector was aware that staff needed to prioritise responses and that at busy times it was realistic to have to wait for a short while for assistance. Progress logs and medical records maintained by the home showed that service users had been referred to health practitioners as the need had arisen and for routine treatments and check ups. There was evidence of contact with general practitioners, physiotherapists, continence advisor, community mental health services and the district nursing services, as well as services for chiropody, optical and dental care. Members of staff were observed to treat service users with respect and to knock on bedroom doors before entering. Service users confirmed that this was always the case. One service user exhibited repetitive behaviours. Members of staff were observed to deal with this calmly and with patience and to attempt to alleviate the service user’s anxiety. Medicines were administered from mobile lockable trolleys on each floor of the home. Both were stored securely when not in use. A senior was observed to administer medicines. She presented as knowledgeable about this responsibility and explained that she had undertaken distance leaning as well as in house training in safe procedures. The practice seen met safe guidelines. It was noted that service users who were prescribed “as required” medication for pain relief were asked whether they required anything for pain. Seen in the medication file, alongside the medication administration record for each service user, was another record detailing the causes and effects for each prescribed medicine. This additional record meant that guidance was readily available to staff to explain why medicine must be administered and to also set out adverse reactions that might occur. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users had been supported, on the whole, to experience a lifestyle that met their expectations. Recent staff shortages had meant that service users hadn’t been able to take part in activities for stimulation as often as they wished. EVIDENCE: Whilst it was evident that activities such as quizzes, parties, external entertainers and similar were provided, it was acknowledged by the manager that the vacant post of activity co-ordinator had not enabled the home to maintain its previous level of provision in this areas. Feedback from service users to the question, “Are activities arranged by the home that you can take part in?” was mostly “Always or usually”. A few responded, “Sometimes” and one stated that there “Had only been two sing-a-longs and an Xmas bazaar in 10 weeks and I’m not interested in sing-a-longs” and another “I think there could be more things organised”. Given that recruitment was underway for the activity co-ordinator’s post it is expected that these arrangements will improve in the near future. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 13 Service users confirmed that their visitors had been welcomed into the home. One relative stated, “Staff are friendly and let me know how my relative is”. Bedrooms seen, showed that service users had been able to bring possessions into the home to personalise their rooms. One service user told the inspector that they could do what they wanted in the home. There were no rules and they didn’t feel “restricted”. Menus submitted with the pre-inspection questionnaire showed a nutritious choice throughout the day. Service users spoken to confirmed that they liked the meals served in the home and said there was plenty to eat and drink. Written questionnaire also showed satisfaction with meals and that service users had been consulted about their preferences, “I have spoken to the chef as she comes around-ask us what the meals are like”, “Usually-Once they got to know my likes and dislikes”, “I like liquidised meals and I receive them”. The meal served on the day of the inspection was plentiful and smelt and looked appetising. Service users were offered a real choice of meat curry or Mediterranean fish pie. It was noted that a service user was also served other meal because these two choices were not to their liking. Records indicated that those with weight loss or small appetites had been assessed and arrangements were in place provide an appropriate diet and to monitor their food intake. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had been protected by the homes complaints and protection procedures. EVIDENCE: Service users spoken to raised no concerns about their care, although one service user repeated expressed a wish to “Go home”. Service users, who were able to, explained that they were able to speak to staff if they were worried. One said, “They will listen to me”, and another “I would tell staff but I have no complaints”. The written feedback also showed that the majority of service users understood how to make a complaint and included, “I make my point known if needed”. Records indicated that that there had been few complaints since the last inspection and that appropriate investigation and responses had taken place in response to issues raised. Records also indicated that staff had received guidance on procedures for the protection of vulnerable adults. Evidence of further briefing to ensure that all personnel were aware of these procedures was seen to be underway. Three personnel files were assessed and showed that thorough procedures had been followed to ensure that personnel from the right background and of the Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 15 right calibre were employed. References and checks via the Criminal Records Bureau and Protection of Vulnerable Adults Register were on file. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users had been provided with a comfortable, clean and well-adapted environment that was suitable for their needs. The deterioration of the floor in a corridor meant that there was a risk that this would be come a trip hazard to anyone using the corridor in the near future. EVIDENCE: As detailed previously, this purpose built home provided spacious accommodation. The inner courtyard garden and a sensory garden to the rear had been well maintained and provided pleasant places to sit out in or look out at from the building. The home had been decorated and maintained to a high standard with the exception of the floor to one corridor. Records indicated that the manager had raised this issue for more than a year. It was explained that there had been a Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 17 dispute between the Council and BUPA as to who had the responsibility to fund its repair. There must be urgent action on this problem before the floor becomes a serious trip hazard. Areas seen at this inspection were clean and orderly. Infection control measures were in place to separate soiled linen, wash crockery and cutlery in the units in dishwashers and to ensure that hand-washing and protective clothing was carried out/in use to prevent the spread of infection. Service users’ comments about the environment were most favourable, “ The home is lovely and clean”, “ No fault-staff fussy-and like it clean”, “Lovely and clean, could not wish for better”. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had been properly cared for by members of staff who understood their needs and how these were to be met. EVIDENCE: Rotas submitted for the inspection showed that the deployment of care staff was satisfactory. There was also a well organised ancillary team to carry out the catering, cleaning, laundry, building maintenance and administrative functions of the home, which meant that the care team could concentrate their efforts on direct care tasks. Staff discussed their training opportunities in favourable terms. Records indicated that staff had received basic training. Whilst there was a core of staff, who had worked at the home for a significant time; more recent changes in the team had meant that the ratio of personnel who held National Vocational Qualifications in care, had lessened since the last inspection. The preinspection provider questionnaire showed the ratio of qualified care staff to be 34 . The manager explained that newcomers would be enrolled for such training in the near future. Recruitment procedures, as detailed in section 4 of this report, were sufficiently robust to protect service users and to demonstrate equal Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 19 opportunity practice. Files seen contained interview questions and evidence that applicants’ previous employment history had been explored. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards, 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had been managed in the best interests of service users. There were strategies in place to enable service users to influence the running of the home. EVIDENCE: The manager and his senior team were qualified and experienced to administer and manage the home. This team had been established for a significant time. This continuity had enabled the senior team to develop as a cohesive leadership force within the home for the benefit of those who lived, worked and visited the home. There were evident systems in place to communicate with staff so that the operation ran efficiently and to consult with service users to ensure their opinions influenced aspects of the day-to-day life in the home. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 21 Service users commented that they could talk to members of the team and the manager. Service users described service user meetings when they had been able to contribute to plans for activities, menus and similar. Minutes of these meetings were seen. Records also indicated that service users had been consulted formally through the home’s annual quality review processes. A report and arising action plan from this process was seen. Service users who were able to manage their financial affairs were encouraged to do so. In reality, the majority of service users had passed this responsibility to their members of their family. Small amounts of monies were given to the home to make small purchases on behalf of service users. Documents seen showed that these purchases had been properly recorded. Previous inspections had established that the organisation had comprehensive health and safety procedures. Training records and observation of staff practice showed that training had resulted in safe practice. Members of staff were observed to use safe moving and handling techniques, safe medication procedures, hygienic handling of food and safe handling of hazardous substances. Information provided by the provider indicated that equipment had been regularly serviced. The organisation used a comprehensive self-audit tool that included aspects of health and safety. The manager had completed the various sections of this tool, which were carried out on a quarterly basis. Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 23 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. 1 Standard OP19 Regulation 16(2)(c) 23(2)(b) Requirement The registered person must make safe the floor in the link corridor between units A and C and replace the carpeting if necessary. Timescale for action 30/06/07 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 Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Allison House DS0000014875.V323946.R01.S.doc Version 5.2 Page 25 - 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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