Inspection on 09/05/07 for Allison House

This inspection was carried out on 9th May 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 23/06/06

Allison House 11/10/05

Allison House 09/06/05

Allison House 08/11/04

Allison House 01/06/04

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

CARE HOMES FOR OLDER PEOPLE Allison House Fudan Way, Teesdale Thornaby Stockton-on-Tees TS17 6EN Lead Inspector Katherine Acheson Key Unannounced Inspection 9th May 2007 09:15 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 DS0000000140.V339144.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 DS0000000140.V339144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allison House Address Fudan Way, Teesdale Thornaby Stockton-on-Tees TS17 6EN 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) 01642-675983 01642 675985 Cleveland Alzheimer’s Residential Centre Mrs Angela Jane Blythe Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 8 places can be used for people with dementia aged 50 . 23rd June 2006 Date of last inspection Brief Description of the Service: Allison House is a modern, purpose built facility that is registered to provide personal and nursing care to thirty-eight older people with dementia. The home is single storey and is divided into two units, Aspen and Willow. Each unit has a number of lounge areas and a dining room. There is also an activities room. Bedrooms in the home environment are single in nature and meet the required amount of space. Bedrooms do not have en-suite facilities. Externally there are surrounding grounds and a pleasant enclosed garden/seating area for resident use. Car parking is available at the home. The home is on a bus route and close to Stockton town centre The cost of care at the time of the inspection visit ranged from £497 to £547 per week. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection lasted for six and a half hours. Discussion with residents was difficult due to their dementia, however two residents were spoken to briefly. Six relatives were spoken to during the visit. The homes Laundry Assistant and cook were spoken to and lengthy discussions also took place with the Manager and Deputy Manager of the home. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. Numerous records including care plans, menus, recruitment and training records were examined. complaints and staff The Inspector walked around the home with the Deputy Manager. Requirements identified at the last inspection in December 2006 were revisited. The details of any issues identified at this inspection requiring action are to be found at the back of this report. What the service does well: The Manager and Deputy Manager of the home both work two different supernumerary days a week which means that they are on duty in addition to other trained nurses. On supernumerary days general managerial duties are carried out. On the day of the inspection the Deputy Manager of the home was working her supernumerary day whilst the Manager was taking charge of resident care and working with care staff. The Deputy Manager should be complimented on the smooth running of the inspection and her efficiency. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 6 Good recruitment procedures are in place. Appropriate checks are carried out before a staff member starts working at the home. Relatives spoken to during the inspection spoke highly of the Manager and staff team. Comments made included: “The staffs is very caring and cooperative” “You couldn’t ask for better staff, they are very sociable and make you welcome” “I trust them they do what is necessary” “They are brilliant with her”. What has improved since the last inspection? What they could do better: Staff administering medication to residents must ensure that they use the correct codes on Medication Administration Charts when medication is not given to a resident. The code used will explain the reason as to why medication has not been administered. Induction training needs to be developed to include all of the required elements. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 7 The homes hard wiring, periodic inspection of electrical installation servicing is out of date. The Manager must ensure that this is serviced every five years. Water temperatures in the home environment and fire tests need to be tested on a more regular basis. 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 DS0000000140.V339144.R01.S.doc Version 5.2 Page 8 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 DS0000000140.V339144.R01.S.doc Version 5.2 Page 9 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): Standards assessed 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of prospective residents are carried out to ensure that the home can meet their needs. EVIDENCE: Before going into Allison House, residents are assessed by a Social Worker or health care professional. A copy of this assessment is forwarded to the management of the home so that a judgement can be made to see if needs can be met. Staff at the home then carry out their own pre-admission assessment to ensure that the needs of the resident can be met at home. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 10 Two residents files were looked at during the visit, both of which contained a detailed assessment of needs and evidence of personal choice. Allison House does not provide intermediate care so standard 6 is not applicable to this home. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 11 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 assessed 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that residents receive is based on their individual needs. Care plans are detailed, which will help to ensure that resident’s needs are met. EVIDENCE: Two plans of care were looked at during this visit both of which contained detailed information about the resident and the help they needed. Likes, dislikes and personal preferences were recorded. clear evidence of choice. Care plans were evaluated on a monthly basis. deteriorations and improvements made. Allison House DS0000000140.V339144.R01.S.doc Care plans showed Evaluations included Version 5.2 Page 12 Care plans contained signatures to confirm that they had been drawn up with and reviewed by residents and relatives. Care plans showed evidence of regular visits from G.P’s, District Nurses, Dentists, Opticians and the Chiropodist. Two residents and six relatives were spoken to during the inspection comments made in respect of care provided included: “It’s a good place” “You couldn’t ask for better staff” “The staff are brilliant, they have hearts like lions” “Very caring and cooperative” “They have lived so long because they are so well cared for” Relatives spoken to confirmed that dignity and privacy is respected. During the inspection arrangements for receiving, storing, administering, recording and disposing of resident’s medication were observed and examined. The home has a medication policy. Medication was stored appropriately. Trained nurses administer medication to residents. During the visit a medication audit of one of the residents files sampled during the inspection was carried out. Medicines prescribed by the GP were written up on a Medication Administration Chart (MAR chart). The home use the MAR chart to record the amount of medication coming into the home and check that it matches with the amount prescribed and dispensed. MAR charts contain a code to use if medicines are not administered, an example being if a resident was in hospital, asleep or refused their medication, however staff are not always using the codes identified on the mar chart, The Deputy Manager said that she would take immediate action to address the situation. The Mar chart of this particular resident identified that they were not always receiving their nighttime medication, as they were asleep at the time of the medication round. The Inspector was informed that the GP is to be contacted to review the times that medication is to be given. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 13 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 assessed 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate and enjoyable activities do take place at the home. Visitors are encouraged and made to feel welcome at anytime. Food provided is varied, appetizing and appealing and provides residents with a wholesome balanced diet. EVIDENCE: The home does not employ an Activity Co-ordinator it relies on care staff to provide stimulation through leisure and activities when time permits. The home benefits from having a good sized room which residents use when taking part in activities. Resident activities are planned for the month ahead. Activities taking place in the Month of May included sing a longs, arts and crafts, dominoes, baking, hairdressing and nail care. Relatives spoken to during the inspection said: Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 14 “There are activities going on like baking” “Entertainers come into the home to sing to residents” “I don’t visit on an afternoon so I have not seen the activities. Mum listens to music” “The home has bought some new equipment for residents to use”. The Deputy Manager advised that current residents or their families have not expressed a wish to practice a religion, however if they did the home would support them to do so. Contact with family and friends is encouraged and that visitors are made to feel welcome at any time. One relative spoken to during the visit said, “I couldn’t be made to feel more welcome”. The lunchtime of residents was observed. Mealtime was relaxing with residents enjoying the food provided. Food served was well presented. Staff were sitting and helping those residents that required support or feeding at mealtime. The home has a fourteen-day rolling menu with an alternative choice available at each mealtime. During the visit the Inspector chatted with the Cook who said that lots of work had been put into improving the food provided. Popular new additions to the menus have included spaghetti bolognaise, curry and garlic bread. Most of the time fresh vegetables are used and there is lots of home baking. Relatives spoken to during the inspection said: “The food smells very nice” “The corned beef stew is lovely” “The food is very good you couldn’t ask for better” “They tend to over cook things like the fish”. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 15 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): Standards assessed 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are encouraged and supported to make any complaints they feel necessary. Adult protection procedures are in place, which helps to protect residents from abuse. EVIDENCE: The home has a complaint procedure, however this procedure advises residents and relatives to complain in the first instance to the Manager and then Commission for Social Care Inspection. This procedure should be updated to inform residents and relatives of their right to complain to commissioning agencies such as Social Services and Primary Care Trusts. Relatives spoken to during the inspection said that they would feel comfortable in raising and concern or making a complaint to the staff or management of the home. One relative said, “The Management are very approachable”. The home keeps a record of complaints. There have been six complaints in the last twelve months. The homes adult protection procedure has been developed in line with the Department of Health guidance. No Secrets. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 16 Records were available to confirm that staff had received training in adult protection and signs and symptoms of abuse. There have been not been three adult protection referrals in the last twelve months, all of which have been dealt with appropriately by the home. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 17 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 assessed 19, 20 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: During the visit a walk round of the home took place. Communal areas were homely with appropriate furnishing throughout. Since last inspection the home has benefited from the purchase of new chairs and sideboards/dressers. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 18 On the day of the inspection the home was clean and in the main odour free. In the couple of areas in which odours were identified Cleaners were busy taking steps to address the odours. Bedrooms looked at during the visit were personalized and contained appropriate furniture. The enclosed garden area was well maintained and well stocked with plants. The home has a policy in respect of control of infection. Staff spoken to during the inspection said that there was always a plentiful supply of protective clothing. Appropriate laundry facilities are in place. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 19 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 assessed 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. Staff at the home are trained, skilled and in sufficient numbers to meet the needs of people living at the home. EVIDENCE: Staffing rotas looked at during the inspection informed the Inspector that on Aspen unit there are three care staff on duty between the hours of 7:30am and 9pm. On Willow unit there are four care staff on duty on a morning four on an afternoon and six on an evening. In addition there are two nurses on duty during the day and one on an evening. There are three care staff and one nurse on night duty. The Manager of the home works full time, two days of which are supernumerary. The Deputy Manager also has two supernumerary days each week. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 20 Some additional staffing is provided to a number of residents who require one to one support. This support in the main is provided by agency staff who have worked at the home regularly and know the residents well. Relatives spoken to during the inspection said: “Staffing levels have increased, there are enough staff on duty, residents are well cared for” “There is always plenty of staff” “There are times when you have to look for staff”. The homes recruitment procedure is robust. The files of two newly appointed staff were looked at during the visit. Evidence was available to confirm that appropriate Criminal Record Bureau checks are carried out before staff start working at the home. Both files examined contained all of the required information including, proof of identity, photograph and two references. Records were available to confirm that all new staff receive induction training, however this does not meet with induction standards set by Skills for Care, a discussion took place with the Manager in respect of this. Thirteen of the twenty-nine care staff working at the home have achieved an NVQ level 2 in care with a further seven care staff working towards the qualification. Recent training provided to staff working at the home has included moving and handling, fire wound management and venupuncture. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 21 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 assessed 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In general the home is well managed, quality assurance systems are in place to ensure that the home is run in the best interest of residents. EVIDENCE: The Manager is a Registered Psychiatric Nurse who has worked in the nursing and social care environment for many years. The Manager has recently achieved an NVQ level 4 in Management and is awaiting certification. Relatives spoken to during the inspection spoke highly of the Manager and staff team. Comments made included: Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 22 “The Management of the home have raised their game in terms of food, staffing levels well everything, things are very different to two years ago” “It has been an uphill struggle but they have got there” “The Management are open to suggestions, it is much better now”. Quality assurance and quality monitoring practices are in place. Surveys are sent out to residents/relatives on an annual basis to see if they are happy with the home and care that is provided. Regular residents and relatives meetings are held, with a small number of relatives taking and active part in supporting the Manager to continue to improve standards within the home. One relative said, “We are working together for the good of everyone”. The Manager said that as a result of their dementia residents are unable to manage their own finances. Those residents who want a small amount of change in their pocket do so. The home does not handle the personal allowance for residents, relatives/representatives or Social Services maintain control. Records were examined to confirm that the Gas boilers and fire extinguishers had been serviced within the last year. The Manager said that a rolling programme of servicing of appliances and equipment is in place. Records examined highlighted that the servicing for the fixed electrical installation (hard wiring) were out of date having last been serviced in December 2000. Records were available to confirm that water temperatures in resident areas are taken on a monthly basis. A discussion took place with the Manager in respect of the Health and Safety Guidance to monitor water temperatures weekly. It was also observed that tests of the fire alarm system had reduced from weekly to monthly. The Inspector was informed that immediate action would be taken to revert to weekly testing of both water temperatures and the fire alarm system. Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 23 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 Requirement Timescale for action 09/05/07 2 OP30 18 3 4 OP31 OP38 18 23 The Registered Person must ensure that correct codes are used on Medication Administration Charts if medication is not given to residents to ensure safe practice The homes induction must be 30/07/07 updated to include all of the required elements to ensure that staff are appropriately trained The Manager must provide 30/07/07 evidence of completion of her NVQ Level 4 in Management • The Registered Person 09/05/07 must ensure that the fixed electrical installation (hard wiring is serviced every five years • The Registered Person must ensure that fire drills and testing of the fire alarm system are carried out on a regular basis • The Registered Person must give consideration to the Health and Safety Executive Guidelines to monitor bath and shower water temperatures weekly DS0000000140.V339144.R01.S.doc Version 5.2 Allison House Page 25 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 OP28 Good Practice Recommendations The registered person should continue to make arrangements for a minimum of 50 of care staff to be qualified to NVQ Level 2. Consideration should be given to the replacement of corridor carpets. The Complaints policy/procedure should be updated to include information of resident’s rights to complain to commissioning agencies such as Social Services and the Primary Care Trust. The homes statement of purpose and service user guide should also be updated to reflect such information. 2. 3 OP19 OP16 Allison House DS0000000140.V339144.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Stockton-on-Tees Local Office Unit B – Advance St. Mark’s Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 DS0000000140.V339144.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!