Inspection on 27/11/06 for Alma Rest Home

This inspection was carried out on 27th November 2006.

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

Alma Rest Home 10/02/06

Alma Rest Home 20/09/05

Alma Rest Home 13/01/05

Alma Rest Home 13/08/04

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

CARE HOMES FOR OLDER PEOPLE Alma Rest Home Alma Residential Home 19-23 Alma Road Sheerness Kent ME12 2NZ Lead Inspector Graham Cummings Unannounced Inspection 27th November 2006 11:33 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 Alma Rest Home DS0000023899.V318988.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. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alma Rest Home Address Alma Residential Home 19-23 Alma Road Sheerness Kent ME12 2NZ 01795 665051 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) Mr Patrick Nicholas Pinagapany Mr Patrick Nicholas Pinagapany Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user whose DOB is 15/5/1920 room 8 will be OP until they leave then will revert to DE. 10th February 2006 Date of last inspection Brief Description of the Service: The Home provides residential care for older people, all but one of whom have dementia. Recent alterations to the Home now mean that all service users have their own rooms, many of which are en-suite. The Home is on several floors and there is a lift access to all levels. The Home has a large lounge area in which there is plenty of space to wonder if that is what the service users want to do. The dining areas are also part of this space. There is also a conservatory and small courtyard garden where service users can relax or entertain family and friends. The Home is situated near the sea front in Sheerness, and is close to shops and many other amenities. Sheerness has a railway station and the Home is near a bus route. The fees range from £400 to £420 per week. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection was completed by this site visit carried out by Graham Cummings on the 27/11/06. The site visit consisted of viewing three care plans, thre staff files talking to the Team Leader and toured the home. The home has a good atmosphere, The manager was on leave but had put in place a good structure for the Team Leader that included regular telephone contact to ensure everything was running well. The home is registered for twenty and presently has a full occupancy with a waiting list. Work has been completed on moving the external fire-escape, the extension is being built to increase the occupancy of the home by two. The small undersized bedroom upstairs is being used to increase an adjoining bedroom. The work being carried out during the last inspection has been completed and the new flooring and decoration looking good. Medication administration training has taken place, this was a Certificate of Attendance, other training includes Dementia, First Aid and Manual Handling. The home employs twenty seven care staff, of these ten have completed their NVQ, 4 have started and two are booked to start and have a start date. The home’s Statement of Purpose and Service User Guide could benefit from being updated, there were no dates on the document to indicate when it was last evaluated. The home has purchased a care plan computer programme and those seen were well completed and allowed room for evaluations to be recorded. The risk assessments seen were well written and informative, however, they did not contain the Service User’s name and therefore could not be identified if misplaced. As the care plans and associated forms are all on the computer it is essential that the data is input very carefully monitored and it would be good practice to try and find a system to ensure that the data input is checked and correct. The Inspector noted that one of the Waterlow Pressure Assessment forms had the wrong figure input. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 6 What the service does well: 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. Alma Rest Home DS0000023899.V318988.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 Alma Rest Home DS0000023899.V318988.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): 1,2,3,5,6 Quality in this outcome area is good. Prospective Service Users have the information to make an informed choice about living at the home. Service Users have their needs assessed and along with relatives are able to visit the home before making a decision. Service Users can be confident they will have a written contract once they move into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector looked at the home’s Statement of Purpose and it contained good information on the home, however there was no date on it to show when it was last evaluated and updated. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 9 The home carries out a full needs assessment of an individual prior to any placement taking place. Service User’s, relatives and care manager are all encouraged to visit the home prior to any placement agreement being made. The home does not take referrals for intermediate care. Alma Rest Home DS0000023899.V318988.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): 7,8,9,10, Quality in this outcome area is good. Service Users can be confident that they will have an individual plan of care and have their health needs met. Service Users can be confident that they are protected by the home’s policies and procedures for medication. Service users can be confident that they will be treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently purchased a computerised care planning programme, the Inspector looked at three care plans and found them to be well written and informative. They had also been evaluated. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 11 It was noted that the individual Risk Assessments did not have names on them and this needs to be rectified. An issue that needs to be addressed is how information that is input onto the care plan is checked and monitored to be correct. The Inspector noted that a mistake had been made on information put onto the Waterlow Pressure Sore Assessment although staff knew the correct information when asked, human error on transferring the information had occurred. All Service Users are registered with a local Doctor, Optician and Dentist. During the inspection it was noted that staff knocked on doors before entering maintaining Service user privacy and dignity. No Service User self medicates and the Inspector checked the Medication Administration Records and found these to be complete and up to date. Staff have attended medication training since the last inspection. Alma Rest Home DS0000023899.V318988.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): 12,13,14,15 Quality in this outcome area is good. Service Users’ outcomes and lifestyles meet their needs and they have good contact with relatives. Service Users are given choice and benefit from receiving a wholesome and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the Service Users relatives live locally and just call in without appointments, this differs from relatives who live a greater distance away who tend to telephone to say they are coming to ensure the person being visited is in. The home employs an Activities Co-ordinator and activities include, scrabble, skittles, pairs, walks, cooking and shopping. Staff also read the daily newspaper to Service Users. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 13 The menu was seen and provides a good nutritious diet. Service Users have a choice of three main meals at lunch including a vegetarian option. Alma Rest Home DS0000023899.V318988.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): 16,18 Quality in this outcome area is good. Service Users can be confident that their complaints will be listened to and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home nor the Commission have received any complaints since the last inspection. There has been an incident that was recorded on a Regulation 37 that was dealt with quickly and efficiently resulting in Service User living at the home being kept safe. Staff attended Adult Protection training on the 28/06/06. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 15 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): 19,20,21,23,24,25,26 Quality in this outcome area is good. Service Users benefit from living in a pleasant, safe, comfortable and well maintained home. The home has sufficient numbers of lavatories and washing facilities to meet Service User needs. Service Users benefit from bedrooms that are comfortable and suit their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently registered for twenty Service User’s all who have single bedrooms, fourteen with an en-suite of wash hand basin and toilet. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 16 There are two baths and two showers. The parts of the home seen were clean and well furnished with two day rooms for communal use. The Inspector did not tour the whole home at this inspection, the last inspection a full viewing took place and the home met the required standards. The Inspector was informed that no changes to Service User rooms had taken place since the last inspection. Work has begun on building the extension to accommodate two bedrooms, the external fire escape has been moved to allow for this. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 Quality in this outcome area is good. Service Users have their needs met by the staff on duty and they are protected by the home’s recruitment procedures. The care of Service Users is enhanced because staff have access to good training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs twenty seven care staff and ten have an NVQ and six are completing it. The home follows a good recruitment practice that includes notes from interviews, two references, CRB’s and trial shifts before employment, these were seen on all three of the files the Inspector viewed. Telephone checks are also made to referee’s to ensure authenticity. The Inspector was informed that staff training had recently been carried out in Dementia, medication administration, First Aid and Manual Handling. The Inspector saw a training matrix that confirmed the dates of the training and certificates were seen on the staff files viewed. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 18 Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 19 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): 31,33,35,37,38 Quality in this outcome area is good. Service Users live in a home that is managed by a person fit to be in charge. Service Users live in a home that is run in their best interest with their finances, health, safety and welfare are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager has implemented the requirement made at the last inspection relating to training in medication. The home has also implemented a computerised care plan and staff also write the daily notes on the computer. In order to protect confidentiality the Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 20 programme has different levels of access from support staff to middle management to the manager. Access to the different levels is through fingerprint recognition. As the care plans and associated forms are all on the computer it is essential that the data input is very carefully monitored. The Inspector noted that one of the Waterlow Pressure Assessment forms had the wrong figure input. It would be good practice to try and find a system to ensure that the data input is checked and correct on a regular basis. The Manager supervises the Deputy, who supervises the Assistant deputy and Senior. The Assistant deputy carries out the Supervision of care staff. The Inspector looked at 3 staff files and found that Supervisions on files showed that 1 had received one supervision since 20/9/06; the second had two since 11/5/06 and the 3rd had four since 20/11/05. Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 21 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 3 3 X 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13(4)(c) Requirement The registered person shall ensure that – unnecessary risks to the health or safety of service users are identified and so far as possible eliminated - in that all risk assessments should have the name of the individual service user concerned written on the document Timescale for action 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP18 Good Practice Recommendations That the Statement of Purpose and Service User Guide are reviewed and a date shown on the document of when this was done. That a monitoring system is put in place to ensure that the computerised care plan information is input correctly and that service users are able to have copies of the document if they request it. That all staff receive a minimum of 6 supervisions per year that are recorded and signed and dated by both parties. DS0000023899.V318988.R01.S.doc Version 5.2 Page 23 3. OP36 Alma Rest Home Alma Rest Home DS0000023899.V318988.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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