Inspection on 13/02/09 for Alnbank

This inspection was carried out on 13th February 2009.

CSCI found this care home to be providing an Excellent service.

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

Alnbank 16/02/07

Alnbank 18/12/05

Alnbank 20/09/05

Alnbank 08/12/04

Alnbank 10/06/04

Similar services:

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Dilston College Of Further Education

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Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Alnbank Alnmouth Road Alnwick Northumberland NE66 2PR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 1 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Alnbank Alnmouth Road Alnwick Northumberland NE66 2PR 01665603584 01665606039 dorothy.kent@northhumberlandcaretrust.nhs.u k Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northumberland County Council SSD Name of registered manager (if applicable) Mrs Dorothy Margaret Kent Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of servcie users who can be accommodated is: 10 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 10 Date of last inspection Brief description of the care home Alnbank is converted from a Georgian family home set in grounds that include lawns, a shrubbery and orchard. It is owned by Northumberland County Council and now provides care and support for up to 10 adults who have a learning disability. The home is situated on the fringe of the historic town of Alnwick with its many facilities and transport links to other areas. The home has 10 single bedrooms one of which has ensuite toilet and hand basin. On the ground floor there is a large lounge and separate Care Homes for Adults (18-65 years) Page 4 of 28 care home 10 Over 65 0 10 Brief description of the care home dining room. Upstairs there is another small lounge and a kitchenette. The home has 3 bathroom/toilets and 2 shower/toilets for residents. Inspection reports and information about the home are readily available. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The Visit: Care Homes for Adults (18-65 years) Page 6 of 28 The inspection was unannounced and was undertaken by the link inspector for the service. The inspection started at 10:30am and lasted 6hrs. During the visit we: * Talked with people who use the service. * Talked with the home manager and staff on duty. * Looked at information about the people who use the service and how well their needs are met, * Looked at case records for three residents and other records that must be kept, including medication. * Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. * Looked around the building to assess if it was clean, safe and comfortable. * Checked what improvements had been made since the last visit. Also surveys were sent to residents, staff and professional visitors. Responses were received from five residents supported by relatives or staff, five staff members and 5 professional visitors. Information from these sources is used in this report. The current fees for this service are 1271 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good admissions processes support people to make the right choice of home and ensure their needs are met in a person centred way. Evidence: Each of the residents currently living in the home have been there for several years. However should anyone be admitted a process is in place to ensure that appropriate professional people are involved and that enough information is obtained to limit the possibility of admitting someone whose needs cannot be met. Care plans contained the original pre admission information, although this has been updated to reflect the individuals current needs and a copy of the contract with the placing authority. The relative of a previous resident commented that; Alnbank is a fantastic place to live with a staff team who made us very welcome. Care Homes for Adults (18-65 years) Page 10 of 28 Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are involved in their own care planning and are consulted on their lives in the home. Evidence: Four people who live in the home were spoken with. One person told us about their life in the home. That they enjoy the freedom of choice to be able to use their bedroom as they choose and to make drinks and snacks. They also said they enjoyed swimming, playing football, playing the guitar, drawing and writing. Another resident seen in his room said he likes to spend some time alone watching television. He has a small fridge in his room to keep his drinks cold. Residents talked about the support the staff provide so that they can be independent. They said that they are able to make decisions and choose what they want to do, and they are able to make their views known. People living in the home were seen throughout the day coming and going with staff and family support. Alnbank has a Person Centred outlook that involves each person in writing their own care plan and making decisions and choices about their Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: lives in the home and the support that they need. Three care plans were looked at, they had all been reviewed and revised since the last inspection. The care plans are clearly written, with good details of each persons needs and procedures and guidelines for meeting those needs. They are written in a positive and person centred manner. For example, one person has a care plan for managing their personal care which is clearly written, and was agreed by the person concerned. The format of the care plans describes the need to be met and precisely what involvement the staff member should have to promote good skills in personal care management. The risk assessments that we saw included a management plan for supporting the person to achieve an activity and manage any risk involved. For example, one person is at potential danger from electricity. As a result a risk management plan was drawn up with them to help the person understand the dangers. Safety was also improved by buying a device to cover sockets and limit the danger. Other risks assessed included; playing football, road safety and wandering. Staff sign plans of care to show there awareness of the issues identified. Most people in the home have communication difficulties, however with staff support they are all able to make their views known. Communication tools are also used and these details are recorded in the plans of care. Residents comments in the returned surveys included; I really like my key worker who does what I ask. I like to make my own decisions. I am helped by my key worker with what I want to do. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are encouraged to make choices for their activities and staff support them to develop their skills for independence. Evidence: Three of the seven people who currently live in the home attend day care regularly during the week and each of the others has some involvement. Two people attend college to improve their life skills. One person has a programme of daytime activities in the home as he chooses not to go out regularly. Staff support people in the home with domestic skills and three people use the homes laundry as it contains a domestic style washing machine. This is done with supervision. The care plans include details of peoples independent living skills, and people are asked what they would like to do. People meet with their key worker each month to discuss and plan past and future goals. New goals are then recorded in a plan. To promote independence residents are Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: offered a key to their bedroom and two people have taken up this offer. One person with hearing difficulty has a flashing light in his room as a fire alarm and the home has a cordless phone to enable people to take calls in private. Following a risk assessment a fence has been erected in the grounds to ensure people in the home are safe. The manager stated that each person in the home had been on holiday last year although one person does not like to stay away and so was supported to go on day trips. The home has a seven seater vehicle that is used to visit places of local interest. Everyone is encouraged to keep in touch with their families. One person has a specific care plan regarding family contact. Another resident visits his family at regular intervals and this is recorded in his plan of daily living. The relative of a recent resident stated they were made very welcome when visiting. The menus on display on the homes notice board show a choice each day. The meals promote good healthy eating with various vegetables and fruits promoted. Occupational therapists have been brought in to assess people when they are not able to use domestic cutlery and some people have been provided with special equipment to aid eating. A relative stated everyone has a proper home cooked meal and no convenience food. The manager stated that residents are involved in shopping tasks and this was confirmed by one resident. The manager also stated that menus had recently been changed following a house meeting. The kitchen was found to be in good order with appropriate quantities of food and an audit system in place to ensure good practice. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported to maintain their health needs and promote good health care for the people in the home. Evidence: The care plans describe the needs of each resident and how they should be addressed. All health care appointments are recorded and the case records that were reviewed showed that regular health care is obtained to maintain the good health of the residents. The plans also showed that residents are encouraged to walk to aid there fitness. When deemed necessary by the manager, outside professionals are involved to assist in the health and wellbeing of the resident. Residents appeared content and comfortable with the staff team throughout the inspection. The home has systems in place to manage peoples medication safely. All the staff have training in administering medication and supervision until they are judged to be Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: competent to administer medication without supervision. We checked the medication records for two people. The records were free of errors, with no signature gaps found on the MAR (medication administration record) charts. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home takes complaints seriously and staff are well trained to ensure everyone is protected from abuse. Evidence: The home provides a copy of the complaints procedure to new residents in the Service User Guide and a copy is on the wall near the entrance for the benefit of visitors to the home. The manager takes complaints seriously and records all issues that she or her staff team consider affect residents. Since the last inspection there have been 12 instances where staff felt that residents might be dissatisfied with the service. How these issues were addressed is recorded in a log maintained for this purpose. This is good practice and demonstrates that staff are constantly looking at how there practices affect residents. Recently a new format has been developed with pictures to better support people who want to complain. This format was used to record the most recent issue. The home have received no formal complaints since the last inspection. Most of the surveys returned confirmed that residents were aware of how to complain. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: One response stated, no one told me how to complain so I just went to the office and told them and they put things right for me. Two staff spoken to were able to confidently state how they would deal with any adult protection issues. All staff are provided with training relating to the protection of vulnerable people. The manager and senior care staff have done additional training. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained. Residents are in comfortable surroundings. Evidence: The home is clean and well maintained. Some redecoration has been done and more is planned. The manager regularly reviews the standard of the accommodation and action plans for improvement are in place. Residents bedrooms are individual in style. In addition to a large lounge on the ground floor capable of seating all residents, there is a small lounge and kitchenette on the first floor for residents who want to entertain friends in private. Systems are in place to ensure that good infection control is practiced. The laundry has equipment that meets disinfection standards and has walls and floor that are easily cleaned. It is recommended that light pulls in communal toilets be replaced with easily cleanable ones to further promote infection control. The kitchen is large with good storage for food provisions. The equipment and benches are easily cleaned. Residents can use the kitchen although this is discouraged when the main meal of the day is being prepared. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The homes grounds are large with lawns and borders. There is also an orchard and areas for outside activities. A large fence was recently erected to promote residents safety when using the grounds. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient numbers of suitably trained and competent staff are employed to provide people with the right level of support to ensure their needs are met. Staff get regular training and supervision to ensure the necessary skills are available to provide the people who live at the home with good support. Evidence: Prior to the inspection the manager provided information that all care staff employed in the home have a National Vocational Qualification (NVQ) in care. This should provide a basis for excellent support for the residents. A training and development plan is in place for all staff. This helps identify any gaps in training and to ensure update training is organised at the appropriate times. Staff confirmed that they receive a good standard of training and that any requests for additional training are considered. No new staff have been employed since the last inspection although staff have been transferred from other services. The manager keeps some information relating to staff employed but this could be improved to ensure the requirements of registration are maintained and that information is readily available for inspection. The manager stated Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: that full information is held in the council offices. Regular staff meetings take place and all staff are supported by regular 1-1 sessions with management. The manager maintains a training matrix that is used to ensure a balanced workforce supports people who live in the home. The records show that in the previous year staff have been provided with the following training; manual handling, food hygiene, first aid, health and safety, infection control, safeguarding, diversity and the safe handling of medication. Nine staff also have a specific qualification associated with learning disability. All of this training promotes a strong staff team, enabling them to provide good support and care to the resident group. The five staff who reponded to a survey all gave positive information about the service. Comments included; training is ongoing and up to date. We are given choices of the training available. CRB checks are done every three years. The home provides care to a good standard. One of the staff team felt paperwork could be reduced to enable them to spend more time with residents. Professional visitors to the home commented; staff are very pro active. Care staff are very professional. Residents commented; staff are nice. Lovely staff. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Alnbank is a home that is well run for the benefit of the people who live there. Evidence: The manager, who has managed the home for several years, is well aware of the needs of each person in the home. She has the Registered Managers Award to demonstrate her abilities and also undertakes additional training that has recently included a four day health and safety awareness course to promote good practice in the home. The manager received praise from the staff team and residents appeared to be content and the interaction between them and all staff was good. The home is well run and systems are continually being improved. A quality monitoring system is used to monitor standards and most recently better communication tools have been produced to assist staff when working with residents with poor communication. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Residents are interviewed each month, using a picture format, to determine their satisfaction with the service provided. Visitors to the home are also surveyed. Senior managers visit the service to audit systems and manager checklists monitor the quality of the environment. Staff are involved in regular meetings that are minuted and supervision and appraisal sessions take place to promote good practice. The home has procedures in place that make sure residents finances are safeguarded. The manager demonstrated that regular servicing of equipment takes place, that staff, through training, promote safe working practices to ensure the safety and welfare of people who live in the home. The certificate demonstrating that electrical appliances are checked for safety was in order. A fire risk assessment has been produced. Staff have received fire instruction and fire drills take place to ensure residents are maintained in a safe environment. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 34 19 The manager must ensure 31/03/2007 the information detailed in Schedules 2 and 4 of The Care Homes Regulations are available for inspection in the home. Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 The manager must ensure the information detailed in Schedules 2 and 4 of The Care Homes Regulations are available in the home. The manager must be able to demonstrate, when requested, that appropriate staff recruitment has taken place to protect vulnerable people in the home. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 30 Change the cord light pulls in communal toilets to a type that are more easily cleaned. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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