Inspection on 16/02/07 for Alnbank

This inspection was carried out on 16th February 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alnbank 13/02/09

Alnbank 18/12/05

Alnbank 20/09/05

Alnbank 08/12/04

Alnbank 10/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Alnbank Alnmouth Road Alnwick Northumberland NE66 2PR Lead Inspector Allan Helmrich Key Unannounced Inspection 16 and 28 February 2007 12:15 Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 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 Alnbank DS0000035342.V326700.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 Adults 18-65. 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. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alnbank Address Alnmouth Road Alnwick Northumberland NE66 2PR 01665 603584 01665 606039 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) Northumberland County Council SSD Mrs Dorothy Margaret Kent Care Home 13 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (1), Physical disability (1), of places Sensory impairment (2) Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Manager completes the NVQ Level 4 in Care and Management by 2005. 18th December 2005 Date of last inspection Brief Description of the Service: 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 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. The home’s fees are determined according to the needs of each resident. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s annual unannounced key inspection visit. The inspection was done over two days and took 7 hours. Time was spent talking to the manager; two care staff and several residents. Some of the home’s care records were reviewed and the systems that maintain residents safety. Also as part of the inspection the care plans for three residents were inspected against the actual care provided. This is called ‘case tracking. The communal areas of the home were inspected and the kitchen and laundry area. Permission was obtained from residents to look at bedrooms. Questionnaires were provided for residents and visitors to the home. Three responses were received from visitors. All of the responses were positive about the home and no issues were raised. What the service does well: What has improved since the last inspection? A programme of work is in place to update the home and improve the decoration. Some new carpets have been laid. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A system is in place to ensure the needs of prospective residents can be met. EVIDENCE: The home has not admitted a new resident for over five years. The case files reviewed contained a good standard of information for staff regarding the care needs of each individual. The plans show that whenever it is necessary relevant professionals are involved in the admission process to provide both support and training for the staff team. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of each resident are described in a personal plan. The system of involving residents in their care could be improved. Residents are supported to take risks and supported to manage their finances. EVIDENCE: Three care plans were reviewed; each contained a good standard of information about the resident and the type of support and assistance required. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 10 When there is an issue regarding freedom of choice, a risk assessment is conducted. Staff identify any risks in daily living and a risk management plan is put in place to enable the resident to lead as fulfilling a life as they are able. The home is developing picture formats to involve residents in decisionmaking. Care records are evaluated and reviewed on a six monthly basis. Also each month the resident’s key-worker produces a summary based on information from daily recordings. Several residents have complex needs and some are unable to communicate effectively. The monthly review does not always involve the resident. The reviews do not include all areas of care or goal planning and do not always identify issues that have affected the daily life of the individual. The manager ensures reviews of care involving the resident, care staff, care managers and supporters are done every six months. Each resident is supported to manage their finances within their abilities. All monies kept for residents’ are accounted; receipts are obtained for purchases and two staff countersign all transactions. This is good practice. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live a normal life within the community. Residents are encouraged and supported to maintain friendships and family links. Residents are free to move around the home and the staff team manages any health and safety issues. A range of healthy meals is provided. EVIDENCE: Residents are very much part of the local community. They were seen coming and going during the inspection with staff support. Risks associated with daily living are identified and plans are put in place to manage these. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 12 Regular weekly activities include; college based activities, swimming, carpet bowls at a local sports centre and the development of personal skills to encourage independence. Residents are supported to attend church events, but this is rarely taken up, other than at Christmas time. Staff are using pictures to show residents their weekly routines and activities. Residents use community facilities for health and personal grooming. They are included in regular house shopping and are involved in house meetings when a range of issues are discussed. Residents spoken to in the lounge during the inspection talked about their enjoyment of past outside activities and of future holidays in the planning. Details of each resident’s family contacts and friends are recorded in the individual case records. Some residents have no family support but those that have are assisted to maintain regular contact in a way that benefits the individual resident. All three visitors questionnaires confirmed their contentment with the welcome they receive into the home and one commented ‘it is always a pleasure to visit Alnbank’. The home’s menus were provided prior to the inspection. These show that a range of different meals is provided. The main meal of the day is in the evening and contains a range of fresh vegetables to encourage a healthy lifestyle. Sandwiches provided during the day were fresh and tasty. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live their chosen lifestyle. An experienced staff team addresses their physical and emotional needs. The home’s systems for dealing with medication are good. They protect the people who live there. EVIDENCE: Throughout the inspection, residents were coming to staff for support and information. Staff were seen providing emotional support and guidance. Staff always took the time to talk through any issue mentioned by a resident. Residents appeared content and comfortable with the staff team throughout the inspection. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 14 Care plans describe the needs of each resident and how they should be addressed. All healthcare appointments are recorded and the case records that were reviewed showed that regular healthcare is obtained to maintain the good health of the residents. When deemed necessary by the manager, outside professionals are involved to assist in the health and wellbeing of the resident. The homes system for recording and administering medicines is appropriate to the size and style of the home. Staff are trained in handling medicines and further refresher training is planned. Staff have access to a medical reference book. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good complaints process supports residents and they are protected from abuse by a staff team that are aware of vulnerable adult procedures. EVIDENCE: All three responses from visitors to a questionnaire were aware of the homes complaints procedure and one respondent indicated they have used it. The residents seen during the inspection were not able to use the complaints process but staff use their knowledge of the residents to complain for them. The home’s complaint process in the Service User Guide given to residents and their families has details for the Commission that require amendment. The manager takes complaints seriously and records all issues that she or her staff team consider affect residents. The home’s complaint log provided information of 15 instances where staff felt that residents might be dissatisfied with the service. How these issues were addressed is recorded. This is good practice and demonstrates that staff are constantly looking at how there practices affect residents. 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 Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 16 protection of vulnerable people. The manager and senior care staff have done additional training. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. Residents appeared to be ‘at home’ 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. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 18 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. 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. The home’s grounds are large with lawns and borders. There is also an orchard and areas for outside activities. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent trained staff team supports residents. A training and development plan for staff ensures residents needs are addressed. The home’s system for recruitment could not audited to ensure the wellbeing of residents. EVIDENCE: Currently twelve of the seventeen care staff have a National Vocational Qualification (NVQ) in care and the manager is committed to ensuring all staff attain this qualification. 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. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 20 The requirement made at the last inspection, to ensure appropriate recruitment information is available for inspection has not been addressed. This information is held in the council offices and only a selection of information is available in the home. The detailed information identified in Schedules 2 and 4 of the Care Homes Regulations 2001, used by The Commission for Social Care Inspection, to identify good recruitment practices that protect residents is not available. Regular staff meetings take place and all staff are supported by regular 1-1 sessions with management. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager who is qualified and competent, works to improve the care provided to the residents. The staff team and outside managers regularly assess the quality of care provided. A good standard of health and safety is maintained for the benefit of residents. EVIDENCE: The manager is experienced in working with people who have a learning disability and she has recently obtained the Registered Managers Award. Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 22 The manager received praise from the staff team and residents appeared comfortable with her. She is working to improve the care practices to ensure each resident is given the opportunity to be as independent as they are able. The home is well run and systems are continually being improved. Senior managers visit the service to audit systems and a formal quality assessment tool is completed to check the quality of the service for residents. The residents seen during the inspection appeared to be content and the interaction between them and staff were good. The home is safe and no hazards were seen. All staff receive health and safety training. Fire training is provided and the fire log showed that regular checks are done. The risk assessment of the building recently re-assessed by the manager was not dated. Following the inspection the manager confirmed the home’s liability insurance is in order. Service agreements are in place for gas equipment, water temperatures are regularly checked and hazardous substances are secured. Alnbank DS0000035342.V326700.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 Requirement The manager must ensure the information detailed in Schedules 2 and 4 of The Care Homes Regulations are available for inspection in the home. Timescale for action 31/03/07 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. Refer to Standard YA7 Good Practice Recommendations Staff should involve residents more in the monthly assessments of their care plans. All care plans and goal plans should be evaluated in addition to the health and welfare issues currently identified. Amend the contact details for the Commission for social Care Inspection in the home’s complaint procedure. The manager should date the fire risk assessment after each re-assessment. 2. 3 YA22 YA42 Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Alnbank DS0000035342.V326700.R01.S.doc Version 5.2 Page 26 - 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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