Inspection on 18/12/05 for Alnbank

This inspection was carried out on 18th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alnbank 13/02/09

Alnbank 16/02/07

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 Deborah Haugh Unannounced Inspection 18th December 2005 11:00 Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 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.V269259.R01.S.doc Version 5.0 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.V269259.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alnbank Address Alnmouth Road Alnwick Northumberland NE66 2PR 01665 603584 01665 603584 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.V269259.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the Manager completes the NVQ Level 4 in Care and Management by 2005. 20th September 2005 Date of last inspection Brief Description of the Service: Alnbank is a Local Authority home that provides care and support for 10 adults who have a learning disability. The home is situated on the outskirts of Alnwick, and is close to a number of interesting amenities, including shops, historic places of interest, and leisure facilities. Alnbank is a detached building and is set within its’ own grounds. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 18/12/05 at 11am at the weekend. At the time of this inspection the Registered Manager Mrs Dorothy Kent was not on duty but the Acting Assistant Unit Manager Christine Crate was in charge. There are 9 service users living at Alnbank. Staffing levels were checked. Time was spent looking around the communal areas of the home to check the cleanliness, maintenance and decoration during the visit. Two Care Plans were examined. Arrangements for the administration and management of medication were checked. Recruitment, training, finances, catering, protection, health and safety and quality assurance were also examined. What the service does well: There is a homely atmosphere with service users using all areas of the home. Bedrooms were not checked on this occasion but at the last inspection they were personalised and decorated to the person’s preference. The communal areas are homely well maintained and decorated. Staff know the service users well and are able to describe in detail the support they provide. Service users are encouraged to make decisions which affect their lives. The staff team are responsive to the requests of the people they care for. The service users have a good community presence and maintain relations and friendships outside of the home. Care plans are good and there is a multi-disciplinary approach to care with health and social care professionals. Good arrangements are now in place for nutritional needs. Staff are motivated to improve the quality of life for the service users. Staffing levels meet the needs of the service users and are kept under review. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 6 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. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 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.V269259.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 2 was assessed at the last inspection and met. EVIDENCE: Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 & 9 (NMS 7 was assessed at the last inspection and was met) Care plans are detailed and identify the needs of the service users and actions to meet them. Service users are supported to be as independent as possible and risk assessments are completed. EVIDENCE: Two care plans were checked and these are informative and provide detail of the needs of the service users. Risk assessments are in place. Staff demonstrated their knowledge and good relationships with service users. Some of the service users have complex needs and are unable to communicate them but staff are attentive. The care plans are evaluated on a regular basis and reviews are carried out on a six monthly basis. Nutritional assessments and care plans have been put in place and appropriate advice and guidance has been sought. Basic information regarding service users contacts is now in place. Confidential information is handled appropriately. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 10 The manager intends to use the first person for care plans in the future eg ‘I prefer’. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 17 Service users are able to fulfil their potential, participate in community activities and their rights are respected. Service users have nutritious food, which is varied, and choices are available. EVIDENCE: Each person living at Alnbank has opportunities for personal development. A range of activities takes place within and outside the home. These include, swimming, concerts, shopping, pub lunches and going out to places of interest. Service users attend day services and college courses. Service users have family and friends whom they maintain contact. People are able to visit any time and are made welcome. On arrival service users and staff were having freshly baked cheese scones and drinks. The atmosphere was relaxed and jovial. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 12 Staff respect service users’ privacy and dignity. Due to the special needs of some of the service users they are unable to verbally express their needs but the staff are aware of their body language and cues to indicate their wishes. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 (NMS 18 was assessed at the last inspection and was met) The health needs of residents are well met with multi disciplinary working taking place on a regular basis. The arrangements for the administration of medication protect service users but two areas need improving. EVIDENCE: The staff monitor service users health needs which is recorded in the care plans. Routine health checks are carried out and service users attend appointments with relevant health care professionals with staff support. An audit of the medication systems was satisfactory but two areas require improvement. (See Requirements) Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 (NMS 22 was assessed at the last inspection and met) Service users are protected from potential abuse, neglect and harm. EVIDENCE: Staff have received training in the Protection of Vulnerable Adults and the Local Authority is the lead agent in protection. Care plans provide guidance to staff when dealing with service users who may become distressed and aggressive. Advice is sought from the Behaviour Analysis and Intervention Team (BAIT) where appropriate. Service users financial arrangements were audited in the presence of two senior members of staff. Suitable records and systems are in place. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 (NMS 30 was assessed and met at the last inspection) The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: The communal areas of the home were inspected. The home is spacious and comfortable for the service users who live there. At the last inspection service users bedrooms are personally decorated with photographs, belongings and keepsakes. The maintenance and cleanliness of the home is good. There are 3 bathrooms and 2 shower rooms, 2 toilets and 1 en-suite. The hot water temperatures are checked each month and thermostatic valve controls are fitted to each water supply. Thermometers are now available in each bathroom/shower to check hot water temperatures each time someone bathes. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33 & 34 Staffing numbers are in keeping with agreed levels so that they are appropriate to the assessed needs of the service users, size, layout and purpose of the home. The Registered Provider ensures that service users are cared for by staff that are trained. Robust staff vetting must protect Service users. EVIDENCE: The home is maintaining the level of staffing in accordance with previous agreements. A minimum of two staff must be on duty during the waking day and 1 waking night staff. The staffing levels are increased at busy times and where service users are accessing an activity. The manager is continually revewing the night staffing levels to ensure they meet the needs of the service users. On - call management arrangements which are informal must still be formalised by a rota. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 17 A complete audit of recruitment processes could not be undertaken because records were not available in the home. Recruitment records must be available in the home for inspection (Criminal Records Bureau and Protection of Vulnerable Adult checks) Staff receive appropriate training to their role and this includes mandatory and refresher training. Staff have had training in Protection of Vulnerable Adults, Alzheimer’s, challenging behaviour, autism, personal relationships, loss and bereavement. Staff have achieved over 50 of staff trained to NVQ Level 2 or equivalent by 2005. 2 staff have D32/33 NVQ Assessor Award 5 Staff have NVQ Level 3 and 1 person has commenced Level 3 4 Staff have NVQ Level 2 1 Staff member is a qualified nurse in Learning Disability 3 Staff have in-service certificates ICSC 3 Staff have Level 2 in Learning Disability Award and 2 people have commenced. 1 Staff member has Level 3 in Learning Disability Award Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 &42 The home is being managed effectively to safeguard residents, maintain safety and to fulfil their potential. Formal Quality Assurance systems are not in place by the Local Authority so the service is not formally audited externally. EVIDENCE: The manager is experienced and is completing NVQ Level 4 for the Registered Managers Qualification. The manager is committed to maintaining and improving the life opportunities of the service users and this is evident by staff practice. The home has its informal quality assurance system in place where service users are asked for their views on the home. The home holds service users meetings and uses pictures/photographs to illustrate the content in the minutes. This is excellent. Service users are consulted about decisions, which affect their lives. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 19 The home does not have a formal quality assurance system in place from the Local Authority. CSCI have been informed that the Local Authority is developing a quality assurance system in consultation with service user representative groups. As mentioned previously hot water temperatures for showering and bathing are now checked on every occasion with thermometers. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alnbank Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 3 X DS0000035342.V269259.R01.S.doc Version 5.0 Page 21 Yes 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 2 Standard YA33 YA20 Regulation 18 13(2) Requirement On - call arrangements must be formalised by a rota. OUTSTANDING 30/09/05 Medication issues must be addressed 1. Two signatures must be obtained for written meidcation Administration Records (MAR) 2. The BNF must updated. CRB’s and POVA checks must be available in the home for inspection Timescale for action 19/12/05 31/12/05 3 YA34 17 schedule 4 31/12/05 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 YA6 Good Practice Recommendations Consider using first person for care plans. Alnbank DS0000035342.V269259.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 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.V269259.R01.S.doc Version 5.0 Page 23 - 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. 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