Inspection on 01/11/06 for Alne Hall Cheshire Home

This inspection was carried out on 1st 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

Alne Hall Cheshire Home 14/10/08

Alne Hall Cheshire Home 09/02/06

Alne Hall Cheshire Home 02/06/05

Alne Hall Cheshire Home 01/11/04

Alne Hall Cheshire Home 02/06/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Alne Hall Cheshire Home Alne York North Yorkshire YO61 1SA Lead Inspector Gill Sample Key Unannounced Inspection 1st November 2006 10:15 Alne Hall Cheshire Home DS0000027956.V319448.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 Alne Hall Cheshire Home DS0000027956.V319448.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. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alne Hall Cheshire Home Address Alne York North Yorkshire YO61 1SA 01347 838295 01347 838941 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) www.leonard-cheshire.org.uk Leonard Cheshire Mrs Irene Smith Care Home 30 Category(ies) of Physical disability (25), Physical disability over registration, with number 65 years of age (5) of places Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 15 Nursing (PD & PD(E) - maximum 5 PD (E)) 15 Residential (PD&PD(E)) - maximum 5 PD(E)) Registered for a maximum of 30 persons 9th February 2006 Date of last inspection Brief Description of the Service: Alne Hall is a Leonard Cheshire home situated in the rural village of Alne, approximately 12 miles from York. The home provides personal and nursing care for younger adults with physical disabilities and may provide service to up to five people over 65 years of age with physical disabilities within a total of thirty residents. Respite care is provided by the service using one room reserved for this purpose. The home is a detached listed building set in its own grounds, there are well laid out gardens, which are accessible to the residents. The home has twentyeight single rooms and one double room, which is used for single occupancy. The building consists of the original Hall which has been extended to provide further bedrooms, facilities and services. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. The weekly fee is calculated following individual assessment of prospective service users. Additional charges not covered by the fee are hairdressing at cost price, transport at 30p per mile, the cost of holiday accommodation and a contribution to activities outside the home, such as theatre tickets. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report gives the findings of a key inspection of the service including a site visit which was made on 1st November 2006. The inspection focussed on certain key standards and those recommendations made at the last inspection. A total of six hours and fifteen minutes was spent at the home. There were twenty seven residents living at the home. Prior to the visit, the registered manager had provided written information about the service to the Commission and the background history of the home was analysed using records held at the Commissions York office. At the visit, general areas of the premises were seen and a number of bedrooms, bathrooms and living areas. Some written records were also examined and practice was observed during the visit. Individual discussions were held with residents, the deputy head of home, the nurse in charge and staff on duty at the time. Written comment cards were distributed to service users at the visit, eleven of which were returned to the Commission’s York office. What the service does well: What has improved since the last inspection? The organisation has been seeking to provide a service in different accommodation than Alne Hall, which is not entirely suitable for the needs of adults with physical disabilities. The organisation’s intention was to buy a suitable site to provide purpose built accommodation closer to York so that the service better suited the physical, social and leisure needs of its service users. It has not been possible to find a suitable site and the period of uncertainty about the future of Alne Hall has been settled. The organisation’s proposal is now to remain at Alne Hall and possibly develop the land adjoining the home for service users, using the space created to provide improved accommodation Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 6 to a better standard within the Hall. This decision has meant that service users are no longer fearful of their future at the service, and several commented about their relief at the organisation’s decision to remain on the Alne Hall site. 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. Alne Hall Cheshire Home DS0000027956.V319448.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 Alne Hall Cheshire Home DS0000027956.V319448.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. Prospective service users can be assured that they will have chance to experience the service and that their individual needs will be assessed and recorded prior to entering the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Case records examined showed that information had been gathered about prospective service users and an assessment made of their needs. Where information had been supplied by a purchasing local authority, this information was used as a basis to make an assessment and develop a plan of care to ensure individual’s needs would be met. Service users confirmed that they had had chance to visit the service and talk with other service users prior to deciding to come into the home. One written comment from a service user said “I came to Alne Hall for eighteen months to see how I got on. I really like the service and when a permanent position came up I decided to take it”. Risk assessments were seen detailed in care records dealing with risks associated with manual handling and the activities of service users. Alne Hall Cheshire Home DS0000027956.V319448.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 and 9 Quality in this outcome area is good. Service users can be assured that their needs will be continuously assessed, that their decisions will be respected and that they will be able to improve their personal skills in a safe manner with the support of staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation of practice throughout the visit to the service confirmed that service users make their own decisions and choices. A group of volunteers, often from overseas, provide support to service users and one said “I look forward to meeting the volunteers, who are students from overseas, and learning about their culture”. A handover of information between shifts was observed which gave an update for each individual to staff taking over so that service users would have continuity of service. Care records examined confirmed good practice. Individual records set out the areas of support needed and the areas of personal development for individual service users. Care records were well organised so that complex information could easily be found by staff. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 10 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. Service users can be assured that their needs will be continuously assessed, that their decisions will be respected and that they will have opportunities to improve their personal skills in a safe manner with the support of staff and volunteers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records examined showed that a wide range of leisure activities are available to people who use the service, both within and outside the home. These included outdoor activities such as horse riding and involvement in local village events, and activities within the home are based within a purpose built activities room, a computer room and the ballroom. A music session was observed at the site visit which was well attended and the leader of the group involved all service users in the session. Pre inspection information detailed individual work with service users on literacy and numeracy skills. Service users were seen using the Internet to play backgammon and search information. The service has a number of overseas volunteers which one service user said he enjoyed, as this brought other cultures into the home. Service users have opportunities to influence the service at bi-monthly Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 11 meetings. Service users’ written comments said that they were able to do as they wished while at the home. Comment cards from service users reflected the flexibility of the service within the limitations imposed by the building and its location. “I like the fact that at Alne Hall I have been able to keep my pets, which has meant a lot to me and helped me to settle in”. One service user commented that they would like to go out more, but could only do so if this was offered. Other comments were that at evenings and weekends, there are fewer staff so activities are limited to what service users can manage for themselves, and another “a bit too quiet at weekends”. Lunch and tea was seen being prepared and served. Service users said they enjoyed the meals at the home, and were able to have an alternative to the main course offered, “You can say you don’t like it and you can get something else”. Staff and volunteers were seen assisting service users to eat during the meal on a one to one basis. The home’s dining room is spacious and light, and a pleasant place in which to eat which is suitable for the needs of service users. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 12 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 and 20 Quality in this outcome area is good. Service users can be assured that their health needs will be identified and met in a timely way and that their physical, social and emotional needs will be recognised and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users using the service have a range of physical disabilities and health conditions which require specific care in terms of nursing and medical intervention. Case records showed that the physical and health care needs of service users are recognised and addressed. One service user explained “they (the staff) noticed that I went to the loo a lot and through that it was found that I had diabetes, now that’s incredible”. Attendance by medical practitioners was recorded on case records, and records contained optical prescriptions and noted optical and dental appointments. Handover of information detailed medical or health issues affecting service users on the day. Medication was observed being administered. The procedure followed ensured the safety of service users and records seen were up to date. Any service user who wishes to self medicate have lockable facilities in their own room so that they can do so. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 13 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 and 23 Quality in this outcome area is good. Service users are able to make a complaint using information provided by the home and are protected by the awareness of staff of potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken with and written comments received from them demonstrated that they are aware of who to talk to if they had any concern or any complaint about their service. Several detailed that they would be able to talk with their key worker about anything they were unhappy about. Written information is available to service users detailing the home’s complaint procedure. Discussion with staff on duty demonstrated their awareness of how to protect vulnerable adults and what to do if they witnessed poor practice by others. One said that they had worked at the home for a number of years and knew all the residents and staff. The local authority’s procedure on what to do should abuse be alleged or suspected was available to managers and staff at the home, so that the proper action could be taken to protect service users. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 14 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): 24 and 30 Quality in this outcome area is good. While the building is not entirely suitable for people with physical disabilities, residents live in a clean and well maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The older part of the building has been adapted where possible to suit the needs of physically disabled people but it is not very suitable for the needs of people with physical disabilities. The newer part of the building is better suited to service users but bedroom space is limited, particularly for those service users who use wheelchairs. There is a recognition by the organisation that provision of improved accommodation would improve the service overall, and it has made efforts to seek a solution in re-siting the service to provide better accommodation, with no success. Staff spoken with said that they understood that finance had been set aside to make improvements to the buildings in the near future. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 15 General areas of the home were seen, some bedrooms and bathrooms and the home’s laundry facilities. All were clean and hygienic, the decoration was in good order and provided a homely setting in which to live. Adapted baths and shower facilities were seen which were fitted with ceiling track hoisting to enable service users to be assisted safely to use these facilities. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. Service users are supported by properly trained and supervised staff who have clear roles and responsibilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of staff files confirmed good practice in the recruitment and selection of staff. Proper checks had been made to ensure that service users are protected and robust processes in the recruitment of staff had been carried out prior to new staff starting work at the home. Copies of contracts of employment were seen on file, and “sensitive” information was held on files of individual staff with confidentiality. Training records supplied prior to the visit and staff files seen confirmed that staff received training in mandatory health and safety topics and have opportunities to undertake other training pertinent to their work. Training is in place for the different groups of personnel who work at the home. Nursing staff have opportunities to maintain their registration and keep their expertise current. The volunteer group have a programme of training to enable them to understand the issues of communication, disability awareness and protection of vulnerable people. Twenty seven care staff, including bank care staff and activities staff have achieved NVQ Level 2 or NVQ Level 3 in care. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 17 Staffing rotas supplied prior to the visit showed that staff are on duty at peak times of the day. Service users commented that they would like activities to be provided in the evenings and at weekends saying that activities staff work usually during the day and week. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. Service users can be assured that their views will be recognised and that they will have opportunities to influence the service being provided. Systems in place at the home ensure that the health and safety of service users is being addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with said that the manager of the home was a good leader. Service users said that they had been consulted about the proposed move of the service and that the manager had shared information about the proposal throughout the process. Service users were clear that “if there’s something I didn’t like, I would talk to Irene (the manager) or Ann (deputy manager)”. The registered manager is well experienced in running the home. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 19 The conduct of the service is monitored by a representative of the Leonard Cheshire organisation which ensures that a monthly visit is made to the service to check the views of service users and ensure that proper records are being made. The reports of these findings are sent to the Commission. Service users have opportunities to influence their service and have their views listened to by being engaged in the interviewing of new staff, meeting with the manager and staff at regular intervals. Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 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 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 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 21 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alne Hall Cheshire Home DS0000027956.V319448.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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