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Inspection on 14/10/08 for Alne Hall Cheshire Home

Also see our care home review for Alne Hall Cheshire Home for more information

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People who live at the home say that they feel the home is well run and that they have a say in the running of the home. People are encouraged to be involved in the planning of their care and to make choices. People were observed throughout the day being supported to make decisions and planning what they would like to do. Staff are well trained and feel that they are well supported by the management of the home. People say, "The staff are good and spend time listening to me, I can choose what I want to do and feel that there is alot going on." The range of activities at the home is good and the staffing and volunteer levels ensures that people have a greater range of choices to participate in individual and community activities. Relatives feel the home provides good care, " Alne Hall cannot be praised enough for the care and attention they give to my daughter" Staff are well trained and feel that they are well supported by the management of the home.

What has improved since the last inspection?

There were no previous requirements and recommendations from the last inspection visit.

What the care home could do better:

Care plans are comprehensive and provide good detail but must be updated regularly to make sure that important needs are not overlooked. Recruitment of paid staff is robust and important checks are undertaken, the recruitment of volunteers however was not safe and important checks had been overlooked. It is important that recruitment checks are completed before staff or volunteers commence work at the home.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Alne Hall Cheshire Home Alne Hall Cheshire Home Alne York North Yorkshire YO61 1SA     The quality rating for this care home is:   two star good 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: Linda Trenouth     Date: 1 4 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 27 Information about the care home Name of care home: Address: Alne Hall Cheshire Home Alne Hall Cheshire Home Alne York North Yorkshire YO61 1SA 01347838295 01347838941 alne.hallgeneral@lc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Irene Smith Type of registration: Number of places registered: Leonard Cheshire Disability care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: 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 Date of last inspection Brief description of the care home 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 twenty-eight 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 Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 5 25 Brief description of the care home 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. Care Homes for Adults (18-65 years) Page 5 of 27 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: two star good 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 2 stars. This means the people who use this service experience good quality outcomes. We visited the service over one day for approximately 6 hours. The inspection also included gathering information and evidence before and after the visit to decide the overall judgment. We looked at the records, watched staff working, and talked to people who live at the home. We also looked around the building to see that the home was safe and well maintained. The main purpose of this inspection is to make sure that the service provides a good standard of care. Care Homes for Adults (18-65 years) Page 6 of 27 We sent comment cards to people who use the service and to staff, to give them the opportunity to comment on the service. The manager of the home completed a self-assessment form called an AQAA, which is information we ask for every year and is used as part of the inspection process.The returned self-assessment documentation provides information about staffing and people who use the service. Feedback was given during the inspection to the manager and requirements and recommendations made during this visit can be found at the end of the report. The last key inspection of this service was completed on the 1st November 2006. 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 27 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 27 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. People are told what the service can provide and have their needs fully assessed so everyone can decide if the home is right for them. Evidence: The service user guide is written to meet individual communication needs. This is important so that people could understand what the home can provide for them and what to do if they are not happy. The manager makes sure that the individual information about a persons needs is collected from all available sources. From this information the service can decide if they can meet individual needs. The records seen confirm that assessments are always undertaken. People are supported to visit and are invited to stay to get to know the home better. People are given good opportunities to try out the home. This is important so that they know the home will be right for them. Care Homes for Adults (18-65 years) Page 10 of 27 Care Homes for Adults (18-65 years) Page 11 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to be involved in important decisions in their lives. Evidence: Everyone has a person centered plan, this is important to make sure that people are central to all decisions made about their lives. These plans look at all their individual needs in good detail and give clear instructions to staff. Some care plans however are out of date and reviews are not held frequently enough. This can mean that important needs may be overlooked. People say that the staff involved them in day-to-day decisions and that they contribute to house meetings and other meetings held at the home. People tell us that they feel able to raise any concerns about the home with the staff and the manager. Daily records and observations at the visits show that people are able to make many choices and decisions in their daily lives. People have clear risk assessments in areas such as moving and handling, epilepsy Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: and certain activities. This is important to make sure that people enjoy a fulfilling life with minimal risk. Care Homes for Adults (18-65 years) Page 13 of 27 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. People enjoy a fulfilling life both in the home and the wider community. Evidence: People enjoy a fulfilling life both within and beyond the home. They have their own individualized bedroom where they can spend time relaxing and enjoying their hobbies and interests. People have a wide variety of daily activities offered with full time activity staff available during the week. They participate in both individual and group activities due to good consistent staffing levels. Staff support people in their choice of activities such as art, baking, music appreciation and healing massage. Other activities include going to the cinema, the races, railway museum, boat trips, local places of interest, pub lunches and local organized events. They also have pets visit the home including a pat a pet dog and a donkey. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Birthdays are always celebrated, one person recently celebrated her 70th birthday with a party at the home and then went on to enjoy a visit to, the last night of the proms. Staff say that we try hard to enable people and encourage them to be involved in activities People say that there is a multi sensory room which they like to use to relax. Some people enjoy spending time in their rooms. There are however many activities on offer at the home. People say, the opportunities for outings are very good both for pleasure and shopping Relatives tell us, The home provides a friendly and open environment. There is always some event or activity happening, the home has a good social spirit. Staff provide one to one support in activities such as fishing, horse riding and visiting sports events. Staff say that everyone is helped to choice what they want to do from day to day and supported in the activity of their choice. Staff feel that it is important they enjoyed the local wider community and there are vehicles available at the home to provide transport and some individuals have their own vehicles which staff can drive. People are also assisted to choose and plan a holiday of their choice and staff accompany them on the holiday. One person said, the staff provide opportunities for holidays of your choice People also also enabled to be religiously and politically active. People say that the food is good and they are very happy with their chef, comment cards stated that the food had improved with the introduction of the new chef. the food has improved oodles and the food is very good and there is a good choice currently we have a really good chef Care Homes for Adults (18-65 years) Page 15 of 27 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’s health needs are supported and met. Evidence: People using the service have a range of physical disabilities and health-related conditions some of which require specialist nursing care. The review of the case records provided evidence that individual health-care needs are assessed. People were supported with other areas of their health including Chiropody, Optical, Dentist and Speech Ttherapy. Any recommendations made from other health care professionals were included in the individuals care plan. Comment cards received confirmed that there were some concerns about the lack of physiotherapy. The manager explained that this has recently been withdrawn by the service as the Health Authority is responsible for its provision. All people requiring physiotherapy have now been refereed for assessment. People told us that they felt well cared for one person said, Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: The staff take good care of us one relative said, Alne Hall cannot be praised enough for the care and attention they give to my daughter. the staff always have her welfare at heart The local GP visited the home during the inspection and confirmed that the relationship with the home was good and felt that the staff always asked for the surgerys support promptly. People had other areas of their health support including Chiropody, Optical, Dentist and speech therapists. Any recommendations from other health care professionals was include in the individuals care plan. Care Homes for Adults (18-65 years) Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service and their relatives feel confident that their concerns will be acted on properly and procedures are in place to safeguard people from harm. Evidence: People say that they know how to make a complaint or raise concerns at the home. Relatives also say that they are aware of the complaints procedures. Importantly people feel able to talk to staff and the manager about any area of concern they have. They do this individually on a day-to-day basis and have the opportunity to talk at house meetings, which are held regularly. The service manages peoples monies responsibly with clear accountancy and auditing checks. Staff confirmed that they have completed training in adult protection. Staff also have regular supervision and there are regular meetings to discuss care practice and issues within the home. Staff say that they feel people are well protected at the home and they have a good understanding of their responsibilities to protect vulnerable people. Care Homes for Adults (18-65 years) Page 18 of 27 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. People live in a clean and comfortable home. Evidence: This was an unannounced visit and the home was found to be reasonably decorated, well maintained and clean throughout. Lounges and the dining room are comfortable and furniture appropriate for the needs of people living at the home. Bedrooms are personalized and decorated to suit individual tastes. People have a key to their room if they wish. These areas are well maintained and redecorated as and when required. The home as a well-kept garden and patio area where garden furniture is available. One person said, the gardens are lovely and are well maintained. There is also a separate conservatory available for those people who wish to smoke. All other areas of the home are smoke-free. New boilers have been fitted at the home and new carpets where required, and new Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: bedroom furniture is being fitted in all bedrooms. Sixteen bedrooms have been refurbished with new carpets and curtains. There is an adapted kitchen for people to use, which has adjustable surface heights. There is good provision of mobility and disability equipment throughout the home to make sure people are helped in a safe way and to enable their independence. Care Homes for Adults (18-65 years) Page 20 of 27 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. People are supported by properly trained and supervised staff who have clear roles and responsibilities. Recruitment of volunteers must however be robust to make sure that everyone is safe. Evidence: Staff are safely recruited and rigorous checks are made. Staff undertake good induction training and transfer onto NVQ training. Training records confirmed that staff also undertake mandatory and specialist training they require to safely meet peoples individual needs. The manager says that the recruitment of new staff is almost complete and that staffing levels have improved at the home. Volunteers are also provided at the home both local and international. Their records were reviewed and concerns were expressed about the lack of appropriate recruitment checks. Some essential checks had not been undertaken which could mean that people are unsafe to work at the home. Volunteers however do have good induction training and undertake other training Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: relating to their work. Both staff and volunteers have regular supervision and access to meetings. Staffing rotas reviewed showed that staff are on duty at peak times during the day and staffing levels were good. Care Homes for Adults (18-65 years) Page 22 of 27 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. The home is well-managed. Evidence: Staff say that the manager is approachable and listens to any concerns that they may have. People who use the service said that they are frequently consulted and given information about any day-to-day changes. They feel able to talk to both staff and the manager about any problems or concerns that they have. Relatives comments include, this service is as good as it gets and Alne Hall cannot be praised enough There are regular meetings held for people who live at the home, staff and volunteers working at the home. This ensure that everybody has an opportunity to express their Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: views and is involved in the decision-making. The manager conducts her own audits of the home and the area management have a representative who visits every month producing a report of their findings. These reports were available and provided evidence that the service is constantly reviewing the quality of service it provides. Health and safety is also well managed with the manager and staff making sure that the home is kept safe for everyone in the home. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 25 of 27 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 6 12 The care plans must be evaluated regularly and reviews held at a minimal of every 6 months. This is to make sure that important needs are not overlooked. 27/12/2008 2 34 19 Recruitment policies must be 29/12/2008 adhered to for all staff and volunteers. volunteers m Volunteers must have the same rigorous employment checks as employed members of staff. 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 Care Homes for Adults (18-65 years) Page 26 of 27 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 © (2008) Commission for Social Care Inspection (CSCI). 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