Inspection on 02/06/05 for Alne Hall Cheshire Home

This inspection was carried out on 2nd June 2005.

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 01/11/06

Alne Hall Cheshire Home 09/02/06

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 Alne Hall Cheshire Home Alne York YO61 1SA Lead Inspector David White Unannounced 2 June 2005 09:00 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 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 Stationary 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 J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alne Hall Cheshire Home Address Alne, York, North Yorkshire, YO61 1SA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01347 838295 01347 838941 N/A Leonard Cheshire Foundation 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 J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st November 2004 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 young adults with physical disabilities for up to 30 residents. 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. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. A brief tour of the home was made with the manager and a number of records were inspected. Three residents, one relative of a resident, a friend of a resident, four members of staff and the manager were spoken with. The case files of five residents were inspected including those of the residents spoken with. What the service does well: What has improved since the last inspection? What they could do better: The registered manager could complete the Institute of Leadership and Management Award by the end of the year. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 6 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. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 standard(s) 1 and 2. Residents and prospective residents of the service are fully aware of the care, facilities and services provided by the home, and can feel confident that their needs and aims will be understood by the staff and are met. EVIDENCE: The statement of purpose and the service user guide provide detailed information about the home and are concise and available for residents and their families or representatives. Prospective residents are sent a copy of the Statement of Purpose and Service User Guide so they have relevant information on which to base their decision-making. Prospective residents and their families are encouraged to visit the home prior to any decision being made about moving into the home and a trial period is offered for potential long term placements. The admission procedure is thorough and ensures that new residents are properly assessed and that staff are fully aware of their needs. The manager and/or care supervisor carries out the pre-admission assessment on prospective residents. Pre-admission assessment forms are supported by an initial assessment and care plan from the placing or funding authority where applicable. The case file of a newly admitted resident was inspected. The resident had been admitted for emergency respite care and the records showed that the assessment and care plan had been obtained from the placing authority prior to the home agreeing that they were able to meet the needs of the prospective resident. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 and 9. There is an improved care planning system in place to adequately provide staff with the information they need to satisfactorily meet resident needs. EVIDENCE: There have been some improvements made in the quality of the care planning documentation. Each of the five case files examined, including one of the most recently admitted resident contained a detailed and informative care plan. The plans focus on how residents wish for their personal support needs to be met and contain details of the resident daily living skills, interests and dietary needs. Risk assessments were in place covering a number of aspects of daily living and these focused on promoting independence, mobility and safety. One resident commented that “staff try hard to promote my independence” and other residents spoken with shared this viewpoint. Care plans are subject to regular reviews and encourage the involvement of the family and other health professionals in the review of care. Plans to re-develop the service are ongoing although it is envisaged that the current premises will be de-registered and that care will be provided in smaller community based facilities. This is understandably causing anxiety for some of the residents about the uncertainty of their futures. A small number of Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 10 residents have been to look at other premises within the organisation that are similar in physical layout to the proposed new premises. Residents have also been shown photographs of how the new premises may look. One resident felt that this had “reduced some of my anxieties”. The manager and organisation hold regular meetings with the residents and their families to inform them of progress updates. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15, 16 and 17. Residents enjoy a good lifestyle both in and outside of the home. The meals are good and offer both choice and variety to meet special dietary needs. EVIDENCE: The three residents spoken with enjoy a range of activities in and outside of the home. The home has a dedicated activities team who provide a number of activities to suit all resident needs. A number of volunteers also work at the home and participate in activities such as baking with residents. A number of residents have their own computer in their bedroom but there is also a designated computer room for all residents which has recently been updated so that residents can now access the internet if they wish to do so. Some residents access local college facilities for further education. One resident has recently received an award for “Senior Learner of the year” from the Regional Adult Learner’s Award scheme and the award was on show in her bedroom. The range of activities on offer is openly displayed on notice boards throughout the home and included information about trips and fund raising activities outside of the home. One resident has booked to go on holiday later this year. Residents are able to access the local amenities and facilities. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 12 Since the last inspection a new chef has been employed. Both residents and staff spoke highly of the chef’s abilities. One resident said that the “meals were vastly improved and there was always plenty of choice”. Another resident confirmed that food is always “served warm at the point of eating”. Specialist dietary requirements are met and liquidised meals are prepared individually. The chef is planning to meet with the residents shortly to review the menus having only recently started in post. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20. The personal and healthcare needs of residents are met well with good access available to specialist healthcare services when required. EVIDENCE: The individual care plans inspected contained detailed information about how all aspects of healthcare have been assessed and are to be met. Resident preferences in relation to how their care needs are to be met is clearly documented within the care plans. Residents were observed to receive support in a respectful and dignified manner and all the residents spoken with confirmed this. Residents commented that staff were “always polite and courteous”. Call bells were responded to promptly. All residents are registered with a GP. The home receives a visit from a GP at least weekly so that any medical matters can be attended to. Staff arrange access to services provided by chiropodists, dentists, opticians and physiotherapy as required. Individual plans contained information about visits from health professionals and their input. A number of residents required bedrails and care planning documentation included an assessment supporting the need for the use of bedrails and a signed agreement from the resident stating their consent to the use of bedrails. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 14 Proper medication procedures were in place. Three residents self-medicate and risk assessments had been carried out to support this. One resident who selfmedicates was able to confirm that their medication is kept in a locked drawer in their bedroom. A random check of the controlled drugs supply tallied with the records. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Good complaints and adult protection policies and procedures are in place and are well understood by staff to safeguard residents from abuse. EVIDENCE: Observation showed that staff had time to listen to residents and involved them in decision-making. A relative of a resident commented that the care was good and she was always made to feel welcome by the staff. There is a complaints procedure, which gives details about the stages and timescales of complaints and this information was included within the service user guide. Inspection of the complaints records showed that 2 complaints had been made to the home within the last six months and that proper investigation into the complaints had been undertaken and the outcomes made known to the complainants. Residents and visitors are aware of who they would need to go to if they wished to raise a concern or make a complaint. Staff spoken with have all undergone adult protection training which is also included as part of the induction programme. Volunteer workers in the home are also expected to attend adult protection training. The staff spoken with demonstrated a good understanding of what they would do if abuse was suspected. The registered providers have produced a clear statement and policy about their and their staff’s non-involvement in any resident’s financial affairs. Residents are encouraged to manage their monies until they are no longer able to do so. Some of the care staff have undertaken some recent training on the management of challenging behaviour. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 16 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 standard(s) 24 The standard of the environment is good giving residents a clean and homely place in which to live. EVIDENCE: The home is a detached house with all bedrooms on the ground floor. The premises were in good order and some re-decoration work has been carried out to bathroom and toilet areas, corridors and some bedrooms. The home has purchased additional overhead tracking and electric hoists to assist with the moving and handling of residents. The home is very clean and hygienic throughout. One resident and a relative commented that the maintenance of the home was well looked after. Requirements from fire officer and environmental health inspection visits have been met. New automatic closures on fire doors are to be installed shortly as agreed with the fire officer. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36. Good progress has been made in addressing the care and catering staffing issues that has resulted in both an improvement on staff morale and an improved service for residents. EVIDENCE: Since the previous inspection more permanent care staff and a new chef have been employed. Staff felt that the employment of permanent care staff had “eased the pressures on their time” and they felt “less stressed out”. This had a positive impact on the morale and general atmosphere of the home. A new chef had also been appointed and the residents spoken with all felt that the quality and choice of meals on offer had vastly improved since the chef’s appointment. Residents spoken with felt that the levels of staffing ensured that all their needs could be met. The organisation had very good training programmes and the majority of care staff had attained at least NVQ level 2. Statutory training was provided on a regular basis by the training co-ordinator and staff had undertaken specific courses related to the needs of the residents. One of the staff spoken with had recently completed some challenging behaviour training and felt this had given her better understanding of the impact of deteriorating illness on behaviour. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 18 Staff receive supervision on a two-monthly basis and this enables them to receive the support to be able to carry out their job roles. A recently recruited member of staff was spoken with and she confirmed that she had received induction on commencement of her post. The home has robust recruitment procedures. Three staff files were inspected including those of the mostly recently appointed members of staff one of whom had been employed from overseas. All the relevant information was in place to show that all the necessary pre-employment checks had been carried out prior to new workers commencing working in the home. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42. The home was well managed. Systems were in place to ensure that there is consultation with residents, families and staff about the performance of the service. Proper arrangements are in place to promote a safe and secure environment for residents in which to live. EVIDENCE: The registered manager is well experienced in running the home. She is due to complete the Institute of Leadership and Management Award. Residents, visitors and staff spoke in complimentary terms about the manager’s abilities. One resident said the manager was “always helpful and approachable” and all the people spoken with felt that they could go to the manager with any concerns and would be confident that any matters would be addressed. One resident said she had made a complaint to the manager and the complaints records confirmed that this issue had been dealt with appropriately in accordance with the organisation’s complaints procedure. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 20 Effective arrangements are in place to look at whether the home is meeting its aims. An audit of the service was due to take place within the next month and residents and relatives have been invited to take part. The manager had undertaken a survey of resident, relatives, health professional and other stakeholders the year previously but was aware of the impending service audit and felt that it would be unfair to bombard residents and relatives with similar requests for information from a repeat survey at this particular time. A representative of the organisation undertakes monthly-unannounced visits and a copy of their findings is sent to the Commission. Regular staff and resident meetings are held to seek their feedback and records of these meetings were available. Proper arrangements are in place for the promotion of a safe and secure environment for residents, staff and visitors. A number of satisfactory reports and certificates were seen relating to the premises. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 21 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alne Hall Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 22 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. 1. Standard Regulation None 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. 1. Refer to Standard 37 Good Practice Recommendations The registered manager should complete the Institiute of Leadership and Management Award. Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 Alne Hall J53_J04_S27956_Alne Hall_V227877_310505_Stage 4.doc Version 1.30 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!