Inspection on 30/08/05 for Alpha House

This inspection was carried out on 30th August 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 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

Alpha House 16/05/07

Alpha House 07/12/06

Alpha House 21/12/05

Alpha House 05/01/05

Alpha House 25/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 ALPHA HOUSE 122 Halifax Old Road Birkby Huddersfield HD2 2RW Lead Inspector John Gregory Unannounced 30 August 2005 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. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alpha House Address 122 Halifax Old Road Birkby Huddersfield HD2 2RW 01484 422760 01484 422760 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) Valeo Ltd Mr Steven Garbutt (Acting Manager) Care Home - Personal Care only 3 Category(ies) of Learning Disability - 3 registration, with number of places ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 5th January 2005 Brief Description of the Service: Alpha House is a care home offering accomodation and personal care to three service users who have learning disabilities and behaviour that challenges the service. The accommodation is owned by Valeo Ltd a private limited company providing residential accommodation and domiciliary services in the local area. The accommodation consists of an end terraced Edwardian house operating over three floors .It is situated in a residential area a short distance from the centre of Huddersfield. All the service users rooms are single, one having en-suite facilities. There is a large living area and dining room. There are gardens to three sides of the property with a sitting area and small car park to the rear of the property. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The 5.5 hour inspection was unannounced and took place over the course of one morning in August 2005. Only those standards that the CSCI consider are central to the care process were inspected. A sample of the policies, procedures and records were assessed that were relevant to the standards inspected, and fuller processes were considered through two service users’ files. Four staff files were examined. One service user was seen, the other two were on a trip to the East Coast. One member of staff was interviewed. A brief tour of the accommodation was undertaken. The manager assisted the process of the inspection. The inspector would like to thank the staff and service user of Alpha House for their time, cooperation and hospitality during the inspection. What the service does well: 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. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 6 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 ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 7 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 & 2 Information about the home and its services is available for service users and interested persons, although some attention to this continues to be needed. Full assessments of service users’ needs have occurred but these are of uncertain date and authorship. EVIDENCE: The Statement of Purpose contained all the necessary information. The Service User Guide was held on the service users’ files. Whilst in many respects the document was adequate, it continues to need information adding on the details of the complaints procedure and details of the fees to be paid in order that the service users and their carers be informed of all the conditions operating in the home. The files examined contained a detailed assessment that was not dated or assigned to any individual. There was no evidence of whether the assessment was of recent authorship or whether it was subject to review. It was not possible to determine whether this was relevant to service users’ current aspirations. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 8 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 & 9 The risk assessments relating to service users were clear and remained relevant through regular review, however care plans should be broadened and reviews held more frequently. EVIDENCE: The newly developed care plans examined were relevant to the service users’ domestic care and routines but did not contain areas relevant to the service users’ social activity, family contact or health care. An annual review process was identified which involved persons relevant to the service users’ care and involved a comprehensive review of the service users’ care and progress. Evidence of a 6 monthly review of the care plan by home’s staff was seen on one file which does not meet the necessary standard and ensure that the care plan is kept relevant and up to date. The service users’ risk assessments were extensive and showed evidence of review thus ensuring that service users are supported to take risks. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 9 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, & 17 Work or relevant learning placements are not currently practical for service users due to the level of behaviour that challenges the service. Service users have a varied lifestyle through regular escorted activities. The enterprise is integrated into the local community. The service users have a varied diet. EVIDENCE: Evidence was available on file to support the staff view that the degree of behaviour that challenges the service presently precludes placement in work or in educational placements. This situation is kept under review via the risk assessment process. There was evidence in the daily records of service users going on trips singly or in groups to local places of interest and to do shopping. Two service users had chosen to go on a trip to the East coast on the day of the unannounced inspection. The service users have two holidays per year. The service users live in accommodation indistinguishable from houses in the local community, use the local shops and have good relations with neighbours. The menu was seen and was developed on a weekly basis and contained a ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 10 good range of food including the occasional take away meal. The main meals are taken with staff in the dining room. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 11 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) 19&20 The service users’ health care needs are met and supported by a medication process which protects them and needs only minor attention. EVIDENCE: There was evidence on file to support the view that service users have an annual review of their medical care. The care involves contact with the local primary health care team and other specialisms such as dental and optical care. Referral is made to specialist hospital consultation as necessary. The medication system was examined and records indicated that staff receive training in its administration. The medication was audited and found to be in order save for the need to record the carried forward figure of boxed medication on to the MAR sheet. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 12 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 & 23 The service provider has a complaints procedure which is not fully understood by staff. The service users are protected from abuse by policies, procedures, practices and the training of staff. EVIDENCE: The service provider has a complaints procedure and there have been no complaints recorded in the period since the last inspection. Interviews established some lack of clarity in understanding the procedure, a matter that could be rectified by training. The policies and procedures related to the prevention of abuse to vulnerable adults and staff understood whistle-blowing procedures and there was some evidence of their training in the area, thus ensuring service users are protected. There was evidence of the use of physical intervention on service users in line with the service provider’s policy. Staff had all received training in the area by a trainer who has training updated annually by training within the NHS. The service provider’s systems for the protection of service users’ money were examined, audited and found to be correct. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 13 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 & 30 The home was clean, tidy, basically furnished and well maintained. Attention is needed to the laundry area to ensure that the service is hygienic. EVIDENCE: A tour of the building showed it to be clean and tidy. It was furnished in a basic domestic style consistent with the challenging needs of the service user group. The laundry is in the basement and has commercial washing equipment fitted with sluicing facilities. The walls are of an impervious nature, however the floor is carpeted with an absorbent material which should be replaced by an impervious material. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 14 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) 32,34,35&36 The home is staffed during the day with a level of staffing consistent with the service users’ needs, however the nighttime staff needs re-evaluating. The home’s recruitment process does not fully protect service users. Training in areas related to the home’s specialism should be increased. The frequency of the formal supervision of staff should be increased. EVIDENCE: The rota was examined and staff confirmed that there are two staff on duty during the day time hours with an additional member of staff on duty in the middle of the day. At night there is currently only one sleeping–in member of staff with access to on call senior staff, despite incidence of the use of physical intervention during the day, behaviour that challenges the service. The staff files examined showed evidence of the absence of references on recently appointed members of staff and the absence of health declarations for longer serving members of staff, omissions that must be rectified in order to fully protect staff and service users. It was noted on file that staff receive training in matters related to physical care, health and safety, prevention of abuse and physical intervention. However, the anecdotal evidence given that staff receive a broader training related to the specialism of the home was not supported by the written evidence. There was evidence on file of a process to formally ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 15 supervise staff. This has not reached a level of frequency that would ensure the proper support and development of staff. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 16 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) 39 & 42 There is no recognisable quality assurance system working in the home which ensures that service users’ views are considered or that there any self monitoring or review of the home’s development. The home undertakes most of the practices and checks necessary to ensure safety in the home. EVIDENCE: Whilst evidence was seen of the minutes of the service provider’s business planning process and monthly reports, there was no evidence in the home of any quality assurance system which established the views of relevant stakeholders in a self- monitoring process which seeks to monitor and review the home’s development. The service provider undertakes routine checks of the fire alarm and emergency lighting. There was no evidence of a specific fire risk assessment or fire drills being undertaken in the home. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 17 There was evidence of routine health and safety risk assessments being undertaken. COSSH records were in place. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 18 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 2 2 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 1 x 1 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 ALPHA HOUSE Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 19 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 YA 32 Regulation 18 Requirement Timescale for action 01/10/05 2. YA 34 19 Schedule 2 3. YA 39 24 The service provider must undertake a risk assessment and produce an action plan to ensure that at all times suitabley qualified,competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. The service provider must obtain 01/10/05 the following information in respect of persons working in the care home. - two written references - a statement by the person as to their physical and mental health. The service provider must 01/01/06 establish and maintain a system for reviewing at appropriate intervals and improving the quality of care in the care home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 20 No. 1. 2. 3. 4. 5. 6. 7. 8. 9. Refer to Standard YA 1 YA 2 YA 6 YA 6 YA 20 YA 22 YA 30 YA 35 YA 42 Good Practice Recommendations The service users guide should include details of the complaints procedure and details of the fees charged. The service users assessments should be dated and signed. The care plans should be developed to include details of social activities,family contact and health care. The care plan should be reviewed every 6 months and include all persons relevant to the service users care as agreed with the service user. The carried forward figure of boxed medication should be written on the MAR sheet Staff should training in the management of complaints Laundry floor should be covered in impervious material. The staff should increased training in the area of Learning disabilities. The service provider should routinely undertake fire risk assessments and Fire drills. ALPHA HOUSE J51J01_S26303_Alpha House_V220862_300805.doc Version 1.40 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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. 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