Inspection on 01/02/06 for Alphin House

This inspection was carried out on 1st February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alphin House 15/01/07

Alphin House 21/06/05

Alphin House 06/01/05

Alphin House 12/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Alphin House Alphin House Mill Lane Alphington Exeter Devon EX2 8SG Lead Inspector Ms Rachel Fleet Unannounced Inspection 1st February 2006 10:45 X10015.doc Version 1.40 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 Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 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 Older People. 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. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alphin House Address Alphin House Mill Lane Alphington Exeter Devon EX2 8SG 01392 251728 01392 493461 kay.bainbridge@devon.gov.uk 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) Devon County Council Kay Bainbridge Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (8), Physical disability of places over 65 years of age (8) Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Alphin House is a purpose-built care home, owned by the Local Authority, Devon County Council. The home offers long-stay care, short stay respite care, and intermediate care. Intermediate care is provided for assessment stays or recuperative care, prior to an individual returning home or moving to a rehabilitation facility as appropriate. The home cannot accommodate anyone with nursing needs other than those that the district nurses can meet. The Home is surrounded by level gardens, with a patio area at the rear. Internally, there are three units: one on the ground floor and two on the first floor, each with its own lounge and dining room, bathroom and toilets. There is also a large ground floor lounge/dining room, which is also used for activities. The entrance foyer is used as the designated smoking area. There are wide corridors, with level access to all areas, and a passenger lift between floors. All bedrooms are for single occupancy only. Residents are encouraged to furnish and personalise their rooms. The main kitchen caters for the Home, a Day Centre, and a Meals on Wheels service. The home is in a residential area of Alphington, approximately two miles from the centre of Exeter. A Post Office, shops and village hall are within walking distance. There is a regular bus service from the main road into Exeter City Centre. A day centre has been built in the last year on the site, connecting to the home. This facility is not regulated by CSCI, and is run as a separate service. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was at the home for just over five hours for this unannounced inspection. She met with residents around the home, talking to ten of the 35 residents in some depth; she also spoke with four staff besides the manager, and looked at documentation – including four care plans with associated records, for case-tracking purposes. CSCI comment cards were returned by 12 residents and five visitors/relatives. Standards that were met at the last inspection have not been re-inspected on this visit. The report from that inspection, carried out on 21 June 2005, should therefore be read along with this report, for fuller information. What the service does well: What has improved since the last inspection? Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 6 Care planning systems have been reviewed, and those seen had good amounts of well-presented information to guide staff as to how they should meet residents’ needs. Assessments for risk of falling and nutritional screening had been included. Minimum/maximum temperatures of the drug fridge are monitored daily. Monies have been set aside to replace damaged flooring in the laundry. ‘Quality of care’ reports include action plans to address any issues raised. 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. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents’ needs are fully assessed to ensure the home can meet their existing needs should they be admitted to the home. EVIDENCE: Care notes included pre-admission assessments of needs carried out by community professionals (- usually social workers). The home manager also goes to meet prospective long-stay residents in their current home, to assess their care needs. She said individuals are often already known to the home, having stayed there for respite care. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 There is an individualised care planning system in place, which informs staff well about residents’ needs. The health needs of residents are generally well met, with evidence of good multi-disciplinary working taking place. Residents’ rights to respect and privacy are generally upheld. EVIDENCE: All comment cards from residents said they felt well cared for. The five comment cards from visitors said they were satisfied overall with the care provided. Care plans detailed how staff should meet residents’ various needs, in ways appropriate to that resident, including for short-stay residents. Recent reviews had been carried out. The recording system has been newly introduced; care needs to be taken to ensure reviews evaluate the sufficiency of care planned and given. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 10 There was monitoring of nutritional needs evident in care records, and residents confirmed they were weighed regularly. Infection control measures and physiotherapist input were noted in some. Records were kept of medication received and disposed of. Variable doses were noted when administered. Controlled drug stock levels tallied with records where checked for three medications. Medication dispensed by staff was seen in one bedroom some hours after the resident should have taken it. This issue had also been raised at the last inspection. Most residents spoken with felt staff were respectful, and their privacy was respected; one said other staff sometimes came to talk to their carer when the resident was having a bath. Of 12 comment cards from residents, 11 said their privacy was respected; one said ‘sometimes’. The five comment cards from visitors said they could visit residents in private if they wished to. During the inspection, residents waited in their own room to see the District nurses. Staff were seen delivering residents’ post to them unopened. Staff were friendly but respectful during the inspection, when attending to residents. Preferred form of address was recorded. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The diet provided is adequate, with residents’ views influencing the catering service. EVIDENCE: All residents spoken with said the food was good or acceptable, and that they had sufficient choice regarding meals. Of 12 comment cards from residents, nine said they liked the food and three said ‘sometimes’ (although these individuals also indicated they did not wish to raise this with an inspector). There are several dining areas. The atmosphere in these at lunchtime during the inspection was relaxed but organised. Meals could be taken in residents’ rooms if they wished it. Menus had been discussed at a recent residents’ meeting, with seasonal changes made subsequently; a staff spoke of other requests made at residents’ meetings, relating to catering arrangements, which were also followed up by the home. Provision of teapots, for example. Weekly menus looked balanced, being mainly traditional English food, and with the main meal planned for lunchtime. A snack and hot drinks were available during the evening. Staff had no concerns about food provided. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The core standards were met at the last inspection. EVIDENCE: Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25 Residents live in comfortable surroundings suited to their needs. The core standards were met at the last inspection. EVIDENCE: Residents were satisfied with the temperature and lighting in their rooms, one saying the home had appropriately sorted out a recent problem with the heating in their room. Radiators had individual temperature controls. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 29 Residents are cared for by a competent staff team. Robust recruitment practices help to protect residents by ensuring they are cared for by suitable staff. Other core standards were met at the last inspection. EVIDENCE: Residents were generally positive about staffing levels, staff skills, commenting they knew what they were doing and that they were cheerful. Two felt there had been fewer agency staff employed recently. Staff confirmed there was consistency in agency staff supplied. One resident, who was very positive about the home, felt the home was short of staff but that the staff did their best. The manager confirmed there are some staff vacancies, but these are fewer than on the previous inspection. There is a good training programme, with input from community-based NHS trust professionals. Staff were positive about these training opportunities; one said supervision sessions included discussion of any training needs. The pre-inspection questionnaire indicated 50 of staff have a Care NVQ2 or higher. Three staff files were seen and all contained required information. A new staff described how their application to work at the home had been dealt with, evidencing that the home had followed good recruitment procedures. They had shadowed other staff during their induction period. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38 Residents and staff benefit from the experience and skills of the manager. The home is run with the residents’ interests at heart. Good systems are in place to promote the health and safety of residents and staff. Other core standards were met at the last inspection. EVIDENCE: The manager Kay Bainbridge has been in post for eight years. She achieved the Registered Managers Award in 2004. Since then she has undertaken training that will allow her to train staff in safeguarding / protection of vulnerable adults. Residents felt the home was well managed, and said they saw the manager regularly, one describing her as ‘helpful’, another saying they Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 16 could see her if they wanted to. Staff said senior staff were always available to advise or support them. A staff said the manager often reminded the staff “ the residents always come first”. Two residents felt able to say something to staff if ever they had a complaint. Results of a ‘quality of care’ survey, with an action plan, have recently been produced. These showed that the home takes all comments seriously and plans to address any issue raised, even if only expressed by one individual. Residents and staff spoken with had no concerns about safety or hazards at the home. And all comment cards from residents said they felt safe at the home. Pre-inspection information provided by the home showed maintenance checks and servicing were up-to-date. The fire log had records of safety checks and testing at recommended intervals. Fire exit routes were clear where checked. Nearly half of the staff have a first aid qualification. Damaged laundry flooring is being replaced within three months. Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X 3 X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13(3) Timescale for action The registered person shall make 15/03/05 arrangements for the safekeeping and safe administration of medicines received into the care home. This is with regard to ensuring that systems for monitoring taking of medication are robust. Requirement 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 Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Alphin House DS0000028741.V273688.R01.S.doc Version 5.1 Page 20 - 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!