Inspection on 21/06/05 for Alphin House

This inspection was carried out on 21st June 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 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 01/02/06

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 Mill Lane Alphington Exeter EX2 8SG Lead Inspector Rachel Fleet Unannounced 21 June 2005 09:25 hrs 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 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 D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alphin House Address Mill Lane Alphington Exeter Devon EX2 8SG 01392 251728 01392 493461 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) Devon County Council Kay Bainbridge Care Home 35 Category(ies) of OP Old age (35) registration, with number PD Physical disability (8) of places PD(E) Physical dis - over 65 (8) Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06 January 2005 Brief Description of the Service: Alphin House is a purpose-built Care Home, owned by the Local Authority, Devon County Council. It is in a quiet residential area of Alphington, approximately 2 miles from the centre of Exeter. Local amenities such as 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.The Home offers a mix of long-stay care, ‘short stay’ respite beds, and intermediate care (recoup) beds. 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 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. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited the home for seven hours. There were 32 residents at the home on that day. She met with 13 residents (speaking with eight in depth), one visitor, and two visiting health or social care professionals who also completed CSCI comment cards. All those spoken with were very happy with the overall care provided. She also spoke with three staff – who were positive about the Home - and the Manager, besides looking at care-related records and looking around the home. 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. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 7 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 standard(s) 6 Residents have appropriate professional assistance during their stay to help them return home. EVIDENCE: A visiting professional with responsibilities for residents admitted for intermediate care was positive about care given to them, and said there was good communication with the Home’s staff. Care records showed support from various community-based professionals. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 8 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 standard(s) 7, 8 & 9 Residents are well supported on a daily basis, by an individualised approach to care. There is a possibility that some needs will not be met or not met consistently, which might affect longer-term well-being. Improvements in medication systems ensure safer administration to residents; certain aspects could be further improved to add to this. EVIDENCE: Each resident had individualised care documentation, some being involved in reviews. There were good working relationships with district nurses, medical professionals, etc. Some more detail was needed in some care plans (especially for short-stay residents). Social histories, how needs were to be met (including those relating to diabetes), nutritional screening and risk of falls, for example. Written input by various external health professionals was highlighted to make it easier to follow their involvement. Residents said staff were attentive to their needs, and spoke of their key workers helping them in particular ways. An excellent new storage area has been created for medicines (including a new lockable drug fridge), with better systems in place for recording of Controlled Drugs. Fridge temperatures were monitored weekly at present; this should be more frequent, particularly now insulin is being stored. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 9 Expiry dates need to be monitored on items only used occasionally. One resident, who had been assessed as capable of taking medication unobserved, was seen to have breakfast-time medicines still in their room at lunchtime. Staff do not necessarily wait to see that residents actually take their medication, being guided by risk assessments. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13 & 14 Residents enjoy a good variety of activities, also benefiting from links with the community. They are enabled to take control of their daily lives where possible. EVIDENCE: A lively quiz took place while the inspector was at the Home. Residents described a range of activities they enjoyed – bingo, the ‘sing-along’ sessions, hairdressing day, sitting outside, outings to Dartmoor, etc. They said there was a regular church service held at the Home. Visiting professionals had very positive comments about the activities provided. A visitor was happy with the Home, a number being seen coming and going during the inspection. Residents said their visitors were made to feel welcome. Residents were given menu choices, with a choice of dining areas. And encouraged to suggest how things might generally be improved in the daily life of the Home. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 11 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 standard(s) 16 & 18 The home has a satisfactory complaints system, with residents feeling that their concerns or complaints would be listened to. Staff have appropriate attitudes and knowledge, to help ensure residents will be protected from abuse. EVIDENCE: Residents felt able to speak with staff if they had a concern or complaint. No complaints had been noted in the Complaints record book since the last inspection, although one was recorded in care records, which the Manager was fully aware of. No complaints were raised with the inspector during the visit. Eleven compliments were recorded since the beginning of the year, mostly from visitors/relatives. Residents were positive about staff. Staff spoken with had had training relating to protection of vulnerable adults, and described appropriate action to be taken should they witness any abuse. They said they would feel able to speak up in such circumstances, senior staff being supportive. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 12 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 standard(s) 19, 25 & 26 Residents enjoy and benefit from very good personal and shared facilities, kept to a high standard. Control over their environment would be increased if the occupant could control heating in bedrooms. EVIDENCE: Residents were happy with the facilities in their bedrooms, and said they were usually kept sufficiently clean. Rooms were personalised. One resident had recently been moved to a larger room so that there was enough room for carerelated equipment to be used properly. Bedroom doors can be locked, if residents choose to do so. Radiators do not have accessible individual controls. Toilets and bathrooms (including a shower room) had helpful aids and adaptations. Intermediate care staff gave advice as necessary. Several residents were enjoying the sunshine, seated outside during the visit. There is a variety of sitting areas within the Home. Care staff said they had adequate supplies of disposable gloves and aprons. Laundry areas were orderly, with machines that had appropriate programmes. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 Residents are looked after by caring and skilled staff, who benefit from good training opportunities. EVIDENCE: Residents who spent time in their rooms said staff popped in at intervals to see them, and that call bells were answered sufficiently quickly. They said staff knew what they were doing, and were patient and helpful. Staff spoken with felt staffing levels were usually appropriate for the current dependency levels at the Home. There are longstanding care staff vacancies at the Home, but a core of longserving staff also. Agencies supplying staff try to provide the same people each time, for continuity of care. One visiting professional observed that even when short-staffed, residents are treated with care and respect. One staff described appropriate induction processes for new staff. Staff had attended some specialist training, and an ongoing varied programme of training was seen – using outside agencies for this. They were able to describe how to meet certain care needs relevant to some residents the inspector had spoken with. One staff said they would request an update on a particular topic at their next supervision. One said they would like to know more about caring for people with low mood or depression. A visiting professional said staff were always willing to learn from them, and followed through any instructions or advice on care. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 Good systems are in place to include residents in the running of the Home, and to provide them with a safe place to live. Their financial interests were protected by the Home’s procedures for handling personal monies. Risk to staff safety remains, with regard to flooring in the laundry. EVIDENCE: Records, receipts, etc. were checked for three residents’ personal monies accounts, and were satisfactory. Staff described appropriate practices if shopping for residents. There is a three-yearly financial audit by the Provider. Residents said residents’ meetings were useful. The Manager is keen to address any issues raised by residents, staff or CSCI. Results of the last ‘quality of care’ survey were available in the entrance hall; inclusion of an action plan would further strengthen the Home’s Quality Assurance systems. The Residents’ Handbook seen in bedrooms included the most recent CSCI report. Residents confirmed they heard fire bells tested regularly. Fire safety checks were recorded at recommended intervals. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 15 Kitchen areas were well kept, with staff aware of how to get COSHH information if needed. An area of flooring in the laundry area still presents a tripping hazard (- having been noted on previous inspections) - mentioned by staff during the inspection when discussing health and safety generally. The Manager confirmed window restrictors were checked and recorded monthly by the handyman. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 2 Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 17 Yes 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 OP7 Regulation 15(1) Requirement Timescale for action 15 08 05 2. OP9 13(3) The registered person shall prepare a written plan as to how residents needs in respect of their health & welfare are to be met, including residents admitted for shorter stays. The registered person shall make 15 08 05 arrangements for the handling, safekeeping & safe administration of medicines received into the care home. This is with regard to daily minimum/maximum fridge temperature readings; and ensuring that wherever medications are left with service users that systems for monitoring taking of medication are robust. 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 OP7 Good Practice Recommendations You should include a risk assessment, with particular attention to prevention of falls, in each residents care D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 18 Alphin House 2. 3. 4. 5. 6. OP8 OP25 OP33 OP38 plan. You should include nutritional screening, on a periodic basis, in each residents care plan. Thermostats should be fitted to radiators in bedrooms, to enable residents to control the temperature of their room. You should include an action plan with Quality of care reports. You should ensure risks are as far as possible eliminated with regard to tripping hazards such as the flooring in the laundry. Alphin House D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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 D54 D06 S28741 Alphin House V229049 210605 stage 4.doc Version 1.30 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. 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