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Inspection on 08/04/05 for Alphington Lodge Residential Home

Also see our care home review for Alphington Lodge Residential Home for more information

This inspection was carried out on 8th April 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.

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

What the care home does well

The care provided in this home helps make sure residents feel safe and is provided in a way that residents like. Residents confirm that they are given choice in their daily lives and that staff are caring people who know how to do their jobs properly. The home provides comfortable, well-maintained accommodation.

What has improved since the last inspection?

A system for recording complaints is now in place.

What the care home could do better:

Record keeping and recording of care plans could be improved. Recruitment procedures should be more closely followed.

CARE HOMES FOR OLDER PEOPLE Alphington Lodge 1 St Michaels Close Alphington Exeter EX2 8XH Lead Inspector Stephen Spratling Announced 08 April 2005 09:30 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. Name Version 1.00 Page 3 SERVICE INFORMATION Name of service Alphington Lodge Address 1 St Michaels Close, Alphington, Exeter EX2 8XH 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) 01392 216352 Nicola Hitchcott, Anna Hitchcott Susan Reynolds Care Home 28 Category(ies) of OP Old age (28) registration, with number of places Conditions of registration Date of last inspection NO 02 November 2004 Brief Description of the Service: Alphington Lodge is a period property with large level gardens and an enclosed courtyard. It is situated in the centre of the Alphington within short walking distance of local shops, church, pubs and health centre. The home is registered to provide accommodation and personal care to up to 28 older people. The accommodation comprises the main building, which has three floors, all served by passenger lift and a cottage annexe with two groundfloor rooms. All rooms provide single accomodation, 14 are ensuite. The home has three pleasant lounge/dining areas. Name Version 1.00 Page 4 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced with seven weeks notice. During the day the inspector spoke with 11 residents, 4 visitors, 5 members of the care staff, the manager and the homes accountant. He looked at the lounges, corridors, some of the bathrooms, some of the bedrooms and around the garden. The inspector also looked at some of the records kept by the home including those written about people living at the home (assessments/care plans etc). The inspector has also received CSCI comment cards from 2 residents and 4 relatives of people living at 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Name Version 1.00 Page 5 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 Name Version 1.00 Page 6 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) 3 & 5 The homes assessment process is thorough and ensures that it is able to meet residents needs. Residents have sufficient information about the home to help them make a decision about moving in. EVIDENCE: Before people move into the home detailed assessment information about the care they need is gathered to ensure that the home can care for them properly. Residents files contain assessment information provided by nurses, care managers and information gathered by the home staff. Residents confirmed that they are asked about the help they need. Residents, visitors and staff spoken with confirmed that people are welcome to visit the home, spend the day and have a meal, more than once if they wish, before deciding to move in. Name Version 1.00 Page 7 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, 9 & 10 Care planning arrangements go some way to ensure that residents needs are met, but some improvements are needed. The homes assessment of residents wishing to manage their own medication potentially put residents at risk. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Care plans are available, show evidence of review and provide limited description of how residents needs should be met; one care plan seen said that the resident needed catheter care but did not describe how or how often that catheter care should be done. No risk assessment had been completed regarding one resident who had chosen to administer their own medication but a format was shown to the inspector which the manager indicated she plans to implement. Staff know that they must treat residents with respect and that some people prefer to be spoken to in a more formal way than others. Residents and visitors say that staff are kind, polite and patient. Name Version 1.00 Page 8 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 & 15 Residents are supported to live as they wish, spending time where they want to and with whom they want to. Visitors are made welcome at the home. Suitable activities are available. Good food is provided and eaten where residents choose. EVIDENCE: Residents said that they are able to spend time where they wish and that there are suitable activities regularly laid on, which they can attend if they want to. The homes statement of purpose makes clear there are no restrictions on visiting. Visitors were seen coming and going freely from the home, visitors told the inspector that they are free to visit without prior appointment and always made to feel welcome; residents confirmed this. Every person spoken with said they like the food indicating it is often good and sometimes very good. Residents were served meals either in their rooms, at their armchairs or around small tables in the lounge/dining areas depending on their personal preference. Name Version 1.00 Page 9 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 Complaints and concerns are listened to and prompt action taken. Measures have been taken to protect residents from abuse. EVIDENCE: The complaints procedure is on display in the entrance hall of the home. Four of five relatives completing CSCI questionnaires said they are aware of the complaints procedure. All residents and visitors asked about complaints indicated that they would feel able to speak to staff or the manager if they had a concern/complaint and be confident that they would be taken seriously. Three staff who spoke with the inspector said they and received guidance about the recognition and reporting of abuse and all three were aware of the homes whistle-blowing policy; all five staff spoken with displayed positive and respectful attitudes to residents. Name Version 1.00 Page 10 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 & 26 The home provides a clean safe and well maintained environment for residents. EVIDENCE: All areas of the home seen were pleasantly decorated and clean. Residents and visitors confirmed that the home is always kept clean and free from unpleasant smells. Name Version 1.00 Page 11 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 & 29 Enough staff are employed to ensure residents needs are fully met. Recruitment procedures are in place but are not sufficiently robust to maximise protection of residents. EVIDENCE: Residents told the inspector that they never have to wait long for help and that staff do not rush them, many praised staff for their kindness and commented that they think the staff work very hard. All visitors spoken with said that there are usually enough staff on, four of five relatives completing CSCI questionnaires said there are sufficient numbers of staff on duty. Care staff said that they feel able to do their work properly without rushing; saying that sickness of colleagues sometimes leaves them short but that cover is provided on these occasions, when possible. The inspector looked at the recruitment files for three members of care staff, two showed that pre-employment checks had been completed before carers started work the third contained all the required information but dates on the Criminal Records Bureau check showed that it had been received after the carer had started work. Name Version 1.00 Page 12 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) 35, 37 & 38 There are systems in place to ensure service users financial interests are protected. Some of the record keeping needs to be improved. The Home pays proper attention to health and safety. EVIDENCE: The inspector checked the money held by the home on behalf of two residents against the account kept; this was accurate with deposits and withdrawals signed by two people. This money is kept securely. The manager does not act as appointee for any of the residents. It was not possible clearly identify who had completed residents daily care record sheets as they were not signed. Name Version 1.00 Page 13 The fire log book indicated that alarm and equipment checks are being carried out as recommended by Devon Fire and Rescue Service; staff confirmed that they receive regular training about moving and handling, first aid, infection control, health and safety. Name Version 1.00 Page 14 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x 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 x x 3 x 2 3 Name Version 1.00 Page 15 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 YA29 Regulation 19 (1) Requirement The registered person must not employ a person to work in the care home unless.. he has obtained in respect of that person all the information and documents specified in paragraphs 1 to 7 of schedule 2 (Criminal Records Bureau checks must be received before staff start work where exceptions are made Department of Health Guidance must be followed) Timescale for action 08/04/05 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 7 Good Practice Recommendations Service users plans should set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. Risk assessments should be completed and acted upon to minimise risk when residents wish to self administer medication. 2. 9 Name Version 1.00 Page 16 3. 37 Individual records should be properly maintained (signed/dated) Name Version 1.00 Page 17 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 Name Version 1.00 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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