Inspection on 22/05/06 for Alpine Care Home

This inspection was carried out on 22nd May 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

Alpine Care Home 09/11/09

Alpine Care Home 17/09/07

Alpine Care Home 15/11/05

Alpine Care Home 28/04/05

Alpine Care Home 23/02/05

Alpine Care Home 19/05/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Alpine Rest Home Alpine Rest Home 10 Bradbourne Park Road Sevenoaks Kent TN13 3LH Lead Inspector Mrs Ann Block Unannounced Inspection 22nd May 2006 09:40 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 Alpine Rest Home DS0000023925.V294856.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. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alpine Rest Home Address Alpine Rest Home 10 Bradbourne Park Road Sevenoaks Kent TN13 3LH 01732 455537 01732 455537 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) Mrs Jane Chandra Mangalem Rajamogan Mr Kanagaratnam Kernal Rajamogan Mrs Susan Mary Barth Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of one service user with a learning disability is restricted to one person whose date of birth is 12/04/1932. 15th November 2005 Date of last inspection Brief Description of the Service: Alpine Rest Home is a care home providing personal care and accommodation for thirty older people. Mr. and Mrs. Rajamogan own the home, which is situated in a residential area of Sevenoaks. The town centre, with the usual amenities, is a bus ride from the home. There is a main line railway station half a mile away. The house is a large detached property with parking to the front and a garden to the rear. Accommodation for residents is over two floors accessed by a lift. There are eighteen single and six shared rooms. One of the shared rooms has an en-suite bathroom. There are two large lounges, a dining room and a visitors’ room with bathrooms and toilets on the first and second floors. At the time of writing this report, fees ranged from £316 to £400. Alpine Rest Home employs care staff, working a roster, which gives 24-hour cover. Ancillary staff includes two cooks, a kitchen assistant and domestic staff. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection was carried out by Ann Block, regulatory inspector with an unannounced site visit to the home between 9.40am and 6.10pm on Monday 22nd May 2006. During the process residents, the manager and staff agreed to speak with the inspector both privately and in groups. Three clients were case tracked which included talking with the resident where possible, talking with staff involved in their care, looking at associated records and observing practice. A tour of part of the home was made. At the time of writing this report, no survey forms or pre inspection questionnaire had been returned to the commission, information from these will be used to assess the service at the next key inspection. Feedback was provided to the manager during and at the end of the site visit. Overall residents are very happy in the home, they feel they made the right choice to come there. One had been quite worried about moving area and coming into a new home but had settled in easily. She agreed that her son was right when he said he had found ‘a lovely home for her which would suit her’. One resident was quite vocal at the lunch table in her praise for the home and in particular the staff and manager. One resident said ‘I like some staff better than others but they’re all good’. What the service does well: Alpine Rest Home is particularly good at accommodating people with problems in addition to older age. The service has a good working relationships with local placing agencies who offer a support network. Residents are treated as individuals with the dignity, rights and respect due to older people. Written care plans support staff’s sound understanding of each person. Health care is well managed and tailored to the individual. Aids to mobility and safety are provided as necessary. Residents can follow their own pursuits and activities, having a range to choose from. They can maintain contact with friends and family and know such people will be welcomed to the home. Home cooked and well presented food is provided with dietary needs met. Residents have opportunities to talk about the service and if necessary, make a complaint and be listened to. Alpine Rest Home offers a homely and comfortable environment which is well maintained. Residents have their needs met by staff who residents think are kind and caring, who enjoy working at the home and providing a good standard of care. Servicing of supplies and equipment is carried out. The proprietors take an active interest in the home and invest money to provide residents with a good quality of life. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 6 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. Alpine Rest Home DS0000023925.V294856.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 Alpine Rest Home DS0000023925.V294856.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): 1,2,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can make a choice whether Alpine Rest Home will be suitable for them through a sound admission process. EVIDENCE: A statement of purpose and service users guide is available to residents and families. As some residents are not particularly interested in the formalities of moving into the home, families may be provided with information and look round the home on the residents behalf. Similarly with contracts/statement of terms and conditions. Some will be issued to residents, others to their representatives. Detail of the contract was not explored at this site visit. Residents felt the home had come up to their expectations and they felt they were receiving value for money. The service prides itself on being inclusive, the manager said she would properly consider all applications regardless of race, sex or disability. The Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 9 assessment process would identify whether individual needs could be met. The home has a good relationship with placing agencies, including Darent House who have commented that ‘Alpine Rest Home is very good at taking people who no one else will take’. Many successes have been with residents who have suffered psychological trauma during their lives which leads them to have mental health problems such as ongoing depression. Part of the admission process for such residents is to ensure prompt on call and support systems are in place. Pre admission information as part of the assessment process variously includes information from family, care managers, health specialist and the manager’s own assessment. The admission process for one resident case tracked had included appointing a link carer who worked with the client between Darent House and Alpine Rest Home, with regular days spent at the home to smooth the transfer process. Trial periods are provided, the length will depend on the complexity of the settling in process. A care file included evidence that a review had been carried out during the trial period. One resident had come for a period of recuperation following an operation, she had made the decision to return home but said if she did decide to come into residential care permanently she would certainly consider this home. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 10 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): 7,8,9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are recognised as individuals who are treated with respect and dignity with their own hopes and aspirations set out in their care plan. Small improvements in recording would better evidence this process. EVIDENCE: Alpine Rest Home is particularly good at meeting individual needs as far as possible within a residential home. Residents and staff accept the differing personalities of each person, a number mentioned how both staff and residents supported those with special needs. Staff have an excellent understanding of individuals as demonstrated during the handover process, often shown by the way in which needs are anticipated, thus reducing anxiety. Each resident has a care plan which concisely records detail about the person as confirmed in conversations with residents and through observation. Daily records are held which less well evidence activities of daily living. Care plans are reviewed and signed by the resident where possible. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 11 Records of residents’ daily lives substantiated that health care is well met with appointments made for specialist and ancillary health care. Records include any specific health problems which staff said would be monitored. The medical record is very good as it gives clear detail of changes in a condition, relevant dates and can be easily shared with medical staff on a need to know basis. Residents spoke of having chiropody, dental, optical, physiotherapy and district nurse visits in house. Staff spoke highly of the district nurses and how supportive they were of the client group. Residents may either register with a general practitioner or keep their own if moving locally. Medication is administered by monitored dosage system as far as practical using a secure drug trolley. Practice includes confirming medication administration with professionals if there is a query. Records are held to evidence that medication has been administered as per prescribers’ directions to the correct person. Staff administering medication have had safe handling of medication training. Specific health practices are demonstrated to key staff by the district nurse as required. Specialist services such as the dietician are contacted and will carry out an assessment with suggestions made to improve quality of life where possible. Residents spoke very highly of the staff team and felt that staff treated them with respect. They spoke of situations where their privacy was maintained. One resident said she was able to choose whether to have her door open or closed and that staff always knocked before they entered. Residents are asked by what name they want to be called and this is used consistently. A resident appreciated having time by herself to relax in the bath but having staff to help her get in and out. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 12 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): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a setting which recognises them as individuals with the right to exercise control over their lives, who they see, what they eat and what activities they want to do. EVIDENCE: Residents move into Alpine Rest Home knowing the nature of the service, that it is homely, fits into the local area, friendly and with a ‘family’ feel. Residents considered the home to meet their expectations of such a service, commenting particularly on the friendliness of the staff. As already mentioned, a particular strength of Alpine Rest Home is the manner in which residents are treated as individuals with their individuality respected. Residents spoke of how their personal preferences were met and this was confirmed in practice, such as times of getting up and going to bed and time of day to have a bath. One person said she preferred to remain in her room where she liked to read or watch TV in private. Staff knew this was her choice and took her meals and drinks up to her, making sure they responded to her call bell promptly. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 13 The home has a budgie and a cat. One resident had always loved animals and was seen to have a great affection for the cat who, by rolling over to have her tummy tickled, was fully aware of this. Residents who hold religious beliefs have local churches and visiting ministers both High Church and Church of England. One resident said she really appreciated having communion brought to her. The home has an activities coordinator who is available once a week. Residents are provided with activities in the afternoons, sometimes by the co-ordinator and sometimes by other staff. During the afternoon of the site visit a number of residents were playing a well loved clock game devised by the activities coordinator. Staff and residents said it was a great favourite along with ball games, music and quizzes. ‘Music for Health’ provided by a domiciliary group is much appreciated as are the weekly visits from young people from Sevenoaks school. A photo album maintained by the home shows individuals enjoying other activities. An activities calendar is kept and includes art and craft, quizzes, bingo and birthday celebrations. Group outings are organised three times a year, local trips are also available, such as coffee out and walks to the lakes. One resident said she loved to be able to go out for a walk by herself, either round the lakes or to do errands for people. She said she had walked into Sevenoaks to look round the shops. She valued this freedom and said she always made sure staff were aware she was going out. Visitors are welcomed into the home by staff and residents much as into an extended family. The visitors’ book recorded a number of regular visitors. A visitors’ room is available, should residents choose not to use their bedrooms or communal areas. Food is basic home cooking. Residents spoken to said the food was ‘very nice’. On the day of the site visit the main meal was shepherds pie which each resident in the dining room was eating. A group of residents said they hadn’t remembered what was for lunch but it was a nice surprise. They said that if they didn’t like it the cook would do them a salad or fish or perhaps an omelette. For dessert a diabetic version of the pudding was available. One resident prefers to have a sandwich at lunch time and a cooked meal in the evening, staff spoke of how they met his choice. Plenty of drinks were offered at the dining table, when residents were seated in the lounge and in bedrooms. Kitchen stocks confirmed that the cooks had access to a range of good quality, varied and properly stored ingredients. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 14 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): 16,17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to people who listen to any concerns and who will take action. EVIDENCE: Residents are at ease talking with staff who listen to their views and concerns including their keyworker, the manager and senior carer. Information about how to contact the CSCI is also displayed within the home. One resident is generally unhappy with life and expresses at great length criticism of the government, the home and people in general. Staff are aware there is little they can do at present but showed endless time and patience listening to her and trying to reassure her. Records of complaints and their investigations are maintained. All permanent residents are on the electoral role and are able to vote if they wish. Staff had a good understanding of the procedures in place within the home for the protection of residents from potential abuse, one finding it difficult to conceive it could happen in at Alpine Rest Home as she felt residents were treated so well. Written policies and procedures are available for staff. A new member of staff spoke of reading through such policies as part of her induction. Where there are any concerns regarding adult protection, the home Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 15 fully cooperates in the process to ensure practises are implemented to address identified risks. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 16 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): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a homely, well maintained and comfortable environment in which to live. EVIDENCE: A garden to the rear of the property includes a patio area. Part can be used by residents with mobility problems, the higher level would be more difficult to access. The proprietors continue to invest money in refurbishing the property. Over the last year new carpets have been fitted, some communal areas and bedrooms have been redecorated. The manager was in the process of setting up hanging baskets and tubs for the front of the house to give it a welcoming aspect. Adequate lounge and dining facilities are provided. There are two large attractive lounges, a dining room and a visitors’ room. Six toilets are provided Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 17 including some in easy reach of communal areas. One double room has an ensuite toilet and washbasin. There are two bathrooms available to residents, both with hoisting facilities. One has just been upgraded and at the time of the site visit was in the later stages of being decorated before being made available. Residents were aware of this temporary inconvenience and said it hadn’t caused them any problems. Residents’ rooms seen were pleasant and personalised. There are eighteen single and six shared rooms. Each room seen has a wardrobe, drawers, lockable space, washbasin and an easy chair. All residents are provided with a lockable facility. Residents can choose whether to lock their doors. Accommodation for residents is over two floors accessed by a lift. A main staircase can be used but is gated at the top for risk prevention. A separate steep staircase leads to a attic room, access to this should also be made safe. To prevent the risks of scalds hot water temperatures are checked regularly and recorded, radiator covers are in place in risk areas. Alpine Rest Home felt warm and bright during the site visit with plenty of natural light. One resident had her bedroom window open as she said she liked fresh air. Overall the premises were clean, hygienic and free from offensive odours. Staff were aware that some cleaning, particularly under beds and heavy furniture, was not always done and spoke of how they helped the domestic in this task. The laundry room has suitable facilities to reduce the risk of cross control.. Soiled items and clinical waste are dealt with appropriately. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 18 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): 27,28,29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a staff team who understand and anticipate residents’ needs and wishes. Residents would be better protected by improvements to the recruitment procedure and a review of NVQ qualifications. EVIDENCE: Residents consider that there are sufficient staff to meet their needs. Whilst residents have use of a call system, they said they rarely needed to use it as staff knew individual routines and came promptly if they did call. Staff seen at during this site visit spoke with a very good understanding of residents, as confirmed in practice. There were excellent relationships between staff and residents with a good balance between professionalism and friendliness. Residents said that staff were ‘kind’, ‘friendly’, ‘I couldn’t do without them’ and that they were very responsive and had time to listen. The roster records the full name of all staff working on shift and shows where shift vacancies occur and how these have been covered, in addition a separate record is kept of hours actually worked. The manager works in a hands on capacity if necessary. Recruitment is taking place for an assistant manager. There is a senior carer. In addition to care staff ancillary staff are employed. Three carers are usually on duty in the mornings with two in the afternoons, although this can be flexible dependant on residents’ needs; two waking night Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 19 staff are on duty at night. In the best interests of covering vacant shifts, it was noted that a member of staff worked two consecutive weeks of 60 hours each week without evidence of the working time directive exclusion having been agreed. The manager was aware this was not best practice. Staff follow an induction process which includes duties shadowing a more experienced member of staff, a process confirmed by both staff and residents but not so well in documentation. Due to local recruitment difficulties, some staff are employed through an agency in Sri Lanka. The manager said that if she couldn’t recruit locally she asked the proprietor, who owns other residential care homes, to request an overseas member of staff to be allocated to them. The files of two such staff held copies of documentation obtained by the agency in Sri Lanka which included forms of reference, police conduct certificate, educational certificates and work permit. The manager assured the inspector that the proprietor owned the homes named on the work permits. An application form is normally completed when the staff are allocated to the home, one form had not been completed although the person had been working for a month. The police conduct certificate in both cases was dated 6 months previously and whilst there is no suspicion that the staff are not suitable to work at the home, there must be satisfactory evidence that the manager has carried out all necessary checks to ensure residents are fully protected in the appointment of staff. The home has a training programme, which aims to enable members of staff to update their levels of competence, gain new skills and insights. Training includes manual handling, dementia, health and safety, infection control, fire, abuse, first aid, medication administration, healthy eating and challenging behaviour. Catering staff prepare and cook all meals with the exception of two days per week when tea is prepared by care staff. The manager said that most staff are trained in food hygiene and those who actually prepared food would definitely have had this training. Staff spoke of training courses they had undertaken. The manager has attended training in mental health and 5 of the care staff have received training for people with bi-polar problems, how to react and to assist. The manager said that three staff have obtained an NVQ level 2 or above in care with two currently working towards it from a care staff team totalling thirteen. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 20 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): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a needs led and safe service, which is run in their best interests by a manager and staff who are committed to providing a good quality of life for older people. EVIDENCE: The manager is competent to run the home, has been in place for four years and has had previous experience of residential care. She has obtained an NVQ level 4 in management and care. Residents consider the manager is available and approachable. Staff take on responsibilities in the manager’s absence but recognise final responsibility as being the managers and have systems to contact her if necessary. All spoken to felt that the manager was committed to Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 21 providing a good standard of service and had the needs of older people at heart. The home has a quality assurance system in place and individuals are able to express their views. At the last inspection it was said that questionnaires are sent to residents and their relatives and a corporate annual development plan is undertaken. Unfortunately the manager had only returned from a weeks leave on the day of the site visit. She said that this, combined with the vacancy for an assistant manager, meant she had not sent out any questionnaires as part of the commissions key inspection process nor been able to complete the pre inspection questionnaire. The home has been awarded Investors in People. Residents, senior staff and general staff meetings are held with minutes of the last staff meeting seen on display. The manager said that some residents were less likely to fully participate in larger meeting so she made sure she met with them on a one to one basis. Residents joined in the inspection process and have information about the commission posted on display. Written policies and procedures are available to provide guidance for staff. Staff spoke of reading these policies as part of their induction. The home has a system for the maintenance and storage of information relating to residents and staff, including accidents and incidents, which preserves confidentiality, meets data protection guidelines and is accessible on a need to know basis. Notification of accidents and adverse events is provided to the commission as required by regulation. An up to date insurance certificate is displayed within the home. Staff supervision is currently shared between the manager and senior carer, the senior carer said that normally the manager would supervise new staff. One carer said she had received supervision from the senior carer, newer staff said they had yet to have their first supervision. Frequency of supervision was side to be approximately every three months. From discussion with residents and staff, there is a good awareness of health and safety. Staff spoke of fire drills attended and when fire alarms were tested. They were aware of action to take in the event of fire. The manager said that two fire doors have already been replaced, recommendations from the fire safety officer regarding replacement of the remaining fire doors to the current standard would take place as necessary. Invoices showed that maintenance and servicing of equipment and supplies is taken seriously such as repairs to the lift, replacement of fire doors and jetting of external drains. There is currently no maintenance person. The manager said she could request repair work through the proprietors as was evidenced during the site visit when a flickering light bulb was replaced. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 22 The proprietors or their representatives take an interest in the overall running of the home and a visit under regulation 26 is carried out and recorded monthly. Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 23 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 2 1 3 Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 24 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 OP29 OP37 Regulation 19 (2) 17(2) Requirement The registered person must ensure that records concerning persons working in the care home comply with schedules 2 and 4. 15.11.05 - In that, whilst it is appreciated that POVA first and full CRB disclosures can take time to be returned, the necessary pre-employment checks must be undertaken, including a most recent employer reference and proof of eligibility to work in the UK. 22.05.06 – there was insufficient evidence that checks on suitability and fitness had been carried out immediately before the member of staff started work at the home. Timescale for action 31/07/06 Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 25 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 2 Refer to Standard OP19.1 OP28.1 Good Practice Recommendations Consideration should be given to restricting access to the staircase leading to the attic room It is recommended that a review should be undertaken to ensure that a minimum ratio of 50 of the care staff team will be qualified to NVQ level 2 or above by the end of 2005. 22.05.06 - This recommendation is repeated from the inspection of 15.11.05. Action should be taken to enrol staff on NVQ programmes as soon as possible. 3 4 OP30.2 OP33 That satisfactory induction has taken place should be better documented by being reliably dated and signed. It is recommended that the home’s quality assurance system should be expanded to include the views of social and health care professionals. 22.05.06 - This recommendation is repeated from the inspection of 15.11.05. Action should be taken as soon as possible to coordinate a comprehensive quality assurance system with the outcomes sent to the commission. Staff supervision should include recorded one to one meetings with new staff as part of their induction procedure and at intervals of not less than 6 times a year. 5 OP36.2 Alpine Rest Home DS0000023925.V294856.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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