Inspection on 23/07/07 for Alpine Lodge

This inspection was carried out on 23rd July 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alpine Lodge 28/07/06

Alpine Lodge 06/12/05

Alpine Lodge 09/06/05

Alpine Lodge 02/12/04

Alpine Lodge 05/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Alpine Lodge Alpine Road Torquay Devon TQ1 1RB Lead Inspector Peter Wood Unannounced Inspection 23 July 2007 10:30 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 Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 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 Adults 18-65. 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 Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alpine Lodge Address Alpine Road Torquay Devon TQ1 1RB 01803 295514 01803 400214 agnes@alpinelodge.rch.co.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) Alpine Lodge RCH Ltd Mrs Helen Agnes Rochester Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (23) Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection Key: 28 July 2006 Random: 07 February 2007 Brief Description of the Service: Alpine Lodge is registered for up to 23 young and older people who live at the home with mental health needs although the number of people who live at the home is effectively limited to the 21 single rooms. The one double room is used as a large single room. There are currently 18 people who live at the home. The large detached house is in a residential area of Torquay within walking distance of the town centre. It has two porta-cabins to the front of the house used as the managers office, staff office and accommodation for 3 staff. There is a small parking area, with gardens to the front of the building and a ramp leading to a patio area at the side. The house can be accessed to the front via shallow steps, with additional steps and stairs throughout the rest of the building. These steps might pose a problem for people with mobility problems who live in the home. The accommodation is laid out over three floors. Two flatlets with their own kitchen facilities are located in the basement, with other bedrooms on the ground and first floor. The ground floor also has a TV lounge, a games room, quiet room, dining room, kitchen and laundry room. There is one bathroom and three shower rooms and additional toilet facilities. CCTV is in operation in the kitchen, linen room, front entrance and office. Fees are £450. Copies of inspection reports are available at the home. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken over one weekday in July 2007. The focus of this inspection was to inspect all key standards and to seek the views of people who live at the home, staff, relatives and professional visitors to the home, the latter mainly using survey forms. At the time of writing three survey forms have been returned from staff, eight from people who live at the home, and one from a relative of a person who lives at the home. We spent considerable time with the registered manager examining documentation, particularly that relating to client assessment and care planning, staffing and health and safety. We selected and closely examined a selection of files of staff and people who live at the home. We also consulted people who live at the home who were at home at the time of the visit, including sharing lunch with them. We also consulted staff who were on duty. We undertook a full tour of the public parts of the building, and took up the offers of several people who live at the home who were pleased to show us their rooms. We were also given the home’s Annual Quality Assurance Assessment (AQAA) document, which is extensively quoted, with minor amendments for clarification, throughout this inspection report. What the service does well: What has improved since the last inspection? The Registered Manager has worked hard to meet the four requirements and eight recommendations made at the last Inspection. The manager has now Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 6 completed all required units of the Registered Manager’s Award, and coursework is now with the tutor who has been ill. Lockable storage has been provided for some people who live at the home in their bedrooms for valuables and medication. Staff with limited English language skills have been helped to receive tuition, though the staff have declined to undertake the learning. Staff now have individual training and development assessments and profiles. All staff have now done Induction and Foundation training. Lockable storage is now provided in their bedrooms for the valuables and medication of people who live at the home. Freezer and fridge temperatures are now kept daily, rather than weekly. 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. The summary of this inspection report can be made available in other formats on request. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made at the time of admission which now include the aspirations, not just the needs, of people living at the home. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “We regularly review our Statement of Purpose and Service Users’ Guide to give to prospective service users, current service users and to anyone else enquiring. All prospective service users have a risk assessment and care plan in place before being admitted, this coincides with care plans from professional bodies. Preferably professionals will fill in our referral form, and prospective service users will be invited to the home for lunch and a visit. They will then be asked if they would like to stay over for the night so they have some insight into how the home is run and meet with others. We avoid unplanned admissions where possible, all service users have a contract of terms and conditions between the home and service users.” Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 9 Examination of a selection of files of people who live at the home demonstrates that most referrals are from members of specialist mental health teams, sometimes using the Care Programme Approach. These are therefore usually appropriate, made on the basis of professional assessment prior to admission. The home uses its own Referral Form as an assessment tool. This concentrates on the physical and mental health needs of the client, but now includes elements such as personal development, education, occupation, leisure needs, and overall goals. However, these appear to be added on rather than integrated within an holistic assessment of the client. Nevertheless, including such elements enables the assessments to be more comprehensive, from which more complete care plans can be generated. Perhaps reflecting the nature of his condition which resulted in his admission here, one person who lives at the home wrote: “I moved in rather unexpectedly. No planning about it. I don’t know really why I live here”. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are completed, now generated from more comprehensive assessments, enhancing their scope. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “Each individual service user has a care plan and risk assessment which they read and sign in agreement. This incorporates their general well being, and what we can do for them, mental health issues and outcomes and personal development. These are reviewed on a regular basis and updated when needed on or before review. Staff respect service users’ decisions to make individual choices and are on hand to assist. Most service users at the home manage their own finances although some of them have an independent appointed Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 11 person to assist. I am on hand wherever possible to assist those who have difficulty sorting out finances. If I cannot help I will contact the FAB team on their behalf. Service users can and have joined in staff meetings and are encouraged to put their views across. The home has a missing persons policy and procedures in place which are used quite frequently. Service users’ records are accurate and secure and stored appropriately, and all staff are aware of confidentiality.” Examination of a selection of files of people who live at the home, consulting people who live at the home directly and reading survey returns demonstrates that each resident has a care plan, which is reviewed regularly. These are now generated from assessments which are more comprehensive than previously. These plans record how staff should work to meet clients’ identified needs, which now include personal development, education, occupation, leisure needs, and overall goals and aspirations. Daily records are kept, but do not always reflect that care plans are being followed and that staff are systematically working towards the goals and aspirations of people who live at the home. Documentation needs further improvement to become a useful tool and a true system of assessment / planning / implementation recording. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home helps to support and maintain resident’s personal and family relationships, and their rights and responsibilities are recognised. More emphasis is required, however, on identifying and meeting resident’s holistic needs. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “We encourage service users to use practical life skills i.e. doing their own washing, keeping their rooms clean and tidy, attend courses when available, join in with activities and outings, pursue hobbies and interests. If finance is needed we will endeavour to assist. Service users look after their own finances, and where appropriate self-medicate with lockable storage in their rooms. We Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 13 encourage service users to keep in touch with family/friends, who are more than welcome into the home. All service users’ rooms are lockable of which they have a key. Staff sit and chat to service users on a daily basis and the manager is always available within reason. We also encourage service users if they have small pets to bring them into the home with them. We encourage service users to fill out their applications to vote and will escort them on the day to the polling station. Staff give support and time for service users to use facilities outside the home whether it be for shopping or visiting. A few of our service users will walk into town but find the hill coming back to the home a bit too much. We will then endeavour to pick them up from the town in the mini bus. Alpine Lodge has a lockable post box so only staff have access so mail does not get lost. All personal mail is then passed onto service users. All service users are asked on admission their preferred form of address, which is recorded. Rules on smoking, alcohol and illicit drugs are recorded in the contract. Alpine Lodge has a weekly menu plan and there are choices of meals. If service users do not like what is on offer they can ask for something else. If service users need special dietary needs these will be assessed on referral and on care plans. Service users can choose where to eat, whether the dining room or their own bedroom. If service users wish to have meal at a later time they will inform staff and the meal will be put aside”. Examination of a selection of files of people who live at the home, consulting people who live at the home directly and reading survey returns demonstrates that care plans now include resident’s personal development, educational, occupational and leisure needs, but more as an addendum rather than part of an holistic view of the client as a whole. The home provides a table-tennis table, computer, board games and tea and coffee-making facilities for those people who live at the home deemed safe to have such equipment. A daily timetable of activities indicates the paucity of activities undertaken by most people who live at the home most of the time. The comments of people who live at the home vary greatly, from “always” to “never” as to whether the home arranges activities that the client can take part in. While some people who live at the home went out to the shops with a member of staff on the morning of the inspection day, most people who live at the home spend an inordinate amount of time in bed or watching television. Some people who live at the home enjoy music or have other individual interests. However, it is proving hard to encourage some people who live at the home to take part in any activities. Trips out have been organised which people who live at the home told us they enjoyed. Friendships and family contact is encouraged. Staff demonstrated the respect they have towards the people who live at the home and encourage people who live at the home to show respect for the property and person of their fellow people who live at the home. People who live at the home said they enjoyed the food. We observed staff asking people who live at the home their choice of lunch and tea for the following week, evidencing the choices which were available. The dining room has been improved and enhanced since the last inspection. The dated tables with integrated seating have now been replaced with very attractive tables (with tablecloths) and Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 14 separate chairs. People who live at the house welcomed this improvement, telling us that is now nicer than before. Staff reported that people who live at the home respect their newly refurbished dining room and helped to keep it neat, tidy and clean. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are well supported with their physical and mental health needs met. They are able to administer their own medication, and medication administered by staff is done so safely. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “Service users receive personal support in private, and intimate care is given by a person of the same gender where possible. Times for getting up / going to bed are flexible. Bathing and personal care is down to the individual although staff will advise service users on this. Service users choose their own clothing and how they wish to dress, although sometimes staff will intervene and advise service users if attire is not totally appropriate. Service users can choose who they wish to work with re staff regarding their personal support where possible. All service users have a registered mental health professional who Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 16 visits on regular basis and updates their care plans, Alpine Lodge staff endeavour to assist service users keep appointments with professionals assisting in their care. Service users are supported to take control of their own healthcare where possible. Staff will inform of appointments made previously. If they are selfmedicating staff inform them when their medication is getting low so they can re-order. Any potential complications re physical and emotional health are identified quickly and dealt with at an early stage, and referral made to appropriate specialist when required. All visits from medical / health care practitioners are undertaken in private; a member of staff is present only with the service user’s consent. Records are kept of all medication administered, received and returned to the pharmacy. Controlled drugs have a separate metal storage cupboard which is lockable. All medicines are administered by appropriately trained staff. If staff have any queries re homely remedies they will contact the pharmacy and seek advice, them inform service users if they should or should not take said homely remedies. Staff monitor service users taking their medication unless they are self-medicating”. Examination of a selection of files of people who live at the home, consulting people who live at the home directly and reading survey returns demonstrates that the assessments and care plans generated from them focus on their physical and mental health needs, which are well identified and met. Since the last inspection these have also included other needs and aspirations to some extent. People who live at the home reported that they feel safe and well supported living at Alpine Lodge “they look after us OK”. They feel respected and are encouraged and enabled to have as much control over their lives as possible. This includes varying degrees of control over their own medication as they wish, are sufficiently confident, and following an appropriate risk assessment. A lockable facility is provided for those people who live at the home who administer their own medication. The manager sees the home very much as part of the local circle of support for people with mental health problems, alongside (other) professionals such as GPs and particularly the team of various professionals in the community mental health teams. People who live at the home reported that they received as much support as they wished and needed, “I can talk to staff or Agnes”. Records and discussion with the manager confirm that the physical and mental health needs of people who live at the home are assessed and attended to appropriately, subject to the willingness of the resident to accept the medical and dental treatment they need. The home has appropriate policies and procedures in respect to the receipt, storage, administration and disposal of medication. The home has a proper medication cabinet and uses the blister pack monitored dosage system. This system allows nearly all medications the home uses to be within the system, reducing the number of separate packs of medications that need to be separately wrapped. This in turn reduces the likelihood of error. However, medication (and meals) is still administered through the hatch from the kitchen to the dining room. Whilst this provides security for staff administering Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 17 medication, which the manager told us has previously been necessary, this practice has an institutional feel about it. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comments from people who live at the home, relatives or other visitors to the home are treated seriously. People who live at the home are listened to and issues resolved promptly. Practices at Alpine Lodge protect people who live at the home from abuse, neglect and self-harm. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “Alpine Lodge has a complaints / protection policy in place and staff adhere to this policy. Staff and myself will listen to the views and concerns of service users and others, we encourage discussion through meetings etc. Service users are aware of our complaints procedure and all complaints are dealt with within 28 days. A record is kept of all issues raised and all details are kept re investigations, action taken and outcome. Any suspicion of neglect, abuse, financial, deliberate intent, discriminatory will be dealt with immediately (including whistle blowing).” Examination of a selection of files of people who live at the home, consulting people who live at the home directly and reading survey returns demonstrates that people who live at the home consider Alpine Lodge to be their home, as long as they wish. One or two people who live at the home told us of their Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 19 plans to move away when their circumstances change. A copy of the complaints procedure is available to all people who live at the home and visitors to the home and detailed in the home’s Statement of Purpose and Service User Guide. Although no complaints had been formally recorded, people who live at the home told us that they are confident through experience that their views are welcomed, encouraged, listened to and acted on. The home has policies and procedures to minimise the likelihood of abuse of people who live at the home in all its forms. Records evidence that the manager and staff have received training in issues relating to abuse and the protection of vulnerable adults. Talking to them indicated that they knew what constituted abuse and what to do if they came across an abusive situation. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst considerable improvements have been made, there is still a long way to go before the home could be described as smart and homely, well furnished and decorated. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “Alpine Lodge is suitable for its stated purpose and meets service user’s individual and collective needs. All bedrooms are for single occupancy, they have lockable doors, and are furnished to a reasonable standard, service users are encouraged to bring their own furniture or personalise it out how they would like, i.e. putting up posters, having their own music systems subject to fire and safety requirements. All bathrooms / shower rooms and toilets provide Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 21 sufficient privacy as they all have locks on doors. There is adequate shared space, a large garden with decking area, a TV lounge, a main lounge and dining room. There is also a quiet room where service users if they want privacy can use this facility. The home has a “No Smoking” policy. The home makes satisfactory requirements for repair and maintenance.” A tour of the building and discussion with the manager, staff and people who live at the home demonstrates that much time, effort and resources have been spent on improving the environment at Alpine Lodge to keep it clean, safe and in a good state of repair. Improving the furniture, furnishings and decoration is, however, still a work in progress. A very pleasant decked area has been laid in the garden, and a summer house has been erected. Part of the lawn has been fenced off to prevent the dogs of people who live at the home from fouling the garden and thus discouraging people who live at the home from going outside and using the garden. These improvements are designed to entice people who live at the home out of the house during the summer weather. Owing to the recent “No Smoking” legislation, the home now boasts a dedicated yet attractive smoking shelter created by joining two arbours together. Smokers who live at the home can now sit undercover but with open sides as per the specification for smoking shelters. A full time maintenance person is employed so repairs are carried out swiftly. Owing to their illnesses, many people who live at the home do not take as much pride in their appearance as they perhaps may have done when well. Sadly, the appearance of many people who live at the home and the environment in which they live to some extent reflect each other. Improving the environment may improve the value people who live at the home put on themselves. In turn this enhanced self-worth have may effect their appearance. People who live at the home said they were happy with their bedrooms. Whilst some of those seen were well personalised and contained expensive items of equipment, much of the furniture and furnishings of others required renewal. The furniture, furnishing, decoration and upkeep of some bedrooms was very poor. The carpet, furniture and decoration of the main lounge have been greatly improved since the last key inspection. However, the greatest change is in the dining room where the institutional tables with integrated seats have been replaced with good quality tables (with tablecloths) and chairs which are much more homely in character. People who live at the home told us that they welcomed these improvements while staff told us that people they respected the improvements and kept the tables and chairs in good condition. The furnishings and decoration throughout the house used to suffer from the heavy smoking of many of the people who live at the home and staff. Now that smoking can take place only in the arbour, the odour and general condition should improve. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Vulnerable people who live at the home are cared for by competent staff who are properly recruited to protect them. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “All staff have job descriptions and have had CRB (Criminal Record Bureau) checks. Alpine Lodge does not have a huge staff turn over so service users can build up confidences with staff. Staff are approachable, good listeners, reliable, interested, motivated and honest. We get on well with GPs and other professional bodies that have an ongoing concern related to our service users. We have an ongoing training programme, and 5 staff are registered to start their NVQ in September 07. We hold regular meetings with staff and the manager works on floor with staff monitoring work, giving support and guidance where needed on a regular basis. Alpine Lodge is staffed 24 hrs a day; at night there is a waking and a sleeping member of staff.” Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 23 Examination of a selection of files of staff, discussions with the manager, staff and people who live at demonstrates that they are cared for by staff competent by experience if not by training to meet the needs of those currently living in the home. Staff training records including evidence of NVQ (National Vocational Qualification), First Aid, Food Hygiene and Fire Safety. Two staff members (of 10) hold NVQ 3 in mental health. One staff member holds NVQ 2 in mental health and is in the midst of completing NVQ 3. One staff member is in the midst of NVQ 2. This level of qualification (30 ) falls well short of the requirement that 50 of care staff have achieved NVQ 2 by December 2005. Staff files include evidence of references being obtained as well as CRB checks, terms and conditions, and job description. People who live at the home described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. Comments from staff reflected their confidence, care for the people who live at the home and loyalty to the home. Staff told us that they work as a team and spend quality time with people who live at the home. Staff receive on-the-job monitoring by the “hands-on” manager, who undertakes an annual appraisal with them all. However, supervision, as described in the National Minimum Standards, does not yet take place. Good supervision can greatly enhance staff’s professional work, and is a requirement that must be met. A relative commented that: “I am very pleased with the way they look after my son. The staff are very helpful and my son is happy there.” Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Alpine Lodge is a well-managed safe home run in the best interests of people who live at the home. However, the Registered Manager must become appropriately qualified. EVIDENCE: The manager writes in the Annual Quality Assurance Assessment (AQAA) that: “The manager has worked for Alpine Lodge for the past 17 years and has a NEBSM certificate (National Educational Board of Supervisory Management). She is in midst of completing the Registered Managers award. The manager Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 25 inspires to achieve written aims and objectives of the home, and see that policies and procedures are implemented, certificates and licences are obtained. My approach and that of my staff is open, and positive. I am able to relate the aims and purpose of the home to staff and service users alike. Service users and staff are able to approach me at any time (within reason) with matters relating to the home or of a personal nature. I have in place an annual quality assurance programme, which incorporates feedback from service users, staff, professional bodies and relatives, which is then acted upon. Policies and procedures are annually reviewed and updated; they will be updated more frequently if needs require due to legislation changes. Staff have access to all policies and procedures. All records are maintained, service users have access to their individual records, these records are secure and in good order. All of standard 42 is up to date and training is ongoing”. Interviews with and survey returns from people who live at the home, staff and a relative provide evidence of the good management of this home. Examination of documentation including resident’s care files, policies, procedures, risk assessments, accident book, and health and safety literature confirm that the health, safety and welfare of people who live at the home are promoted and protected. People who live at the home told us that they are happy living here. They value their private and communal rooms, the management style of the owners, and the food. They know they can come and go as they wish, have confidence in the owner, manager and staff, and most enjoy living with their fellow residents. All people who live at the home consulted told us that they appreciated being able to live here. The Registered Manager and Registered Provider have developed a quality assurance system that includes an annual development plan that has been sent to the Commission. The Registered Provider also visits Alpine Lodge monthly and until recently when it has no longer been required, reports his findings to the Commission. The Registered Manager is also an NVQ Assessor and is in the midst of completing the Registered Managers Award and NVQ 4. These qualifications were originally required by the Commission to be obtained by the end of 2005, though the Commission no longer makes it a condition of her continued Registration. Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X X X Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 27 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 YA37 Regulation 9 (2) (b) (i) Requirement The registered manager must be suitably qualified. This was made a requirement at the previous inspection. 2. YA24 16, 23 Furniture, furnishings and decoration must be renewed as their condition deteriorates so they remain fit for purpose. This was made a requirement at the previous inspection. 3. YA32 18 50 of staff should attain NVQ level 2 in care. This was made a requirement at the previous inspection. 23/10/07 23/10/07 Timescale for action 23/10/07 Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 28 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 YA35 Good Practice Recommendations Staff should receive equal opportunities training including disability awareness. All staff should have done Induction and Foundation training. Staff training should meet all the provisions of this standard. Staff should receive appropriate supervision at least six times a year covering all the items listed in the standard. 2. YA36 Alpine Lodge DS0000018312.V341904.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 - 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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