Inspection on 06/12/05 for Alpine Lodge

This inspection was carried out on 6th December 2005.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alpine Lodge 23/07/07

Alpine Lodge 28/07/06

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 Sam Sly Unannounced Inspection 6th November 2005 9.30 Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 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 Lodge DS0000018312.V252930.R01.S.doc Version 5.0 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.V252930.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alpine Lodge Address Alpine Road Torquay Devon TQ1 1RB 01803 295514 01803 295514 agnes@alpinewlodge-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.V252930.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs Helen Rochester to complete NVQ 4 and the required components of the Registered Manager Award by the end of 2005. 9th June 2005 Date of last inspection Brief Description of the Service: Alpine Lodge cares for up to 23 young and older residents with mental health needs, although the number of residents rarely exceeds 17/18. This 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 manager’s office and accommodation for three staff. There is a small parking area, with gardens to the front of the building and ramps leading to the garden and a patio area to the side. There is also an aviary, and a decking area is in the process of being built. The house can be accessed via shallow steps, with additional steps and stairs throughout the rest of the building, which might pose a problem for residents with additional mobility needs. There are three floors, with two bed-sit type rooms in the basement, and other bedrooms on the ground and first floor. The ground floor also has a TV lounge, a games room, quiet room, dining room, locked kitchen, and locked laundry room. There are two bathrooms (one in the process of refurbishment), two shower rooms and additional toilet facilities. In total Alpine Lodge has 21 single and 1 double bedroom. CCTV is in operation in the kitchen and the entrance to Alpine Lodge. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place on a weekday in December. This was the second statutory Inspection of the year, and it is advised that the Commission’s report dated 9th June 2005 is read in addition to this one to get a holistic view of Alpine Lodge. Neither the Owner nor the Registered Manager was present during the Inspection, and the Manager’s office was locked so access to some paperwork was restricted. Judgements were made based on discussion with the three staff on duty, discussion with those residents that wanted to talk, a tour of all the communal areas of the home and some of the resident’s bedrooms, and examination of paper documents and computer records. There are currently thirteen residents at Alpine Lodge. What the service does well: What has improved since the last inspection? What they could do better: Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 6 Care plans must capture resident’s needs in the areas of personal development, education, occupation, and leisure and highlight overall goals and staff must methodically work towards meeting these needs. Daily recording must demonstrate that care plans are implemented by staff. The registered manager must gain the necessary qualifications. 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 Lodge DS0000018312.V252930.R01.S.doc Version 5.0 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.V252930.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Although assessments covered most areas, not all resident’s needs and aspirations were reflected. EVIDENCE: The information about four resident’s needs available for staff on the day of Inspection was examined. Some information was on paper, some on a computer system. All residents had care plans developed by the Home. The two most recently admitted residents had Care Programme Approach plans, and plans established by the Home. Although covering most areas of need, missing elements of the Home’s care plans were personal development, education, occupation, leisure needs, and overall goals. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Care plans were completed but had missing elements including overall goals making it difficult for staff to work with residents towards increasing skills and gaining independence. EVIDENCE: Each resident had a risk assessment and care plan, reviewed regularly. However, although plans recorded how staff should work with most identified needs, missing elements were personal development, education, occupation, leisure needs, and overall goals and aspirations. Daily records were being kept, but did not always reflect that care plans were being followed and that staff were systematically working towards residents goals and aspirations. Each resident had a risk assessment that detailed identified risk and how staff should minimise these risks. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 & 16 The Home supports and maintains resident’s personal and family relationships, and their rights and responsibilities are recognised. More emphasis is required by staff on identifying and meeting resident’s personal development, educational, occupational and leisure needs. EVIDENCE: On the day of Inspection, one resident went out with a member of staff to visit an ex-resident who had recently moved, some residents went into Torquay by themselves; one of them to the Acorn Centre, and two residents were taken out by a support worker from the Acorn Centre. Staff said that there had been several trips organised over the summer, which those resident’s that went on enjoyed. Staff said that it was hard to motivate some residents and hard to plan regular activities as appointments often disrupted plans, and sometimes when activities were organised residents decided not to go at the last minute. There had been an educational course running at Alpine Lodge until recently. The residents that had attended said they enjoyed it. Staff said it would be starting again at another Care Home locally and those residents wishing to attend would be taken. There was no start date yet. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 11 Care plans did not detail resident’s personal development, educational, occupational and leisure needs. Staff said there was information in the Home about activities in the community for residents, but it could not be found on the day of Inspection. Long-term residents did not go on annual holidays. The Home had provided a table-tennis table for residents and tea and coffeemaking facilities. The Registered Manager helped, or got professional help for residents, to sort out benefits and financial problems and residents were encouraged to look after their own financial affairs. Staff supported residents to maintain appropriate and meaningful relationships with friends and family, and visits could be private in their bedrooms or in quiet communal rooms. Residents all had single lockable bedrooms and the staff on duty respected their privacy on the day of Inspection. Resident’s access in the Home is restricted; the laundry and kitchen are locked. However, residents can use these facilities with staff support and on the day of Inspection one resident was cooking his own lunch. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Residents are able to administer and control their own medication, and medication administered by staff is done so safely. EVIDENCE: Medication procedures in the Home were followed and medication was administered safely. One resident self-administered medication, and although the bedroom door had a lock, lockable storage was not provided in the room for their medication and valuables. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Practices at Alpine Lodge protect residents from abuse, neglect and self-harm. EVIDENCE: Paperwork received from the Registered Manager prior to the Inspection and discussion with staff on duty proved that all staff had attended Adult protection training, knew what constituted abuse and what to do if they came across an abusive situation. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The general look and feel of Alpine Lodge is smarter and more homely, with genuine efforts being made to improve the environment, keep it clean, safe and in a good state of repair. EVIDENCE: Much time, effort and resources have been spent on improving the environment at Alpine Lodge. As well as an on-going repair programme, larger projects have been started on refurbishing and redecorating bedrooms, installing a new shower room, and making a large decked area in the garden. A full time maintenance person is employed so repairs are carried out swiftly. Some maintenance issues were identified on the day of Inspection and staff quickly brought them to the attention of the maintenance person. Residents said they were happy with their bedrooms and the facilities available to them. There had been no visits by the Fire service or the Environmental Health Department since the last Inspection. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 The Home’s recruitment process protects residents and staff are experienced and well supported enabling them to maintain the safety of residents. EVIDENCE: On the day of Inspection staff were working with a particularly troubled resident, whose behaviour was unsettling other residents. The staff were following the resident’s care plan strategies calmly and a professional was later involved. Staff said the constant abuse received from residents wears them down and it is sometimes hard to remain interested and motivated. . Residents said that staff were ‘kind’, ‘approachable’ and ‘nice’, and that the Registered Manager ‘got things done’. Staff information and files were unobtainable as the Registered Manager’s office was locked. However, information received by the Commission prior to the Inspection showed that only two staff had gained NVQ 2 and one gained NVQ 3 out of a staff group of eleven. Staff has also attended a medication awareness course, Fire Awareness, adult protection and Health and Safety courses. It was unclear whether staff had all completed the Home’s Induction and Foundation programme, which had been shown to the Inspector at the last Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 16 Inspection, as records were unobtainable. The Registered Manager had made a staff training programme and incorporated this into the Home’s annual development plan. Staff said they had received appraisals but not regular supervision sessions, although the Manager was available on a daily basis for advise and support. The Pilipino staff, although able to converse with residents, still felt English language lessons would help them become more involved in supporting residents. This remains a recommendation to the Home. There have been no new staff members for over a year, and all staff have had Criminal Record Bureau checks and the appropriate employment processes followed. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 Residents and stakeholders can be confident their views underpin the review and development of Alpine Lodge. To ensure Alpine is managed to it’s full potential the Registered Manager must become appropriately qualified. EVIDENCE: 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 is also visiting Alpine Lodge monthly and reporting his findings to the Commission. The Registered Manager is still working to attain the qualifications required by the Commission for her role. There remains a Condition on the continued Registration of Alpine Lodge that the qualifications are reached by the end of 2005. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 2 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alpine Lodge Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x x DS0000018312.V252930.R01.S.doc Version 5.0 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 14 Requirement Timescale for action 09/03/06 2 YA6 15 Resident’s assessments must cover all areas of need including personal development, social, educational and leisure needs. Resident’s care plans must 09/03/06 reflect all areas of need, including personal development, social, educational and leisure needs. Daily recording must demonstrate the action taken by staff to meet these needs. Resident’s social, educational and leisure needs must be identified, recorded so staff and residents are working towards achieving goals. The registered manager must be suitably qualified. 3 YA14YA13YA12 12 (1)(2)(3) 09/03/05 4 YA37 9 (2) (b) (i) 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 20 No. 1 2 3 Refer to Standard YA26YA20 YA17 YA24 Good Practice Recommendations Lockable storage should be provided for residents in their bedrooms for valuables and medication. Freezer and fridge temperatures should be kept daily. All windows, where there is a risk of someone falling, should have restricted opening. The front door bell should work. The window identified at Inspection should have a curtain fitted. 50 of staff should have achieved NVQ 2 by December 31st 2005. Staff with limited English language skills should be helped to receive tuition. Staff should receive equal opportunities training including disability awareness. Staff should have individual training and development assessments and profiles. Staff should have done Induction and Foundation training. Staff should receive appropriate supervision on a regular basis. Comments made by stakeholders should be incorporated into the aims, objectives and targets in Alpine Lodge’s annual development plan. 4 5 6 YA32 YA33 YA35 7 8 YA36 YA39 Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Alpine Lodge DS0000018312.V252930.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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