Inspection on 09/06/05 for Alpine Lodge

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alpine Lodge 23/07/07

Alpine Lodge 28/07/06

Alpine Lodge 06/12/05

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 Announced 9 June 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alpine Lodge Address Alpine Road, Torquay, Devon, TQ1 1RB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 295514 01803 295514 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 D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 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. Date of last inspection 24th February 2005 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. 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 accomodation 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 which might pose a problem for residents with additional mobility problems. 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 laundry room. There is two bathrooms and two shower rooms and additional toilet facilities. There are 21 single bedrooms and 1 double, although at present all residents are accomodated in single rooms. CCTV is in operation in the kitchen and the entrance to Alpine Lodge. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was announced and took place on a weekday. Two additional announced visits had been made since the last Inspection, one with regard to concerns about medication practices, and the other to follow up outstanding requirements. Outcome letters sent to the registered provider can be obtained from the CSCI office on request. Evidence was gathered from the pre-inspection information provided by the registered manager, examination of a range of documents and records, and discussion with residents, staff on duty and the registered manager. A tour of the building was also made. Some residents did not want to talk, or allow access to their bedrooms. What the service does well: What has improved since the last inspection? The majority of staff have attended adult protection training, recruitment procedures now vet staff appropriately, staff appraisal have taken place, and the majority of Criminal Record checks have been carried out on staff, so residents are more likely to be protected from abusive situations. There has been progress on redecorating and refurbishing the home. These efforts have made the home smarter and more welcoming for residents. The laundry has been totally rebuilt and is clean, bright and will prevent the spread of infection. The acting manager is now registered with the Commission, and staff and residents said that she had made lots of positive changes to the running of the home, including improving the environment and enabling staff to take residents out and about more. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 6 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 Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 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 standard(s) 2 The assessment procedure did not reflect the needs and aspirations of residents, so staff had no goals to work towards. EVIDENCE: Individual records were kept for each resident, and examination of the two most recently admitted resident’s records found that assessments did not fully reflect their needs. This meant that care plans did not guide staff as to the aspirations and needs of residents. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Care plans were not reflective of resident’s needs and aspirations, which meant staff were not guided towards working with residents to achieve their personal goals and an independent lifestyle. EVIDENCE: Each resident had a risk assessment and care plan which was reviewed regularly, however risk assessments examined were not fully reflective of risk identified in Care Programme Approach paperwork, and plans did not identify goals for staff and residents to work towards. This meant staff would not be systematically working with residents towards rehabilitation, independence and personal development. Daily records examined confirmed that staff were not following resident’s care plans. Resident’s said they were able to make choices about their lives, including going out, food, activities and improvements to Alpine Lodge, and the Registered Manager was regularly asking residents whether they were happy at Alpine Lodge, and acting on any suggestions. The comments received on the day of Inspection were very similar to those recorded by the Registered Manager during her last resident’s survey, which suggested that residents felt Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 10 able give their views openly. All resident’s looked after their own finances, or had external support to do so. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 17 Residents are offered a varied diet and on the whole enjoy their meals. EVIDENCE: All but one resident spoken to said they were given choice at meal times, and that meals could be described as ranging from adequate to very good. They liked the variety offered. A meal was shared with residents on the day of Inspection that was tasty and had a Pilipino influence inspired by the staff member that had prepared it. The issues raised by the resident that was not happy with the food were fully understood by the Registered Manager and being acted on. A recommendation was made to involve residents in the preparation of meals as part of their personal development, as this was not happening at present and some residents wanted to become more independent. The kitchen at Alpine Lodge was always locked, which meant residents wanting to help prepare meals would have to be given access. The locked kitchen policy was recorded in the Statement of Purpose. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 Residents receive the personal and healthcare support they require, and the administration of medication protects residents. EVIDENCE: Most residents were self-caring but required prompting on personal hygiene issues and this was recorded in care plans. Some of the residents required assistance to bathe and shave and said this support was given in an acceptable manner. The Registered Manager was planning to install a shower room, in the autumn, on the ground floor, which would be easier to access for the less mobile residents. Staff members accompany residents to medical reviews when required and physical and emotional health is monitored regularly. The Registered Manager is in regular contact with the local mental health team, and there was evidence that appropriate referrals are made when residents become ill. Due to concerns about the administration of medication the Commission’s Pharmacy Inspector had visited Alpine Lodge on 18th January 2005 and made a number of requirements and recommendations, which had been acted on, by the Registered Manager and her staff. Medication procedures in the home were found to be followed, thereby protecting residents. Discussion took place with the Registered Manager about ensuring self-administration of medication Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 13 was promoted during the assessment of potential residents, and supported by staff so that residents grew in independence. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22 and 23 Complaints and concerns would be listened to and acted on by the Registered Manager, following clear guidelines. Once all the staff had attended the proposed training, residents would be protected from abuse, neglect and selfharm. EVIDENCE: There was a clear complaints procedure available to residents, and residents said they felt able to approach staff and the Registered Manager with concerns that would be acted on. Half the staff team had attended adult protection training, and there was information available in the home about ‘No Secrets’ and the local authority ‘Alerter’s Guidance’. The Registered Manager was arranging for the remaining staff to attend training, as this was an outstanding requirement from previous Inspections. Staff had also received training on managing aggression. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24 and 30 The general look and feel of Alpine Lodge was smarter and more homely, with genuine efforts being made to keep it clean and safe and improve the environment for residents. EVIDENCE: The Registered Manager had made genuine efforts to smarten up the outside appearance of Alpine Lodge and had plans to adapt the garden so that residents would use it more. Inside as well, a major overhaul of the laundry facilities now ensured, that residents could use it if accompanied by staff, and that there was less likelihood of cross infection. Maintenance, refurbishment and repairs are an ongoing issue at Alpine Lodge, with a full time maintenance person employed. All the maintenance issues picked up during the inspection had already been identified by the Registered Manager and recorded for action. The Registered Manager also had plans to improve the bathroom facilities for the less able residents. Residents spoken to were happy with their bedroom facilities and several said they enjoyed using the table tennis that had been set up in the sun lounge. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, and 36 There are sufficient staff, who are experienced and well supported, enabling them to maintain the safety and care of residents. However, not all staff have had thorough checks on their fitness. EVIDENCE: The staff team was stable, with three staff living on the premises. Staff were keen to learn, demonstrated an understanding of residents needs, enjoyed their work and said they felt supported by the Registered Manager. Regular staff meetings were taking place, and staff said the Registered Manager was available on a daily basis for advice and support. Each staff member had received an appraisal, which they said had been a valuable experience. The type of supervision being given was discussed and the Registered Manager said she would seek advice on changing the format. Three staff were from the Philippines, and although able to converse with residents, felt English language lessons would help them become more involved in supporting residents. It was recommended that the Registered Manager help them access appropriate courses. The recruitment process had been improved, although no new staff had been employed since the last Inspection. Two staff members had still not had Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 17 Criminal Record Bureau checks, although the Registered Manager was in the process of applying. This was an outstanding requirement from previous Inspections. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 Residents and stakeholders could not be confident that the quality monitoring, review and development of Alpine Lodge is underpinned by their views. The health, safety and welfare of residents are promoted and as far as possible protected by the Registered Manager and her staff. EVIDENCE: The Home now has a manager registered with the Commission, who is experienced and supportive of her staff team. Staff and residents spoken to confirmed this. There remains a condition on the registration of Alpine Lodge that by the end of the year (2005) the Registered Manager must attain the qualifications necessary to take full responsibility for managing Alpine Lodge. The Registered Provider has begun to regularly visit Alpine Lodge and report his findings to the Commission, and the Registered Manager was working on an annual development plan, but Alpine Lodge still lacked an appropriate Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 19 quality assurance system, which would capture the views of residents and stakeholders and highlight areas that need development. This has been an outstanding requirement from the Commission going back to 2002. The required accident and fire records were being kept appropriately, and regular health and safety checks were being carried out. The whole house was in the process of being re-wired during the Inspection. Staff had attended health and safety training and more was planned. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alpine Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 3 x D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 21 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. 2. Standard 2 and 9 6 Regulation 14 15 Requirement Residents assessments must cover all areas of need including risks. Residents care plans must reflect all areas of need, including risks, identified in the assessment. Care plans must state how these needs are to be met by staff at Alpine Lodge. All staff must have attended appropriate adult protection training (Previous requirement timescale 23/05/05 not met). All staff must have had a Criminal Record Bureau check (Previous timescale - 23/03/05 not met). There must a quality assurance system at Alpine Lodge that captures the views of residents and stakeholders. An annual report must be produced, with a copy available for CSCI other interested people (Previous requirement - 23/03/05 not met) The registered manager must be suitably qualified. Timescale for action 17/08/05 17/08/05 3. 23 13 17/08/05 4. 34 19 17/08/05 5. 39 24 17/09/05 6. 37 9 (2) (b) (i) 31/12/05 Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 22 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. 3. 4. 5. 6. 7. Refer to Standard 6 17 36 35 35 20 33 Good Practice Recommendations Daily recording should reflect that the residents care plan is being followed and that their aspirations and goals are being reached. Residents should be encouraged, as part of their personal development to be involved in preparing meals. All staff should receive appropriate supervision on a regular basis. Staff should receive equal opportunities training including disability awareness. Staff should have individual training and development assessments and profiles. Staff should have all done Induction and Foundation training. Residents self-administration of medication should be promoted from admission onwards. Staff with limited English language skills should be helped to receive tuition. Alpine Lodge D54-D07 S18312 Alpine Lodge V222589 090605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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. 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