Inspection on 24/10/05 for Alsager Court Care Centre

This inspection was carried out on 24th October 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

Alsager Court Care Centre 08/05/08

Alsager Court Care Centre 04/07/07

Alsager Court Care Centre 24/10/06

Alsager Court Care Centre 27/04/06

Alsager Court Care Centre 04/11/04

Alsager Court Care Centre 15/06/04

Alsager Court Care Centre 20/02/04

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

CARE HOMES FOR OLDER PEOPLE Alsager Court Care Centre Sandbach Road North Church Lawton Stoke On Trent Staffordshire ST7 3RG Lead Inspector Sue Dolley Announced Inspection 24th October 2005 09:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Alsager Court Care Centre DS0000006648.V254176.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alsager Court Care Centre Address Sandbach Road North Church Lawton Stoke On Trent Staffordshire ST7 3RG 08453 455743 01270 883256 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) Blanchworth Care Homes Ltd Mrs Sylvia June Knox Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: Alsager Court Care Centre is a 28- bedded care home for older people. The home is situated off a busy main road in a residential area of Church Lawton, near Alsager. It provides ground floor accommodation and is set within two acres of landscaped gardens. There are 24 single rooms and 2 shared rooms, and 16 of the rooms have en-suite facilities. The current owners took over the running of the home in September 2001. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took 7 hours on 24th October 2005, to assess if residents’ needs were being met. A tour of the premises included all shared areas such as lounges, dining areas, shared bathrooms and toilets, the laundry and kitchen. Several members of management staff on duty, 4 staff members, 2 residents and 1 visitor were spoken to during the inspection. A variation application to change the categories of care provided is currently being processed. What the service does well: What has improved since the last inspection? Since the last inspection, some maintenance work has been undertaken and redecoration work has taken place in two bedrooms. A sink in a toilet area has been replaced with a smaller version to maximise available space. A sluicing facility has been provided for the home and awaits fitting. The completion of care plan documentation has improved and there has been an increase in the time allocated to staff to organise activities for residents. Resident meetings have been reintroduced to promote discussion, autonomy and choice. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 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. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Prospective residents and their carers are provided with useful information about Alsager Court Care Centre to enable them to make an informed choice when choosing a placement. The process of moving people into the home is well managed to make sure individual needs are met and residents quickly settle into their new environment. Prospective service users and their carers are encouraged to visit the home and to meet with staff and residents to view the facilities and to assess the suitability of the home. EVIDENCE: The home provides useful information for prospective and existing residents. A variation application to change the categories of care provided is currently being processed. The Statement of Purpose and Service User guide are being updated to reflect the proposed changes to include nursing and dementia care. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 9 Each resident has a contract/ statement of terms and conditions and four examples were checked. These provided clear and concise information about the care and services covered by the fee. Two of the examples did not identify rooms to be occupied. See Recommendation 1. Prospective residents are encouraged to visit the home before deciding to move in on a trial basis. The registered manager liaises with social services and health care representatives; residents and their family supporters to gather information for an initial assessment and to determine if needs can met. This information is used to develop care plans. 4 residents’ care files were checked and provided comprehensive information with only a few omissions .For example a clothing and property inventory had not been maintained for one resident and details regarding bathing frequency had not been completed. For another resident the laundry requirements had not been stated and details relating to any food allergies and food likes and dislikes had not been completed. Advice was given at feedback to the inspection regarding these matters. All care needs were clearly identified and the care plans explained how needs could be met. Some social history information was included with help from residents’ relatives. The reason for admission was clearly stated and the names of residents’ key workers were provided. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. Residents are looked well in respect to their health, personal and social care needs. The recording and administration of medication needs to be further improved, to ensure all residents receive their medication as prescribed. EVIDENCE: Four plans of care checked detailed action to be taken by care staff to ensure all aspects of health, personal and social care needs were met. The standard of recording in the care plan documentation had improved since the last inspection and the care files were well -organised and provided up to date information. Daily care checklists had been completed and indicated all personal care tasks undertaken. Any necessary changes to care were thoroughly recorded within the plans of care, daily care records and the daily report diary. These records provided evidence of close monitoring of need and continuity of care throughout day and night. Care plans had been updated monthly or more frequently as appropriate. Detailed records were kept of GP visits and community nursing visits and care had been adjusted accordingly. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 11 All risk assessments were appropriate and had been regularly reviewed regarding manual handling, the possibility of experiencing falls and the development of pressure areas. A local pharmacy supplies the majority of medication in a monitored dosage system. In September 2005 all staff responsible for administering medication received additional medication training to update their practice. The study session covered • Accountability and confidentiality • Supply, storage and disposal of medicines • Introduction to medicines • Documentation and records • Competency in Clinical practice. The registered manager monitors the administration and recording of medication when she is on duty from Monday to Friday each week. Sample staff initials were kept on file although one member of staff had not dated her sample signature. Photographs of residents were kept on file to aid identification. Despite the above areas of good practice and monitoring, the medication records showed some unexplained errors in recording and lack of explanation when drugs had not been given for some reason. See Requirement 1. (Similar requirements have been made at the last two inspections). Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 Residents’ interests are recorded within the care files and residents meetings provide a forum for people to discuss their social and recreational needs. Staff members also speak with residents individually to enable residents to express their views and discuss their expectations. EVIDENCE: Minutes of the last two resident meetings were read. At a meeting held in May residents discussed food choices, menu changes and meal times. The catering staff responded positively and made changes to suit residents needs and wishes. Following requests by residents at a meeting in September the home has provided an increase in the level of planned activities. Residents meetings have now been scheduled to take place quarterly. The minutes of the last meeting held in September did not contain the names of residents and staff members who had attended. See Recommendation 2. Since the last inspection the registered manager has attended a company wide training session regarding organising suitable activities for older people and has shared the training information with several of the care staff. To the satisfaction of residents there is now at least 30 minutes of planned activity each morning and afternoon with longer sessions arranged by the activities coordinator on some days. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 13 A local church choir have agreed to attend once a month. A piano has recently been donated to the home a pianist and singer will attend weekly. A clothing party has been planned to take place for residents in November and Christmas Shopping trips to a neighbouring town are to be arranged. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Residents and their supporters are not currently provided with information about accessing local available advocacy services which might help them to protect and promote their legal rights. EVIDENCE: The Statement of Purpose includes a residents’ charter and provides a summary of residents’ rights, which helps to inform residents and their supporters. Currently the home does not have information or literature to inform residents of local advocacy services, which could help them to protect their legal rights. See Recommendation 3. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,23 Alsager Court Care Centre is well maintained, clean and hygienic. It is decorated and furnished to a good standard providing a comfortable and homely environment for residents. The home is suitably equipped to aid mobility and residents’ rooms are personalised and are arranged to suit their needs. EVIDENCE: The communal areas, lounges and dining room, kitchen, bathrooms, toilets and the laundry were checked and all areas were well maintained, well equipped and clean. Residents confirmed that the home is always clean and fresh. Good standards of housekeeping were evident throughout the home. The grounds are kept tidy, safe and attractive and are accessible to service users, and allow access to sunlight. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 16 Many of the bedrooms are individually decorated and furnished to suit individual choice and preference. Two bedrooms have been redecorated since the last inspection. All bedrooms have suitable door locks, call alarm facilities and are centrally heated. Many radiator covers are in place and pipe work has been covered in areas where risk assessment has deemed necessary. Several of the bedrooms have only one double electrical socket and must be provided with a second double electrical socket. This electrical work has been costed and the work to install further sockets is awaited. See Requirement 2. Residents have toilets within close proximity of their bedrooms. One bathroom has recently been refurbished and contains a bath for residents with mobility difficulties. Unfortunately residents choose not to use this facility. The possibility of changing this bathing facility to a standard bath with a hoist is currently being considered. This will ensure that there are a sufficient number of suitable bathing facilities throughout the home to meet the needs of residents. A sluice facility had been obtained and now awaits fitting. The kitchen and laundry were well organised. Advice was given at feedback to the inspection as one washing machine had developed a small leak. Advice was also given as the hairdressing room was inappropriately being used for the storage of residents’ wheelchairs although staff members had been asked to return service users wheelchairs to residents’ bedrooms or use the adjacent bungalow for storage. It is recommended that a diffuser be fitted to the fluorescent light in the hairdressing room. See Recommendation 4. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Much of the recruitment information is stored on computer and cannot be checked for inspection purposes without access provided by the registered manager. EVIDENCE: One recruitment file was checked and was complete with all necessary references and criminal record bureau checks received prior the commencement of employment. Recruitment information is accessed electronically. The registered manager provided the inspector with access to this information during the inspection. As on previous inspections it was confirmed that much of the recruitment information is stored on a computer programme maintained by company headquarters. This information was not entirely complete and the locality manager had to telephone company headquarters during the inspection to obtain information regarding the date of a recruitment check. The home must keep a full record of all persons employed and this information and documents relating to staff recruitment and identity should be accessible for inspection purposes See Requirement 3 and Recommendation 5. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,34,37,38 The registered manager is a qualified nurse and is competent and experienced in the delivery of care to older people. She has an open management style and is approachable. A positive and inclusive atmosphere has been encouraged within the home and both residents and staff feel supported and valued. The company headquarters are responsible for the accounting and financial procedures of the home. Financial records and a business and financial plan for the establishment were not available for inspection within the home. It was therefore not possible to consider the accounting and financial procedures adopted to demonstrate current financial viability. Alsager Court Care Centre ensures residents’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. It runs in the best interests of service users and staff and promotes and protects their health, safety and welfare. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 19 EVIDENCE: The registered manager has recently completed work to achieve a registered managers award. She regularly undertakes training to update her knowledge and is familiar with conditions and diseases associated with old age. The processes of managing the home are open and transparent and there are clear lines of accountability within the home and with external management. Policies and procedures are in place for the management of petty cash. A business and financial plan for Alsager Court Care Centre was not available. There was no evidence of budgetary management or accounts within the home as all budgetary information is held at company headquarters. See Requirement 4 and Recommendation 6. The registered manager ensures that staff members receive suitable induction training and training in moving and handling, fire safety, first aid, health and safety and infection control. Individual care planning and risk assessment documentation was thorough. Servicing and maintenance checks for the home were mainly up to date to promote the health and safety of residents and staff. Advice was given at feedback to the inspection as the fire risk assessment had not been signed on behalf of the company. Emergency lighting checks normally undertaken on a monthly basis had not been completed during August 2005. See Recommendation 7. All accidents records provided comprehensive information and there was evidence of safety procedures posted around the home for staff members to refer to. The fire precautions records showed that regular fir evacuations/drills had been undertaken. Alsager Court Care Centre has undertaken to provide the Commission for Social Care Inspection with a copy of the latest report from the Fire Brigade. Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 2 18 X 2 2 X 2 3 X X X STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X 2 X X 3 2 Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 21 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 OP9 Regulation 13 Requirement Arrangements must be made for the accurate recording, handling and safe administration of medicines received into the care home. (Similar requirements were made at the previous inspections on 4th and 9th of November 2004 and on 9th May 2005). Arrangements must be made to ensure residents have at least two accessible double electric sockets in their bedrooms. (This requirement was made at the previous inspection on 9th May 2005 and the timescale for completion elapsed on 09.08.05) A full record of all persons employed must be kept as detailed in Schedule 4. A record of accounts is required to be kept in the care home for inspection by any persons authorised by CSCI to enter and inspect the home. (This requirement was made at the previous inspection on 9th May 2005 and remains outstanding). Timescale for action 24/11/05 2 OP19 23 31/12/05 3 4 OP29 OP34 17 & Schedule 4 (6) 17 & Schedule 4 24/11/05 31/12/05 Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 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 Refer to Standard OP2 OP14 OP17 OP20 OP29 Good Practice Recommendations Each statement of terms and conditions should identify the rooms to be occupied. Ensure the minutes of resident meetings include the names of residents and staff who have attended. Facilitate access to available advocacy services by providing contact details to residents and their supporters. Fit a diffuser to the fluorescent light in the hairdressing room. Access to information and documents relating to staff recruitment and identity should be available for inspection purposes. (This recommendation remains outstanding from the previous inspection on 9th May 2005). Ensure a business and financial plan for the establishment is available for inspection purposes. Ensure emergency lighting checks are undertaken and recorded monthly. 6 7 OP34 OP38 Alsager Court Care Centre DS0000006648.V254176.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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