Inspection on 04/07/07 for Alsager Court Care Centre

This inspection was carried out on 4th 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 but made no statutory requirements on the home.

Other inspections for this house

Alsager Court Care Centre 08/05/08

Alsager Court Care Centre 24/10/06

Alsager Court Care Centre 27/04/06

Alsager Court Care Centre 24/10/05

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 Unannounced Inspection 09:45 4 and 6th July 2007 th 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.V338686.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 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.V338686.R01.S.doc Version 5.2 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) WWW.Blanchworth.co.uk Mrs Sally Anne Manby Roberts Mr Jeremy Walsh Mrs Sylvia June Knox Care Home 27 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (27) of places Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 27 service users to include: * Up to 27 service users in the category of OP (old age not falling within any other category) * Up to 15 service users in the category of care with nursing (N) * Up to 7 service users in the category of DE(E) (dementia over 65 years of age) * The following bedrooms are excluded for the provision of care with nursing (N): 3,7,8,24 Date of last inspection 24th October 2006 Brief Description of the Service: Alsager Court Care Centre is a 27- bedded care home for older people. Up to a maximum of 15 residents may have nursing needs and up to a maximum of 7 residents may be over 65 years of age and have dementia care needs. 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 rooms, which could be shared to a maximum of 27 places. 16 of the rooms have en-suite facilities. The current owners took over the running of the home in September 2001. Each person living at the home is provided with a written contract which specific information relating to their room, the fees and any additional cost and the terms and conditions. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced visit took place on 4th July 2007 and lasted seven hours. As the manager was unavailable at the time of the visit, feedback to the inspection was given at a further visit on 6th July 2007. The visits were just one part of the inspection. Prior to the visits the manager was asked to complete an Annual Quality Assurance Assessment questionnaire to provide up to date information about the services in the home. Questionnaires were also made available to people living in the home, to their family members and to visiting professionals to find out their views about the care home and the care. These questionnaires helped to inform the inspection process. Information received since the last site visit was considered. During the visit two hours were spent observing the care being given to a small group of people with dementia care needs. The care of three people was looked at in depth. All observations were followed up by discussions with staff and examination of records. Various other records were seen and the premises looked at. What the service does well: What has improved since the last inspection? Staff members have attended training in many different aspects of care and more staff members have now received training related to Dementia Care, Challenging Behaviour and the Protection of Vulnerable Adults. Social activities are well advertised and recorded. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 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.V338686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive pre–admission assessments are completed by a Registered Nurse and assessment information is gathered from a number of different sources to ensure all care needs are identified and can be met within the care home. EVIDENCE: People enquiring about a placement at the home are provided with copies of the Statement of Purpose, Service User Guide and a copy of the most recent Commission for Social Care Inspection report. Enquirers are encouraged to visit the home to assess for suitability and to the use the information provided to make an informed choice about the home prior to selecting it, to provide a placement and care. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 9 Reference copies of the Statement of Purpose and Service User Guide were available in the office during the inspection visit and were referred to on the notice- board in the reception hallway. A copy of the latest Commission for Social Care Inspection Report was also available for visitors and others to read and was displayed next to the visitors’ book in the reception hallway. Prior to potential placements a Registered Nurse carries out a pre-admission assessment, by gathering information from a number of different sources to identify all care needs and to ensure they can be met by the home. A total of five care files were checked during the inspection visit and the preadmission documentation and initial assessments for three recently admitted people were read. The assessments had been thoroughly completed and assessment summaries provided detailed information to explain specific care needs to care and nursing staff and to identify the action to be taken to assist people in all aspects of daily living. The pre admission assessments had taken place in a variety of settings and information to inform the assessments had been gathered from the person being assessed, their relatives and carers at home, social work representatives and health care professionals. This had helped to build clear and accurate pictures of each person’s needs and circumstances and had enabled staff members at the home to develop plans of care for daily living and for the longer term. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although people are generally well looked after in respect of their health and personal care needs, the recording and administration of medication needs improvement to ensure people cared for receive their medication as prescribed. Staff members also need to be less, task orientated and to work as a team to observe people, to identify and respond to changing individual needs. EVIDENCE: Each person living at the home has a written care plan. This a bound booklet with colour coded pages relating to admission, assessments, care plans, monitoring and liaison with professionals and relatives. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 11 The five plans of care checked detailed action to be taken by staff to ensure all aspects of health and personal care needs were met. Daily records of care were informative. The detail provided staff members with sufficient information about each person and alerted staff to any changes, which enabled them to provide continuity of care. Checklists were maintained to ensure help with personal hygiene and care was provided. In each care file there was a pen picture to describe the person cared for more fully and to provide care and nursing staff with background information. It was evident that whenever possible, the person to be cared for and /or their relatives had been involved in the care planning and had taken an active role in providing important personal information. In each case a key worker had been identified and the care files were well maintained and up to date. They detailed any changes to care needs fully. Prompt referrals had been made to appropriate health care professionals as necessary, and the outcomes of healthcare visits were well documented and relayed to caring relatives. Descriptions of emotional wellbeing were provided, the risk of falling was well documented and people’s likes and dislikes had been explored and recorded. From observations of people during the two-hour observational period it was evident that the assessment relating to eating and drinking was in need of review for one person. Care staff members were observed to be courteous and respectful with the people they cared for and any personal care was provided in the privacy of bedrooms and bathrooms. Care staff members were observed to knock on bedroom doors and to wait to be invited in. During the visit two hours were spent observing the care being given to a small group of people with dementia care needs and to other people being cared for. The observation provided an opportunity to sit alongside people for a couple of hours during a regular part of the day, in communal areas. This helped to gain insight into their general state of well being during this time and provided insight into staff interaction with people cared for. These observations along with other data information collected during the visit helped to assess the quality of the care environment, and gave an opportunity to represent the experiences of care for people who struggle to speak out for themselves. Three people with dementia care needs were identified and observed in the dining room during lunchtime. Their state of being and engagement was recorded and any staff interaction was noted. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 12 Staff members sensitively assisted people to eat, at their own pace and supervised the majority of people during their mealtime. They encouraged conversation, provided practical help and helpful advice and support. Several members of the staff team transported people to and from the dining room and delivered meal selections to the tables. The people being observed spoke with each other and with staff briefly. Each approaching member of staff encouraged conversation and described the food provided to tempt people to eat and to enjoy their meal. Requests for help were swiftly tended to and people’s needs were successfully anticipated for the first thirty- five minutes of the observation. As people finished their lunchtime meal, staff members began to escort people from the dining room to various parts of the home. One person was escorted from the room in a wheelchair and shouted out perhaps distressed because she didn’t know where she was being taken as it hadn’t been explained. One member of staff remained to assist a person to eat and tried to observe six other people seated on another three tables some distance away. This responsibility caused the carer some anxiety. One person being observed hadn’t enjoyed a drink of juice that they had been given. Various staff members offered sweetened tea as an alternative. The person was clearly unsettled. When left alone at the table, the person repeatedly poured, emptied and mixed the water, juice and tea in cups and glasses placed on the table and during the process drank copious amounts of the mixed drinks. Much of this activity went unnoticed by staff members who were busy transporting people from the dining room. One person spent time conversing with the cook and the interaction was good humoured and friendly. At one dining table three people had finished their meal and staff had cleared the table. On three occasions within a ten -minute period a member of staff approached the group to escort them away from the table although the people said they were happy to stay. Observations continued in the main lounge were eight people were seated. One person was writing, two were dozing, two watched a game of tennis on television and three other people sat passively and engaged very little. In this location several people drifted in and out of sleep and appeared uncomfortable as they slept in awkward positions. One person unsuccessfully struggled to position a footstool and another person repeatedly spat out pieces of nut from a chocolate given to her by the person in the next chair. One person awoke coughing. This period of observation spanned fifty minutes during which time people were left unattended. During this time one member of staff appeared very briefly, but only to offer the inspector a drink. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 13 Towards the end of the period of observation one person awoke and immediately attempted to stand and began to walk very unsteadily, grasping for furniture as they went. Several of the people in the lounge shouted out to the person to encourage them to sit down again, to avoid a fall. The inspector pressed the alarm call to gain the attention of a member of staff who came to assist. The above findings were discussed with the registered manager at a meeting to provide feedback about the inspection visit. The observation information is be used to inform future practice and the caring process. The period of observation highlighted numerous examples of friendly interaction and positive exchanges. It also highlighted a need to be less task orientated and to focus more on a person centred approach to care giving. Staff members need to reminded not to leave people unattended for long periods and to work as a team to support each other to observe people cared for, to enable them to identify, anticipate and respond to their changing needs. Alsager Court has a comprehensive medication policy and training programme. Any member of staff who administers medication is required to attend an inhouse training session, have supervised administration and be deemed competent to administer medication. The medication administration records commencing on 11th June 2007 were checked. These were contained in two separate files. Each contained photographs of the people cared for to aid identification. Sample signatures and initials were on the files along with copies of the medication administration policy. Within the medication administration records for people receiving residential care there was a gap in the recording of medication for one person. There were three errors in recording for one person. Medication to be given at night was recorded as given in the morning and this was not clearly explained for those three occasions. The administration instructions were not made clear for one medication. Within the medication administration records for people receiving nursing care, medication for one person prescribed to be taken three times a day was recorded as given twice on one day. For another person there was an unexplained gap in recording and one food supplement was signed as given once a day on three occasions instead of twice a day as prescribed. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 14 A person had received one medication four times a day on two days instead of three times a day. Medication to be given once a day was not signed as given for one person and medication to be taken once a night had not been signed as given for another person. This evidence indicates a need for further improvement in the recording and administration of medication to ensure people cared for receive their medication as prescribed. Five members of staff had recently attended End of Life training. Specific plans of care are developed for any person who requires end of life care. This is done with sensitivity whilst ensuring any specific wishes are carried out. One of the care files checked did not include information to be used ‘in the event of a death’, but all next of kin details had been completed. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is some opportunity for people living at the home to participate in activity. Opportunities for social interaction could be enhanced to help satisfy social needs and encourage contact with others. EVIDENCE: Routines within the home are flexible and allow for individual preferences and abilities. Visitors to the home are warmly welcomed. People are encouraged to personalise their bedrooms with furniture and other personal items important to them. An annual plan of activities has been devised taking into account relevant events throughout the year. The activities provided are linked with peoples past and present hobbies and are facilitated by an activities co-ordinator who also has some care responsibilities. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 16 Since the last site visit activities are better documented. A notice board in the reception hall displayed photographs of people enjoying various activities within and outside the home. There were photographs of people enjoying a trip to The Blue Planet Aquarium and taking part in a Christmas party. A Summer Barbeque was also advertised. The activities diary was checked and provided evidence of a range of activities undertaken including reminiscence sessions, bean bag games, quizzes, music and movement, gardening, singsongs, hairdressing and beauty therapy, knitting and church services. Activities were not available on a daily basis and group activities relied on the availability of one activities co-ordinator. The rota did not identify hours specifically for the organisation of activities when the usual activities co-ordinator was not on shift and occasionally the activities coordinator had been unable to provide activities when she had been needed into cover care shifts instead. A number of people cared for made positive comments about the quality of food provided. Menus have been devised in conjunction with a dietician to ensure nutritionally balanced meals. A wide choice of food is available and alternatives can be prepared as requested. By arrangement and for a small charge visitors can take a meal with people cared for if they wish. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Past concerns and complaints have been few and records provide details of appropriate action taken to resolve any issues. EVIDENCE: Alsager Courts complaints procedure is included in the Statement of Purpose and Service User Guide and copies of these documents are provided to all prospective residents. The complaints procedure is also displayed on the notice board situated by the front door. The complaints file was checked and only one complaint was received within the last twelve months. It was found not to be upheld and was responded to appropriately. There was evidence of staff members recently attending in house training in Dementia Care, in Managing Challenging Behaviour and in the Protection of Vulnerable Adults. Staff members learn to identify subtle as well as obvious forms of abuse and the channels for reporting any concerns. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 18 Staff members are also made aware of the Whistle Blowing policy and how they can be protected if they do raise any concerns. A practical training session aims to provide staff with strategies to identify, diver and manage challenging behaviour demonstrated by people being cared for. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean, bright and welcoming. It is decorated and furnished to a good standard providing a comfortable and homely environment in which to live. EVIDENCE: Alsager Court provides ground floor accommodation only and therefore people have easy access to the well- kept gardens surrounding the home. Alsager Court has applied for funding from the Capital Grants to provide a sensory garden area to enhance people’s enjoyment of the outside area in fine weather. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 20 A tour of the premises was undertaken and included the communal lounge, communal bathrooms, the dining area, sun lounge, laundry, kitchen and six bedrooms. The premises were well maintained, fresh, clean and welcoming. Survey forms contained positive comments about the constant and good standard of cleanliness throughout Alsager Court. The home is suitably equipped to aid mobility and bedrooms had been personalised and arranged to suit individual needs. The small laundry was a little cluttered, but freshly laundered clothing was well organised and had been placed in individual trays and was awaiting return to peoples bedrooms. In the kitchen, advice was given as the interiors of a small fridge and a microwave needed cleaning. Within the home there was evidence of regular wheelchair maintenance, call alarm checks, and monthly emergency lighting checks to ensure safety. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are met within the home although the home sometimes relies heavily on the support of agency staffing to maintain staffing levels. Staff recruitment procedures are thorough to protect people living at the home and staff members are well trained to ensure a good standard of care is provided. EVIDENCE: The staffing rota clearly recorded and identified person in charge arrangements. A core of staff members have been employed for a long period of time and know the people cared for well. There were sufficient staff members recorded on the duty rota to meet personal care needs. The Commission for Social Care Inspection had been notified on a few occasions in the last twelve months when there had been unavoidable staff shortages due to staff sickness at short notice. Some agency staff members are regularly employed and this provides some continuity to people cared for. A robust recruitment procedure helps to safeguard people living at the home and was evidenced by checking recent recruitment information stored on the computer in the home. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 22 A staff- training plan is in place to provide all staff with up-to-date training. In addition staff members can access the Blanchworth Care NVQ centre and are able to undertake NVQ levels two and three within the workplace and are assessed by qualified colleagues within the Home setting. Staff members are keen to undertake training relevant to their work and this was evidenced by viewing the training report and numerous training certificates recently provided to staff on a variety of subject matters. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and knowledgeable in the provision of care to older people. She manages the service efficiently and is committed to ensuring the health, welfare and safety of the people cared for and the staff members. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manger is a qualified nurse and is competent and experienced in the delivery of care to older people. She has an open and inclusive management style and has achieved the Registered Managers Award. The registered manager has twelve hours supernumerary management time each week. Monthly monitoring visits are undertaken to Alsager Court, to monitor the practice and conduct within the home, to provide guidance to management and staff during the visits and to obtain the views of people cared for. The results of a Quality Assurance Questionnaire Audit undertaken by Blanchworth Care were available to view within the home and related to the year up until June 2006. These results related to 11 questionnaires returned. Favourable responses were received regarding the admission procedures, the care provided and attention to hair and nail care and the domestic arrangements within the home. The results of the survey related to the year up until June 2007, are now awaited and will be made available on the notice board. A sample of personal account balances, records and receipts were checked. The money held within the home is documented on an individual basis and the samples checked were correct. When money or valuables are brought into or taken out of the home, two signatures are obtained. Any person wishing to have their finances managed for them have an individual bank account, which provides statements and the ability to access funds as required. The registered manager ensures safe working practices through training and through risk assessments carried out to identify, reduce and manage risks. The accident records were checked and accidents were thoroughly recorded. The fire policies and procedures manual was checked and provided evidence of satisfactory fire safety checks and staff training. Advice was given at feedback to the inspection as the certificate of employers liability insurance on display had expired by one day. The manager later checked with headquarters and it was confirmed that the new certificate was awaited. Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 25 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 26 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 (2) Timescale for action The registered person must 31/08/07 make arrangements for medicine records to be correct, clear and made at the time of giving the medicines. (Similar requirements were made at five previous inspections on 4th and 9th of November 2004, 9th May 2005, 24th October 2005, 27th April and 5th May 2006,24th October and 9th November 2006). Requirement 2. OP9 13 (2) The registered person must 31/08/07 make arrangements for residents to have their medicines to the prescribed directions. (Similar requirements were made at five previous inspections on 4th and 9th of November 2004, 9th May 2005, 24th October 2005, 27th April and 5th May 2006, 24th October and 9th November 2006) Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 27 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 OP7 Good Practice Recommendations Encourage staff members to focus more on a person centred approach to care giving and to be less task oriented. Staff members should be reminded not to leave people unattended for long periods and should work as a team to support each other to observe people cared for, to enable them to identify, anticipate and respond to their changing needs. People cared for should be provided with opportunities for regular daily activities to satisfy their social and recreational needs and staff time should be made available to accommodate this provision. 2. OP12 Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Alsager Court Care Centre DS0000006648.V338686.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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