CARE HOME ADULTS 18-65
Alston Court 6 Fluder Hill Kingskerswell Newton Abbot TQ12 5JD Lead Inspector
Michelle Finniear Unannounced 1 November 2005
st 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. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Alston Court Address 6 Fluder Hill, Kingkerswell, Newton Abbot, Devon, TQ12 5JD 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 873558 01803 873558 Mr Kenneth Richard Harris & Mrs Helen Marie Harris Mrs Helen Marie Harris Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7/4/05 Brief Description of the Service: Alston Court is a care home providing personal care and accommodation for 10 adults aged between 18 to 64 years, with learning disabilities and/or physical disabilities.It is owned by Burlington Care Homes (Devon) Limited. The registered owners are Mr and Mrs Harris, and the manager is Mrs Helen Harris. The home is a large detached house within extensive grounds located on a hill on the outskirts of the village of Kingskerswell. It is approximately two miles from the town Of Newton Abbot. Amenities in Newton Abbot include super stores and high street shops, public houses, a post office, racecourse and railway station. There is easy access into the city of Exeter, by a regular bus or train service.The home was first registered in 1992. The accommodation is on two floors with access via a staircase. All bedrooms are for single ocupancy, and two have en-suite facilities. There are two lounges on the ground floor.There is a wheelchair accessible garden around the property with a large sun terrace and car parking in front of the house. There are far reaching views of the countryside from many of the rooms.The home provides many varied social activities in and out of the home. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Since the last inspection the home has changed ownership, with the registered manager and her husband buying the home from the previous owner and moving in to the home. This inspection was unannounced, which means that neither the owner nor the people who lived at the home were given notice about the date and time of the inspection. This inspection took place over four hours on a late afternoon and evening in November 2005. The timing of this inspection was to give the opportunity to meet with service users, the majority of whom go out to day placements. To complete the inspection a tour was made of some areas of the home, all service users were met, and discussions were held with the owners who comprised the staff on duty after 5pm. What the service does well:
Alston court provides a comfortable and informal living environment, for service users, whose lives have not significantly changed with the change of ownership, as the new owners were very well known to them. The transfer was extremely well managed, with a retirement presentation for the old owner being held to mark the change of ownership and assist service users in understanding and accepting the change. Service users have personalised and individual accommodation in single rooms, some with ensuite facilities, and a choice of communal space, with two large lounges on the ground floor. All areas of the home seen were well furnished and attractive, which means that service users have a nice place in which to live. Many of the service users have lived at the home for a significant number of years as a group, and are well settled with strong relationships between them. Activities outside or inside of the home are encouraged, and the week of the inspection the service users were preparing for a Halloween party, which included inviting staff and making costumes etc. The new owners ‘live in’ at the premises. This means they know the service users very well, and are in close daily contact, sharing some meals. The home has good systems for consulting with service users, staff and relatives about how the home operates, which ensures that they have a say in the way in which the home is run.
Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 6 Service users said the home was “a nice place to live”. What has improved since the last inspection? 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. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 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 Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 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) Not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion, but were on the occasion of the last visit. For information on the homes compliance with these standards please refer to the report of 7/4/05. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 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) 7, 8, 9, Service users are enabled to make responsible decisions and choices about their lives. EVIDENCE: During the course of the inspection service users could be seen making choices about activities to follow, food and menu planning, deciding on activities for later in the week and making choices about healthcare – including whether they wished to have a flu jab or not. Information was given to service users to support them in making responsible choices, but their decisions were respected. Since the change of ownership new bank accounts have been provided for service users which will enable them to have greater independence in dealing with their own finances. Someone from the bank concerned visited the home and explain the changes to service users so that they had full information about what was happening. Risk assessments are undertaken for all activities carried out to ensure that service user safety is maintained with a minimum of restriction.
Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 10 Service users are involved in all decision making activity at then home, and as the owners eat with service users, much discussion occurs informally over the meal table. The home also has regular ‘House meetings’ where service users can raise in a more formal setting any issues they wish to discuss with the group. Service users confirmed that a meeting was to be held the night following the inspection, which was substantially to discuss and plan the Christmas Party. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 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) 11, 12, 13, 14, 15, 16, Service users at Alston Court follow full and active lives. EVIDENCE: During the course of the inspection service users could be seen participating in household chores, returning from work or day centre placements, making arrangements for a Halloween party in the home later in the week and two were taken to a local evening social club. Discussions with service users indicated that they follow full and active lives, however it is acknowledged that in some instances the local authority is withdrawing services for some service users which is a cause of concern to them. Service users work and social activities are based both in Learning disability services and also the wider community, which means that service users have opportunities to mix with and make friends with people who do not share their disability. On the day of the inspection as an example one service user had attended a local day centre and undertaken craft based activities, one had worked in a local charity shop, one had attended an Adult Training unit, one
Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 12 had worked at a local fish distribution warehouse, and another had been swimming and to the Gym. Evening activities include attendance at evening classes and social events, including belly dancing classes for one service user. This demonstrates that service users have choices about how to spend their free time and opportunities are available for them to follow meaningful and valued activity. Timetables are prepared in a symbol format so that service users who need that support have a pictorial record of their daily and weekly activities. Service users confirmed they are supported to maintain and develop their own hobbies and interests. A group of service users and staff are going to Butlins for a weekend before Christmas, and have had holidays throughout the year. Others are choosing to stay at home. Service users confirmed that they are planning together to go to Florida next year as a group. This indicates that service users have opportunities to choose where and with whom they have holidays. Service users rooms have locks so that they can maintain their privacy if wished, and the choice of communal space means that service users do not all have to sit together if they wish to use the lounge. One service user said that “sometimes we shout at each other” but that this was just like being in a family. Open discussion is held on changes to the home, and service users participate in household activities and learn life-skills, which includes assistance in shopping for and preparing food. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 13 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 Service users personal and healthcare needs are met. EVIDENCE: Whilst the majority of service users are physically able, some require support, advice or prompting in managing their own personal care needs. Where physical or intimate care is needed a service user confirmed that the staff were kind and maintained their privacy. A service user also confirmed that they had a specific problem with a chest and heart condition and that they were aware of the need for an influenza Vaccination which had been booked for them with their agreement. This indicates that service users are empowered to make decisions regarding their health care in an informed way. Another example of this is a service user who has a large involvement in the management of their diabetes, which includes specialist professional support. Care required does include a need for some moving and handling tasks and some environmental adaptation which has been provided. Moving and handling has been risk assessed and the required equipment has been provided. This ensures that service users and staff are protected from injury during this process. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 14 Access to specialist services is facilitated, including the involvement of specialist clinics and advice. This includes advice on healthy eating principles and preventative healthcare and screening, which supports service users rights to access all the facilities of the NHS. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 15 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 Alston Court has a satisfactory complaints system which ensures service users have opportunities to air their views. EVIDENCE: Service users spoken to were clear as to who they would discuss and y concerns or issues with and said that they felt quite happy to discuss any issues with the homes management. The home has a formal complaints procedure and no complaints have been received. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 16 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 Alston court provides an attractive, homely and safe environment for service users to live in and staff to work in. EVIDENCE: A tour was made of some areas of the home, including communal areas, the kitchen and the homes office. All areas seen were clean, warm and comfortable. Communal areas are attractively furnished in a way that is homely and domestic but still provides suitable facilities for a service user who uses a wheelchair. The laundry was clear and appropriate measures for infection control are in place. This means service users have a hygienic and comfortable environment in which to live. Since the change of ownership the new owners have commenced work to resite the homes office to the basement area, providing better accommodation for staff who may sleep in. There are also plans to improve the homes kitchen and areas of redecoration planned. On this visit the kitchen was clean and service users spoken to had a good understanding about food hygiene principles.
Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 17 Each service user has a single bedroom, some with en-suite facilities and there is a choice of communal areas, parking and attractive gardens. Information was sought from the local Fire and environmental health agencies in relation to ensuring the safety of the home for the change of ownership. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 18 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) Not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion, but were on the occasion of the last visit. For information on the homes compliance with these standards please refer to the report of 7/4/05. Staffing levels on this visit were appropriate for the service users living at the home, ensuring that they were able to follow activities, attend day services and receive personal care required. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 19 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) Not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion, but were on the occasion of the last visit. For information on the homes compliance with these standards please refer to the report of 7/4/05. Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 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 x x x x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Alston Court Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations Alston Court D54-D07 S65029 Alston Court V258587 011105 Stage 4.doc Version 1.40 Page 22 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
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