Inspection on 07/02/08 for Alston Court

This inspection was carried out on 7th February 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alston Court 04/05/06

Alston Court 01/11/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Alston Court 6 Fluder Hill Kingskerswell Newton Abbot Devon TQ12 5JD Lead Inspector Andy Towse Unannounced Inspection 7 and 14 . February 2008 10:00 th th Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 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 Alston Court DS0000065029.V350381.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alston Court Address 6 Fluder Hill Kingskerswell Newton Abbot Devon TQ12 5JD 01803 873558 01803 873558 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) Mrs Helen Marie Harris Mr Kenneth Richard Harris Mrs Helen Marie Harris Care Home 11 Category(ies) of Learning disability (11), Physical disability (11) registration, with number of places Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2006 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. 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 occupancy, and two have en-suite facilities. There are two lounges on the ground floor. There are far reaching views of the countryside from many of the rooms. Fee levels for placements at the home are £380.00 per week. Some additional charges are made for holidays and transportation. CSCI Inspection reports are available in the home for service users or others to read if they wish. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This was an unannounced inspection. It took place over two days. Prior to the inspection information was supplied by the registered manager, who forwarded an Annual Quality Assurance Assessment (AQAA) form to the Commission for Social Care Inspection (CSCI) which contained information about the home and recent developments concerning it. In addition, surveys were forwarded to professionals involved with the home, members of staff and people who live at the home. The surveys contained questions about how these groups of people perceived the standards of care at the home. This information was complemented by the inspection, which comprised a site visit which included a tour of the premises. During this inspection there were private discussions with individual people who live at the home, staff, and briefly, a visiting care professional. The registered manager was involved in both discussing the ethos of the home, describing how the home was run and making available policies, procedures and other documentation, including care plans. What the service does well: The home operates a very thorough admissions procedure. This includes visits, some of which are overnight, by the prospective new resident. This assists the home to know the person and also allows the person to make an informed choice about whether or not to move into the home. In addition to this it is the policy of the home for and manager, or designated senior staff member, to visit the prospective resident in their own place of residence and carry out a thorough assessment regarding that person’s needs. People benefit from well written care plans which are reviewed regularly. The home has an emphasis upon people living as independently as they are able and those living at the home are encouraged to take responsibility and make decisions regarding their day to day lives. Those living at the home have a choice of holiday destinations which reflect their preferences. Those living at the home benefit from there being staffing levels which are flexible to meet their needs. The staff group receive ongoing training and regular supervision. New staff participate in an appropriate induction programme which ensures that they have the necessary skills to work within Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 6 the home. The management of the home have a commitment to staff training and development. The environment is clean and well maintained, with all people having single occupancy rooms. The layout of the home is suitable to meet the needs of those who live there. 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. The summary of this inspection report can be made available in other formats on request. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is excellent. People moving to Alson Court benefit from a thorough assessment procedure which ensures their needs and aspirations are fully assessed and can be met by the home. People benefit from an admissions process which allows them to visit the home and make an informed choice about whether to move in or not. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose says that anyone ‘coming to Alston Court is encouraged to visit the home by coming for tea or an overnight stay in order to sample the atmosphere and level of service.’ The home’s admission policy sets out in detail the procedure for admission to the home. It places an emphasis upon the choice of the individual but also, that individual being accepted by those who already live at the home. In addition to visits to the home and trial periods spent at the home, the prospective resident, or their advocate/guardian will also be sent written Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 9 information about the home, to further assist them in making an informed choice about whether to move in or not. All four people living at the home who replied to the pre-inspection surveys aid that they had received enough information about the home prior to moving in. There have been no new admissions since the last inspection. In order to examine the practice of admitting people to the home we spoke with the registered manager and saw records relating to an admission which was taking place and also looked at the records relating to a previous admission. The person who is currently in the process of being admitted to the home has already visited Alston Court, when they stayed for a meal and were accompanied by their social worker. This person has also been visited where they currently live by the registered manager of Alston Court and a senior staff member. From this visit and following discussion with professionals and others knowledgeable about the person, a thorough assessment had been written. This outlined the person’s abilities, personality and level of need. The assessment enabled the home to both determine whether it could meet this person’s needs and also to ensure that it could negotiate the correct funding to ensure that these needs were met. Records showed that following visits to prospective new residents, the home also carried out further research into specific identified needs if this was required. Records relating to another admission were also examined. Although this had been a quick admission due to circumstances beyond the control of the home, records showed that this person had still had the opportunity of visiting the home before deciding whether to move in or not. All of those who responded to the pre inspection survey considered that they received appropriate information about the home prior to moving in. The files of people living at the home also contain copies of contracts or statements of terms and conditions. These include details regarding fees to be paid and the services covered by these, together with information concerning the rights and responsibilities of those receiving the service and those offering it. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent Those living at the home benefit from well written and regularly reviewed care plans. Those living at the home are enabled to make decisions about their lives. People benefit from well written risk assessments which enhance their ability to live independently. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 11 The files relating to three people who live at Alston Court were inspected. They all contained care plans. These were written in a format which was easy to understand. It comprised a definition of an issue which needed addressing, an aim, relating to what needed to be accomplished and an intervention strategy, outlining what action needed to be taken, and by whom, to achieve the aim. Care Plans were comprehensive, relating to all aspects of people’s lives. They covered issues such as personal hygiene, family contact, illnesses, for example, diabetes, psychological issues such as self harm and communication problems. Wherever possible people were encouraged to become involved in the compilation of their care plans and examples of their signatures on the plans confirmed this involvement. There is a system in place for the regular reviewing of care plans. During individual conversations people living at the home confirmed that they attended the review meetings relating to their care plans. All files inspected were seen to contain risk assessments. Risk Assessments were seen to be used to help formulate care plans. Whilst the home was aware of hazards to certain people emanating from illnesses or their disabilities, risk assessments were formulated to enable people to have as independent a life as possible whilst still safeguarding them as much as was feasible. Records showed that the rights of those living in the home were respected as were their rights to make decisions. This includes going out unaccompanied, choosing holiday destinations, meals, shopping for clothes, social activities and selecting colour schemes for their bedrooms and the home. People who live at the home are encouraged to make decisions about their lives. Previously one person used the services of an advocate and the manager is considering referring another to have the benefit of this service. Entries on a person’s file showed that attention was focused on enabling this person to have the time and opportunity to make decisions regarding their lifestyle. Care Plans were seen to contain instructions to staff to ‘encourage and support where necessary’ a person to carry out domestic tasks and in accessing the community. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good, The daily routines at this home encourage independence. People are encouraged to lead active and full lives. Meals available at the home reflect the choices of those who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management of the home are pro active in ensuring that those who live there have active lives that meet their aspirations. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 13 Whilst at the time of the inspection none of those living at the home was attending college, some had done so in the past. Staff were obtaining information on forthcoming ‘Living Skills’ courses at a local college which might be of interest and benefit to those who live at the home. One person from the home has a job which gives therapeutic earnings and absorbs a considerable amount of that person’s time and interest. Due to this person’s work commitments it was not possible to speak with them during the inspection. Entries on daily records showed that people used a private day service and participated in activities such as swimming. Care Plans showed that staff support and encourage those who live in the home to engage in daily housework, meal planning, shopping and the preparation of food. There were entries in records showing that people made themselves cups of tea, got their own dinners, and did ironing. On the days of the inspection, those who were not involved in activities in the community were assisting with housework, stripping wallpaper of the hallway wall in preparation for redecoration, vacuuming hallways, or assisting with food preparation. People were also seen preparing to go to attend activities in the community. These were both in small groups and in 1:1 with staff members. People also spoke about being responsible for keeping their rooms tidy and also seeing to their own laundry. Those spoken to confirmed that they followed a wide variety of interests and had an involvement in the local community. Of the four people who responded to the pre inspection surveys, three said that they were always satisfied with the activities available at the home People have the choice of a wide range of holidays. These have ranged from trips abroad to places such as Florida to small group holidays in England or abroad. The destinations of holidays reflect the choices of the people living in the home. The home has a relaxed attitude towards pets. One person had a pet bird and took responsibility for its welfare. The home’s Statement of Purpose says that the home has a ‘responsibility to service users with regard to Health and Safety’ and in accordance with this, a cat at the home which showed signs of aggression was re-homed. The manager’s dog is sometimes on the premises and was popular with most of the people spoken to. All bedrooms in Alston Court are single occupancy. Bedrooms have lockable doors however only a minority of people chose to keep their rooms locked. Staff were seen to interact well with people who live at the home, spending Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 14 time talking with them. Bedrooms are regarded as areas private to their occupants. On all files is a consent form, signed by the room’s occupant, which sets out the circumstances in which the management and staff team may enter the bedroom. People have access to all the communal areas of the home, including the kitchen, where they were seen making themselves drinks and assisting with meal preparation. Staff in discussion showed that they respected the privacy and dignity of those living at the home. Mail was seen to be given to people to open and staff knocked on bedroom doors prior to going in. The home operates an open house policy regarding visitors who can visit at any reasonable time. The home’s Statement of Purpose encourages contact between those living at the home and their family and friends. Records showed that many of those living at the home have regular contact with relatives and friends The menu is chosen by those who live at Alston Court. The home operates a three week menu. This means that the same meal is not repeated over that period. What is on the menu is chosen by those who live there. Copies of the menu showed who had chosen what specific meal. The menu showed that Alston Court offers those who live there a varied diet which reflects their choices. This includes such variety as kedegeree, risotto,cous cous and curry as well as fish, chips and mushy peas and sausage, mashed potato and beans. Whilst the menu reflects the choice of an individual person, there is always an alternative available. Entries on care plans showed that the home also advises people on healthy eating and healthy lifestyles, especially those who have special dietary needs. The lunchtime meal is prepared by those living at the home, assisted by staff. At breakfast, people also choose what they want to eat. Those residing at the home were seen to eat their meals in a relaxed atmosphere in the dining room of the home. Responses from those asked and from the pre inspection survey show that those living at Alston Court are generally positive about the food available to them. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This home has an appropriate medication administration system, with people being encouraged to take responsibility for their own healthcare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care Plans are compiled with the involvement of those who live at the home. They are specific to their needs. Those living at the home said that they could choose at what times they got up and went to bed. There are male and female care staff which allows for those living at the home to have a choice of which staff work with them and of the same gender if this is preferred. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 16 The home uses four surgeries in the area which gives those living at the home a choice of which surgery to attend and in cases of people being admitted locally, they are able to retain the services of their existing general practitioner Records on files showed that specialist support was sought when people’s needs required it. An example of this was records showing that one person was falling regularly. Advise was sought from a physiotherapist regarding exercises which might reduce the occurrence of falling. In addition, medical procedures such as a heart scan and a CT scan were also carried out and further investigation, involving the use of an MRI scan at Bristol is being arranged. In this instance records showed that a relative was fully involved in attending appointments with consultants. Other examples included the use of a physiotherapist to draw up exercises for one person and on the day of the inspection, a healthcare professional participating on a desensitising programme for a person who was having difficulty with blood tests. Some of those living at the home have specific needs related to various syndromes. In instances where this occurred, files were seen to contain researched information about the specific syndromes. They also contained specific instructions about how such syndromes affected people and appropriate responses from staff relating to these. The home has also previously used the services of advocates, who enable those who live in the home to make choices and let their preferences be known and acted upon The home has written procedures regarding the storage and administration of medication. Medication is supplied by Boots who also offer training for staff relating to its storage and administration. Only staff who have had training in the administration of medication and who are regarded, by the manager as competent to carry out this function are allowed by the manager to administer medication. Records relating to the administration of medication were seen and were regarded as an appropriate record of medication which had been administered. All bedrooms have secure storage where medication can be kept. The manger considers that this offers more privacy to people when having their medication administered. Records, signed by the pharmacist record medication returned to the pharmacy. Wherever possible, those living at the home are encouraged to take responsibility for their medication. An example of this being one person who has diabetes and is supported, by appropriately trained staff, to administer Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 17 their insulin. This person, in discussion, demonstrated considerable awareness of their medical condition. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Thos living at Alston Court are protected by the home’s complaints procedure and staff who are aware of what constitutes abuse and what to do should they suspect that it is occurring. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a written complaints procedure. It is contained in its full version in the home’s ‘Policies and Procedures’ file. Staff sign to confirm that they are conversant with what is contained in this file. Copies of the complaints procedure are also printed in a clear print, pictorial and ‘widget’ format. This makes them more easily understood by those who live at Alston Court. In addition, all who live at Alston Court are given copies of the complaints procedure with their copies of the home’s Service User Guide. Responses by people who live at the home contained in the pre inspection surveys confirmed that they knew who to contact if they were not happy or wanted to make a complaint. During the inspection we spoke privately with several of those who live at Alston Court. When asked they all were confident Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 19 that they would talk to the manager of the home or members of staff should they feel unhappy about any aspect of the service they received. We also spoke with three members of staff. They were asked about how they would define abuse. All gave competent responses, covering all aspects of abuse. They were also fully aware of who they should contact and what action they should take if they suspected that abuse was occurring. Most staff have had formal training relating to the Protection of Vulnerable Adults and the registered manager is herself a trainer in the subject of the protection of vulnerable adults. In one instance a staff member had not, at the time of the inspection received formal training relating to the protection of vulnerable adults. This was a recently recruited staff member and had, by the responses given, been told about abuse and what action to take as they gave competent responses to questions relating to abuse. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25,26 and 30 Quality in this outcome area is good. People live in a well maintained environment which meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Alston Court is a detached residential property situated in it’s own grounds. It is indistinguishable from other residential dwellings in a pleasant residential area. All those who live at Alston Court have single occupancy rooms or in one case a self contained apartment. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 21 Four people who live at Alston Court showed the inspector around their rooms. All rooms were seen to a have been personalised by their occupants. This was shown by pictures, soft toys, televisions, collections of dvds, cds and books. In conversation people said that they chose the colour schemes of their rooms. People were seen to have access to all areas of the home. They were seen freely walking into the kitchen to make themselves cups of tea and also taking responsibility for carrying out domestic tasks. Internally the home was seen to be well maintained, and at the time of the inspection the main hallway and stairwell were in the process of being redecorated. The home has a separate laundry area which was seen to be clean. On the days of the inspection the home was seen to be clean with a good standard of hygiene and cleanliness. All those who live at the home and responded to the pre inspection survey responded that the home was ‘always’ clean. Policies are in place regarding the control of infection combined with staff training. There has been a recent inspection, with positive findings, of the kitchen area by the Environmental Health Department. Externally there is a private garden area. This currently provides a place for recreation where barbecues can be held or people just sit outside. In the report of the previous inspection the manager discussed the development of certain areas of the garden. At this inspection she informed us that as a project for the forthcoming year she plans to have the rear garden landscaped and the lower part of the garden made into a more accessible recreational area for those who live at the home. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. Those living in the home benefit from staffing levels which meet their needs. Staff receive appropriate training and supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the course of the inspection we spoke with three members of staff. They all spoke positively about the training they received. One recently recruited staff member had received a thorough induction programme which had taken place over a period of weeks and was focussed on the needs of people with learning disabilities. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 23 When staffing levels were discussed, all staff thought that the staffing levels were ‘good’ or ‘fine’, and in discussion examples were given of staff having the capacity to take people out either in a 1:1 situation or very small groups. Responses by the four people in the pre inspection survey, confirmed that they all considered that there were always staff ‘available’ when they were needed. These discussions confirmed that staffing levels within this home were flexible to meet the needs of those who live there. The home offers its staff a thorough induction. All staff are encouraged to participate on NVQ 2 courses with the majority of staff having achieved this award or participating on it. NVQ 2 is a national qualification which is a recognised qualification for staff working in care homes. Staff files showed that staff received regular supervision. This was recorded on formatted sheets and covered subjects such as feedback on work performance, care planning and training and individual development issues. Supervision is important as it ensures that staff feel supported, work at their optimum level and provide a consistent standard of care. The home operates a schedule of training, which includes formal induction and foundation training through to statutory courses which staff have to complete within the a specified time scale. Records showed that staff received training relating to mandatory subjects such as health and safety and moving and handling. Staff records were seen. The files belonging to three members of staff were inspected. All staff files contained police checks with the manager stating that no staff member commenced work until these had been received. Whilst one file did not contain a reference, this had been applied for and was received before the end of the inspection. This was atypical and not reflective of the overall recruitment practices seen during this inspection. In discussion staff said that they felt they were well supported by the management. Staff spoke about handover sessions between shifts which ensured that there was good communication between shifts regarding the ongoing needs of those who live at the home. Staff meetings are also held regularly. Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good Those living at the home benefit from it’s management by an experienced and qualified person The home has an effective Quality Assurance System which seeks and acts upon the views of those it consults. The home is maintained to ensure the health, safety and wellbeing of those who live and work there This judgement has been made using available evidence including a visit to this service. EVIDENCE: Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 25 The registered manager has had a career working with people with learning disabilities, mental health problems and/or challenging behaviour. She has been working at Alston Court since 2002 and so has a good knowledge regarding the needs of those who reside there. During the inspection she informed us that she has now completed her Registered Managers Award (RMA) and has her NVQ 4 in care. This means that she has the qualifications and experience expected of someone running a residential care home. The home operates a Quality assurance System. In order that the views of those living at the home can be obtained in an impartial manner, the home uses the services of a advocate from the VOCAL organisation. This person, who is independent of the home assists people in responding to a questionnaire regarding the service they receive and their aspirations for the future. The manager showed us responses received from people to the questionnaire and also what action she had taken regarding them. These ranged from an increase in staffing levels, to a change in the menu and altering dining arrangements. The Quality Assurance system also seeks out the views of other stakeholders in the home. Responses from these were seen to be generally positive. Regarding the home, the registered manger was able to show documentation, such as that relating to fire safety risk assessments, valid electrical testing certificates and a very recent and positive Food Safety Inspection carried out by an environmental health officer regarding the home’s kitchen and food storage and preparation. Those staff files which were inspected combined with discussions with the manager and staff confirmed that staff received appropriate training regarding health and safety and felt confident regarding issues relating to this. i Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 26 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 Standard No Score 1 X 2 4 3 X 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 27 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. 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. Refer to Standard Good Practice Recommendations Alston Court DS0000065029.V350381.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Contact Team Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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