CARE HOMES FOR OLDER PEOPLE
Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL Lead Inspector
Helen Abel Unannounced Inspection 12th December 2005 10:15 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 Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Alston House Address 380 Aylestone Road Leicester Leicestershire LE2 8BL 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) 0116 291 5601 0116 291 5611 Mrs Margaret Madden Mrs Carol Smith Care Home 19 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (19), Sensory Impairment over 65 years of age (2) Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service user numbers. No person falling within categories MD(E) or DE(E) may be admitted to the home when 6 persons of categories/combined categories MD(E), DE(E) are already accommodated within the home. Service user numbers. No person falling within category SI(E) may be admitted to the home when 2 persons of categories/combined categories SI(E) are already accommodated within the home. 22nd August 2005 2. Date of last inspection Brief Description of the Service: Alston House is a registered for older people and can accommodate up to nineteen older people, including up to six older people with dementia, up to six older people with mental disorder and up to two older people with sensory impairment. The home is situated off a main road, along a tree-lined road and approximately 15 minutes away from city centre. There are shops within five minutes walking distance from the home and a small park nearby. The home provides two-storey accommodation with communal areas and conservatory on the ground floor. Bedrooms are located on both the ground floor and first floor that can be accessed by the stairs or the passenger lift. A large parking area is to the front of the home. There is a well-maintained garden to the rear of the home with seating and mature plants and shrubs. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced during a week day morning over a four hour period. I spoke with residents, staff and the Registered Manager. A part tour of the premises took place and some staff and care records were inspected; as well as policies and procedures relating to the management of the home. What the service does well: What has improved since the last inspection?
Risk assessments for an identified resident have been updated. Weighing equipment to meet the needs of residents with mobility difficulties is in the process of being obtained by the Registered Provider. New carpets for the hallways and passageways are to be provided as part of the new renovation plans to take place in 2006. A review of the Criminial Record Burea Checks (CRB’s) has been undertaken to further safe guard residents. New staff are provided with a basic staff induction; followed by the National Training Organisation for Social Care (TOPPS) induction ensuring staff are competent to do their jobs. The cleaning cupboard is kept locked and the use of bleach has been reviewed in line with health and safety policies and procedures. The Statement of Purpose has been updated and is available to residents and visitors. Nutrition section/sheets are used as part of the care plan to ensure food and fluid intake is monitored and health care needs are fully met. Alternative floor covering has been provided for an identified resident’s room to assure a more pleasant and comfortable environment. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Assessment systems area fully implemented which ensure that the service meets resident’s needs. EVIDENCE: Assessment systems are in place, with new residents provided with a Statement of Purpose document containing key information about the home. Useful information is also displayed around the building. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9,10,11 Residents are treated with respect and their right to privacy upheld. EVIDENCE: Staff were observed treating residents with kindness and sensitivity when talking with residents as they moved around the home, and when dealing with challenging behaviour. Resident’s rights and wishes around death and dying are taken seriously and acted upon by the home. Clear reference is made to these issues in the terms and conditions and is set out in the Statement of Purpose. The Registered Manager spoke of taking steps to arrange access to advocacy and legal services for individual residents. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All these outcomes were inspected at the last inspection and were compliant. EVIDENCE: Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 Residents are protected from abuse. EVIDENCE: The Registered Manager spoke of training used with staff around managing challenging behaviour and protecting adults from abuse. After a training session staff will complete a training questionnaire to check their learning. Protecting Adults is also part of the National Vocational Qualification Training that all staff currently undertake. The Registered Manager has arranged for outside agencies to be involved in guiding residents when drawing up wills, and other legal matters. Advisory Services contact information is displayed around the home. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23,25,26 The premises were warm, clean, safe and comfortable. EVIDENCE: Most parts of the home were inspected and found to be well maintained and clean. Rooms were personalised with resident’s belongings and small items of furniture. One resident was reading a book in his bedroom and pointed out, “I have a good bedroom with a good view.” Some of the ground floor carpets were looking old and worn and will be replaced as part of major renovation work for 2006. The communal lounges were busy with residents. In the afternoon residents were seen talking to staff and some female residents were having their finger nails painted and manicured. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 Residents needs are met by the number and skill mix of staff EVIDENCE: Comments received from residents are as follows: “ Staff look after me alright” “The carers are lovely. They are very good here.” A resident expressed a spoke of wish to do knitting and crocheting and another resident spoke of his enjoyment of steam trains. Managers agreed to pursue these interests for individuals and arrange resources to be brought in and trips arranged. The management team work hard to ensure staff receive support and guidance, and gave examples of monitoring care practices to ensure residents are in safe hands. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 34,35,36,37 The management and administration procedures ensure the home is run in the best interests of the residents. EVIDENCE: The Registered Manager has achieved qualifications in management in care, and is experienced in managing and working with older people. The management team demonstrate leadership and work closely with another care home run by the same registered provider, sharing experiences and good care practices. The Inspector noted daily activities are arranged but not always delivered. The meal option book is a good resource and maybe utilised by the cook when discussing meal options with residents. This would aid resident’s independence and decision-making abilities. Managers were receptive to these recommendations.
Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 15 A satisfaction questionnaire is due to go out in January to residents, their families and friends and staff, seeking their views on the service provided. The management team are working towards the Investing In People Award, which focuses on providing appropriate staff supervision and training. The Inspector recommended the cook’s designated toilet is kept secure for good hygiene practice; a sign is displayed and light repairs be made to the toilet floor. Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 3 x x x 3 3 x 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 x Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No 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. 1 2 Refer to Standard OP33 OP33 Good Practice Recommendations Following on consultation with residents a list of activities to be drawn up and provided on a regular basis. The meal option book to be used as an aid by the cook when talking to each resident and offering a choice of menu. This pictorial aid will allow residents with communication difficulties the opportunity for independence and choice. Ensure the food handler’s toilet is kept secure and is identifiable with a sign. Undertake light repairs to the toilet floor. 3 OP38 Alston House DS0000006408.V271362.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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