Inspection on 19/04/06 for Alston House

This inspection was carried out on 19th April 2006.

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 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 House 22/06/09

Alston House 22/06/09

Alston House 04/06/09

Alston House 05/05/09

Alston House 04/11/08

Alston House 03/06/08

Alston House 12/12/07

Alston House 19/09/07

Alston House 12/12/05

Alston House 22/08/05

Alston House 22/11/04

Alston House 20/07/04

Similar services:

Applegarth

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL Lead Inspector Mrs Diane Butler Unannounced Inspection 19th April 2006 10:00 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.V288046.R01.S.doc Version 5.1 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.V288046.R01.S.doc Version 5.1 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.V288046.R01.S.doc Version 5.1 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. 12th December 2005 2. Date of last inspection Brief Description of the Service: Alston House is a care home for older persons, providing accommodation and personal care for up to nineteen residents. The home can also care for up to six older people with dementia and/or a mental disorder and up to two older people with a sensory impairment. The home is situated on the Aylstone Road in Leicester approximately 15 minutes away from city centre. There are shops within five minutes walking distance from the home and there is a small park nearby. Accommodation is on two floors with the upper floor accessed by lift or stairs. There are two lounges, two dining room areas and a conservatory on the ground floor. The home offers both single and shared bedrooms some of which come with ensuite facilities. A large parking area is to the front of the home and there is a well-maintained garden to the rear of the home. Current charges range from £350.00 per week to £400.00 per week. Additional charges are in place for hairdressing, chiropody treatment and transport to appointments. Details of all charges can be found in the homes Statement of Purpose document which is given to all prospective and current residents. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit, which took place over a five hour period on Wednesday 19th April 2006. When undertaking key inspections the Commission for Social Care Inspection (CSCI) focuses on the outcomes for residents living in a home. In order to do this, the inspector ‘case tracked’ three residents. This means the inspector checked their care records and met with them. Where communication was difficult, observation was used to evidence whether care needs were being met. The inspector talked with staff on duty at the time of the visit and observed them going about their daily work. The inspector also had the opportunity to talk with three other residents, three visitors to the home, the manager and the general manager. Correspondence received since the last inspection and the last inspection report have also been taken into account when producing this report. What the service does well: What has improved since the last inspection? New care plan and risk assessment documentation has been developed. This new paperwork will provide a more thorough picture of the resident’s individual care needs, give a clearer picture of any identified risks and include the actions to be carried out by the staff team. Moving and handling training has been provided for half of the staff team and the manager plans to provide this training to the remaining staff in the near future. Further training in Infection control is arranged for June this year. An activities programme has been devised and activities are now offered on a regular basis. The homes policies and procedures have been reviewed. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 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.V288046.R01.S.doc Version 5.1 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.V288046.R01.S.doc Version 5.1 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): 1,3, Standard 6 was not applicable at the time of the visit. Quality in this area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents have their needs assessed before moving into the home and are assured that these will be met. EVIDENCE: The manager explained that all prospective residents are assessed before they move into the home. On checking the paperwork/files belonging to the three residents case tracked, all three were found to include an assessment of need completed by both the residents social worker and the registered manager. Two relatives visiting at the time of the inspection confirmed that someone from the home had visited their relative before they moved in and that a member of the family had had the opportunity to look around the home to decide if it was the right place for their relative to live. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 9 All residents and/or their families receive a copy of the homes Statement of Purpose document, which includes details of the Terms and Conditions of residency. Information includes details of the homes charges, what services the home provides and how the resident and or their relatives can make a complaint if they are not happy with something. Relatives spoken with during the inspection confirmed that they had received this information and signed copies of this document were included in the three files checked. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Residents are looked after well and personal support is offered in a dignified and respectful manner. EVIDENCE: Three care plans were looked at during the inspection. All were up to date, had been regularly reviewed and included the current needs and risks to the individual residents. The manager is in the process of transferring all the current care plans and risk assessments onto new paperwork. This will provide a more thorough picture of the resident’s needs and risks, if any, and identify actions to be carried out by the staff team. Details of visits carried out by health care professionals were seen. These included the residents GP, Community Nurses and the chiropodist. The Procedures for the administration of medication were in order with all paperwork completed appropriately. All staff responsible for the administration of medication have received relevant medication training. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 11 Discussion with residents and visitors confirmed that staff had a good awareness of how to ensure that a resident’s privacy and dignity are maintained. One relative explained: “They don’t mind if he/she spills something down themselves, they just change their clothes and that maintains his/her dignity”. Throughout the inspection the inspector observed staff interacting with residents in a positive and dignified manner. All staff spoken with were well aware of the individual care needs of the residents and residents (and their relatives and friends) spoken with during the inspection stated that they were currently being well looked after. Comments received included: “Ohh they do look after me” “They are smashing” “There ever so good” “He likes it here very much” Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Visiting is encouraged to enable residents to maintain contact with family and friends. EVIDENCE: Residents are offered choices on a daily basis. Choices include when to get up or go to bed, what to wear, when and where to eat their meals and whether to join in activities provided. An activities programme has been produced as recommended in the last inspection report and activities offered on the day of the inspection included a ball game in the morning and a musical entertainer in the afternoon. Family and friends are encouraged to visit the residents. One visitor spoken with stated: “We can come at any time, and they always give you a cup of tea”. A second visitor explained: “I am always made very welcome”. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 13 The menu record was seen and was found to be offering a varied and nutritious diet. A choice of meal is offered at all meals and a copy of the menus can be found on the notice board situated at the entrance to the lounge. The meal seen on the day of the inspection was well presented and appealing in appearance. The manager has developed a pictorial aid and, once in use, will enable residents with limited communication to continue to have the opportunity to choose what they would like for their meals. This is seen as good practice. Comments received during the visit included: “I like my sandwiches” “I enjoy my meals” “I’m not keen on dinner, I prefer my breakfast” “The food is always good” “Lovely food” Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Appropriate arrangements for the receiving and responding to complaints are in place. EVIDENCE: There is a complaints procedure in place. A copy of this is displayed within the home and a copy is included in the homes Statement of Purpose document, which is given to all residents and/or their relatives. When asked if they knew whom to talk to if they weren’t happy about something one of the residents spoken stated: “I’d speak to one of them” [staff member]. The registered manager explained that no complaints had been received since the last inspection in December last year. This statement was supported on checking the complaints book. Abuse awareness training is provided to all staff during their induction training and is also included in the National Vocational Qualification NVQ level 2 which care staff have either completed, are currently completing or are awaiting to commence. Staff spoken with during the inspection were aware of what to do should they suspect any act of abuse and the registered manager is aware of the procedure to follow with regard to adult protection. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. Though the home is clean and comfortable, the decoration and floor coverings in some areas of the home are in need of attention. EVIDENCE: The rooms belonging to the residents whose care plans were checked were seen. These were clean, appropriately furnished and included the residents personal belongings. On speaking with a fourth resident the inspector was told that they were worried about falling because of the floor. On inspection of the floor covering it was noted that it was ripped in a number of places and sticky to walk on. The manager stated that this would be looked into. Furnishings in the lounge areas, dining areas and conservatory are domestic in character and in good condition. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 16 The carpets in the back lounge and conservatory identified at the last inspection as being old and worn are due to be replaced on 3rd and 10th May this year. It was noted that the carpet in the ground floor corridor was in very poor condition and the decoration in two of the corridors was also in need of attention. The manager explained that the owner was planning to address these areas this year. During a walk around the home it was noted that one of the two assisted baths was out of action. The general manager stated that this was being dealt with. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures for the recruitment of staff are in place to ensure residents are not put at risk. EVIDENCE: There were sufficient numbers of staff on duty on the day of the inspection to meet the current needs of the residents. Both care workers spoken with confirmed that staffing levels were sufficient to enable them to care properly for the residents without feeling rushed. Through discussion it was evident that all the staff on duty were aware of the care needs of the residents case tracked. Two staff files were checked, both were found to include all the necessary information including references, proof of identity and a criminal record bureau check (CRB). Staff spoken with during the visit confirmed that they had received induction training on commencement of their employment and ongoing training is provided including dementia awareness training, moving and handling training, fire training and training in dealing with challenging behaviour. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home is managed efficiently and appropriate policies and procedures are in place to ensure the safety of the residents. EVIDENCE: The registered manager has many years experience in care and has completed her National Vocational Qualification level four in care and the Registered Managers Award. Staff spoken with stated that they were well supported and positive relationships between management, staff and residents were evident throughout the inspection. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 19 Money kept on behalf of one of the resident’s spoken with was checked. This was found to be in order with the appropriate signatures, records and receipts to ensure that the resident’s finances are safeguarded. All staff have received training in infection control and observations during the inspection confirmed that staff used appropriate protective clothing when carrying out their duties. The manager explained that a further training session on infection control was planned for June this year. Care workers spoken with confirmed that staff meetings are held on a regular basis and the manager explained that regular spot checks are carried out on the staff to ensure that a quality service is offered at all times. The manager explained that questionnaires are used to gain the views of the residents, their relatives and the staff with regard to the service provided in the home. Questionnaires could not be located at the time of the inspection. Policies and procedures required for the safeguarding of residents were in place and all records seen on this occasion were accurate, relevant and up to date. Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 21 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 OP19 OP33 Good Practice Recommendations It is recommended that the areas identified as in need of attention, including flooring and decoration is dealt with as soon as possible. It is recommended that quality assurance questionnaires are used to gather the views of the residents and/or their relatives and the results of these be collated and made available to interested parties. It is recommended that the broken bath be repaired as soon as possible. 3 OP21 Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 22 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 © 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 Alston House DS0000006408.V288046.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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