Inspection on 03/06/08 for Alston House

This inspection was carried out on 3rd June 2008.

CSCI found this care home to be providing an Adequate 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 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 12/12/07

Alston House 19/09/07

Alston House 19/04/06

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL Lead Inspector Diane Butler Unannounced Inspection 3rd June 2008 09:30 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.V365957.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 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 Manager post vacant Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (19), Old age, not falling within any other category (19), Sensory Impairment over 65 years of age (2) Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service user numbers. No person falling within categories OP, MD(E) or DE(E) may be admitted to the home when 19 persons of categories/combined categories OP, 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. The maximum number of persons to be accommodated at Alston House is 19. 12th December 2007 2. 3. 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 some of whom have mental health needs, dementia and/or a sensory impairment. The home is situated on the Aylestone Road in Leicester approximately 15 minutes away from the 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 three 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 secure 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, (a document which provides relevant information about the home) which is given to all prospective and current residents. A copy of the latest Inspection report is available at the home, or it can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the acting manager. Alston House DS0000006408.V365957.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 1star. This means the people who use the service experience adequate outcomes. This was an unannounced visit, which took place over a 7 1/2 hour period in June 2008. When undertaking key inspections the Commission for Social Care Inspection (CSCI) focuses upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, speaking with them where possible and discussion with staff on duty at the time of the visit. Three relatives and one visitor to the home were also spoken with. Where communication was difficult observation was used to evidence whether care needs were being met. Further planning for this visit included checking the service history of the home and the last Inspection report and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the Commission for Social Care Inspection prior to the visit. The AQAA document is the main way that providers inform us of how well their service is delivering good outcomes for the people using it. Surveys were also sent to a selection of service users currently living at the home and a selection of support workers to gain their views of Alston House. One service user survey and one support worker survey had been returned at the point of this inspection visit taking place. Comments received include: “Care plans are always up to date”. “They always seem quite helpful”. “I do think they sit to long, I think they need more stimulation as they get bored and stiff. The only time they are moved is for toilet and meals”. “I have been there a few times at meal times and I must say they are quite well presented and look appealing”. “I can’t fault the home for cleanliness”. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Ensure that all people paying for a service are aware of all the charges made and what those charges are for and ensure that charges made for additional services provided are included within the homes documentation. Residents must be made aware of all extra charges made for services provided to enable them to make a choice as to whether to use that service or not. Ensure that care plans include all the needs of the residents and the actions to be carried out by the care workers to meet those needs. Care workers need to know the tasks they are to carry out in order to meet the resident’s needs. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 7 Ensure that risk assessments contain all the risks presented to both the resident and the staff. Care workers need to be aware of all the current risks to the residents and the actions to take to minimise those risks. Ensure that all medication and medication records are appropriately maintained, up to date and accurate and medication storage meets legal requirements. Residents need to be protected by robust polices and procedures within medication management. Ensure that daily records are up to date and accurate. Residents need to be protected by accurate and up to date records including daily records and accident records and staff need to be made aware of all accidents that happen in the home. Provide more activities and opportunities for positive interaction this would enable the residents to maintain a more meaningful way of life. Provide further training in safeguarding to ensure that all staff are aware of their responsibilities around protection. Ensure that an advocacy service is available for residents who need assistance with their personal finances, this will protect both the resident and the staff working in the home. Ensure that the areas of the home identified as of need of decoration are done so in a timely manner. Recommence the quality monitoring systems that are in place including questionnaires for residents and their relatives in order to get their views of the service provided. 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 House DS0000006408.V365957.R01.S.doc Version 5.2 Page 8 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.V365957.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,45,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are assessed before moving into the home to ensure that their needs can be met. Residents would be further protected by ensuring that extra charges for services provided are clearly identified in the homes literature. EVIDENCE: A statement of purpose document is in place. The acting manager stated that this document, which includes details of the terms and conditions of occupancy, is given to all prospective residents. This was confirmed on speaking with two relatives who confirmed that they had received this information. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 10 A new service user guide has also been developed which gives additional information about the services the home can offer. It was noted that neither the statement of purpose, service user guide or the terms and conditions of occupancy currently inform residents of extra charges made in conjunction with additional services provided. Please see Management and Administration section standards 31 – 38. The acting manager explained that whenever possible prospective residents would be visited prior to them moving into the home so that an assessment of need can be carried out. An initial assessment is also obtained from the resident’s social worker. If residents are admitted in an emergency an assessment is obtained from the persons social worker and the homes own assessment is carried out within 48 hours of the person moving into the home. Files checked included copies of assessments completed by the registered owner and by the resident’s social worker. A copy of their terms and conditions of occupancy was also in place. All prospective residents and/or their families are invited to look around the home and a trial period is offered. One relative explained, “We came and had a look around to see what it was like”. Intermediate care is not currently provided at Alston House. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents currently receive the care and support they need however, shortfalls within care plan and risk assessment documentation could result in care and support needs not being identified and ultimately not being met. EVIDENCE: Three resident files were checked and all were found to include a copy of their care plan, which had been developed following their arrival at the home. All three care plans included the actions to be carried out by the care workers to meet the residents identified needs and all had been reviewed on a monthly basis. Where changes in care needs had occurred the care plans had been amended to reflect this. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 12 On checking the care plan belonging to a resident who visits the home for both day care and respite periods it was noted that it didn’t include information regarding the monitoring and care of their diabetes. The acting manager explained that when the resident stays overnight their blood sugar levels are checked twice a day and insulin is administered. It was also evident that staff were not always recording when the blood sugar levels were being checked. This was discussed with the acting manager who immediately amended the care plan to reflect this information. Risk assessments were in place for all three residents. These documents identified the risks relating to the individual resident and the actions to be carried out by the care workers to minimise those risks including risk associated with falling and leaving the home alone. It was noted that for the resident who suffers with diabetes, the risks associated with this condition were not fully included in their risk assessment documentation and actions that care workers should take had also been left out. This shortfall was also identified at the last inspection in December 2007. The acting manager immediately amended the risk assessment to reflect this information. Although senior care workers have received training in the use of equipment for the monitoring of blood sugar levels and the administration of insulin, it was noted that this was provided in 2006 and was not with regard to the current resident in their care. This was discussed with the acting manager who contacted the community nurse during this visit to arrange for updated training in this area. Daily records showed that health care professionals were involved in the residents care. These included the local GP, community nurse and chiropodist. Medication records were checked and although the majority of records were accurately completed a small number of errors were identified. These included on two occasions when medication had been given but not signed for and a course of antibiotics that had not been appropriately signed into the home. On checking the medication storage it was noted that the current arrangements for securing the medication trolley to the wall was faulty with the acting manager awaiting a new chain, problems were also evident with the lockable storage for the controlled medication, the acting manager explained that she was in contact with a locksmith to ensure that storage of all medication complies with the relevant regulations. Residents and relatives spoken with during the visit stated that they were being appropriately cared for and there current care needs were being met. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 13 Comments received included: “They look after mum really well, they are great” “They are absolutely marvellous, I can sleep easy at night knowing mum is here”. “The care that mum has received has been perfect, they have been very good for mum”. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although some activities are offered, residents would benefit from a more structured activities programme. EVIDENCE: Choices are offered to the residents on a daily basis including when to get up, what to wear, where to eat their meals and whether to join in activities when offered. There is currently no structured activities programme within the home though music and movement sessions are provided and staff provide physical activities such as ball games and one to one sessions on a regular basis. One visitor explained’ “Most days they massage the residents hands and I see them doing activities with them as well”. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 15 A survey received prior to this visit commented on the current situation with regards to activities being offered it stated: “I do think they sit to long, I think they need more stimulation as they get bored and stiff. The only time they are moved is for toilet and meals”. It was noted during the visit that the majority of the residents only moved from their chairs when care workers supported them with personal care or to have a meal at the dining table. The acting manager agreed that more opportunities for activities would be of benefit to the residents currently living in the home. Visiting is strongly encouraged and all relatives spoken with during this visit stated that they were made welcome and could visit at any time. Comments received included: “We can visit at any time and we are always offered a cup of tea”. “You are made to feel welcome, they are very nice”. Residents and relatives spoken with during the visit stated that the food served in the home was generally good, a copy of the day’s menu can be found on the notice board situated in the dining area and we were informed that an alternative is always available for those who didn’t want what was on offer. Comments received included: “The foods good, yep it’s ok”. “Mums now eating properly, and she says the food is very good”. “The food is excellent, there’s plenty of it and no two meals are the same”. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confident that their concerns will be listened to and dealt with appropriately. EVIDENCE: A complaints procedure is in place. A copy of this can be found on the notice board situated in the hallway near the front door and details are also included in the Statement of Purpose, which is given to all residents (or their relatives) living at the home. It was noted that the current complaints procedure needs amending to include the new contact details of the CSCI. It also directs any complaints to CSCI. The home needs to inform interested parties that complaints need to be directed firstly to the home, secondly to social services who have lead responsibility to investigate complaints involving funded residents and then if still unresolved to CSCI who can look into concerns as part of the inspection process. The acting manager stated that no complaints had been received since the last inspection in December last year. This was confirmed on checking the complaints book. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 17 Residents and/or their relatives spoken with were aware of whom to talk to if they were concerned about anything and all were confident that any issues raised would be dealt with appropriately. One relative stated: “I would talk to xxxx [the acting manager] she is very approachable”, one resident explained, “I would tell any of the staff, they have got to know me and we have discussed different things”. All new staff are provided with a practical guidance on adult protection and details of the Department of Health’s ‘No Secrets’ document on employment and care workers spoken with during the visit were on the whole aware of their responsibilities if they had a concern or were worried that a resident was being abused. It was noted that no formal training has yet been provided for the care workers around safeguarding though the acting manager has completed basic awareness in adult protection. It was strongly recommended that the acting manager refresh all staff on their responsibilities within safeguarding. At the last two inspections carried out in September 2007 and December 2007 it was identified that one resident was in need of the support of an advocate with regard to their finances, on speaking with the acting manager it was noted that this service had yet to be sourced on the residents behalf even though the need for such support was still there. The acting manager stated that this would be looked into. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a comfortable place to live, which will be further improved by the redecoration currently underway. EVIDENCE: The communal areas within the home are appropriately maintained and suited to the current residents needs. Furnishings in the lounge areas, dining areas and conservatory are domestic in character and in good condition. One resident’s room was seen during the visit, this was furnished in the way that they preferred and included some personal belongings. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 19 It was noted that a number of the doors to residents’ rooms, parts of the downstairs corridors and the skirting boards in the main dining area were quite badly scratched, this was also noted at the last inspection in December 2007. The acting manager explained that the maintenance worker was in the process of decorating a number of areas within the home and the areas identified were due to be addressed. A number of improvements have been made since the last inspection in December last year, a new flooring has been ordered for the main lounge area in the home and this is due to be laid in the near future and vanity units in some of the residents rooms have been upgraded. There is a secure garden to the rear of the home that residents can access and benches are available for residents and visitors to use. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected by the homes current recruitment practices. EVIDENCE: The acting manager explained that no new staff members had started working at the home since the last inspection in December 2007 however; she was in the process of recruiting three new care workers who would commence their induction once all the required checks were in place. On checking two files it was noted that the relevant checks were in place including references, CRB (Criminal Record Bureau) check and POVA (Protection of Vulnerable Adults) check. There were sufficient numbers of staff on duty on the day of the visit to meet the current needs of the residents. Relatives spoken with felt that on the whole there were enough staff on duty to meet their relatives needs and the care workers spoken with felt that there were normally enough staff on each shift to enable them to provide the necessary care and support for the residents. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 21 A number of training courses are currently being completed via distance learning, the acting manager explained that care workers work through all the courses at their own speed until all have been completed, this was confirmed on speaking with one of the care workers on duty at the time of the visit. Courses currently being completed include health and safety, palliative care, healthy eating and dementia. Care workers have also been provided with fire safety awareness training and stoma care training since the last inspection. Residents, relatives and visitors spoken with stated that the staff working at the home were competent and knowledgeable. Comments received included: “The staff are wonderful, they treat me very well”. “The staff are marvellous, I have seen them deal very well with some difficult situations”. “The move and handle people appropriately”. “They know what they are doing”. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all records required by regulation for the protection of the residents are up to date or accurate. Residents would be further protected by ensuring that extra charges for services provided are clearly identified in the homes literature. EVIDENCE: At the time of the visit the home was without a registered manager. The acting manager has many years experience in care and has completed her National Vocational Qualification level four and Registered Managers Award. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 23 Visitors at the home at the time of the visit stated that the acting manager was approachable and would have no hesitation to talk with her should they need to. Care workers spoken with felt supported and stated that there was always someone available to talk to should they need to. The acting manager has commenced supervisions for the care workers at Alston House and a format for annual appraisals has been developed. It was also noted that both the acting manager and the owner carry out ‘out of hours’ spot checks to ensure that staff are carrying out their responsibilities appropriately. This is good practice. The acting manager stated that staff meetings are held on a regular basis, this was confirmed on speaking with care workers on duty during the visit though minutes were not available. On checking the diary it was noted that the next full staff meeting is to be carried out on 18th June. Money kept on behalf of three residents was checked. On checking the records held for hairdressing it was noted that the charge made by the hairdresser did not correspond with the charge made by the home. Current charges made by the hairdresser include: Cut £5.00 Shampoo and set £6.00 Shampoo, set and cut £8.00 Perm £25.00 Charges invoiced to the residents by the home include: Cut £8.00 Shampoo and set £10.50 Shampoo, set and cut £12.50 Perm £28.00 No explanation for this could be given at the time of the visit except that it could be an administration charge and no explanation for this is included in any of the home’s documentation. On speaking with the hairdresser we were informed that current practice is rather than producing an individual receipt for each resident the charges are written on one sheet which is given to the person in charge. The hairdresser then receives the money in one lump sum. An urgent action letter was issued following this inspection requiring the registered provider to clarify the discrepancies identified. On checking the money held on behalf of one of the residents it was noted that the resident personal allowance sheet did not tally with the amount of money being held. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 24 The acting manager explained that this was because she had yet to take out the money for the most recent visit to the chiropodist although it had been deducted from the balance sheet. This meant that there was £15.00 more in their money wallet than the balance sheet stated. Not all care plans or risk assessments were accurate on the day of the visit however the acting manager immediately addressed the shortfalls identified. On checking the accident records held it was noted that not all accidents were being recorded in the daily records and the daily records indicated that no falls had taken place. The accident book showed that one resident had suffered a number of falls, including falls on 7th March, 10th March, 17th March and on the night of the 31st March, on checking the daily records the entries were as follows: 7th March: ‘Has been fine today’. 10th March: ‘xxx was fine, ate dinner and tea’. 17th: ‘Slept well, no problem, xxx appeared to be well all day’. 31st March: ‘ slept well, no problem’. Quality assurance questionnaires are not currently used to gather the views of the residents living at the home, though the acting manager stated that she talked with the residents and/or their relatives on a daily basis to ensure that they were satisfied with the care and support they were receiving. The acting manager explained that all care workers are provided with moving and handling training. This was confirmed on discussion with the care workers and visitors during the visit. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 2 2 3 X X X 3 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 3 2 X 1 3 1 3 Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP2 Regulation 17.2 Requirement The registered person shall maintain in the care home the records specified in Schedule 4. Schedule 4.8 states: A record of the care homes charges to the service users, including any extra amounts payable for additional services not covered by those charges, and the amounts paid by or in respect of each service user. 1.The registered person must ensure that all people paying for a service are aware of all the charges made and what those charges are for. 2.The registered person must ensure that charges made for additional services provided are included within the homes documentation. Service users must be made aware of all extra charges made for services provided to enable them to have a choice as to whether to use that service or not. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 27 Timescale for action 18/06/08 2 OP7 15 (1) The registered person shall, after 18/06/08 consultation with the service users, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The registered person must ensure that all care plans show the assessed needs of the residents and the actions to be taken by the staff to meet those needs. Care staff need accurate information in order for them to meet the needs of the residents in their care. 3 OP7 13(4)(C) The registered person shall ensure that: Unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person must ensure that risk assessments are thorough in content and include all the possible risks associated with the identified task/risk. Care workers need to be aware of all the current risks to the residents and the actions to take to minimise those risks. 18/06/08 4 OP9 13(2) The registered person shall make 18/06/08 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 1. The registered person must ensure that all medication Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 28 received into the home is appropriately recorded and medication records are up to date and accurate. 2. The registered person must ensure that all medication is stored in line with legal requirements. Residents need to be protected by accurate medication management, storage and record keeping. 5 OP37 17(1) The registered person shall maintain in the care home the records specified in Schedule 3. and ensure that these are kept up to date. The registered person must ensure that daily records are up to date and accurate. Residents need to be protected by accurate and up to date records including daily records and accident records and staff need to be made aware of accidents that happen in the home. 18/06/08 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 OP2 Good Practice Recommendations The registered provider should source an advocate to assist the resident identified during the visit with their contract and finances. DS0000006408.V365957.R01.S.doc Version 5.2 Page 29 Alston House 2. OP12 3 4 5 OP18 OP19 OP33 The registered provider should ensure that more activities and opportunities for positive interaction are provided; this would enable the residents to maintain a more meaningful way of life. The registered person should provide further training in safeguarding to ensure that all staff are aware of their responsibilities. The registered person should ensure that the areas of the home identified as of need of decoration are done so in a timely manner. The registered provider should recommence the quality monitoring systems that are in place including questionnaires for residents and their relatives in order to get their views of the service provided. Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alston House DS0000006408.V365957.R01.S.doc Version 5.2 Page 31 - 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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