Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diane Butler Date: 0 4 1 1 2 0 0 8 Information about the care home
Name of care home: Address: Alston House 380 Aylestone Road Leicester Leicestershire LE2 8BL 01162915601 01162915611 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Margaret Madden care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category sensory impairment 0 0 0 0 Over 65 19 19 19 2 Conditions of registration: 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. Date of last inspection Brief description of the care home Care Homes for Older People
Page 2 of 12 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 wellmaintained 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. Care Homes for Older People Page 3 of 12 What we found:
This was an unnanounced visit which was carried out following concerns received about Alston House. We arrived at the home at 07.45am to check on how many people were up and dressed. Eleven of the sixteen people living there were up and dressed, with the majority asleep in their chairs. The senior care worker explained that six people were up and dressed on her arrival at the home at 7.00am. The acting manager explained that a number of the people living there tend to wander through the night and some are incontinent. Staff have been told that rather than them wandering in their nightwear to help them to dress and bring to the lounge for cup of tea. Those who may have been incontinent, staff have been told to assist to wash and dress rather than leave them in their bed. A discussion took place as to whether, if this is very early morning, it may be more appropriate to assist with washing and putting on clean night wear and enable them to go back to bed. The initial assessment paper work was checked for one person living in the home. This had been carried out prior to them moving in and an assessment from their social worker had also been obtained. A care plan and relevant risk assessments had been completed following the assessment and all the relevant information had been included in these documents. This included the actions staff were to take to minimise any risks identified. We checked medication procedures. We were informed that only senior staff or staff with medication training give out the medication. On checking the records we were informed that the signatures recorded on the medication administration records all belonged to senior staff or staff who had completed the necessary training. It was noted that there is currently no specimen signature list to check against to confirm this. The medication records show that night medication is to be given at 10.00pm however it was evident that this was being given before the day staff left at 9.00pm. The acting manager explained that this was so that the night staff did not have to dispense medication. This does mean that the day staff are signing to say they have given medication at 10.00pm when it has actually been given at 8.45pm - 9.00pm. The training files of the senior carers and carers responsible for administering medication were checked to confirm that they had completed the necessary training. Two files were without certificates though the acting manager confirmed that the training had been completed. We checked the kitchen and preparation areas, which were found to be clean and tidy. We checked the staff rota to check on numbers of care staff on each shift. It was evident that prior to the visit there were only two care workers rotared on each shift. The question was raised as to whether this was sufficient to meet the needs of sixteen Care Homes for Older People Page 4 of 12 people. The days following the visit it was evident that there were three care workers rotared on. We were informed that this was due to someone returning home from hospital. The acting manager explained that this would now be the regular numbers of care workers on each shift. We looked at what equipment was available to assist with the moving and handling of the people living in the home. There is a stand aid and an Arjo Hoist available for use, both of which have recently been serviced. A number of slings are available for the hoist in different sizes and the acting manager explained that disposable slings had recently been purchased to be used for anyone with MRSA. It was evident that some staff had been working without formal moving and handling training, however the acting manager explained that she had completed a moving and handling train the trainer course and had shown new staff what to do until formal training could be arranged. This was arranged for 29th October when six staff attended. On requesting to see the acting managers training certificate we were informed that this was currently not available. We were informed that following the recent moving and handling training all care workers are now appropriately trained in moving and handling. What the care home does well: What they could do better:
Ensure that the people living at the home have the choice as to what time they are assisted to get up and start the day. Everyone should have the choice of getting up or staying in bed on a daily basis. Ensure that there is a specimen signature for each staff member who administers medication. This will enable the acting manager to audit medication records appropriately. Ensure that medication is given as written on the medication administration records. Records kept must accurately show the time any medication is given. Continually monitor staffing levels to ensure that staff can meet the ever changing needs of the people in their care. Provide evidence of all training provided in the home. The registered provider must be able to demonstrate that staff have received relevant and up to date training. Care Homes for Older People
Page 5 of 12 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 2 17.2 The registered person shall 18/06/2008 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. 2 7 13(4)(C) The registered person shall ensure that: Unnecessary risks to the 18/06/2008 Care Homes for Older People Page 7 of 12 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. 3 7 15 (1) The registered person shall, after 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. 18/06/2008 4 9 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 1. The registered person 18/06/2008 Care Homes for Older People Page 8 of 12 must ensure that all medication 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 37 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. 18/06/2008 Care Homes for Older People Page 9 of 12 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Ensure that staff are 14/12/2008 accurately recording the time that medication is being administered and at times as stated on the medication administration records. People who use the service need to be protected by accurate medication management and record keeping. 2 27 18 Ensure that appropriate 21/11/2008 numbers of staff are on duty at all times. People who use the service must be confident that their care and support needs will be met. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 9 The registered person should develop a sample signature list for all staff administering medication. This will assist with the auditing process of medication records. Care Homes for Older People Page 10 of 12 2 12 The registered person should remind all care workers of the importance of offering choices on a daily basis including when to get up and when to go to bed. The registered person should ensure that evidence of all training completed is available in the home at all times. 3 37 Care Homes for Older People Page 11 of 12 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 12 of 12 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
