Inspection on 17/01/06 for Althorpe Care Home

This inspection was carried out on 17th January 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

Althorpe Care Home 09/02/09

Althorpe Care Home 31/10/06

Althorpe Care Home 03/06/05

Althorpe Care Home 15/12/04

Althorpe Care Home 31/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Althorpe Care Home 3 Main Street Althorpe Scunthorpe North Lincolnshire DN17 3HJ Lead Inspector Stephen Robertshaw Unannounced Inspection 17th January 2006 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 Althorpe Care Home DS0000059503.V270137.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. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Althorpe Care Home Address 3 Main Street Althorpe Scunthorpe North Lincolnshire DN17 3HJ 01724 783363 01724 783363 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) Complete Care (UK) Ltd Mrs Sandra Rosamond Jane Kirk Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd June 2005 Brief Description of the Service: Althorpe Care home is situated in the village of Althorpe, which is close to Scunthorpe. The home is registered to care for twenty three individuals over sixty five years in the category of old age, not falling into any other category. The building is said to be over two hundred years old and has had the benefit of an extension that was built approximately twelve years ago. Nineteen single and two shared bedrooms are accommodated on two floors accessed by a stair lift. However, as there are still some stairs to manoeuvre at one end of the second floor, service users residing in these specific bedrooms would need to be mobile. There is a large well-maintained garden with mature horse chestnut, apple and holly trees. It is easily accessible to all of the service users. There are facilities for car parking in the grounds. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was over a period of seven hours on 17th January 2006. The service users spoke very positively to the inspector in relation to the care and the environment provided through Althorpe care home. The staff group is well established and receive appropriate training to make sure that they can meet the needs of the service users. What the service does well: What has improved since the last inspection? All service users in the home now have individual care plans that have been developed by the home. A risk assessment has been completed for service users access to the top floor of the home. The hot water temperature at the outlets are now regulated close to 43°c. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 6 All staff now receive a minimum of two written references before the management employs them. The homes quality assurance and monitoring system is almost complete and the local authority have recently assessed the services provided in the home and awarded the home its Gold Quality assurance award. The damp identified in the home at the last inspection had all been rectified. The decoration of the downstairs had been completed and the area was much brighter than previously 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. Althorpe Care Home DS0000059503.V270137.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 Althorpe Care Home DS0000059503.V270137.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): 2,3, and 4 The service users are provided with choice to live at the home and in every aspects of their daily lives in the home. EVIDENCE: There were nineteen service users in the home at the time of the inspection. The inspector observed all of the care file information in relation to three of the service users. Each file seen by the inspector included the homes statement of terms and conditions for the individual service users. This detailed any fees that they may have to pay in relation to the care that they receive at the home and periods of notice required for termination of the placement. All of the care files observed by the inspector included a full and comprehensive assessment of their care needs before they were admitted in to the home and there was evidence that the assessments are regularly reviewed to make sure that if a service users need change they are recognised through an appropriate assessment and a new care plan can be developed. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 9 The assessments were a combination of the homes pre-admission information and assessments completed by care management teams that were funding individual placements at the home. The assessment information included who would be responsible for the funding of the placement. Service users spoken to by the inspector stated that ‘the staff were very good and friendly’ and that ‘the staff care for all my needs’. This supported the evidence that the home has the capacity to meet the assessed needs of the service users. Althorpe Care Home DS0000059503.V270137.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 and 9 Service users have their health and personal care needs met through the home. The home does not provide nursing care however the staff involve professional healthcare workers to support them with the healthcare needs of individual service users. EVIDENCE: National Minimum Standard 8 was exceeded. The care plans observed by the inspector had all been developed from their needs that were identified in the service users assessments. Since the last inspection of the home the paperwork to support the care plans has much improved and included clearer detail of how individual care needs must be met. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 11 The individual care plans had all been evaluated on a minimum of a monthly basis and had been signed and agreed to by either the service users themselves or their representatives. Individual care files showed how healthcare professionals that are based in the community are involved supporting the home with the care of individual service users. This included GP’s, Occupational Therapists, District Nurses, Opticians and Dentists. Individual service users noted showed that when their health deteriorated it was assessed if they were fit enough to remain at the home or if they required admitting in to hospital. When these changes were identified new care plans and risk assessments were developed. The inspector observed the case files for three service users and they all included assessments that included nutritional and psychological needs. All of the staff that administer medication to the service users in the home have received accredited medication training and before they can begin to give out medication to service users they must also have been approved by the homes manager. All of the medication in the home was appropriately stored and recorded. The MARS records were up to date and accurate. The controlled medication in the home was appropriately stored and recorded. A new fridge had been purchased by the home for maintaining temperature of appropriate medication. The temperatures of the fridge were regularly recorded and maintained. The inspector observed medication being administered in the home and good practices were followed. Service users stated to the inspector that they always received their medication and that the staff always made sure that they took it. Althorpe Care Home DS0000059503.V270137.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): 12,14 and 15 The service users are encouraged to maintain and developed activities that they were involved in before they wee admitted in to the home. EVIDENCE: The service users at the home are encouraged to make decisions about all areas of their daily lives including what time to get up in a morning, what time to retire to bed at night, what to eat, and where to eat it, and whether or not to become involved in activities in the home. The service users spoken to by the inspector said that the staff were ‘very supportive’ and encouraged them to become involved in activities in the home but did not ’pressure’ the service users to take part if they did not want to. Service users said that there was a ‘variety’ of activities for them to choose from every week and that there was a ‘religious service almost every week’ and ‘every Friday’ they had the opportunity of ‘going to a luncheon club’. The forthcoming activities were well advertised around the home. The service users said that the staff reminds them of activities if they have forgotten about them. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 13 Service users confirmed to the inspector that they are supported and encouraged to maximise their personal autonomy and choice at the home. The inspector ate with a group of the service users. The meal was well presented and of a good quality. Service users stated that their meals were always of a very ‘good standard’. The kitchen was observed by the inspector and was found to be very clean and their were plentiful food supplies. There were no special diets required by any of the service users at the home except for low sugar and low fat. One-service user had a pureed meal to assist their eating and digestion as identified in their care plan. The cook did not follow a set menu for any of the meal times. She decides on the day what to prepare for the service users. The manager stated that she was reviewing this policy to help to manage budgets and to ensure that the service users were receiving their nutritional needs throughout the week. Althorpe Care Home DS0000059503.V270137.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): 16,17 and 18 The service users are protected in the home and there is an easy to access complaints procedure. EVIDENCE: Since the last inspection there were no complaints recorded directly to the home. However one complaint was made directly to a local care management team who investigated the complaint. The complaint was in relation to poor electrical lighting equipment at the home. The local authority investigated the complaint. The management and staff of the home were very co-operative with the investigation. The complaint was not upheld. Staff working at the home receive adult protection training provided through the local authority and they also undertake a level two certificate in the Care of vulnerable adults provided through a private training organisation. The management of the home cover the cost of this course, which is £85 for all individuals involved in the training. The staff interviewed by the inspector were aware of adult protection issues and how to report suspected abuse. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 15 Individual service users case files showed that where appropriate they have been included on the electoral register and if required who is responsible for their financial arrangements through either the Court of Protection of Powers of Attorney. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 16 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): 19,20,21,23 and 25 The environment is appropriate to meet the needs of the service users. EVIDENCE: Since the last inspection of the home the environment is much improved. The corridors have been decorated making them much lighter. New carpets have been purchased for the corridors and are waiting to be fitted. The manager confirmed that plans have also been completed to redevelop some of the bathrooms at the home. Builders have been asked for quotes to carry out the work. A very small bath identified in previous inspection reports is to be replaced by a walk in shower room. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 17 The roof has been leaking in one section of the home. The roof is listed and the management have applied to the local council to allow them to replace the roof in the damaged section. Temporary arrangements have alleviated the leak problem. Some of the corridors in the home are two narrow to allow access to large wheelchairs and are further restricted through grab rails that assist the mobility of other service users. This should be identified in the homes statement of purpose and service user guides. The lighting and furniture in the home is all domestic in character. Service users stated to the inspector that they ‘liked the decoration of the home’ and they were ‘very happy’ with their individual rooms. The emergency lighting in the home is tested on a monthly basis. Two of the bedrooms in the home include en-suite facilities. The home does not have separate sluice facilities but the laundry includes a washing machine that is programmable to disinfection and sluicing standards. The manager also stated that there were possible plans to develop a new laundry area for the home as the current one is very small and limited. A maintenance programme has almost been completed providing low temperature surfaces on the radiators in the home. There was only one radiator that was not covered but there were plans for this to be completed. Regular maintenance checks are carried out on the water system in the home to ensure the safety of the service users. Hot water temperatures are randomly checked every two weeks. The records in the home indicated that the hot water at the outlets are maintained close to 43°. A tour of the premises completed by the inspector found it to be clean, tidy and free of any offensive smells. Staff training records and interviews with staff confirmed that they received training to control the spread of infection and observations showed that they put this training in to practice. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 18 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, and 30 Staff working at the home receive all of the appropriate mandatory training and supervision to make sure that they can meet the needs of the service users. EVIDENCE: The manager of the home confirmed that she uses the Residential Forum to calculate the appropriate staffing levels for the home. Staff training records showed that the staff receive all of the appropriate mandatory training to make sure that they can keep the service users safe and maintain a healthy lifestyle. There are no staff under eighteen working in the home and no staff under twenty one are ever left responsible for the running of the home. The management have appointed a new external training company to provide NVQ training to the staff group. The training company provides the home with an NVQ assessor for two full days each month. Staff interviewed by the inspector were very positive in relation to NVQ training. The staff personnel files indicated that generally all of the appropriate vetting procedures were used by the home before employing new workers. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 19 Positions were advertised then applicants were short listed and interviewed before positions were offered. In all cases except one either POVA clearances or Criminal Record Bureau checks were completed before new staff began to work at the home. One member of staffs file indicated that their POVA first record# was received at the home after the member of staff had already started working. The manager was told b y the inspector that this practice must not be repeated as it could place vulnerable service users at risk of abuse. Staff confirmed to the inspector that they had received individual copies of the General Social Care Councils codes of conduct and practice. The staff also confirmed the evidence that they received induction and foundation training that met the national Training organisations workforce training targets. The manager stated that the home would be implementing the new standards when they are introduced later this year. Training records supported the evidence that all staff working at the home receive in excess of the required minimum three days paid training per year. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 20 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 and 38 The management of the home makes sure that the safety and welfare of the service users are maintained and supported at all times. EVIDENCE: The management provided an up to date business and financial plan for the home and provided evidence that the appropriate levels of insurance for the business where in place. The inspector observed the pocket money accounts for three of the service users. These were all accurately recorded and were up to date. Receipts were in place where appropriate and all transactions included two signatures. Individual service users care plans identified if their finances were managed by their representatives for example as directed by the Court of Protection or Power of Attorney. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 21 Personal inventories for individual service users showed what they had brought in to the home and if anything was given to the home for safekeeping. The homes quality assurance and monitoring system has improved and has almost become a complete system. The home was recently awarded the local authorities Gold Award for quality assurance. The manager of the home is close to completing both the Registered Managers Award and the NVQ 4 in care. She already has a BTEC National Health and Social Care certificate, and a certificate in professional development. The manager also completed a certificate in supervisory management in September 2003. Staff supervision records showed that the frequency and content of their supervision had improved since the last inspection and indicated that the minimum requirements of six formal supervision periods would be met by all of the staff working in the home this year. Records showed that all of the staff had been issued with new supervision contracts and had returned them signed in agreement. Staff confirmed in their interviews with the inspector that they are regularly supervised and the supervision covers the philosophy of care in the home, all aspects of their practice and their personal career development needs. The management of he home do not use voluntary workers at the home. The records held in the home are much improved especially in relation to individual service users care plans. The inspector observed all of the records required by regulation. The majority of the homes health and safety maintenance monitoring, records and certificates were in place however the home had not received the certificate for a recent inspection of the electrical safety systems in the home. The home had installed new oil-fired boilers. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 22 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 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 X 3 X 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 2 3 3 3 3 2 Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 23 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 OP29 Regulation 18 Requirement The registered person must ensure that new staff receive a minimum of a POVA first check before they commence work at the home. Timescale for action 18/01/06 Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 24 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 3 4 5 6 Refer to Standard OP15 OP21OP19 OP28 OP31 OP33 OP38 Good Practice Recommendations The registered person should make sure that there is a set menu available in the home that changes over a regular basis. The registered person should complete the plans for the redevelopment of the home including the development of the bathrooms and the roof repairs. The registered person should continue with the NVQ training of the staff to make sure that a minimum of 50 of the care staff have achieved NVQ 2 or equivalent. The registered person should make sure that the manager of the home completes the registered Managers Award and NVQ 4 in care. The registered person should make sure that the home has an effective quality assurance and monitoring system in position. The registered person should ensure that a certificate is obtained by the home for the recent inspection of the electrical safety systems. Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Althorpe Care Home DS0000059503.V270137.R01.S.doc Version 5.1 Page 26 - 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. 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