Inspection on 09/02/09 for Althorpe Care Home

This inspection was carried out on 9th February 2009.

CSCI found this care home to be providing an Excellent 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

Althorpe Care Home 31/10/06

Althorpe Care Home 17/01/06

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 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Althorpe Care Home 3 Main Street Althorpe Scunthorpe North Lincolnshire DN17 3HJ     The quality rating for this care home is:   three star excellent 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. Lead inspector: Theresa Bryson     Date: 0 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Althorpe Care Home 3 Main Street Althorpe Scunthorpe North Lincolnshire DN17 3HJ 01724783363 01724783911 sandra.althorpe@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Complete Care (UK) Ltd Name of registered manager (if applicable) Mrs Sandra Rosamond Jane Kirk Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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. At the time of the site visit to the home the fees for the care provided are reviewed Care Homes for Older People Page 4 of 26 0 Over 65 23 care home 23 Brief description of the care home annaully. Additional charges are made to the service users for private hairdressing and chiropody services. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The site visit took place over one day in February 2008. Prior to this we sent surveys to people using the service and staff and spoke to some relatives and health professionals by telephone. We also looked at the notifications sent to us by the home through out the year and the service history kept by The Commission. The home also sent to us their Annual Quality Assessment Audit which gave us lots of statistical information about the home and what evidence they felt was available to support the care they give to people living there and how they protect them from harmful situations. On the day we were able to speak to a selection of people who live there, some staff Care Homes for Older People Page 6 of 26 and relatives and health professionals visiting the home. We also looked at a number of different records and documents, toured the home and spoke to the management team. What the care home does well: What has improved since the last inspection? Since the last inspection the home has improved how the care plans are evaluated to met peoples current needs and each key worker has a buddy system to ensure more than one person knows the finite details about each persons individual needs. The policy manual has been reviewed and this has included the infection control policy. Staff have also attended courses to up date their knowledge base when coping with infection problems, to ensure people are safe. The Company has a business and financial plan in place to ensure it is keeping on top of any issues which may affect the smooth running of the home and safety of people living there. The supervision of staff has improved and more sessions had been recorded to ensure senior staff are monitoring them so people living there are free from harm. Care Homes for Older People Page 8 of 26 What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive tool is used to record peoples needs to ensure the home can meet their needs prior to admission. Evidence: Documentation was seen of the latest admission to the home. This included a comprehensive pre-admission form which had been completed by a member of the management team. This ensured that prior to admission the home could see whether they could meet a persons needs and was then used as a basis to plan a program of care. People spoken to said this had reassured them and they felt on admission that staff knew a lot about them. For those on a rolling respite program needs were documented as being reviewed on every admission. This was confirmed when speaking to residents on this program who stated staff always ask if anything has changed and I see they Care Homes for Older People Page 11 of 26 Evidence: write this down. The home does not provide intermediate care so Standard 6 is not applicable. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Regular evaluation of care plans ensure that peoples current needs are being met and they are free from harm. Evidence: Prior to the site visit we sent out a number of surveys to people who use the service and had a good response, all giving positive feedback about their stay in the home. We were also able to speak to a number of people on the day. Their views also reflected the same types of comments. For example one person said I love it here, Im so well looked after and another the girls look after me, I only ring my buzzer when I need to, but they come immediately. 3 care plans were tracked in depth which showed that peoples needs were being evaluated regularly and the documentation gave an holistic view of their needs. There was good follow through when people, for example, had an accident. The records showed details of what had happened, immediate care and in some cases after care to hospital or for advice by local health professionals such as GPs and district nurses. Care Homes for Older People Page 13 of 26 Evidence: Depending on need assessments were in place for example for bowel movements, client movement plan and handling assessment or dietary needs. The regular evaluations show that staff are keeping up to date with peoples current needs to prevent them from being harmed. There had been an improvement in the way staff are recording peoples weights and this is now documented for each person and linked to other parts of the care plan. Safe practises appeared to be in use when a medication round was observed and all records appeared to be accurately kept. Health professionals were also spoken to prior to the visit and on the day. They said they had a good rapport with the home and were passed information in a timely way. One person said I would put my own mother in here. The management team were working to wards a more in depth approach to End of Life Programs and had commenced some training in this area. Documentation was also seen that a policy is being developed to ensure, where appropriate, all permissions are in place to operate a do not resuscitate (DNR) process. This still needs a little bit of work and the management team were recommended to use the appropriate web sites to gain a more in depth understanding of this topic. Staff were observed during the day assisting people with a number of tasks including personal care and when some ones life was drawing to a close. This they did with a great deal of dignity and respect to every one, including relatives. Relatives spoken to or who had returned questionnaires said how kind staff are and they pass on new information quickly. The management team are also quick to respond where care by other agencies has been less than perfect. For example a recent hospital admission by one resident had resulted in them being returned in a less than satisfactory manner. This was reported to the local safe guarding team to investigate and all documentation of this event was seen on this visit and was clearly and legibly written. The management team ensuring that people are free from harm and risk. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social, cultural and religious expectations are being met. Evidence: In each care plan peoples needs had been assessed to ensure staff were aware of their social, cultural and religious needs and develop a separate program of care. People spoken to whilst on the site visit were able to tell us how they were kept occupied through out the day. This included keep fit (daily), games afternoons, art and craft, entertainers visiting and individual events. One person was able to show us what they were knitting and said staff ensure I always have enough wool to work with and another said staff ensure I have a newspaper and there are always books and magazines to read. The records also showed what group and individual events had taken place. The home is situated in a small village community and the staff appeared to keep abreast of local events to offer to take people to and also events in the larger industrial town of Scunthorpe, where more variety was on offer. A member of staff has commenced work who is solely there to facilitate activities, which the home hopes will open more doors and they will possibly be able to Care Homes for Older People Page 15 of 26 Evidence: recommence their newsletter. This will ensure that staff can keep abreast to ensure individual expectations are being met. People spoken to and in the surveys commented on the food. Saying I get more than enough to eat and plain food, but very good. On touring the kitchen food was being prepared in a clean and safe environment and all records appeared to be up to date. The last environmental health officers visit had been in June 2008, and there were no outstanding issues which needed addressing. Staff were able to explain the process of ordering food and said they were happy with the quality of food provided to be able to fulfill the 2-week cycle of menus and varied meals needed for diabetics and those on high protein diets. Advice was sought from other health professionals when needed and information sheets, from the hospital dietitians office were seen to be in use. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust systems are in place to ensure people are free from harm and risk. Evidence: Since the last inspection no issues about the home had been raised to us and when looking at the homes own complaints log there was nothing recorded from internal concerns. People spoken to stated they had every confidence in the management team in addressing concerns, should they arise. The policy manual had been reviewed in the last year and staff records showed there had been a good attendance by staff on topics such as safe guarding vulnerable adults and the Mental Capacity Act. This has kept them up to date with latest legislative issues to be able to protect people they care for. The management team has throughout the year kept CSCI informed of any untoward events in the home. Recently they also refereed an issue to the local safe guarding adults team where they had felt poor practice of an Establishment had resulted in one of their residents being harmed. This was currently being investigated by that team. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to live in comfortable and safe environment. Evidence: A tour of the home took place with the deputy manager being present. The surroundings were comfortable and adaptations had been made to ensure peoples individual needs and tastes had been taken into consideration. The home is partially an older building with a modern extension and care is taken by the Provider to ensure the Listed Building status is adhered to and all improvements are sympathetic to the building as well as addressing peoples needs. Most bedroom areas are therefore very individual in there layout and there was ample evidence that people had been able to bring in their own personal belongings. One person said how this had helped them settle in as some ornaments and pictures were precious to them. Homely touches were in place such as the hairdressing area which had appropriate posters and equipment in use, making it look like a salon. The dining area was large but comfortable with clean table cloths in place throughout the day and room made for those using wheelchairs to sit comfortably. Care Homes for Older People Page 18 of 26 Evidence: The garden area was large but well maintained and all areas were free from hazards and accessible for wheelchair users. Staff spoken to and who returned surveys said that they have most equipment they need to enable them to do their jobs effectively but felt the home would benefit from the long expected extension to the building to enable them to address end of life care in more appropriate settings. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust systems are in place to ensure staff are safe to work with people prior to commencement of employment and are then trained to do their jobs. Evidence: People spoken to who live in the home did not indicate that their current needs were not being addressed. One person said they come immediately I want them and another staff will do any thing I ask them to within reason. The management team were able to show records to prove that the dependency needs of each individual living in the home were being evaluated regularly and this was then used with an appropriate staffing matrix to determine numbers of staff on duty to meet peoples needs. The care staff are well supported by kitchen, domestic/laundry, maintenance/garden and activities staff. Plus the management team. Communication books were seen where staff can on a daily basis write notes about individuals in the home, broken equipment or jobs which need doing to pass to day and night staff. Staff said this worked well for them and the management team could then track if topics had not been addressed. This ensures staff are keeping up to date with the needs of people and ensuring the home is safe to live and work in. 5 staff files were tracked in depth and there was sufficient evidence to show safety checks had been made prior to commencement of their employment. Staff spoken to Care Homes for Older People Page 20 of 26 Evidence: and in surveys returned appeared to appreciate the training put in place to enable them to do their jobs. 100 of care staff have obtained their NVQ in Care Awards which has been a remarkable achievement for the home. We were offered the training matrix to see for 2008/09 which showed what individual topics staff needed still to achieve and the various topics already on the training program. Apart from mandatory topics staff had received training in service specific topics such as dementia, vision and safety, preventing falls, bowel care practices and aggression management. This enable staff to be using techniques to care for people using the most up to date information. Each staff member had their own professional development manual to enable them to take ownership of their personal training needs. Staff said it helps me think what else I can do to help people I look after. Health care professionals spoken to said that the knowledge base of staff was good and they felt that they were good at following instructions to care for people and as one person said actually know what they are doing and why. This ensures people are free from harm and are being safely looked after. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People views are valued and quality checks are made to ensure the home is run for the benefit of the people using the service. Evidence: The management team were spoken to at length about the running of the home, local needs being addressed and their involvement in local Provider groups in the area. This, they stated keeps them abreast of local issues. The site visit forms completed by the Responsible Individual for the Company were seen and had been individualized for this home out of the group of Company homes. This showed their continued involvement and input in the running of this home. The home has achieved a lot of awards and currently holds the Investors in People award which looks at how it invests in staff training and quality of care. The local authority also has an award scheme which looks at quality and whether it feels the people using the service are well cared for. This home has the highest standard Gold Care Homes for Older People Page 22 of 26 Evidence: Award. Alongside of these schemes the Company also has an extensive quality assurance program, records of which were seen at the site visit. This included surveys to people using the service and other stakeholders. Also monthly care audit checks to ensure peoples current needs are being met and recorded supervision and training sessions of staff. The quality circle acts as a staff meeting where people can bring concerns, ideas and needs to a bigger forum to be addressed. All is fed back to staff through regular meetings and to people using the service individually. A key worker backup system is in place to ensure that at all times a staff member is responsible to ensure individual needs are being met. Records and documents were also seen to ensure us that correct and accurate records are kept to ensure peoples personal allowance money is not being used fraudulently. Monthly checks are in place and recorded on individual peoples records. The residents fund records also appeared to be in order and showed a good use of the funds raised for such items as entertainers and social needs equipment. The policy and procedure manual had been undated in the last year to ensure staff were adhering to latest information available to enable them to look after people. To ensure staff adhere to these policies supervision records showed staff discussions take place to test their knowledge base. This should be balanced with more formal observational supervision to ensure their theoretical knowledge is transported into their practice. Safety certificates were seen which showed the management team were ensuring the home was a safe place to live and work. The business plan for 2007 to 2010 was still in place, but we were assured this is reviewed annually in case minor changes needed to take place. People who live in the home said they were comfortable and felt safe and also expressed, along with relatives, that they felt if they had any concerns the staff would deal with them promptly and efficiently. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 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 11 The management team should ensure that they research the appropriate web sites to ensure their documentation for their do not resuscitate policy reflects current legislative guidance. The management team should ensure that observational supervision of staff takes place to ensure their theoretical knowledge is being put into practice. 2 36 Care Homes for Older People Page 25 of 26 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 © (2009) 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 26 of 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. 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!