Inspection on 26/02/07 for Alverstoke House Nursing Home

This inspection was carried out on 26th February 2007.

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

Alverstoke House Nursing Home 05/02/09

Alverstoke House Nursing Home 06/09/05

Alverstoke House Nursing Home 26/04/05

Alverstoke House Nursing Home 29/09/04

Alverstoke House Nursing Home 04/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Alverstoke House Nursing Home Somervell Close Alverstoke Gosport Hampshire PO12 2BX Lead Inspector Mrs A Taggart Unannounced Inspection 26th February 2007 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 Alverstoke House Nursing Home DS0000055635.V326097.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. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alverstoke House Nursing Home Address Somervell Close Alverstoke Gosport Hampshire PO12 2BX 023 9251 0254 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) Mrs Janet Hudson Mr Andrew John Hudson Mrs Rosemary Patricia Cook Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (30), Physical disability of places over 65 years of age (30), Terminally ill (30), Terminally ill over 65 years of age (30) Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the TI and PD categories should only be admitted over the age of 60. 6th September 2005 Date of last inspection Brief Description of the Service: Alverstoke House is a privately owned care home located in a residential area of Gosport. The manager, Mrs Rose Cook, has been in post since the home opened. The home offers nursing care for up to 30 clients from the age of 60 years. Nursing and care staff are on duty 24 hours a day. The home is situated within easy access of local amenities as well as being in easy access to the coastal area of Stokes Bay. The home is furnished and decorated in a homely fashion enhancing the comfort of the clients at the home. Building work has recently been completed to give more communal space for the clients in the form of a dining conservatory area as well as improving the front garden area for the use of the clients. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit, a pre-inspection questionnaire was sent to the Registered Manager for completion, survey forms were sent to service users, comment cards to families and other professionals involved with the home and a planning document was completed. Five comment cards were returned, all very complimentary about the care provided. The unannounced visit was carried out at 9.15am and lasted for 5.5 hours, which covered the early and late staff shifts at the home. During the visit the inspector spent time talking to all but two of the residents currently receiving a service and also interviewed four staff members, a visitor and a care manager who was involved in supporting two residents. Four care plans and supporting documentation were tracked with any relevant issues being discussed with the resident or staff team and the inspector also saw four staff files. A tour of the home was undertaken during which time communal areas and resident’s private bedrooms were seen and records for the running of the business, including the complaints book, medication records, incident and accident forms and maintenance records were seen. The Registered Manager, Mrs. Cook had completed the pre-inspection questionnaire and information from the document has also been used to inform the visit. Mrs Cook and the Registered Providers were present in the home and received feedback at the end of the visit. What the service does well: Alverstoke House provides an attractive, homely, warm and comfortable environment for the people who live there. Prospective residents and their families can be confident that their needs will be assessed and be documented in a plan of care. The people living in the home are very complimentary about the care they receive and say that the manager and staff team are very committed, kind and caring. Activities are provided to provide interest and stimulation for people and religious services are held on a regular basis. People were especially complimentary about the standard of meals provided in the home and comments about the home included, “Everything is nice, the staff are lovely and the food is excellent” and “We are all looked after very Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 6 well, they can’t do enough for you. The staff are kind and we have a choice of very good food”. Residents are protected by a robust recruitment process and there are sufficient staffing numbers, including Registered Nurses, to ensure that good standards of care are provided. The home is managed by a capable and competent manager and residents, families and the staff on duty said that she was approachable, kind and fair. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 7 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. Alverstoke House Nursing Home DS0000055635.V326097.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 Alverstoke House Nursing Home DS0000055635.V326097.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides current information about the facilities on offer, carries out assessments in order to determine they can meet individual care needs and contracts of terms and conditions of residency are agreed. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place and residents confirmed that they had received copies when making enquiries regarding vacancies. In order to ensure that the home can meet individual care needs preadmission assessments are carried out by the manager and visits to the home encouraged. Each resident receives a contract of terms and conditions of residency, three samples were seen and all contained the fees charged and had been signed by the resident or their representative. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 10 One person who had recently come to live in the home said’ “I have only been here for two weeks but it is very good. I was recommended to the home and someone came out and assessed me. I then came and visited with my daughter before moving in”. Alverstoke House does not provide intermediate care. Alverstoke House Nursing Home DS0000055635.V326097.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. To ensure that the care needs of residents are met, care plans are in place and the home works with other healthcare professionals. Improvements could be made by agreements being in place for the use of bed rails and the medication recording system being clearer. EVIDENCE: Four care plans were tracked and all contained current and detailed information regarding the support needs of each person. The plans contained life histories, personal care routines, healthcare needs and risk assessments and all had been recently reviewed and updated. The plans are kept in each resident’s bedrooms and the staff on duty are aware of the information contained in the care plans and had a good knowledge of the needs of the people they are supporting. Daily records are also kept and any changes to the care plans are discussed during the staff handover time. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 12 Records show that people have regular access to a Chiropodist and other healthcare professionals such as a speech and language therapist and each month a basic healthcare check is undertaken and recorded for each person in order to see if the care plan needs changing. Risk assessments were in place for the use of bed rails but there were no signed agreements in place for people to be nursed with bed rails. The manager Mrs Cook said that she would address this. All of the people living in the home were very complimentary about the care they received and some of the comments were, “We are all looked after very well, they can’t do enough for you. The staff are kind and as I have a lot of pain they are very gentle with me when they have to do anything”, and “ This is a very nice place, the nurses are very kind, they are very busy but always have time to spend with you. Medication is stored in a locked room and is only administered by trained nurses. The medication was well managed but the recording sheets were difficult to track as codes were used for individual medications and each medication was not signed for individually. Mrs. Cook said that the local pharmacist is about to start providing the home with pre-printed medication recording sheets, which should make the system easier to track. Controlled medications were securely stored and a record book was in use. Two controlled medications were checked and found to be correct. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 13 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In order to provide interest and stimulation, activities are provided, families and visitors are made welcome at any time and the home provides a range of fresh, home cooked meals EVIDENCE: Many of the people currently living in the home are quite frail and are being nursed in their rooms. For people who wish to access them, some activities are provided including gentle exercise, visiting musicians, quizzes and the playing of the piano in the lounge. There are books, games and magazines placed throughout the home and people were reading their newspapers, knitting or watching television. One person was very proud of the range of knitted toys they had made and for another person who has difficulty in communicating verbally, a communication book using pictures and photographs was in use. Another person said that they attended a day centre and people also said that they liked sitting in the gardens in better weather. Residents said that their families and visitors were made welcome at any time and some people especially enjoyed the religious services held in the home. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 14 Menus show that a wide variety of fresh, home cooked food is provided and people were very complimentary about their meals. Lunch, which was the main meal of the day was liver and bacon, cabbage, carrots and potatoes, with bakewell tart and custard to follow. There was an alternative choice available and special diets including pureed meals are catered for. Comments from residents included, “The food is good, very tasty, I enjoy the exercises and the quiz and my family can visit me at any time” also “ I like the food, it is very good food. If you don’t want it at the last minute, they will get you something else” and “The food is very good, you get a good variety and as much as you want”. Nutritional assessments form part of the care plan and supplements are provided when necessary. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 15 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 and 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 families can be confident that their concerns and complaints will be addressed and the home’s policies, procedures and staff training are designed to protect people from the risk of abuse. EVIDENCE: There is a complaints procedure in place a copy of which is included in the Statement of Purpose. Three formal complaints have been recorded since the last visit and records show that the manager, Mrs Cook, has addressed them and responded to the complainants in a timely manner. The people living in the home were confident that any concerns they might have would be taken seriously and acted upon and a visitor said, “ Visitors are made welcome here at any time and the manager and owners are accessible if you need to speak to them. If I have any concerns or complaints I feel comfortable in approaching the manager and any issues are listened to and immediately resolved”. The home has updated its Adult Protection policy, the staff team receive adult protection awareness as part of their induction process and also attend formal training. The staff on duty showed an awareness of protection issues and said they would report any suspected abuse to the manager or owner. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 22 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a homely, clean and comfortable environment for the people who live there. One door which was wedged open could provide a hazard should a fire occur. EVIDENCE: Alverstoke House provides a warm homely, well-maintained and attractive environment for the people who live there. Since the last visit building works have been completed to add a conservatory dining room and the whole of the building is light and airy. The main lounge is comfortably furnished and has a pleasant outlook. In addition to the main lounge there are sitting areas and further conservatories with books and games situated around the house and the garden/courtyard area in front of the house now has an attractive fountain and pond with fish. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 17 There is an ongoing plan of re-decoration and refurbishment underway and residents and visitors said that they were very pleased with the changes. Private bedrooms are very attractive and have been personalised with furniture and belongings brought to the home by the current residents. There is a call bell system in place, specialist equipment such as pressure relieving beds, hoists and assisted baths are available and records showed that they are well maintained. Many people also have their own telephones in place. There were three cleaners working at the time of the visit and the home was clean and hygienic throughout. The staff on duty wore gloves and aprons when providing personal care and hand washes and antiseptic gels were in place to assist with infection control. One resident said she especially like the home because it was always “spotlessly clean”. All bedroom doors have automatic closures fitted so that residents can keep their doors open in the day should they wish to do so. In one double bedroom that had two doors, one door was fitted with a closure but the other had been wedged open, which would have been a risk to residents in the event of a fire occurring. A requirement has been made for this to be addressed and the provider Mrs Hudson said that a magnetic closure would be fitted. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a committed and caring staff team and are protected by there being a robust recruitment procedure in place. EVIDENCE: There was one first level and two second level Registered Nurses and five support workers on the early shift and staffing rotas show that there is a first level Registered Nurse on each shift during a 24-hour period. There were also three cleaners, a cook, kitchen assistant and handyman on duty. Many of the staff team have worked in the home for a number of years and have built up good relationships with the people they support. Both residents and their families were very complimentary about the staff team and said that they were committed, kind and caring. Comments included, “The staff are very kind, in fact very kind indeed” and “ The staff are very, very good. If you ring the bell they come straight away and nothing is too much trouble”. The staff on duty were very kind and respectful in their dealings with residents and ensured that time was spent with people who were being nursed in their rooms. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 19 New staff members receive a structured induction into the policies and procedures of the home and also in the ethos and skills of working with the client group being supported. There is a training and development plan in place and in addition to mandatory training, records show that the staff team have attended courses such as wound care, palliative care, diabetes and adult protection. One support staff member said, “ I have worked here for 16 years. I stay here because the care for residents is so good and I receive regular supervision and have been supported to develop and progress to become and NVQ assessor”. There is a robust recruitment process in place, four staff files were seen and all contained the required documentation including current Criminal Bureau Checks and two references. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed in an open and inclusive manner, records are current and in good order and service users monies are kept safe. EVIDENCE: The home is run by an experienced, competent and committed manager who attends further training in order to update her skills and knowledge. Residents, families and the staff team spoke highly of Mrs. Cook’s management style and said that she managed the home in a well-organised and inclusive manner. A visiting Care Manager said, “ I am very impressed with the home and feel that people have the highest standards of care. The people I am seeing are very happy in the home. The staff team seem very knowledgeable and keep me informed. The Manager is also very good and is approachable and kind”. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 21 The manager does not act as appointee for any of the people living in the home and financial matters are usually managed by families or legal advisors. Where monies are held for residents, they are safely locked away and a records book showed that all transactions are recorded and receipts gained. A quality assurance process has been started by an internal audit being carried out annually. Questionnaires are sent to residents, their families and the staff team and outcomes are detailed in compliance sheets. Mrs. Cook said that the process to include other professionals was being undertaken and the outcomes would be published. Registered Provider visits are carried out monthly and the outcomes are kept on file. Records for the running of the business were seen including the fire book, staff fire training, incident and accident forms and maintenance records and all were current and in good order. As detailed in other part of this report, to ensure that needs are recorded and residents are kept safe at all times, cot sides agreements should be completed, one door which was wedged open should be made safe and the recording of medication should be updated and simplified in order to make it easier to track and identify any errors. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X 3 X 3 X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 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 OP8 2 OP38 Standard Regulation Requirement Timescale for action 15/03/07 To ensure that residents needs 15 (2) (c ) are fully recorded agreements should be gained and recorded for the use of cot sides. To ensure the residents are 13 (4) (c) protected in the event of a fire occurring the risk of the one bedroom door that was wedged open must be addressed 07/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP9 OP33 Good Practice Recommendations Consideration should be given to updating and modernising the medication recording sheets in order to make them easier to track and assess any errors. The quality assurance system in the home should be further developed to include professionals involved with the home. Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Alverstoke House Nursing Home DS0000055635.V326097.R01.S.doc Version 5.2 Page 25 - 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!