Inspection on 06/09/05 for Alverstoke House Nursing Home

This inspection was carried out on 6th September 2005.

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 26/02/07

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 PO12 2BX Lead Inspector Gina Pickering Unannounced 6 September 2005 10:00am th 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 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 H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Alverstoke House Nursing Home Address Somervell Close Alverstoke Gosport PO12 2BX 023 9251 0254 Telephone number Fax number Email 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 Mrs Rosemary Cook CRH - N 30 Category(ies) of OP - 30, PD - 30, PD(E) - 30, TI - 30, registration, with number TI(E) - 30 of places Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users in the TI and PD categories should only be admitted over the age of 60. Date of last inspection 26th April 2005 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 ofers 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 sitauated 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. Buiding work is in progress 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 H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, starting at 9.30 am and lasting six hours. The inspector spoke to eleven clients and four members of staff as well as the manager. Discussion with staff indicates that people as a group living at the home like to be known as clients. Clients commented that staff respond promptly to calls for assistance and that the meals continue to be off a high quality. Staff continue to state that they receive the support and training to met the needs of the client group at the home and offered that the believe there are enough staff on each shift to meet the needs of the client group. It is judged that the management of the home creates a supportive environment for both the clients and the staff at the home. What the service does well: What has improved since the last inspection? Monthly documented audits of the service provided at the home are now carried out, a copy of which is forwarded to CSCI thus enhancing the quality auditing process of the home. The environment of the home is in the process of being improved with the building of a conservatory area and the redevelopment of the front garden area. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 6 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. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 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 standard(s) 6 The home does not offer intermediate care. EVIDENCE: Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 9 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 standard(s) 7 & 10 Health, personal and social care needs are identified and met ensuring that the clients’ welfare is maintained. Clients’ dignity and privacy is assured through the ethos of the home and staff training. EVIDENCE: Care plans are located in the client’s bedrooms. A description of the clients daily routine, how they like their personal care needs to be met, their health care needs are included in the plan of care. There are details of their social and leisure interests. Discussing the details of the care plans with clients evidenced that the information contained in the plans accurately reflects their needs and wishes. Polices and procedures are in place relating to the privacy and dignity of the clients. All care staff undertake induction and foundation training that incorporates the privacy and dignity of clients. Discussion with clients and a relative suggested that the clients are respected; it was observed that staff always knock on clients bedroom doors prior to entering their bedroom. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 10 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 standard(s) 14 & 15 The management of the home allows clients to make their own choices. Nutritious and balanced meals offer a healthy and varied diet for the clients. EVIDENCE: Discussions with the manager and staff members’ indicate that the home has an ethos of encouraging service users to exercise choice regarding their daily life. This was confirmed in conversations with clients. Several clients expressed that it is their choice whether to enjoy the company of other clients in the communal areas or enjoy privacy in their own bedrooms. Clients preferred routines are described in their care plans, which when discussed with the client proved to be an accurate representation of their wishes. Discussion with staff suggest that clients’ wishes are taken into consideration when developing a four-week rotating menu. The menu plan evidenced that clients are offered a varied nutritious diet. The menus are discussed with each client and they are able to make a choice from the menu. Clients expressed satisfaction with the quality and quantity of the meals prepared at the home. Especially enjoyed by many of the clients is the Friday lunch meal when they order fish and chips or pie and chips from the local fish and chip shop. At the time of the inspection there was limited dining areas in the home due to the ongoing construction of the new conservatory dining area. Clients have been Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 11 given the choice of where to take their meals and many of them are taking them in their bedrooms whilst the building work is being completed. It is anticipated that with the completion of the conservatory area the dining areas of the home will be enhanced allowing the clients to enjoy social mealtimes. A record is maintained of all meals taken by the residents. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 12 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 standard(s) 18 Clients are protected from abuse by staff who have a clear understanding of the issues surrounding the protection of vulnerable adults. EVIDENCE: Policies and procedures are in place about adult protection including polices on whistle blowing. The home has a copy of the Hampshire adult protection procedure but in places the homes own policy does not accurately reflect the process that is happening in Hampshire. The manager agreed to amend the home’s policy to accurately reflect the Hampshire procedure. Staff were able to discuss types of abuse and the action to be taken if they suspect an act of abuse has occurred. All care staff undertake induction and foundation training in line with skills for care guidelines that include training about the protection of vulnerable adults. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 13 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 standard(s) 19 & 26 Clients live in an environment that is well maintained and decorated in a fashion that they are content with. Hygiene and cleanliness of the home is generally good contributing to the well-being and health of the residents at the home. EVIDENCE: The inspector toured the home inspecting the communal areas, bathrooms and some of the client’s bedrooms. Bedrooms are furnished to meet the needs of the clients, with many clients having brought items of furniture and ornaments in to personalise their bedrooms. At the time of the inspection a new conservatory area was being constructed to give a greater communal area for the clients. This will be mainly used for dining purposes though the manager informed the inspector that there will be a general seating area available. At present a large lounge area, a small conservatory area, a dining area and a small alcove area gives clients a choice of communal areas. All areas are decorated and furnished in a homely nature. Work has been completed on the front garden area to improve the outlook and pond area for clients to enjoy. The same view will be able to be enjoyed form the new conservatory area once Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 14 completed. A well maintained rear garden gives clients a further choice for enjoying the outside. At the time of the inspection the home was clean and tidy with no offensive odours. A team of cleaners are employed to maintain this standard, who were observed to be diligent in their cleaning on the day of the inspection. Policies and procedures are in place regarding the various issues of hygiene and control of infection. Care staff receive training about hygiene and infection control within the induction and foundation training. All other staff receive training on these subjects within health and safety training. Essential equipment to enhance the control of infection, such as disposable gloves and aprons, are available for all staff. Some bathrooms were noted to have bars of soap and jugs that could be used by various clients. The manager agreed to remove these reducing the risk of cross infection. The home has it’s own laundry that is managed by the care staff. The laundry was observed to be clean and tidy with the required flooring and wall surfaces to ensure the ease of cleaning and enhance the hygiene within the home. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The number of staff employed at the home meets client’s holistic needs. Robust recruitment procedures are used to ensure the protection of the people living in the home. Client’s health and well being are protected by the skills and training of the staff at the home. EVIDENCE: A rota is kept recording all staff that work at the home which evidences the number of staff on duty at each time of the day. This is documented in pencil, the manager agreed to document it in pen. Discussions with clients suggest that although they feel that there is sometimes not enough staff on duty, whenever they request assistance it is given promptly. Discussion with staff suggested that they feel that there are enough staff on each shift to meet the client’s needs. The home has received no complaints regarding clients needs not been met, again leading to the conclusion that the home is adequately staffed to meet the need of the clients. Recruitment polices and procedures are in place that includes obtaining two written references for each prospective new worker and obtaining the relevant CRB and PoVA checks. Reviewing a sample of staff files evidenced that this procedure is being followed in the recruitment of staff. A member of the care staff that has received the appropriate training is responsible for the induction and foundation training of care staff that follows the guidelines laid down by the social skills sector. A training record displayed Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 16 in the managers office evidenced training that staff receive including fire safety, moving and handling, food hygiene, infection control and topics relating to the conditions of and care needed by the clients. Discussion with staff at the home evidence that they believe they have received the training to equip them with the skills to care for the clients. Clients indicated that they believe the staff have the skills and knowledge to assist and support them. Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 33 & 38 Client’s opinions and wishes are an integral part of the running of the home. Good practices ensure that clients’ finical interests are safe guarded. The health and safety of clients is protected by the good practices at the home. EVIDENCE: Following the previous inspection monthly documented audits of the service provided at the home are being completed by one of the registered providers. Opinions of clients, staff and visitors are obtained in this process. The information from these audits is used to improve the service offered by the home. Clients at the home have their money managed for them by either relatives or a solicitor. If they are able to they can manage their money matters them selves. Clients have access to a locked drawer in their bedrooms to store Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 18 money and valuables if they wish to. The home keeps small amounts of money for the clients for which an accurate record is maintained. The inspector viewed this. All clients’ money is kept in named wallets and secured in a locked safe. Policies and procedures are in place covering covers the many aspects off health and safety. Records indicate that all staff receive six monthly training about fire safety and further training about other aspects of fire safety. Health and safety training is also included within the induction and foundation training that all care staff undertake. The fire logbook documents that their recommended fire safety checks are carried out. Risk assessments are completed by an appropriately trained person for the environment of the home that incorporates working practices. A fire risk assessment is in place and was reviewed in March 2005. Service certificates indicate that that all equipment, appliances and services are serviced at the recommended intervals. A record of all accidents in the home is maintained Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x 3 x x 3 Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Alverstoke House Nursing Home H54 S55635 Alverstoke House Nursing Home V245556 060905.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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