Inspection on 14/07/05 for Alvony House

This inspection was carried out on 14th July 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

Alvony House 20/07/07

Alvony House 11/10/06

Alvony House 09/01/06

Alvony House 07/03/05

Alvony House 06/08/04

Alvony House 25/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Alvony House 25 Linden Road Clevedon North Somerset BS21 7SR Lead Inspector Patricia Hellier |Announced 14 July 2005 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. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alvony House Address 25 Linden Road Clevedon North Somerset BS21 7SR 01275 875573 01275 349655 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) Mr Alec Rendall Mrs Veronica Rendall Care Home - Personal Care Only 27 Category(ies) of Old Age - (27) registration, with number of places Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 27 persons aged 65 years and over requiring personal care only. 2. May accommodate one named person aged 50 years or over. Date of last inspection 7 March 2005 Brief Description of the Service: Alvony House consists of two Victorian properties joined by a linking corridor. The home is registered by the Commission for Social Care Inspection to provide residential care for 27 residents aged 65 years and over, with low dependency needs. At the present time there is a condition of registration covering one named resident under the age of 65 years. Alvony House has a warm friendly and homely atmosphere. Accommodation is provided over three floors with access to all floors provided by a stair lift. It is situated a short walk from the local shops and bus route. Dedicated sitting areas and a patio area in the rear garden allow for good weather activities outside. Garden furniture is provided. Provision is made within the home for a variety of activities and outings which also enables close links with the local commumity to be maintained. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six hours on 14 July 2005. The Registered Manager, Veronica Rendall, was present during the inspection. All residents and members of staff on duty also took part in the inspection. Before the inspection the information about the home was received from the pre inspection questionnaire and comment cards from relatives and residents. 5 out of 5 of the residents who returned cards were happy with the home and care provided. They were aware of the complaints process. They stated, “the surroundings and environment are very nice to be in”; “I am very satisfied”. 4 relatives returned comment cards and all stated they “were very satisfied” with the care of their relatives. Two letters of thanks from relatives were seen thanking the staff for “their care and kindness”. The inspector toured the premises; spoke to 5 members of staff, 11 residents and 2 relatives. All residents and staff spoken with told the inspector that the home was very good and the staff very kind. What the service does well: What has improved since the last inspection? What they could do better: Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 6 Individual risk assessments should be completed for residents whose needs identify a risk to potentially cause them harm e.g. falls. Care plans need to record evaluation and outcomes to ascertain that actions are appropriate. Staff are kind and caring. Members of staff interviewed while having some understanding of what abuse is did not demonstrate a working knowledge of the homes policies and procedures; therefore training is required. Infection control practices observed were not in line with the home’s policy thus training and implementation of policy is needed to provide a high level of protection of cross infection for residents Environmental risk assessments to be completed or reviewed in regard to propped open fire doors and window restrictors for upper floor rooms, to maintain safety for residents. 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. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 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 Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 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) 1,3, The Statement of Purpose and Residents’ booklet is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. Social services care plans had been obtained where relevant. A comprehensive assessment was seen for a recent resident. The resident, when spoken to, said, “I am well looked after they know what I need”. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 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) 7,8,10 Service users benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs. Personal and environmental risks were observed to be well managed but with little documentary evidence to support practice. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the resident’s and records for 4 residents were inspected. Two showed falls to have been identified as a care need but risk assessments had not been completed to assist staff in understanding how to minimise the potential risk. Risk assessments need to be formulated together with the resident to ensure their safety in the home while promoting their independence as able. The care plans clearly identified health and social care needs and actions to meet these needs. The evaluation of these actions, and outcomes are not recorded thus not demonstrating awareness of the need for changed approach at times. The inspector observed a variety of approaches to meet a recently admitted resident’s needs and the appropriate inclusion of other professional staff to assist in meeting these needs. The home is to be commended for this good practice. The home has good links with local professionals who they refer to as needed. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 10 Residents spoken with confirmed the staff were well aware of their needs and did everything to meet them. For example one resident said, “They notice when you are unwell and come and help you”. A short-stay resident said, “they are absolutely lovely and I would always come back here.” Another resident said, “They give you lots of choice”. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 11 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) 12,15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Residents right to choice and control over their lives are well respected and encouraged. EVIDENCE: An excellent range of activities is provided with posters displaying information of forthcoming events throughout the home. Residents spoken with said, “we have plenty of choice and variety, there are quizzes and things to help keep your mind active” and “The staff are always willing to accommodate what we want”. During the inspection a number of residents were seen enjoying the garden, with staff ensuring they had appropriate sitting arrangements. Activities were observed to have a high profile in the home and staff were keen that residents had all they needed to enjoy their time in the garden. They are to be commended for their work in this homely process. All the residents said that the ‘food is good’ and that they liked the daily choices offered. For example one resident said “if you don’t like something they’ll change it”. Menus showed a varied, balanced and nutritious diet. The meal on the day of inspection reflected this. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 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) 16,18 Residents are confident that they are listened to and their requests acted upon. Staff were not fully aware of the homes adult protection policy and procedures and this potentially places residents at risk. EVIDENCE: The home has a complaints procedure that is well displayed and all residents have a copy of. It does not contain any timescales for complainants to measure response against. This is recommended. There have been no complaints and residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. One service user said “I’ve nothing to complain about, it’s the best home I’ve been in”. A comprehensive policy and procedure for responding to allegations of abuse is available. The home also has a whistle blowing policy and staff said they would report any concerns to the manager. Staff were not able to tell the inspector who outside of the establishment they could contact. Staff said they had never seen any signs of abuse in the home and demonstrated understanding of what abuse is. All three staff interviewed were not conversant with the homes Adult Protection policy. Training is therefore required. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 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 Residents are provided with safe, comfortable surroundings. Infection control practices require some attention. EVIDENCE: The property is well maintained, with homely and comfortable communal spaces. The accommodation is furnished to a high standard with fixtures and fittings complementing the general relaxed atmosphere of the home. Residents’ rooms are personalised and comfortable. Special attention has been paid to the provision of aids and environmental markings for the visually impaired e.g. white lines at step edges, handrails in the garden painted white. The home is clean and pleasant. The lack of dispenser soap and hand towels, or alcohol gel, in bathrooms and residents’ rooms gives rise to poor infection control practices and is not in line with the local policy. The treatment of laundry does not comply with the homes current policy and a review of systems is recommended. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 14 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) 27,30 The numbers and skill mix of competent staff are sufficient to meet residents’ needs. Training of staff is provided in a variety of topics to ensure competent staff. EVIDENCE: Residents spoken to said that the staff were ‘kind and caring’ and ‘always had time to help in an unhurried way’. During the visit staff were observed spending time with residents and call bells were answered quickly. The staff rota showed appropriate numbers of staff on duty. The manager’s duties were not recorded and thus the rota did not give an accurate record of those on duty at any time. The manager is not usually part of the staff complement and therefore this provides flexibility to cover any emergencies. Two members of staff have their NVQ qualification and five other members of staff are studying for it. Mandatory training in Health and Safety, Fire and Moving and Handling is provided annually to ensure current best practice guidelines are followed. Other specific training in relation to residents needs is also provided in topics such as dementia and diabetes. This ensures staff are competent to meet residents needs. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 15 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) 32,33,35,38 The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. There is a good system for residents’ consultation and residents feel their views are heard and acted upon. The safety of residents is not always risk assessed and ensured in a safe environment EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Relatives and staff stated that the manager is good at her job, approachable and one relative said she ‘can’t do enough’ and ‘she is always helping’. Residents feel the manager is approachable, available and seeks to ensure all their needs are met. Formal measures to ensure the monitoring of standards and that the residents have a say in the running of the home are in place. Residents say that they Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 16 “feel they can talk to the manager and she will listen to them at any time”. They all praised the staff and said they liked living at the home. The provider acts as appointee for one resident and maintains clear and accurate records of all transactions. Residents’ pocket monies held by the home were inspected and found to be accurate and to have clear records with two signatures for any transactions. These measures provide good safeguards for resident’s monies. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place. Some environmental and individual risk assessments had not been completed to ensure the safety of residents at all times. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 17 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 3 x 3 x x 2 Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 18 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. 2. 3. 4. 5. 6. Refer to Standard 7 7 16 18 26 26 Good Practice Recommendations To complete individual risk assessments for residents with risks identified through the care plan e.g. falls. To evaluate and record outcomes thus informing future actions to ensure needs are appropriately met. The complaints policy to include a timescale for response to a complaint. Staff to have update training in the homes Adult Protection policy and be enabled to apply it. Staff to have training in the homes Infection control policy and implement it. The provision of dispenser soap and paper towels in bathroom areas and residents rooms to encourage good handwashing practice for the prevention of the spread of infection. To record the managers shifts on the duty rota thus ensuring it is an accurate record of all persons working in the home at any one time. To review all the upstairs window opening mechanisms to ensure safety when opening. To complete environmental risk assessments for areas D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 19 7. 8. 9. 27 38 38 Alvony House 10. 38 within the home that could pose a risk to residents e.g.the proping open of fire doors and window restrictors for windows on upper floors. To monitor and record the hot water outlets in bathrooms to ensure not above 43 degrees celcius. Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Alvony House D53-D02 S8137 Alvony House V229757 14.07.05 stage 4.doc Version 1.30 Page 21 - 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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