Inspection on 20/07/07 for Alvony House

This inspection was carried out on 20th July 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

Alvony House 11/10/06

Alvony House 09/01/06

Alvony House 14/07/05

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 Catherine Hill Key Unannounced Inspection 20th July 2007 09:45 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 Alvony House DS0000008137.V341510.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. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alvony House Address 25 Linden Road Clevedon North Somerset BS21 7SR 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) 01275 875573 01275 349655 His home address is his mother in laws Mr Alec Rendall Mrs Veronica Rendall Mrs Veronica Rendall Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 27 persons aged 65 years and over requiring personal care only May accommodate one named person aged 50 years or over. This exemption is specific to one individual and will lapse when that person attains the age of 65 years or leaves the home. May accommodate one additional person for periods of respite; total persons accommodated during periods of respite should not exceed 28. May admit on additional person aged 58 years and over subject to a satisfactory trial period. this condition is specific to a named person and lapses when that person leaves. 11th October 2006 Date of last inspection Brief Description of the Service: Alvony House consists of two Victorian properties joined by a linking corridor. The home provides residential care for up to 27 older people aged 65 years and over, with low dependency needs. At present there is a condition of registration covering one named resident under the age of 65 years and another condition allowing the home to accommodate a 28th person as part of a married couple for respite care. Alvony House has a warm, friendly and homely atmosphere. Accommodation is provided over four floors with access to all floors provided by stair lifts. There are some varying levels around the home which make the environment suitable only for more mobile people. The Home is situated on a hill, a short walk from the local shops and bus route, and next to a small public park. There are pleasant gardens with sitting areas and a patio area. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was done by one inspector over the course of two visits to the home, the first of which was unannounced. Each visit lasted approximately 7 hours. The inspector spent the first visit talking with residents and some of the staff. The second visit was partly spent talking with residents and staff but mainly focused on checking records and recording systems. The inspector spoke with 17 residents, 1 visitor, and 5 staff in depth, as well as with the owner-manager. The inspector saw all communal areas and many residents bedrooms. She looked at a number of records, including: • the homes Statement of Purpose and Service User Guide • residents care plans and associated documentation • medications • activities • the staff rota • staff recruitment, training and supervision • residents cash held for safekeeping by the home • contractors and the home’s health and safety checks. Prior to the inspection, the inspector received 12 responses to the CSCI survey that was circulated to service users, their advocates, and health professionals. These responses gave overall a very positive picture of the service. Prior to the inspection, the home submitted a self-assessment of how it is meeting the National Minimum Standards. Some aspects of this were tested during this inspection. What the service does well: Residents surveys commented on the good homely atmosphere and how every effort is made to make the residents feel relaxed and happy. Other people the inspector met during the visits made comments like its lovely here - very nice. One person said its excellent here. Relatives said in their surveys that the home gives all-round good care, and that staff are receptive to individual needs and have done their best to meet them. Several said that that care is adapted according to personal needs and carers go the extra mile to support residents to remain in Alvony House for as long as they want. One said that the home strikes a good balance between caring and allowing independence”. The majority of residents the inspector Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 6 met in person said that you never have to wait for help but that staff come immediately if you ring the call bell. Several people made comments like they cant do enough for you and they look after me really well. A healthcare professional said that staff appear confident in their roles and are willing to discuss problems with external professionals. This person felt that the service is good at maintaining individuality, communicates well, and provides a high standard of care. Many survey respondents commented that staff appear calm and relaxed, and have excellent rapport with the residents. Several referred to the staff team as excellent. Relatives also commented on the welcoming atmosphere. One relative has the impression that the home is always looking for ways to improve their service. Residents the inspector met confirmed these impressions. Several people made comments that if there are any concerns, you can simply tell the manager and she does something about it. Residents were generally highly satisfied with the meals. Many people described the food as very good. What has improved since the last inspection? What they could do better: The home’s information for prospective residents and their representatives should be updated and expanded to provide more information in some areas. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 7 A couple of surveys mentioned that more activities should be laid on. The home has recently sent out its own surveys to residents and relatives and is planning a range of different activities in response. Activities records should be recorded more consistently and in more depth to show that the home is meeting residents needs. Proper pouring flasks should be provided for taking hot drinks round to the residents. This will help to ensure that drinks arrive at the right temperature and uncontaminated. A resident who responded to the CSCI survey said they would like staff to talk to residents more, as did one of the residents the inspector met at the inspection. However, several other people said that staff do make time to stop and chat. A significant number of residents made comments like the staff are very good but some are better than others, that they are not normally rude but one or two can be, that some staff can get a bit uptight with some of the more demanding people and that some staff can be a bit bossy. Further evidence indicated that this only reflects the practice of one or two people and is not representative of the wider team. The occupants of the one double room should be asked if they would like some sort of divider to create a bit more privacy when they are dressing and undressing. All hazardous chemicals must be stored securely. This will help to ensure that residents are not put at unnecessary risk. The employment history section of the job application form should be expanded to ensure that only suitable people are employed to work in the home. 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. The summary of this inspection report can be made available in other formats on request. Alvony House DS0000008137.V341510.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 Alvony House DS0000008137.V341510.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives receive a useful level of information about the home but some aspects of this could be expanded and updated. The home gathers enough information about prospective residents to be reasonably sure it can offer them a suitable service. EVIDENCE: The homes Service User Guide is kept in the lounge, and the Statement of Purpose is in the foyer. The Statement of Purpose contains all the required information and has been kept up-to-date. The Service User Guide was drawn up in April 2002 and is missing some necessary details. It may be simpler for the home to provide all the necessary information in one document and simply review this on a regular basis. While some information is really detailed and helpful - particularly the information about the homes philosophy of care Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 10 other sections would benefit from more detail. Although there are a number of single steps between the different levels, which make the environment only suitable for more mobile people, the home is very well decorated and furnished, and many rooms are well above the minimum size, but this is not reflected in the Statement of Purpose. Information about the type of service the home is geared to provide could also be usefully expanded to make it clearer to prospective residents and their advocates that the home caters primarily for more able people. The home has also made other improvements that are not reflected in this document: for example, daytime staffing levels have increased and a chalet has been built in the garden for smokers use. Basic information is gathered about prospective residents by the pre-admission assessment. A more in-depth assessment and care plan is done promptly after admission, as the home gets to know the person better. All residents have a contract, regardless of whether they are privately or publicly funded. Contracts are read issued on each fee increase. Older contracts included a note of the room number, but more recent contracts did not. It is good practice to include this information, and the owner-manager said that she intends to recommence the practice. Each person is also given a copy of the homes terms and conditions. The home does not provide intermediate care. Alvony House DS0000008137.V341510.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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care needs are being better documented and continue to be well met. Medications practice is safe. In general, residents are treated with respect and courtesy but not all staff are consistently maintaining this overall standard. EVIDENCE: A new system for keeping residents personal care records has been set up since the last inspection. This provided clear but concise information about each persons needs and what staff should be doing to meet them. Once it is fully up and running, it should provide a good framework to support the home’s care practice. Information was easy to find on these records, and staff are using them to record a useful level of detail. Staff felt that the new format makes it much easier for them to maintain meaningful records. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 12 The inspector looked at three residents files in depth. All essential information and a recent photograph is kept on a front sheet for ease of access. A detailed but concise physical and psychological assessment is carried out on each persons needs, and there is information on issues such as the persons height, weight, skin, and nutritional needs. The assessment also covers the persons emotional wellbeing and social aims. Where possible, the resident or relative also signs this record. Interesting histories have been written up on each person with help from residents and relatives. Where possible, copies of photographs have been included. Two of the files seen included pictures of the resident as a baby, as a small child with siblings, at their wedding, and with their own children and grandchildren. These provided a really good talking point for staff to discuss with residents, particularly when people start to become confused. These histories also help to remind staff that each resident is a person who has led a full and interesting life, and has a wealth of experience. A risk factor assessment on each persons file indicates if there is any risk associated with particular activities and what action needs to be taken to reduce it to an acceptable level. Activities included taking medications, the risk of falls, using stairs or a stairlift, bathing, open windows, and using the garden or transport. There are sheets in the records for recording personal care such as baths. This will help the staff team to demonstrate the quality of support they offer to less able residents. Where a person is unable to make a decision on their own behalf, the home needs to consult the person and relevant advocates as far as possible, and record the agreement that has been reached. This will help to ensure that peoples needs are understood and met as far as practicable. The home uses a Monitored Dosage System for dispensing medications to residents. Two staff give pills out, providing an additional check to reduce the risk of error. The records seen were in good order and indicated that staff are using the system well. Staff should take care not to touch tablets when they are removing them from the pharmacist’s containers to residents individual pots as there is a risk of contamination, either of the medication itself or of skin coming into contact with powerful chemicals. Every resident the inspector spoke with made positive comments about the attitude of the staff team, but the majority of people also commented that one or two staff can be abrupt, bossy or unhelpful. Some residents were able to identify individual staff. The manager was already aware of this issue and has been addressing it. Alvony House DS0000008137.V341510.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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has very flexible routines and is good at adapting these to suit individual and changing needs. Increasing the schedule of activities will help to ensure that everyones social and leisure needs are better met. Meals are of good quality and well-suited to residents tastes. EVIDENCE: The home is now sending out its own questionnaires to residents and relatives on a yearly basis. Where possible, the resident is asked to fill these in themselves or with a relatives help, so that the home can be sure people feel free to answer openly. A Suggestion Box has recently been fitted in the foyer, and the home’s latest newsletter mentions that each resident has been asked about their ideas for activities. As mentioned in the summary of this report, a couple of CSCI surveys from residents or their advocates said that more activities are needed. Many of the residents the inspector spoke within person were very happy with the current Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 14 level of activities because they largely provide their own entertainment, but a couple of people said they would like more laid on by the home. The activities records in those residents files sampled were either blank or very patchily completed. Some information about activities or social contacts were written in the daily records instead. As staff get more accustomed to using the new recording format, the consistency of these records should improve. An activities book is also maintained. Some entries show regular outings and activities, with a list of which residents participated. However, entries had not been made consistently and there were some time periods when it appeared no activities had been offered to most residents. The residents the inspector spoke with generally felt that the level of activities is acceptable, although some people are looking forward to the planned increase. Several people mentioned recent activities that have not been recorded anywhere, so evidently more is happening than is being recorded. Some of the records in the activities book were along the lines of had legs shaved or had bath. It may be that staff actually meant they spent time talking with the person while engaged in this task, in which case this needs to be recorded. The home has just started a newsletter, and is keeping a book by the front desk for relatives to add any interesting snippets for inclusion. Where possible, residents are able to bring their pets with them when they move in. Morning and afternoon drinks are taken around the communal rooms and bedrooms on a trolley. Tea or coffee was in an open plastic jug with the milk already added. Apart from looking rather institutional, if anyone wants a drink without milk this would mean staff having to return to the kitchen. The lack of lid means that the drink is cooling rapidly, is unprotected from any airborne particles, and is very likely to spill as staff move the trolley. Proper pouring flasks are recommended instead. Many people said how nice the food is. People on restricted diets felt that cooks are creative and make sure they are offered varied and interesting meals. Several people said that alternatives to the main menu are readily available if they prefer. The menu records showed varied meals, well-suited to the needs and tastes of a group of older people, with a few alternatives to suit younger tastes. There is a heavy reliance on fresh vegetables and dishes made from fresh ingredients. A couple of residents commented that staff can sometimes talk very loudly to each other and this can disrupt the normally peaceful atmosphere. It is very easy for busy staff to fall into this habit, and the manager said that she would remind everyone to be vigilant about this. Alvony House DS0000008137.V341510.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents ideas and concerns are taken seriously. Their well-being is protected by clear abuse procedures and by a good level of staff awareness. EVIDENCE: As well as the complaints procedure for residents or their advocates, there is a procedure for staff to follow in the event of receiving a complaint. This helps to ensure a consistently positive reception. Staff the inspector met were very positive about hearing constructive criticism and are evidently keen to ensure the service meets peoples expectations. Many residents commented on what a pleasant and willing attitude most of the staff have. Residents were aware of the complaint procedure, and the general feeling was that they would be comfortable raising any concerns with the staff or manager. The home also has very detailed and helpful guidance on whistle-blowing. Staff the inspector met had been given training in abuse awareness and understood their duties to report any concerns. Alvony House DS0000008137.V341510.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, 23, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from an attractive and well maintained environment that is well-suited to the needs of more mobile older people. EVIDENCE: Alvony House consists of two Victorian properties joined by a linking corridor. The environment is very well maintained, and decorated and furnished to a high standard. All but two bedrooms are singles except for a basement flat and a double bedroom in another basement area. Most rooms have an en-suite toilet and many are well above the minimum size. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 17 Bedrooms are situated on the basement, ground, first and second floor. There are stairlifts for access to all levels except for the basement flat. However, there are several single steps around the home where the floor levels between each wing and some of the communal areas change. People living in the home therefore need to be comparatively mobile. The bedrooms the inspector saw were each very individual. Residents have evidently been encouraged to make these areas their own. The ladies who shared a double room seemed to be very happy with this arrangement that they should be asked if they would like some sort of divider to create a bit more privacy when they are dressing and undressing. The home has two communal bathrooms. Residents have the choice of a bath or shower. There are two lounges and a dining room. There are gardens to the front and rear of the property, which are attractive and well maintained, with a variety of seating. Fire doors are either kept shut or held open with suitable devices that allow the door to close if the fire alarm sounds. Most windows are fitted with restrictors. Those that are not have an environmental risk assessment in place and a disclaimer signed by the rooms occupant. The carpet in the doorway of Room 14 had a frayed edge that could have been a trip hazard. The owner-managers husband had repaired this within an hour of it being pointed out. Residents are welcome to bring items of their own furniture when they move in. Furniture that might topple over has been secured to the walls. The home was clean, tidy and fresh smelling on the days of the inspection, and residents commented that it is always kept this way. One cleaner works on each side of the home every weekday morning. The inspector commented on the first day of this inspection that the design of the safety gate at the top of the stairs to the basement double room could increase the risk of accidents because of the complexity of its opening mechanism. By the second day of inspection, the owners husband had completely replaced this gate with one that is self-closing and can be very easily secured or opened. Alvony House DS0000008137.V341510.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well protected by safe staffing practices. EVIDENCE: Staffing levels have been increased in line with residents increasing needs. Three care staff are now on duty throughout the day, and two staff are on duty at night, one of whom is on waking duty and the other of whom sleeps in. The owner-manager is often on duty, as is her deputy who is responsible for a lot of the administrative work. A cook works each day. A cleaner is on duty each weekday morning. Senior staff occasionally visit the home unannounced at different times, and the deputy works shifts alongside staff so that she is able to monitor that practice matches standards. The husbands of both these ladies do maintenance and redecoration around the home. Task lists are kept so that each member of staff is clear about their areas of responsibility on each shift. Six staff hold NVQ 2 and the home hopes that more staff will do this training. It aims to have 90 of the staff NVQ-qualified. The home has a system in place to ensure that PoVA First checks (initial criminal record checks) are carried out on all prospective staff before they start Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 19 work. Staff files sampled showed that the system is now working well. The current application form does not require applicants to complete a full employment history. This section of the form should be expanded to ensure that the home is requesting full details and can explore any gaps in employment history at interview. This will help to check that only suitable people are employed to work in the home. It was a requirement at the last inspection that all staff receive up-to-date mandatory training. A staff training record has been drawn up to plan and monitor all training. This shows what courses are planned for the immediate future and what additional training is necessary for each staff member. The date each course is done is entered later. All staff now hold a current first aid certificate and basic food hygiene certificate. Staff have recently had training in fire safety and medications, and done distance learning courses on basic food hygiene and the new Mental Capacity Act. Staff the inspector met felt that these levels of training give good support to develop their skills. Alvony House DS0000008137.V341510.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, 32, 33, 35, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-run home with an open culture and management style. Health and safety checks are now been carried out more routinely, which helps to ensure that people using the service are safe. EVIDENCE: Veronica Randell, who owns the home with her husband and is the registered manager, has worked at Alvony House for eight years. She has 20 years previous experience of working in care, and holds the Registered Managers Award. She also does any training courses that her staff team are Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 21 undertaking. Many of the residents singled out the manager as the person they would talk to if they had any concerns. Staff were really enthusiastic about their jobs. People felt that they are encouraged to achieve high standards for the residents, and that just spending time talking with residents is regarded as a key part of their role. One person told the inspector that the team is constantly reminded that the residents are more important than simply completing tasks, and there is evidently a commitment among the team to adapt practice and routines to suit individual residents needs. They described a friendly team and a supportive working atmosphere. Staff felt very well supported but are still not yet having at least six formal one-to-one supervision sessions a year, as recommended at the last inspection. This sort of formal support is important for promoting effective communication, a common understanding of goals, and a consistent approach. Given the comparative ability of the resident group and small size of the staff team, as well as the evident effectiveness of the communication and support systems in place, the inspector suggested that supervision could take place in a variety of ways, not just one-to-one sessions. The home holds cash on behalf of some residents. Accounts and receipts are kept in respect of each. Several of these were checked. In each case, the accounts were clear and tallied with the amounts of cash hold. Suitable accounts for those residents who are not able to be their own signatory but might benefit from being able to earn interest on their money were discussed. Risk assessments have been drawn up on each room in the home, and these cover the contents of the room, their state of repair and if any action is needed to reduce risk. Each assessment is signed and dated. Where appropriate, risk assessments are cross-referenced with any disclaimers or other documents. Some residents have signed disclaimers regarding the radiators in their rooms because they did not wish to have low surface temperature covers fitted. A copy of all these disclaimers is kept at the back of the risk assessment book. The home has a fire risk assessment book but this only contains a note that a professional drew up the fire risk assessment on the 13th of June this year. A copy has not yet been received by the home. The owner-manager again tried to contact the contractor during this visit but was unsuccessful. Homes must have a fire risk assessment, and this requirement will be followed up at the next inspection. It was a requirement of the last inspection that Portable Appliances Testing is carried out by an approved electrician. This was done in November last year. Legionella checks are now being carried out yearly on the home’s hot water system, and hot water temperatures are being recorded weekly. The fire logbook shows that fire precautions tests are being carried out regularly, and Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 22 that drills are frequently held. The home’s eight stair lifts have all been recently checked by a qualified contractor. However, the seat and footrest on the top floor chairlift by Room 7 would not stay up and this might create a hazard to people using the stairs. The manager said she will ask the contractor to come back and look at this stair lift again. The maintenance book included recent certificates for gas checks, as well as the date any repairs or environmental improvements have been completed. Another maintenance book is kept for logging minor repairs, and the inspector suggested that this is also signed and dated rather than simply ticked, as this would provide a much better record of how promptly problems are addressed. Cleaning chemicals were generally kept securely but two dangerous chemicals were found stored on an open shelf in the bathroom with the Parker bath. Some more able residents may want to have access to cleaning chemicals, which can be risk-assessed on an individual basis, but all potentially hazardous chemicals must be kept locked away. A lockable bathroom cabinet may resolve this difficulty. A record is kept of all reported incidents and events. The homes policies and procedures provide clearly laid out and easily accessible guidance to staff. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 23 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 24 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 OP38 Regulation 18 (c) (i) Requirement All hazardous chemicals must be stored securely. This will help to ensure that residents are not put at unnecessary risk. Timescale for action 20/07/07 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. 3. Refer to Standard OP1 OP12 OP15 Good Practice Recommendations The home’s Service User Guide and Statement of Purpose should be updated and expanded to provide more information in some areas. Activities records should be recorded more consistently and in more depth to show that the home is meeting residents needs. Proper pouring flasks should be provided for taking hot drinks round to the residents. This will help to ensure that drinks arrive at the right temperature and uncontaminated. The occupants of the one double room should be asked if they would like some sort of divider to create a bit more privacy when they are dressing and undressing. DS0000008137.V341510.R01.S.doc Version 5.2 Page 25 4. OP23 Alvony House 5. OP29 The job application form should be expanded to ensure that the home is requesting full employment history details and can explore any gaps at interview. This will help to check that only suitable people are employed to work in the home. Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Alvony House DS0000008137.V341510.R01.S.doc Version 5.2 Page 27 - 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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