Inspection on 15/11/05 for Alyson House

This inspection was carried out on 15th November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alyson House 20/11/08

Alyson House 20/02/07

Alyson House 21/06/05

Alyson House 09/11/04

Alyson House 03/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Alyson House 11 Cobham Road Westcliff On Sea Essex SS0 8EG Lead Inspector Ron Reeves Unannounced Inspection 15th November 2005 10:00 Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 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 Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 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 Adults 18-65. 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. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alyson House Address 11 Cobham Road Westcliff On Sea Essex SS0 8EG 01702 345566 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) Mr Eric Tang Mrs May Ying Tang Mrs May Ying Tang Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two service users who are over 65 years of age. Date of last inspection Brief Description of the Service: Alyson House is large detached property, which was adapted and upgraded for its current use seven years ago. Some original features of the property have been maintained. The home is decorated and equipped to a high standard. The property is situated close to Southend seafront and close to local amenities. There are good public transport links nearby. Alyson House is registered to provide care for eight service users who have a learning disability. Service users living at the home are mostly over fifty years of age with two residents over 65 years of age. Accommodation for service users is provided on two floors, accessible by a shaft lift. The home provides all single bedrooms, all but one of these have an en-suite facility. Service users are encouraged to use community and day care facilities. The home has a paved garden area and some parking is available to the front of the building. The home has their own website at www.alysonhouse.co.uk Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on the 15th November 2005 and lasted for 6 hours. A tour of the premises took place and discussions were held with the registered owner and registered manager who was present throughout the inspection. All residents have complex needs and communication difficulties and many were unable to express their opinions about living at Alyson House. However those residents in the home were relaxed and comfortable with the inspector and were able to respond to simple questions. What the service does well: What has improved since the last inspection? What they could do better: The home should review the policies on death and dying and improve the training of staff to cover specific conditions effecting older people. Discussions were held with the manager of making greater use of pictures, symbols and makaton to enhance resident’s communication skills. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 6 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. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 4 The admission process is well managed by the home with comprehensive preadmission assessments. Opportunities are provided for visits and trial stays to enable residents to get to know the home. EVIDENCE: The home has an appropriate statement of purpose and a service users guide, which contains pictures and symbols. The manager confirmed that she always visits and assesses residents before admission and prospective residents are invited to visit the home and have trial stays before agreeing to admission. Admissions to the home are generally through social services, therefore community assessment information was also available on files. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Care planning systems are clear and appropriate. Residents are encouraged and supported to make choices in their daily lines. EVIDENCE: Residents care plans are comprehensively detailed and contained clear evidence of residents needs and wishes. Clear information is available for staff to assist residents in meeting these needs including pen portraits detailing resident’s likes, dislikes and preferences. Comprehensive risks assessments were in place and regularly reviewed. Some residents in the home have limited language but are encouraged to make choices with the use of pictures and flash cards. Good daily records are maintained to keep staff up to date with resident’s conditions. Discussions were held with the manager regarding making greater use of pictures, symbols and makaton to enhance residents communication skills. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-14 & 17 The home provides a range of appropriate activities, both within the home and in the local community, and residents are encouraged to develop their independent living skills. EVIDENCE: Residents are encouraged to develop independent living skills. Three residents regularly attend a day centre and four residents receive training in improving their social skills. Residents are supported to access all local community facilities such as leisure facilities, church services, visits to local pubs and restaurants and visits to Lakeside and Bluewater. All residents assist with the shopping for the home. The home has an open visitors policy and actively encourages the involvement of family and friends in the home. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 11 Residents have unrestricted access to the home and can choose when to be alone. Staff were seen to have developed a good rapport with the residents and residents appeared relaxed and comfortable with the staff. The home uses a four week menu cycle for the provision of meals, however this was seen to be flexible. The home encourages a healthy eating diet for the resident’s. Menus seen showed a wide range of nutritious meals, and as far as is possible residents are involved in choosing meals. For those with communication difficulties, picture cards are used. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Care plans evidenced that resident’s personal and health care needs are being managed effectively, medication practices are appropriate. Further development of the home’s practices and staff training are required for staff to manage the ageing process. EVIDENCE: Residents living at Alyson House are of an older age group and are dependent on staff to manage their personal and health care needs. None of the residents have been assessed as able to manage their own medication. Medication administration in the home is well managed with staff trained and medication recorded and stored appropriately. Discussions were held with the manager regarding extending the range of staff training to include specific illnesses that relate to the ageing process and to produce policies, procedures and practices for staff to manage the impending death of a resident. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22-23 The home has appropriate policies, practices and staff training in place to manage residents concerns and to protect residents from abuse. EVIDENCE: The home has a clear complaints procedure in place. No complaints have been received by the home or by the commission. The manager explained that residents are generally able to express their concerns or indicate if they are not happy about anything. The manager informed that all residents are members of the local Learning Disability Parliament. All staff have received training in the protection of vulnerable adults and in managing challenging behaviour. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 The home provides a good quality of accommodation, which is well furnished and decorated, accessible to the residents and provides a homely, comfortable and safe environment for the residents. EVIDENCE: The home is a large detached house that has been adapted to a high standard to accommodate eight residents. All residents have their own rooms which are of a suitable size, well furnished and decorated and personalised to each individual residents’ taste and preferences. All but one of the rooms have en-suite facilities. The remaining bedroom is located adjacent to one of the homes bathrooms. All bathrooms are spacious, have assisted baths and shower facilities. The home provides a range of shared spaces, including a paved outdoor area with seating, lounge, dining room, conservatory and a relaxation room, which has some sensory equipment. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 15 The home has a large domestic style kitchen and a utility room containing a washing machine, tumble dryer and sluice facility. On the day of the inspection, the home was found to be clean, tidy and odour free. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Staffing levels and skills were appropriate to meet the needs of the residents. The homes recruitment processes were adequate to safeguard the residents. Staff training should be developed to cover specific ailments relating to older people. EVIDENCE: The homes staff rotas showed that staffing levels are being maintained at three staff during the day and one awake and one sleeping-in member of staff at night. These levels may vary according to the needs of the residents and when activities take place. The home does not employ ancillary staff. Care staff undertake cooking and domestic duties. The home does not employ any agency staff. Existing staff cover any shortages. This has resulted in some long shifts being worked on occasions. However these are kept to a minimum by the manager. The home has a stable core group of staff. The manager informed that they had experienced a high turnover of staff but felt the staff group has now stabilised. This has enabled the manager to introduce individual tasks/responsibilities for each member of staff to enhance staff development. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 17 Staff spoken with were clear about their roles and felt that the workload was manageable. Staff training is promoted by the home. The deputy is at present undertaking NVQ level 4 and two support staff training at NVQ level 2. With the ageing resident population training needs be developed to involve specific conditions effecting older people. Staff files seen evidenced that robust recruitment practices are in place, although staff files would benefit from being maintained in a logical order. Records identified that staff receive one to one supervision on a regular basis. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40-42 The registered manager is well trained, experienced and provides strong leadership at the home. Residents benefit from a well run home where their health and safety is promoted. EVIDENCE: The manager is a registered nurse who maintains her skills and registration status and holds NVQ level 4 in management. She has many years experience with the client group and in home management. Staff spoken with felt the manager was easy to approach and supportive. A random sample of the home’s policies, procedures and records showed that they were generally well kept and stored securely in the office. The manager demonstrated a sound knowledge of the Health and Safety requirements in the home. Risk assessments on the building are in place, but should be reviewed on a regular basis. Safety certificates are in place for services and equipment and weekly checks maintained on the home’s fire prevention systems. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alyson House Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 3 X DS0000015416.V265640.R01.S.doc Version 5.0 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 YA35 Regulation 18(c) (i) Requirement Staff training must be developed to ensure staff are knowledgeable of conditions and illnesses that effect older people. Ongoing Timescale for action 31/01/06 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 YA21 YA7 Good Practice Recommendations The home should develop policies and procedures regarding dying or death of a resident. The home continues to develop systems to enable greater communication with the residents. Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Alyson House DS0000015416.V265640.R01.S.doc Version 5.0 Page 22 - 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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