Inspection on 21/06/05 for Alyson House

This inspection was carried out on 21st June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Alyson House 20/11/08

Alyson House 20/02/07

Alyson House 15/11/05

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 Vicky Dutton Unannounced 21st June 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alyson House Address 11 Cobham Road Westcliff on Sea Essex SS0 8EG 01702 345566 01702 345566 mayyingtang@hotmail.com Mr E Tang & Mrs M Y Tang 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 May Tang Care Home 8 Category(ies) of Learning Disability registration, with number of places Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One service user who is over 65 years of age. Date of last inspection 09/11/04 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. Accommodation for service users is provided on two floors, accessible by a shaft lift. The home provide 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 I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of four hours. The inspection mainly focused on the progress the home had made since the last inspection. The registered owner and registered manager were present throughout the inspection. A tour of the premises took place and care and staff records were selected at random and inspected. On the day of inspection the home was operating at full capacity and accommodating eight residents. Three residents were out attending day care facilities but returned later in the day. All residents were spoken with. Many residents at the home have complex needs and communication difficulties. Many were not therefore able to express their opinion about living at Alyson House. No visitors or visiting professionals were present during the inspection visit. What the service does well: What has improved since the last inspection? Some new specialist beds have been purchased. These enable residents to be comfortable and safe. To enhance resident care, night staff at the home have been given a new method of recording their regular checks of residents. This provides a greater level of detail and enables any patterns of residents behaviour to be monitored. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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 standard(s) 2, 3, 4 Resident’s needs are assessed before moving into the home. Opportunities are given for visits and trial stays to ensure that prospective residents have the chance to get to know the home before moving in. EVIDENCE: The home has had two recent admissions. The registered manager confirmed that she had assessed their needs prior to accepting them as potential residents for the home. Pre admission assessments were available on their files. Admissions to the home are generally through Social Services departments, therefore community assessment information was also available on files. It was documented that one resident had been on a weekend trial visit to the home but had wished to stay and not return to their former placement. Both residents were spoken with, had settled well and said that they were very happy at Alyson House. Records showed that staff at the home receive a good induction and ongoing training appropriate to meeting residents needs. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 Care planning at the home supports staff in meeting residents needs. Residents are encouraged to make choices in their daily lives. EVIDENCE: Established residents have comprehensive care plans in place. These include a wealth of information covering all aspects of residents physical and social needs. Clear information is available to staff to assist them in meeting these needs. One recently admitted resident did not have a care plan in place but assessment information provided background and information for staff. Good daily records are maintained to keep staff up to date with residents current events and condition. Some residents at the home have limited language but are still encouraged by staff to make choices with the use of pictures and flash cards. Residents are assisted with financial matters as appropriate, for example one care file included a breakdown of how to assist a resident with a particular financial transaction. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 15, 16, 17 Residents are encouraged to lead fulfilling lives through activities, using the local community and following their own hobbies and interests. EVIDENCE: Residents are encouraged to develop independent living skills. Some have a ‘training day’ each week when staff will take them through different tasks. Religious preferences are recorded in care records and church attendance facilitated when required. Residents with particular interests are encouraged to keep these up when moving into the home. One recently admitted resident’s interests are clearly reflected in their care plan. Three residents at the home enjoy attending day care services. The development of employment skills and career advice services is not appropriate for the residents accommodated at Alyson House. Residents at Alyson House use all normal community facilities such as shops, leisure facilities, barbers, pubs and restaurants. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 11 Residents choices in terms of family contact are recorded. Family and friends involvement is encouraged. A ‘Visitors Statement’ states that there are no restrictions at all on visiting and that service users are at liberty to invite whom they like into the home, offer tea and coffee facilities and so on. All service users rooms are fitted with suitable locks. Due to the level of disability, none currently hold their own keys. During the inspection staff were noted to interact appropriately with residents and give them their full attention. Residents have unrestricted access to all areas of the home and can choose when to be alone. During the inspection residents who were able were noted to move around the home at will. Residents are encouraged to be involved with housekeeping and cooking tasks as an activity, however there are no particular expectations in this area. The home has a no smoking policy. The home use a four week menu cycle as a basis for meal preparation. Staff are aware of individual needs, likes and dislikes. As far as possible service users are actively involved in selecting and choosing meals. For those with communication difficulties picture cards are used. Fresh fruit was readily available for service users. The home has a pleasant dining room. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 Residents health and care needs are well identified and planed for. Medication practices at the home are well managed and ensure that residents are kept safe. EVIDENCE: Daily records and care plans showed that residents daily routines are flexible and in accordance with residents personal choices. The residents living at Alyson House all have a learning disability and are of an older age group. They are therefore very dependent on the staff group to monitor, and arrange ongoing health checks and care. Care records showed that residents have access to all relevant health checks and services. Where issues are identified, such as a deterioration in an existing condition, or general health this is actioned appropriately. As far as possible residents attend their GP surgery for appointments when required. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 13 No residents at Alyson House are able to manage their own medication. The home uses a weekly boxed (NOMAD) monitored dosage system of medication administration. A sample check was made of administrative procedures. These were well maintained. Advice was given on one minor best practice issue. Since the previous inspection the home has developed protocols for medication prescribed ‘as and when required’ (PRN). The registered manager said that six monthly medication reviews are carried out by residents doctors. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22, 23 The home has an established complaints procedure. Adult protection procedures and staff knowledge ensure that residents are protected from abuse. EVIDENCE: The home has a clear complaints procedure in place. No complaints had been received by the home, or by CSCI. Residents are encouraged to say or indicate if they are not happy about anything. Staffing records and discussion showed that staff have received training in adult protection. Although not currently an issue at the home some staff have received training in managing challenging behaviour. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24, 25, 26, 27, 28, 30 The standard of the furnishings, décor and fitments within the home was good, and provided residents with a pleasant, homely and safe place to live. EVIDENCE: The premises and facilities at Alyson House are maintained to a good standard and provided a homely environment. All areas of the home are accessible to residents. A shaft lift provides access to the first floor. All residents have their own rooms which are a suitable size and decorated and accessorised according to individual residents tastes and preferences. Residents spoken with said that they liked their rooms. All but one bedroom provide en suite facilities. The homes bathrooms are spacious, accessible and have assisted baths. Facilities provide service users with the choice of a shower or bath. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 16 The home provides a range of shared spaces, including a paved outdoor area, with seating available, lounge, and separate dining room, conservatory, music room and an art/relaxation room which has some sensory equipment available. The homes laundry and kitchen facilities are domestic in scale. On the day of inspection the home was clean and odour free. Protective clothing was available for staff. The laundry area was suitable for the needs of the home. The washing machine has a sluicing cycle available. The laundry area is kept locked when not in use. Safe storage is provided for COSHH materials within the laundry area. No liquid soap was available in the laundry area. This was rectified. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35, 36 The homes recruitment processes were sufficient to safeguard and protect residents. Some attention to detail is needed to ensure that adequate records are maintained. Staffing levels are maintained at a level that is able to meet residents needs. EVIDENCE: The homes rotas showed that staffing levels are being maintained at three staff during the day and one awake and one sleeping member of staff at night. These levels may vary according to the needs of service users and activities. The home does not employ any separate ancillary staff. Care staff complete cleaning and laundry tasks. However the registered manager reported that every six months cleaning contractors complete a thorough top to bottom spring clean of the premises. Although the home has a stable core group of staff, the home has experienced a high turnover of care staff. Residents at the home clearly had a good rapport with the manager and staff at the home. No agency staff are used at Alyson House so consistent care is provided for residents. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 18 From the files viewed at this inspection recruitment practices at the home have improved, and now better protect residents. Some staff have been recruited via an agency who carry out all checks. The dates on some of this information were confusing. Some shortfalls were still noted. Current photographs were not available. Another had no evidence of a Criminal Records Bureau or POVA first check having been undertaken. It was explained that this member of staff works for some hours in another home and that this information was there. Staff files showed that training at the home is appropriate and ongoing to enable staff to meet residents needs. Records showed that staff receive regular supervision to help them perform well in their roles and give the best service to residents. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 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 registered person has many years of experience in working with service users who have a learning disability, and in home management. She is a registered nurse who maintains her skills and registration status. She has obtained a relevant NVQ level four qualification in management, and undertaken much periodic and relevant training. Records showed that staff are trained in core areas such as moving and handling, first aid and health and safety. It was noted that the homes gas safety certificate had expired. The registered manager undertook to address this, and an in date certificate was sent in to CSCI following the inspection. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 20 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 x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alyson House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 21 YES 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 34 Regulation 17 Schedule 4 Requirement The registered person must maintain a robust recruitment procedure. Records required by regulation must be maintained in the home. Previous requirement date of 01/01/005 not met. Timescale for action 01/08/05 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. Refer to Standard 6 20 30 42 Good Practice Recommendations Care plans should be completed in a timely manner on/at admission. Bottled/boxed medication should be dated when commenced. Liquid soap should be available in all appropriate areas. The homes gas safety certificate to be renewed. Alyson House I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 I56 I06 S15416 Alyson House V234480 210605 Stage 4.doc Version 1.30 Page 23 - 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. 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