Inspection on 27/09/07 for Prince Alfred

This inspection was carried out on 27th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Prince Alfred 07/12/06

Prince Alfred 03/03/06

Prince Alfred 26/11/05

Prince Alfred 06/01/05

Prince Alfred 03/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Prince Alfred Prince Alfred Road Liverpool Merseyside L15 8HH Lead Inspector Jeanette Fielding Key Unannounced Inspection 27th September 2007 09:30 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 Prince Alfred DS0000059310.V345350.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. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prince Alfred Address Prince Alfred Road Liverpool Merseyside L15 8HH 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) 0151 734 2587 0151 734 5998 princealfred@europeanwellcare.com European Wellcare Homes Ltd Cheryl Marie Dobie Care Home 50 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (38), Physical disability over 65 years of age (9) Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 50 Nursing and 50 Personal Care in the overall total of 50. This service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection OP Old age - to include one named service user under the age of 65 years in an overall total of 50. One named service user over age 60 years old within the overall number of 50 older people over 65 years of age. 7th December 2006 Date of last inspection Brief Description of the Service: Prince Alfred is situated in the Wavertree area of Liverpool, within easy walking distance to Wavertree High Street and is close to local bus and rail routes, shops and amenities. The home has fifty single rooms, each with a hand-wash basin. The bedrooms are situated on the first and second floors. The first and second floors can be reached by stairs or by a passenger lift. Bathrooms are located on the first and second floors and toilet facilities are available on each of the three floors. Bathing aids are available. On the ground floor, there are two dining rooms, a conservatory and two lounges, one lounge being available for service users who wish to smoke. There is also a lounge on both the first and second floors. The home has a hair salon. A garden with a seating area is provided. There is a car park at the front of the home. The fees for the home range between £329.25 and £447.56 per week. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted in one day over a period of seven hours. An Expert by Experience accompanied the inspector and spend time speaking with service users to obtain their views about the services and facilities provided by the home and to establish whether realistic choices were available. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the registered manager, nurses, care staff, service users and visitors to the home. Questionnaires were issued to service users to obtain further information. What the service does well: What has improved since the last inspection? 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 Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are undertaken on all prospective service users to ensure that the home can meet all their needs. EVIDENCE: The home has produced a detailed statement of purpose and service user guide. These are regularly reviewed and updated to provide current and prospective service users with full information regarding the services and facilities offered by the home. Prince Alfred is registered to take service users that require nursing and personal care. However, for some years now the management of the service decided that only service users requiring personal care would be admitted to Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 9 the care home and as such the staffing requirement has been adjusted accordingly i.e. the service does not have any qualified nursing staff on duty. Comprehensive assessments are undertaken on prospective service users to ensure that their individual health, care and social needs are identified and can be met prior to a place at the home being offered. The assessment is undertaken with the service user, their family and any health care professional involved in their care prior to their admission. Information is gathered regarding their lifestyle and preferences as well as their health needs. Staff spoken to during the inspection confirmed that they had full information about service users needs and were able to demonstrate that they had this information. The home does not offer intermediate care. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive and informative care plans are prepared for all service users to ensure that staff are given full information about their care and social needs together with individual preferences and thereby provide a good quality of life. EVIDENCE: Individual care plans are prepared for each service user. These are extremely detailed and provide full information to ensure that staff are fully informed of service users needs and how these needs are to be met. All care files contain full risk assessments to identify any potential risk to the service users together with risk management plans to remove or reduce those risks. Care plans are reviewed and updated on a regular basis and whenever the service users needs change to ensure that the appropriate level of care is given at all times. The plans are prepared with the service user and/or their Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 11 representative who sign to indicate their agreement with them. Service users who spoke with the Expert by Experience confirmed that they were happy with the dedicated staff team who took care of all their needs. The daily records are completed by the senior staff, with additional information being recorded separately by the care staff to give greater information regarding the service users’ health and social care provision. The care files contain full details of visits made to and by other healthcare professionals and the care plans are updated when changes to care are recommended by these professionals. The care files also contain a life history of the service user to provide additional information for staff to give greater insight into lifestyle preferences. Records are held of relatives and other prominent persons in the service users life and the staff assist service users to maintain contact with these people as necessary. The home has a robust policy and procedure for the administration of medications which was found to be followed by all staff. All records were completed as required and were clear and up to date. Storage areas were clean and organised and appropriate arrangements put in place for the disposal of unwanted medications to ensure that excess stocks are not held. Training has been given to staff on medications to further ensure the protection of the service users. All service users are accommodated in single bedrooms. Personal care is given to service users in the bathroom or in their own bedroom, as appropriate, to protect their privacy and dignity. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 12 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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A good range of activities is provided in the home to provide service users with entertainment and social stimulation. EVIDENCE: During the visit, service users spoke with an Expert-by-Experience, from Help the Aged, with regard to their lifestyle within the home. Service users confirmed that there is a good programme of activities provided, but some would like more. Service users are given every opportunity to exercise choice in their lives including the time that they go to bed or rise. A support plan is prepared on each service user which is in four parts, “My life up to admission”, “What you need to know to support me”, “How you can keep me healthy and safe” and “Short term goals and long term goals”. This gives the home clear information about individual preferences. Each week, a lady visits the home to provide singing and musical movement for the service users. Recent trips out include New Brighton, Knowsley Safari Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 13 Park and two barge trips. Service users have also enjoyed going out for Chinese and Indian meals and have had a barbeque. Three trips have been arranged to visit Blackpool lights, to give a greater number of service users to go on the trips. Also planned are a Halloween party, a bonfire party and a trip to a Chinese Restaurant. Service users are now starting to make plans for the Christmas activities. Two service users organise a weekly prayer meeting which they lead themselves and have encouraged a good congregation. Ministers of Religion visit the home on a regular basis and provide services for those who wish to attend. One service user enjoys painting and proudly showed this to the inspector and expert by experience. The home evidently encourages service user to continue with activities that they had previously enjoyed. An activities co-ordinator has recently been appointed to meet service users needs. The service has an unrestricted visiting policy and service users are able to choose where to see their visitors. Prince Alfred is close to the shops and some service users go out independently to the local shops. Observation during the inspection showed that that the home has a lot of visitors and that there was a good rapport between visitors and staff. The staff support service users to maintain their personal allowance and where monies are given to the management for safekeeping a record is kept of all incoming and outgoing payments via receipts. A secure place is provided for the storage of service users monies and valuables. Service users are encouraged to bring their furniture into the care home so that they can be surrounded with familiar items providing they comply with current fire regulations. Dining tables were observed to be attractively set with tablecloths, napkins and condiments. A choice of meal is offered with the menus being reviewed and changed according to season and service users preferences. Mealtimes are seen as social occasions by the service users and a lot of interaction was observed. Special diets can be provided in line with the recommendations of the GP, the dietician or the service users preference. Some service users were observed to be assisted with meals and this was undertaken in a discrete and dignified way. Cooked breakfasts are available and the meal served during the inspection appeared appetising. A good supply of fresh fruit and vegetables was held and all areas of the kitchen were clean and organised. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints procedure to protect service users from abuse. EVIDENCE: The home has a robust complaints procedure to give full information to service users and visitors to the home. Information on how to make a complaint is displayed in the foyer of the home and is also detailed in the Service User Guide. A copy of Liverpool City Council’s guidance in relation to adult protection is held together with a copy of the homes whistle blowing policy. No complaints have been received by the home or by CSCI since the last inspection. Information on independent advocacy services is available in the home and how these services can be contacted. Staff have been given training on the different types of abuse and of the action to be taken in the event of it being suspected. This training is updated on a Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 15 regular basis. Staff spoken to during the inspection were able to demonstrate that they had a good knowledge and understanding of abuse and were aware of the action they should take. Prince Alfred DS0000059310.V345350.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, 23 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued investment into the home has improved the quality of the environment to give service users a pleasant and homely place in which to live. EVIDENCE: Prince Alfred is a purpose built home, close to shops and local amenities. Service users bedrooms are located on the first and second floors of the building and all service users have a single room. The communal lounges and dining room are located on the ground floor with additional lounges on the first and second floors. The planned programme of improvements is now well underway, with new flooring fitted to corridors and new carpet on stairways. The second floor Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 17 corridors have been redecorated and are bright and clean. Plans are in place for pictures to be provided to further brighten the corridors. New commodes have been purchased. Some bed bases have been identified by the manager as requiring replacement and this will be addressed in due course. One bedroom was seen to have some damage to the décor due to water damage and requires to be redecorated. Service users are encouraged to personalise their rooms with pictures, photographs and items of memorabilia. It is evident that service users, their relatives and staff have worked hard to provide a homely environment. The home was clean throughout and no unpleasant odours were noted. The home’s housekeeping staff said that the home was much easier to keep clean since the carpets on the corridors had been replaced by flooring. Prince Alfred DS0000059310.V345350.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a well trained staff team to ensure that service users are provided with a high quality of care. EVIDENCE: The staff rota provides evidence that the home is employing and deploying staff in sufficient numbers to meet the needs of the service users. The home has a robust recruitment procedure which is followed for the recruitment of all staff. Prospective staff are required to complete an application form prior to attending for interview. A record of the questions and responses at the interview are held on the files of new staff. Two references are taken and checks are made with the Criminal Record Bureau and Protection of Vulnerable Adults lists to ensure the protection of service users. Files of new staff were inspected and were found to contain all necessary information. The majority of care staff hold NVQ at level 2, with some holding level 3. The remaining care staff are working towards NVQ qualifications and it is expected that all staff will hold this qualification by summer 2008. All domestic staff are Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 19 working to specific NVQ qualifications. Recent training includes dementia care, fire awareness, manual handling, elder abuse and food hygiene. Regular updates in these subjects is given. An update on first aid training is due to be given in the near future. In house training is given to care staff by the manager and senior staff. Service users said that they had chosen one member of staff to be the ‘carer of the month’. All staff are given regular supervision and a record of this is held on their files. Prince Alfred DS0000059310.V345350.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, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is well supported by a committed and caring staff team. EVIDENCE: The manager and deputy manager at the home work closely to ensure that service users are given a good quality of care and environment. Both work full time and are accessible to service users and visitors at all times. The manager supervises the staff at the home and is supervised and supported by the area manager of European Wellcare who makes regular visits to the care home. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 21 Regular staff and service user meetings are held to exchange information and to provide a forum where they are able to put forward ideas about the service and the service provision. It is evident from the records held at the home, and from discussion with service users, that the home is run in the best interests of the service users. Regular checks are made on fire detection equipment and these are recorded. Training in fire awareness and the action to be taken in the event of fire is given to staff on a regular basis. Safety certificates inspected were found to be well maintained and in date. Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 22 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 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 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 4 X 3 X 3 X X 3 Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Merseyside Area Office Burlington House Crosby Road North Waterloo, Liverpool L22 0LG 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 Prince Alfred DS0000059310.V345350.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!