Inspection on 07/12/06 for Prince Alfred

This inspection was carried out on 7th December 2006.

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

Prince Alfred 27/09/07

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 09:30 7th December 2006 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.V296466.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.V296466.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 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.V296466.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. 3rd March 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 hydrotherapy pool and a hair salon. A garden with a seating area is provided. There is a car park at the front of the home. Prince Alfred DS0000059310.V296466.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. During the inspection, records relating to the care required by and afforded to service user were inspected. Staff records were inspected to ensure that all staff had been appropriately recruited and that they had been given training appropriate to the work that they were required to undertaken. A tour of the premises was made. The deputy manager, staff, service users and visitors to the home were spoken to and all spoke highly of the home. 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 contacting your local CSCI office. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 6 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.V296466.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Full information regarding the prospective service users needs is gathered at the pre-admission assessment to ensure that the home can meet their needs. EVIDENCE: The home has produced a detailed statement of purpose and service user guide. These have recently been reviewed and updated to provide sufficient information to enable a prospective service user to make an informed choice regarding their care provider. Service users and their families are encouraged to visit the home to meet staff and other service users and trial stays can be arranged. 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 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. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 8 Comprehensive assessments are undertaken on prospective service users to identify their individual care, dietary and social needs before a place at the home is offered to ensure that the home can meet those needs. The assessments inspected were found to be extremely detailed and provided sufficient information to enable a plan of care to be prepared. Discussion with staff provided evidence that they had been given full information regarding service users needs to enable them to provide the appropriate level of care and support. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. Detailed care plans are prepared for each service user and are reviewed and updated on a regular basis to ensure that service users are provided with the appropriate level of care. EVIDENCE: Individual care plans are prepared for each service user. These were found to be extremely detailed and provided comprehensive information to ensure that staff know what the service users needs are and how their assessed needs would be met. The corporate format of care planning has now been implemented for all service users care files. Full risk assessments have been undertaken and risk management plans have been put in place. Care plans are reviewed and amended on a regular basis, and as the service users needs change, to ensure that the appropriate level of care is given at all times. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 10 The plans are prepared with the service user or their representative and are signed to indicate their agreement with the plan. Two service users confirmed that they knew what was in their care plan and were happy with the agreed level of support. The files also contain a life history of the service user which provides additional information to staff and enables the staff to further understand the service user. Details are kept of relatives and other prominent persons in the service users life and staff assist service users to maintain contact with these people if they are unable to attend to this unaided. The daily records completed by the senior staff are informative and provide details of the actual care given on a daily basis. Details are held of visits to and by other healthcare professionals and the care plans are changed to reflect any recommendations made by those professionals. The services of the District Nurse, Tissue Viability Specialist, Continence Advisor and Social Worker are sought whenever necessary. Regular visits are made to the home by dentists, opticians and chiropodists. Medications are dealt with in accordance with the home’s policy and procedure and all records were well maintained and up to date. The storage area was clean and organised and appropriate arrangements are in place for the disposal of unwanted medications and no excess stocks of medication were held in the home. 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.V296466.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A full programme of activities is arranged to provide entertainment and social stimulation for service users. EVIDENCE: Service users are given every opportunity to exercise choice over activities of daily living such as the time of going to bed and rising, where to have their meals, where they spend their day and where they meet with their visitors. Some service users are taken out by family members and some by staff. The home has a mini-bus to enable service users to be taken out without having to arrange transportation. The cost of petrol for trips out is paid for by the home. Recent trips out include the theatre and New Brighton. A high number of activities takes place within the home and on the day of the inspection, service users were observed to be enjoying singing followed by movement to music which was provided by Jean Hill, who visits the home each Thursday. A regular bingo session is held each week and service users spoken to said that they really enjoyed this. Service users arrange their own weekly prayer meeting and all other service users are welcome to attend. Ministers of Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 12 Religion visit the home on a regular basis. A new activities co-ordinator has been appointed and is due to commence work at the home in early January. 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.V296466.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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. Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has produced a comprehensive 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. Only one complaint has been received by the home since the last inspection and the records show that this was dealt with appropriately and within an acceptable timescale. 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 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.V296466.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained to provide service users with a warm 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. A new conservatory has been built since the last inspection and provides a bright and pleasant area for service users. Some minor maintenance issues were raised with the deputy manager during the inspection and these were addressed immediately. The lounges on the first and second floors did not provide the warm and homely areas that the staff strive to achieve in all other Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 15 areas of the home. The décor and furnishings in these rooms would benefit from improvement. The carpets on the first and second floors have now become stained and worn, however, quotes are being obtained with a view to replacing these. A programme of redecoration of bedrooms has been prepared and rooms will be redecorated in order of priority. The corridors have recently been redecorated and were awaiting the reinstallation of pictures to further brighten these areas. Sufficient bathrooms and toilets are provided and assisted bathing facilities are in place. Service users are encouraged to personalise their rooms and it is evident that relatives and the home’s staff have worked together to achieve this. The majority of rooms were seen to have pictures, photographs and items of memorabilia to reflect the lifestyle, history and tastes of the individual service users. Some damp patches were noted near the ceiling on the second floor of the home. This is due to a problem with the guttering. Arrangements have been made for this to be dealt with and redecoration of these areas is planned. The home is advised to undertake a regular review of the décor and maintenance of the home to enable a plan of redecoration and general improvement to be prepared. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. 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. 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 homes recruitment procedure has been prepared in accordance with equal opportunities. 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. Training continues for all staff with 60 of the staff holding NVQ at level 2 or above. An additional seven staff are currently working towards this qualification. The home employs its’ own bank staff to cover sickness and annual leave to provide a consistent approach to care provision. There has been no turnover of staff since the last inspection. All staff have now completed training on manual handling, abuse, fire prevention, first aid, basic food hygiene and safety in the workplace. One of the staff has considerable experience and qualifications in caring for older people with dementia and Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 17 provides training on this to all staff. Regular supervision is given to all staff and annual appraisals are held. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported well by the staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager continues to work to achieve NVQ at level 4 in management. The manager is accessible to service users and staff as necessary. The deputy manager works full time in the home and is available when the manager is off duty. 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. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 19 A quarterly newsletter is now produced to provide additional information for service users and to keep them informed of future events. This is extremely well presented with pictures, quizzes and details of recent visits and service users spoken to during the inspection said that they really enjoyed reading it. The manager receives regular supervision from the area manager of European Wellcare and she makes regular visits to the care home to provide information and support to the manager. Tests on fire detection equipment are made and recorded as required and all staff are given training on the action to be taken in the event of a fire. Safety certificates inspected were found to be well maintained and up to date. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 20 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 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 3 X 3 X 3 X X 3 Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 21 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. 1. Refer to Standard OP19 Good Practice Recommendations The home is advised to undertake a regular review of the décor and maintenance of the home to enable a plan of redecoration and general improvement to be prepared. Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Liverpool Local Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Prince Alfred DS0000059310.V296466.R01.S.doc Version 5.2 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. 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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