Inspection on 10/11/05 for Princess Alexandra House

This inspection was carried out on 10th 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 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

Princess Alexandra House 04/10/07

Princess Alexandra House 20/12/06

Princess Alexandra House 25/05/05

Princess Alexandra House 10/12/04

Princess Alexandra House 23/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Princess Alexandra House 34 Preston Park Avenue Brighton East Sussex BN1 6HG Lead Inspector Rebecca Shewan Unannounced Inspection 10th November 2005 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 Princess Alexandra House DS0000014226.V264580.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 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. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Princess Alexandra House Address 34 Preston Park Avenue Brighton East Sussex BN1 6HG 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) 01273 565691 Mrs Carole Franklin Mrs Carole Franklin Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is eighteen (18) Service users must be aged sixty-five (65) years or over on admission Date of last inspection 25th May 2005 Brief Description of the Service: Princess Alexandra is registered to provide personal care and accommodation to eighteen older people. The registered provider/manager is Carole Franklin. The home is located in Brighton with good access to local transport and amenities. The home provides a mix of single and shared bedrooms, many of which have en-suite facilities. There is a good range of communal facilities and a passenger lift. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the tenth November 2005. Before the inspection papers held by the Commission for Social Care Inspection were read. The inspection of the home took four hours. A tour of the whole home was undertaken and the Registered Manager, the Deputy Manager, five staff and eight service users (who like to be known as residents) were spoken with. There were fourteen service users living at the home at the time of the inspection. 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. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 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 Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 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&2 There is a need for the Home to update its Resident Handbook to ensure that all residents are aware of consistent information relating to the home. Effective contracts (Terms and Conditions of Stay) between the home and the resident are in use. EVIDENCE: The Service User Guide, known as the Residents Handbook, was viewed and it was noted that some minor updating is required, as the book does not currently contain information that is consistent with the homes policies e.g. the complaints section in the Residents Handbook should read the same as the homes complaint procedure. The Registered Manager said that the Resident’s Handbook is provided to all new residents, existing residents have access to the book at all times of the day and night. The contract held between the resident and the home was viewed. The contract is clear and comprehensive and details all items required by the associated standard and regulations. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 8 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): 9 & 11 The home has made improvements with obtaining suitable facilities for the storage of controlled drugs. There is a need for the home to review the manner in which it records the administration of controlled drugs. Resident’s dying/critical illness wishes are not recorded in their care plan and there is a need for the home to review this. EVIDENCE: The home had obtained an appropriate wall mounted secure box for the storage of controlled drugs. Therefore the previous inspection requirement has been met. Records for recording the date and amount of controlled drugs administered were maintained in a notebook where pages could be easily removed. The inspector discussed the implications of this with the Registered Manager at the time of the inspection. The Registered Manager said that the home does not currently record residents wishes in the event of dying or critical illness, that residents wishes would be respected until such time that the home is unable to meet the needs of the resident and that family members of a dying resident could remain with them for as long as is necessary. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 9 Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 10 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): 13 & 14 The home provides a wide range of choice for the residents in order that they can maintain relationships and attend events within the local community. Residents are encouraged to have control over their lives and to exercise choice. EVIDENCE: Resident said that they enjoyed all of the homes activities and that the homes Activity Co-ordinator was flexible in allowing residents to choose the level of activities attended. Resident’s family, friends and representatives are welcomed by the home. The Registered Manager and her Deputy said that many of the residents enjoy close contact with their families and friends. Residents confirmed that they went on outings to places of local interest and two residents attend the ‘Acorn Club’ every Friday afternoon. Residents are also encouraged to attend the local church. The Registered Manager said that the home does not currently provide church services at the request of the current residents. Residents said that they are involved in all aspects of their care and are encouraged to remain as independent as possible. One resident said that she has been positively encouraged to take control of her life and that they were grateful to the home for allowing them to achieve this. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 11 Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 12 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 & 17 The home has a suitable Complaints Procedure. Resident’s legal and political rights are protected and respected at all times. EVIDENCE: The home has an established Complaints Procedure in place. There is a need however, for the home to ensure that the Complaint Procedure in the Resident Handbook is consistent with the current Complaint Procedure in use by the home. Residents said that if they had any complaints then they knew that they could approach any member of staff of the homes management team. Neither the home nor CSCI have received any complaints, relating to the home, in the last twelve months. Residents vote by proxy and the Registered Manager said that if a resident wished to attend the polling station then they would be encouraged to do so. The Registered Manager said that most residents have family or a representative to ensure that their legal rights are protected. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 13 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): 22,23,24 & 26 Aids and equipment required to promote resident independence were in use throughout the home. Resident bedrooms were comfortable and residents are encouraged to have their personal possessions around them. An Infection Control policy is in place, although there is a need for the home to ensure that appropriate infection control measures are in place at all times. EVIDENCE: A passenger lift, stair lift, grab rails and bath hoist were evident in the home. Residents were also noted to have suitable mobility aids where required. There is a call bell system throughout the home. There are fifteen bedrooms in the home, three of which can be used as double occupancy. The Registered Manager said that all rooms are currently singularly occupied. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 14 Resident’s bedrooms are pleasantly decorated. Two residents said that they are encouraged to bring in their own possessions and personalise their bedrooms. The home has a clinical waste contract in place. The home has an infection control policy in place and the Registered Manager said that all staff are trained in infection control procedures. It was evident from the tour of the premises that bars of soap were present in some of the home’s communal bath and toilet areas. The infection control hazard implications of bars of soap, which could be deemed as for use communally, were discussed between the Registered Manager and the Inspector at the time of the inspection and an immediate requirement was made. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 15 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): 28 & 29 The home has a commitment to its staff achieving National Vocational Qualification (NVQ) level two. There is a need for the home to review the manner in which is maintains staff recruitment files. EVIDENCE: The Registered Manager said that the home has three care staff trained to NVQ level two and a further two care staff are undertaking the training, the home hopes to achieve the required 50 of staff trained to NVQ level two by the middle of next year. Staff recruitment files were viewed and it was evidenced that these file do not contain all items required under the Care Homes Regulations 2001. Items such as proof of identity, a recent photograph, evidence of relevant training and qualifications were not present in any of the staff files viewed. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 16 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): 31,35,37 & 38 The Registered Manager is competent and experienced to run the home and meet its stated purpose. In general service users or their representatives control their own finances. Since the last inspection the home has reviewed its policies and procedures. Urgent action was required to ensure; that all products such as talcum powder and shampoo are clearly labelled with the residents name and those, which are unnamed, are removed from the toilet and bathroom areas, that fire doors are not wedged open and where this is at the residents request, risk assessments are put in place and that fridge and freezer temperatures are taken and recorded on a daily basis. EVIDENCE: Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 17 The Registered Manager has many years relevant experience in caring for older people and is currently undertaking the Registered Managers Award and NVQ level four training. Therefore the previous inspection recommendation has not been fully met, the Registered Manager said that this would however be achieved by March next year. The Registered Manager is an appointee for one resident, all other residents have family or representatives who maintain and safeguard their finances. The Registered Manager said that following the previous inspection all of the home’s policies had been reviewed, dated and signed. Therefore the previous inspection recommendation has been met. The homes maintenance files were viewed and it was evident that fire drills, fire alarm testing and fire equipment checks, water checks and Portable Appliance Testing (PAT) had been carried out. Immediate requirements were made at the time of the inspection as it was noted that potential risks to both service users and staff were apparent: Unnamed products such as talcum powder, bubble bath, perfume and shampoo had been left in the first floor bathroom. A number of fire doors had been wedged open and there were no risk assessments in place to reflect the need for this. Fridge and freezer temperatures are usually checked on a daily basis, however on the day of the inspection it was noted that such checks had not been recorded since the second November 2005. Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X X X X 3 3 3 X 2 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X 3 X Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 19 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. 1 2 3 Standard OP1 OP9 OP26 Regulation 5(1)(e)& 6(a) 13(2) 13(3)& 13(4)(a) (b)(c) 19(1)(a) (i)& Sc2(1-6) 12(1)(a) Requirement That the Resident’s Handbook is updated to contain consistent information relating to the home. That the administration of controlled drugs is recorded in a tamper proof book. That bars of soap are removed from all toilet and bathroom areas. This is an immediate requirement. That recruitment of staff must comply with the Care Homes Regulations 2001. That all products such as talcum powder and shampoo are clearly labelled with the resident’s name and any products, which are unnamed, are removed from bathroom areas. This is an immediate requirement. That all products such as talcum powder, bubble bath and shampoo are clearly labelled with the resident’s name and any products, which could be deemed as for use communally, are removed from bathroom areas. This is an immediate requirement. DS0000014226.V264580.R01.S.doc Timescale for action 10/01/06 10/12/05 10/11/05 4 5 OP29 OP38 10/01/06 10/11/05 6 OP38 12, 13(4) & 23(4) 10/11/05 Princess Alexandra House Version 5.0 Page 20 7 OP38 12(1)(a) & 16(2)(g) That fridge & freezer temperatures are recorded on a daily basis. This is an immediate requirement. 10/11/05 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 Refer to Standard OP11 OP28 OP31 Good Practice Recommendations That residents dying/critical illness wishes are recorded in their care plan. That 50 of staff obtain NVQ level 2 by 2005 (Outstanding from previous inspection). That the registered manager obtains the recommended qualifications in 2005 (Outstanding from previous inspection). Princess Alexandra House DS0000014226.V264580.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Princess Alexandra House DS0000014226.V264580.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. 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!