Inspection on 11/11/08 for Queen Alexandra Cottage Homes

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Excellent service.

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

Queen Alexandra Cottage Homes 18/12/06

Queen Alexandra Cottage Homes 01/02/06

Queen Alexandra Cottage Homes 07/09/05

Queen Alexandra Cottage Homes 13/02/05

Queen Alexandra Cottage Homes 23/07/04

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Queen Alexandra Cottage Homes 557 Seaside Eastbourne East Sussex BN23 6NE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Queen Alexandra Cottage Homes 557 Seaside Eastbourne East Sussex BN23 6NE 01323-739689 01323727533 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Trustees of Queen Alexandra Cottage Homes care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service users must be aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is twenty-five (25). Two places to be available for service users aged between sixty (60) and sixty-five (65) years on admission. Date of last inspection Brief description of the care home Queen Alexandra Cottage Homes is registered to provide care with nursing for up to twenty-five service users who meet the registration category of older people. The home forms part of an Edwardian building, which was purpose built to provide sheltered accommodation for older people, it has been established since 1906. The accommodation offered in the home consists of seventeen single rooms, thirteen with ensuite facilities and four double rooms without an ensuite facility. Lounge areas are now offered on both floors and are attractively decorated with good quality furniture. The conservatory/ lounge leads out to a paved patio where residents can sit and enjoy the gardens. There is a dining area, which is situated next to the kitchen, which is used Care Homes for Older People Page 4 of 26 Over 65 25 0 Brief description of the care home by approximately sixteen residents. There are ample bathing facilities available which have the necessary equipment to meet the needs of the residents accommodated in the home. The home is situated on the outskirts of Eastbourne in a residential area, approximately two miles from the town centre, and it is on a main bus route. The sea front is approximately half a mile away and immediately opposite the home, there is a shopping area, with a post office and a supermarket. Queen Alexandra Cottage Homes also contains self-care bungalows and flats for those requiring supported living. In the middle of the buildings there is a large garden, which is designed in to smaller areas with shelter and water features which are enjoyed by all. Copies of inspection reports and the homes Statement of Purpose are made available on request. Weekly fees charged as of 11 November 2008 range from £645 to £870, which does not include toiletries. Additional charges are made for hairdressing, chiropody, newspapers and outside activities such as visits to the theatre. Intermediate care is not provided. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection took place over four hours in November 2008. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Residents and relatives spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of the inspection was to check compliance with requirements made at the previous inspection and to monitor care practices. On the day of the inspection there were twenty three residents living in the Care Wing. Care Homes for Older People Page 6 of 26 The inspection involved a tour of the premises, examination of the homes records, discussion with the registered manager (Matron) and consultation with three members of staff, seven residents and two relatives. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their relatives have sufficient information about the home and the services provided and, through a comprehensive pre-admission assessment process, know that their care and suport needs are able to be met. Evidence: Information, including the recently updated Statement of Purpose, Service User Guide and Residents Charter is made available to all prospective and existing residents. A thorough Admission Policy and Procedure is in place and the Matron descibed in detail the process by which prospective residents are assessed and their care and support needs identified. A comprehensive pre-admission assessment, incorporating a detailed Dependency Profile is carried out by either the matron or her deputy, to establish an individuals Care Homes for Older People Page 10 of 26 Evidence: suitability and compatibility prior to them being offered a place at the home. On moving in, each resident is issued with a formal contract, including a statement of terms and conditions of residency. Contracts that were examined were found to have been signed by both the resident or their representative and the Matron, on behalf of the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health care needs are met and individual care plans enable staff to meet their assessed needs in a structured and consistent manner. The systems for consultation and participation are good and residents are treated with respect and, where appropriate, are encouraged to make decisions about their day-to-day living. Evidence: Residents care plans that were viewed were found to be generally well maintained and up to date. They showed clear links with the individuals assessed needs and contained details of action and intervention to be taken by staff to ensure consistency of care. There was also evidence of plans, including guidelines for staff and risk assessments, being regularly reviewed and updated. The Matron confirmed that residents and their relatives are given the opportunity to take part in developing and reviewing individual care plans. However, in certain plans that were examined, there was little documentary evidence of residents or their relatives being involved in this process. In many cases, sections for residents to Care Homes for Older People Page 12 of 26 Evidence: complete, confirming that they had been consulted about the content or any changes to their plan, had been left blank. Following discussion with the Matron it is recommended that this issue be addressed. All residents are registered with local GPs and have access to other health care professionals via the surgeries. It was noted, in individual care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Nutritional screening is carried out as part of the initial assessment procedure. As part of their induction programme, the Matron confirmed that all staff receive instruction on the principles of dignity and respect. This was evident, through discussions during the inspection, comments from relatives and from direct observation of staff interacting sensitively and professionally with residents. Satisfactory and up to date policies and procedures are in place for the control, storage, safe administering and recording of medication. However it was noted that that there is currently insufficient space for the safe storage of controlled drugs within the home and it is recommended that a larger cabinet be provided for this purpose. The Deputy Matron confirmed that only trained nurses working in the Care Wing are involved in administering medicines. This was supoprted by documentary evidence and through discussions with care staff. She was also able to confirm that, following risk assessments, there are currently no residents in the home who maintain responsibility for self administering their medication. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish. Opportunities for appropriate recreational and leisure activities are limited. Residents benefit from menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: Residents recreational and leisure interests are recorded in their individual care plan. A member of the care staff is employed at the home as an Activities Coordinator. She works four afternoons a week from 2.00 until 4.00pm. From discussions with residents and their relatives and through direct observation, it is evident that some much needed stimulation within the home continues to be provided through individual and small group activities, including music, arts and crafts, gentle exercise and various games and quizzes. Comments received from residents and their relatives indicate a general but realistic level of satisfaction with the activities arranged in the home: Care Homes for Older People Page 14 of 26 Evidence: She does a marvellous job. But there are so many of us and only one of her! The activities here leave something to be desired. The Matron confirmed that, in accordance with the wishes of the residents, visitors to the home are made welcome at any reasonable time. However, they are asked to respect mealtimes. Residents may see friends or relatives in one of the lounges or in the privacy of their own room. Folowing regular consultation with residents, a five week rolling menu has been developed, reflecting individual choice and preferences and including seasonal variations. The Matron confirmed that a total of three chefs are currently employed at the home, each providing their individual interpretation of the menu. Residents evidently receive a varied, wholesome and nutritious diet. A choice of main meal is always available and special diets are catered for. As part of the inspection process, I joined several residents for lunch and enjoyed a tasty meal in pleasant surroundings and good company. Positive comments demonstrated overall satisfaction with the choice and standard of meals provided: The food here, particularly at lunctime, is very good. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The open and inclusive atmosphere within the home enables residents, staff and visitors to feel able to express any concerns, confident that they will be listened to. Residents are safeguarded from abuse through robust policies, procedures and relevant staff training. Evidence: A clear and accessible complaints procedure is in place. However, following discussion with the Matron, it is recommended that the procedure be reviewed and amended to include updated contact details for the CSCI. The management team operates an open door policy and is evidently considered to be very approachable and understanding. Residents and members of staff spoken to during the inspection confirmed that, should they have a concern or complaint, they would have no hesitation in speaking to the Matron or her deputy and each person was confident that they would be listened to and their concerns acted upon. The home ensures as far as is practicable that residents are protected from all forms of abuse. Recently updated policies and procedures relating to Safeguarding Vulnerable Adults, including a policy on Whistle Blowing are in place. The Matron confirmed that staff are also made aware of these key policies and Care Homes for Older People Page 16 of 26 Evidence: procedures as part of their induction, foundation and National Vocational Qualification (NVQ) training and they are reinforced during staff meetings. This was supported by minutes from previous meetings and confirmed by staff, spoken with during the inspection. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for its stated purpose. Residents benefit from pleasant, good quality accommodation that is comfortable, well maintained and decorated to a high standard. Evidence: During my guided tour of the premises, it was evident that high standards relating to the physical environment remain largely unchanged and with the well maintained decor and good quality furniture and furnishings it continues to provide a very comfortable, safe and homely environment for residents. The Care Wing provides several communal areas, enabling residents to spend time in different parts of the home as they wish. The communal rooms are used for various activities as well as providing quieter areas for residents to meet with visitors. Sufficient bath and shower facilities are provided, each with an assisted bath seat. All bedrooms have toilet and hand basin facilities and some bedrooms have en suite bath or shower facilities. The home provides sufficient toilets. Good quality furnishings and fittings are provided in residents accommodation, throughout the home. Care Homes for Older People Page 18 of 26 Evidence: It was evident that residents are encouraged to bring in their own possessions and small items of furniture, with rooms clearly having been personalised, reflecting individual taste and interests. Since the previous inspection, a two storey extension has been built at the rear of the premises providing a good sized laundry room on the ground floor and a light and spacious staff room upstairs. A programme of routine maintenance, refurbishment and renewal is in place. Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient trained and competent staff on duty at all times to meet the assessed care and support needs of the residents. Robust recruitment procedures and appropriate staff training help to ensure the safety and protection of residents. Evidence: The stable and dedicated staff team is clearly able to meet the assessed, individual and collective needs of residents within the home. The Matron confirmed that staffing levels within the home are sufficient to meet the current care needs of residents. She added that this situation is closely monitored and there is always some flexibility for additional staff hours should the need arise. All shifts are covered by a minimum of eight staff, including a qualified nurse in charge. There are three waking night staff on duty each night. This was further evidenced by the current rota, viewed during the inspection, which details which staff are on duty at any given time and includes their designation. The Matron continues to operate a thorough and robust recruitment procedure and all prospective staff are seen and interviewed by her before commencing work in the home. Care Homes for Older People Page 20 of 26 Evidence: Personal files, relating to newly appointed staff, were found to be well maintained, containing all necessary information, including two written references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. As well as high quality documentation, including comprehensive needs assessments and care plans, there is clear evidence within the home of the positive relationships which have developed and are maintained between staff and residents, providing staff with awareness and sound understanding of an individuals care and support needs. This is evidenced through observation and discussion and confirmed by residents, spoken with during the inspection: The Matron and all the staff cannot do enough for you. Nothing is too much trouble. You only have to mention something and its done. Residents, relatives and members of staff, spoken with during the inspection, confirmed that staffing levels within the home are adequate: Theres always someone around and they are all so kind and helpful. It does get busy at times but we manage. If we need more help, we only have to ask the Matron or nurse in charge. Appropriate induction, foundation and core skills training is evidently provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed by staff and supported by training records examined. Out of a total of twenty seven, there are currently fifteen care staff who hold the National Vocational Qualification (NVQ) at level 2 or 3. A further two members of staff are studying for the award at present. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and staff benefit from the Matrons calm, open and approachable style of leadership and clear and positive sense of direction. Satisfactory quality assurance systems safeguard the interests of residents and they are protected by the homes health and safety policies and procedures. Evidence: The atmosphere in the home remains relaxed, friendly and welcoming. Staff, spoken to during the inspection felt valued and supported by the Matron and confirmed her open and approachable style of leadership and clear and positive sense of direction. The Matron is competent and experienced. She has worked for the organisation for ten years and has been in her current post for four years. She is a registered nurse and has successfully completed her NVQ level 4 and the Registered Managers Award (RMA). Care Homes for Older People Page 22 of 26 Evidence: As previously documented, it is evident that the Matron continues to operate an open door policy, with staff encouraged and able to discuss any issues or concerns that they may have at anytime. Arrangements for formal staff supervision have been reviewed since the previous inspection. The Matron supervises all the qualified nurses within the home. They each have responsibility to provide regular supervision for an allocated number of care staff. Staff spoken with during the inspection acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the management team: They do make you feel involved and valued. They are very supportive and always ready to listen. The homes quality monitoring system includes satisfaction questionnaires for both residents and their relatives. The Matron confirmed that, since the last inspection, surveys have been sent out although as yet only a limited response has been received: Im sure that her great age is largely down to the loving care and attention she receives. I find all the staff extremely helpful and very friendly. Nothing seems too much trouble for them. The health, safety and welfare of residents and staff evidently remains of paramount importance within the home and staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. COSHH assessments and guidelines are in place. Temperature regulators are fitted to all hot water outlets, accessible to residents and all accidents, incidents and injuries are recorded and reported, as required. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that, where appropriate, residents and/or a relative have the opportunity to be involved in the developing and reviewing of care plans and that their involvement is recorded. It is recommended that a larger cabinet be provided for the safe storage of controlled drugs held in the home. It is recommended that the complaints procedure be reviewed and amended to include updated contact details for the CSCI. 2 3 9 16 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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