Inspection on 16/08/05 for Queen Alexandra Hospital Home

This inspection was carried out on 16th August 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

Queen Alexandra Hospital Home 29/05/08

Queen Alexandra Hospital Home 27/06/07

Queen Alexandra Hospital Home 23/01/06

Queen Alexandra Hospital Home 06/01/05

Queen Alexandra Hospital Home 05/05/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Queen Alexandra Hospital Home Gifford House Boundary Road Worthing, West Sussex BN11 4LJ Lead Inspector Diane Peel Announced Tuesday, 16 August 2005, 9.30am V235881 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Queen Alexandra Hospital Home Address Boundary Road, Worthing, West Sussex, BN11 1LJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 213458 01903 219151 Queen Alexandra Hospital Home Limited Mrs Valerie Walker CRH 60 Category(ies) of PD-60, PD(E)-60 registration, with number of places Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Up to four females in the above service user categories may be admitted. Date of last inspection 06/01/05 Brief Description of the Service: Queen Alexandra Hospital Home is situated in a residential area of Worthing with local shops and other amenities within walking distance. The seafront and beach are close by. Residents living at the home are ex-servicemen or women and have chosen the home because of its connections with the armed forces. The home has recently undertaken a major new building project which will increase the number of single bedrooms availiable at the home to 36 and provide a new occupational therapy, physiotherapy unit and further communal areas. A second phase of improvements is planned for the existing building to improve the accomadation and facilities. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours on the 16th August 2005 and was carried out by two regulatory inspectors. The inspectors arrived at 9.30 am and were greeted by the registered manager. A full tour of the home took place and the majority of the forty-seven residents living at the home were met. The inspectors also toured the new building which has yet to be opened. Ten residents were spoken with at length to find out if they felt that their needs were being met. The inspectors joined residents for lunch to sample the meal and meet other residents who were not spoken with privately. The care records of nine residents were inspected during the visit along with other records, which showed how care needs are to be met. The records of four staff were inspected and four staff were interviewed informally during the visit. The manager was available throughout the visit to provide the inspectors with requested information. Eight relative/visitor comment cards and sixteen service user comment cards was returned prior to the visit to the home, which gave positive feedback about the level of care provided by the care staff. What the service does well: The home has high standards and provides a safe environment for residents to enjoy. Care plans are clear and provide staff with the information, which they need to meet the needs of the residents. Residents, who are able, are encouraged to retain an independent lifestyle, accessing local communal facilities and maintaining relationships. Meals are varied, nicely presented, offer choice and are served in pleasant surroundings. Visitors are made to feel welcome and find communication with the management and staff of the home open and friendly. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 6 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. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5,6, A service user guide provides information about the home and the service, which it offers to enable prospective residents to make an informed choice about moving into the home. Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. Prospective residents, their relatives and friends have an opportunity to visit the home to look at the facilities available and assess its suitability before moving in. EVIDENCE: A Statement of Purpose and Service User Guide is provided to assist prospective residents to make an informed choice about where to live. This information is regularly updated to provide accurate information about the service, which the home is able to offer and sets out the criteria for admission to the home. A statement of terms and conditions/contract is provided which states what services are included in the fee paid to the home. Care records viewed at this visit showed that a needs assessment is carried out by an experienced nurse prior to moving into the home. Staff interviewed Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 9 described the assessment process and gave examples of recent visits to assess prospective residents. Some residents commented that they had visited the home before they had moved in whilst others said that they had relatives visit on their behalf. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 The care planning system gives clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised. Medication practices do not ensure effective monitoring of medication, which is self-administered by residents. EVIDENCE: Care plans examined had been developed from an initial assessment carried out prior to residents moving into the home. The plans give clear information to staff to enable them to meet the needs of the residents in all aspects of heath, personal and social care. Staff confirmed that care plans are reviewed once a month and any changes to residents needs are recorded and the plan of care revised. Care records showed that the physical health of residents is regularly monitored, including weight and dietary needs. Residents were able to confirm that they had access to a GP and other heath care services. Medication procedures are in place to protect residents from the mishandling of medicines. Records viewed were generally well kept but it was noted that there Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 11 is no administration record kept of medication which is self administered by residents. Accident records are well managed and showed what preventative action had been taken to avoid similar accidents happening again. Not all accommodation at the home allows for privacy during visits by families and friends. Three relative/visitors and four residents returning comment cards reported that privacy is not always respected and that there is little opportunity to have private visits. However it was noted that the new accommodation has 22 additional single bedrooms and the present shared accommodation will have a maximum of two people sharing. Residents commented that they feel that staff treat them with respect and are helpful. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The home provides a flexible lifestyle for residents which allows them to exercise choice and some control over their lives. Activities provided are varied to suit resident’s preferences and abilities. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Meals are well managed and offer choice. EVIDENCE: Residents living at the home are all ex-service men or women and have chosen to live at the home knowing that residents have this in common. The majority of residents spoken with or returning comment cards feel that the home provides them with a life style, which matches their expectations. Activities are available on most days for residents to take part in if they wish. Organised outings are regular and some residents make their own arrangements to use the local community facilities and visit relatives or friends. One resident commented that he had just been down to the seafront and that organised activities are good. The majority of residents spoken with or returning comment cards thought that the standard of food at the home was very good. One resident said that the standard of food and variety of food had improved since this chef arrived whilst another resident thought it varied. Nine service users returning comment cards reported that they liked the food whilst seven service users returning the cards reported that sometimes they liked the food. The inspectors joined residents Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 13 for the main meal of the day. The meal was nicely presented and was of a good standard. Menus provided prior to the visit to the home show variety and choice. The chef demonstrated his knowledge of special diets and commented that he talks to the resident about the food so that he can adjust the menu to provide choices, which allow for most residents preferences. Staff were available to provide assistance to those residents who needed help to eat their meal. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 There is a clear complaints procedure, which enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. Residents are protected by the homes adult protection procedure and staff have attended training in how to protect vulnerable adults. EVIDENCE: Queen Alexandra Hospital Home has a complaints procedure included in the Service User Guide. There have been no complaints made directly to the home since the last visit. One anonymous complaint was made to the CSCI and the manager was asked to investigate the complaint through the homes complaints procedure. The investigation carried out showed that the registered persons take all complaints seriously and act appropriately to rectify matters of complaint. One resident commented that he found it hard to say anything bad about the home “I do not have any complaints about anything”. Another resident said,” I have never had to complain”. Information provided prior to the visit to the home confirmed that the home has its own policies and procedures for responding to suspicion or evidence of abuse or neglect in addition to the West Sussex Multi-Agency Policy for protecting vulnerable adults from abuse. Staff training records viewed showed that training has been provided for staff to ensure that those in daily contact with residents are aware of their responsibilities in recognising and reporting abuse. Care staff that have completed an NVQ in care have completed Unit Z1 (contribute to the protection of individuals from abuse) as part of their qualification. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19,20,21,22,23,24,25 and 26 Queen Alexandra Hospital Home is in a good location, which enables residents to have access to the local community. The property is well maintained but some bedrooms are in need or redecoration to ensure residents comfort. The home is clean and residents have a safe environment to live in. EVIDENCE: The home is currently being modernised. A new building project has just been completed which has an additional 22 single en suite bedrooms, communal space, a physiotherapy and occupational therapy facilities. The second phase of the modernisation will be to make improvements to the existing building by reducing shared accommodation, enlarging some single accommodation and redecorating accommodation. The present toilet and bathing facilities will be replaced. Residents spoken with were pleased with the improvements, which are being made. It was noted that some private bedroom areas are in need of decoration but residents felt that it was acceptable to wait until the second phase of improvements took place. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 16 The home was exceptionally clean and residents confirmed that the home is always kept clean. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The staffing numbers are set at level, which allows residents assessed needs to be met. Recruitment procedures safeguard and protect residents at the home. The staff-training programme provides staff with the majority of skills, which they need to do their job, and enables them to provide a reasonably safe environment for residents. EVIDENCE: Staffing rotas observed prior to the visit show that sufficient staff are employed with the appropriate skill mix to meet the needs of residents over the 24-hour period. There were many positive comments made about the staff during the visit. One resident said, “the staff are wonderful” and another resident commented, “the staff are very good”. A relative returning comment cards commented on the “ dedication and kindness” of individual carers. Another relative stated, “ the staff have always been welcoming, take their duties to exception and always keep me informed”. Four out of seven relatives returning comment cards thought that there were sometimes not enough staff on duty, however the manager has informed the inspectors that staffing levels are adjusted to meet residents dependency levels using a recognised dependency level tool. The records of four members of staff were examined at this visit. Records showed that a recruitment procedure is followed, which includes applying for two satisfactory references and applying for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA). Records also showed that identification of the person employed has been gathered. An induction process is followed with a probationary period and induction programme. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 18 Staff training records show that 60 percent of care staff now have an NVQ level 2 or above which meets the 2005 target set. A staff-training programme provides staff with the training, which helps them to provide a safe environment for themselves and the residents, which live at the home. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,36,37,38 The home is well managed providing leadership and guidance for staff. Service users are safeguarded by the homes accounting and financial procedures. Alexandra Hospital Home provides an environment, which promotes the health, safety and welfare of residents and staff. EVIDENCE: Residents and staff benefit from a well-organised manager who has the best interests of residents at the forefront of the homes aims and objectives. The manager has more than two years experience in a managerial role and has completed a Level 4 Registered Managers N.V.Q. Staff meetings, residents meetings and relatives meeting are held at the home to create an open, inclusive atmosphere. Accounting systems are implemented by a designated person who has the responsibility of keeping up to date records for viewing by the company. Monies held on behalf of residents do not fully meet the requirements of Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 20 standard 35 and Regulation 20 of the Care Standards Act 2000, but the system used works well for the home. A recommendation has been made that the organisation can demonstrate how individual residents will receive any interest applicable from the residents bank account. The home has an Induction programme, which is based on the TOPSS Induction and Foundation Standards. Ongoing training is provided. A staff mentorship programme ensures that all staff are supervised and records of formal supervision are kept. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 4 4 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION 2 3 3 3 2 2 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 4 3 x 3 2 3 3 3 Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 2. Refer to Standard 9 35 Good Practice Recommendations It is recommended that record is kept of medication administered by those residents who self administer. It is recommended that the organisation can demonstrate how individual residents will receive any interest applicable from the resident’s bank account. Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Queen Alexandra Hospital Home H60-H11 S24198 Queen Alexandra V235881 160805 Stage 4.doc Version 1.40 Page 24 - 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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