Inspection on 07/06/06 for The Alton Centre

This inspection was carried out on 7th June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Alton Centre 04/11/08

The Alton Centre 08/10/08

The Alton Centre 08/10/07

The Alton Centre 20/06/07

The Alton Centre 12/12/05

The Alton Centre 05/05/05

The Alton Centre 16/11/04

The Alton Centre 14/07/04

The Alton Centre 25/05/04

The Alton Centre 13/02/04

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

CARE HOME ADULTS 18-65 The Alton Centre Irchester Road Knuston Spinney Wellingborough Northants NN29 7EY Lead Inspector Mrs Linda Preen Unannounced Inspection 7th June 2006 10:00 The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 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 The Alton Centre DS0000055888.V298162.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 Adults 18-65. 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. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Alton Centre Address Irchester Road Knuston Spinney Wellingborough Northants NN29 7EY 01933 413646 01933 413664 altoncentre@activecarepartnerships.co.uk 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) Active Care Partnerships Ltd Vacant Care Home 31 Category(ies) of Learning disability (24), Physical disability (31) registration, with number of places The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. Care Home with nursing A total of 31 residents in the category of PD (Physical Disability) between the ages of 18 and 65 years may be accommodated in the home. Four named residents in the category of PD over the age of 65 years may be accommodated in the home. A total of 31 residents in the category of PD (Physically Disabled) A total of 24 residents in the category of LD (Learning Disability) between the ages of 18 and 65 years requiring personal care only may be accommodated in the home. No more residents in the category of PD may be admitted to the home when there are already 31 residents in this category accommodated. No more residents may be admitted to the home when 24 residents in the category of LD (Learning Disabilities) are already accommodated in the home. 12th December 2005 Date of last inspection Brief Description of the Service: The home provides care for 31 physically disabled adults and 24 residents with learning difficulties between the ages of 18 and 65 years. Accommodation is mainly provided over three floors and is in single rooms with ensuite facilities. Six residents have their own self- contained bungalows in the grounds but attend the main house for meals and activities. Adaptations such as ceiling hoists and mobility aids are provided according to assessed needs. The home is situated in a small village, close to two local towns and their amenities. Transport is provided in the form of two mini-busses. Residents with Learning difficulties are accommodated in a separate unit that is run on the lines of a college with “Halls of residence” to enable residents to be cared for in small groups. Residents in this area have education programmes in place to ensure that their full potential is maximised. Fees range from £570 to £850 per week according to residents assessed level of care need. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Three hours were spent prior to the inspection reviewing previous requirements and recommendations, collating information provided by the service, and reviewing comment cards received from residents and their relatives. A total of twenty- one residents had returned comment cards and ten relatives. On the whole feedback was very positive except for a comment concerning the upkeep of the grounds. The inspection took place over a period of six and a half hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and other residents and doing a limited tour of the environment. In addition to this, staff recruitment and training records were sampled, medication systems monitored, Health and Safety records were seen and the home’s Quality Assurance programme was reviewed. What the service does well: What has improved since the last inspection? Care plans have been expanded to ensure individual, specific information is recorded to enable staff to meet resident’s needs. These care plans are regularly reviewed and are formulated in conjunction with the resident concerned. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 6 The programme of refurbishment and redecoration has continued with several more resident’s rooms having been redecorated since the last inspection. One resident was pleased that his choice of colours had been considered in the refurbishment of his room. 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. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Thorough assessments and Terms and Conditions ensure that residents are confident that their needs may be met in the home. EVIDENCE: A Statement of Purpose and Service Use User Guide were available in reception. Residents spoken to confirmed that they were able to visit the home and view the facilities prior to moving in. Comprehensive assessments were available in the case files checked, to ensure that resident’s needs might be met within the home. These included import from the resident and from other healthcare professionals. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Good systems are in place to ensure that all aspects of resident need are identified and documented for staff guidance, to ensure that these needs may be met in the home. EVIDENCE: Comprehensive care plans were available for the three residents chosen to case track. These care plans were regularly reviewed and signed by the resident concerned. They had detailed information concerning resident specific needs and how staff were to meet those needs. Residents spoken to expressed their satisfaction at the care and attention received and with the standard of food and activities provided. One resident spoken to stated that the level of care could not be better. Comment cards received were complimentary with residents stating that the atmosphere was relaxed and friendly and that they liked it in the home. All residents seen appeared well groomed and were dressed in an appropriate manner. Evidence was available of resident’s preferred activities and of their preferred times of rising and retiring. Staff and residents confirmed that their choices are considered and that they are allowed to choose how to spend their day. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Social Activities and meals are both well managed, creative and provide daily interest and variation for people living in the home. EVIDENCE: Residents are able to go out into the community if they wish, with family and friends, staff or alone according to risk assessments. A group of residents left to go to the cinema are during the inspection. Other residents attend todays centres and social clubs locally. Regular trips out for meals and to the public house are organised and attendance at sporting facilities encouraged. A group of residents were involved in a lively game of cards during the inspection and another was planning to do some gardening during the afternoon. Visitors are welcome to the home at any time and records demonstrated that residents go out with family and friends if they so choose. Residents are assisted to maintain telephone contact with family members were regular visits are difficult. Residents in the learning disability unit have educational programs provided to ensure that their maximum potential may be reached and a resident in that The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 11 area confirmed that she had enjoyed a session working on her monetary skills during the morning. Records were available of individual choices concerning their lifestyle and residents confirmed that the choices were respected. Residents spoken to stated that the standard of food was very good and that choice was available at all meals. Menus provided as part of the pre-inspection information demonstrated that a varied, nutritious diet is provided. Residents in the learning disability unit are encouraged to participate in simple meal preparation and in the planning of menus. A take-away pizza was planned for the evening meal in this unit at the request of a resident. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be assured that their wishes will be considered in relation to health care support. EVIDENCE: Records of General Practitioner and other health care professional visits were seen in the files monitored. This included access to physiotherapy, chiropody and specialist nurse advice and treatment. One of the residents spoken to confirmed that staff are very approachable and treat him as an individual giving due respect to his opinions. Systems for the receipt, recording, administration and return of medication were seen and found to be satisfactory. Instructions for the administration of some medication was still recorded as “ as directed” which is insufficient instruction when different people are administering medication. The acting manager was aware of this difficulty and is currently in discussion with the general practitioners to rectify the situation. None of the residents currently chooses to self medicate. Consultations have recently taken place with the residents concerning the transfer of all residents to one local general practitioners services in order that The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 13 care may be streamlined. Residents had all agreed to this transfer and arrangements are currently in place to facilitate this. The intention is that the General Practitioner will visit the home every two weeks for routine surgery visits, although residents will still be able to attend the local practice for more urgent visits in between. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 and 23 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be confidant that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: The Commission for Social Care Inspection has received no complaints or concerns since the last inspection. Records in the home demonstrate that one complaint has been received concerning the state of the outside area and garden and the acting manager is in the process of addressing this complaint. A copy of the complaints procedure is available within the home, and resident’s feedback cards confirmed that they are aware of whom to complain to. Staff training records demonstrated that staff have received training concerning abuse and the protection of vulnerable adults and a staff member spoken to was aware of her responsibilities in this respect. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28, 29 and 30. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. A safe, clean, well-maintained, internal environment is provided for the residents. Specialist equipment is provided to meet their needs. EVIDENCE: A limited tour of the environment was undertaken. This demonstrated that a continuing programme of redecoration and refurbishment is in progress. One resident was pleased to report that his opinion had been sought when choosing colours to redecorate his room. The home is surrounded by gardens, which are currently overgrown and untidy so that residents are unable to enjoy this facility. The acting manager is currently taking action to rectify this problem and to restore the grounds to provide pleasant outdoor space. Resident rooms were bright and spacious and showed evidence of personalisation, with small items of furniture, pictures and ornaments on display as well as personal music systems and televisions. Hoists, handrails and wheelchairs are available according to resident need, as well as assistant baths and showers. All areas of the home seen were clean and tidy. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 34, 35 and 36. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Procedures for the recruitment of staff provide safeguards necessary to offer protection to the people living in the home. Staff are provided with training and in sufficient numbers to meet the needs of the residents. EVIDENCE: The duty rota provided as part of the pre- inspection information demonstrates that adequate staffing levels are provided to meet the current residents needs. Residents seen all appeared clean and well groomed and those spoken to confirmed that the standard of care was good. Resident feedback comments recorded that staff were available to help when needed and that they did this in a sympathetic manner. A selection of staff files was seen and these demonstrated that recruitment practices protect residents from potential harm. Criminal Records Bureau checks, references and previous work history are available prior to staff commencing employment. An equal opportunities policy is available and several overseas staff are employed within the home. Work permits were available for these overseas staff where needed. An induction programme is in place to ensure that new staff are aware of policies and procedures within the home. Staff spoken to confirmed that new staff undergo this induction and that they work alongside another staff member during their induction period. Seven staff currently hold a National Vocational Qualification in care in addition to the qualified nurses employed by the home. This does not meet the required The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 17 50 of care staff who hold this qualification and the company is recommended to put measures in place to correct the shortfall. Other training within the home is provided and all staff undergo statutory Fire, Food Hygiene, moving and handling, health and safety and protection of vulnerable adults training. In addition or specialist training to meet the needs of the residents in the home is provided. For example epilepsy, challenging behaviour, pressure area care and wound care. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, and 42 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Management systems are in place to ensure that the home is run with the best interests of the residents foremost, but there is no Registered Manager in the home and Health and Safety checks are not always completed. EVIDENCE: There has been no Registered Manager in the home for some time and the company is required to address this issue urgently. However an experienced manager from within the company has been running the home in the absence of a Registered Manager and management systems have ensured that the home is run in the best interests of the residents and that staff are well supported and supervised. Two deputy managers who are currently working towards a Registered Manager’s award ably assist her. Residents and staff both confirmed that the acting manager is approachable and would listen to their concerns. Observation during the inspection showed that there was a relaxed, friendly atmosphere between the acting manager and other people within the home and that residents greeted her as a friend. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 19 Regular residents meetings are held and one was planned for the week following the inspection. Minutes of these meetings are available. A monthly audit of care is carried out within the home and regular resident questionnaires are completed to ascertain their opinion of the service provided. Copies of the last resident’s questionnaires were available for inspection and these demonstrated an overall satisfaction with the care apart from this situation concerning the garden as previously mentioned. Records of testing of fire alarms and fire-fighting equipment were seen and found to be up-to-date. However the testing of emergency lighting is still not being carried out at the required monthly intervals. This was a requirement following the last inspection and remains outstanding. The Alton Centre DS0000055888.V298162.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 Adults 18-65 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 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 2 X The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 21 Yes 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 YA42 Regulation 23(4) c Requirement Records must be available to demonstrate that the emergency lighting system has been tested at the required monthly intervals. Previous timescale of 14/01/06 not met. An application to register a manager for the home must be submitted to the Commission for Social Care Inspection for consideration. Timescale for action 19/06/06 2 YA37 8(1) 01/07/06 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 YA35 Good Practice Recommendations Action should be taken to address the shortfall of carers in the home who are Qualified to National Vocational Qualification level. The Alton Centre DS0000055888.V298162.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 The Alton Centre DS0000055888.V298162.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. 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