Inspection on 12/07/05 for The Princess Alexandra Home

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

The Princess Alexandra Home 19/08/08

The Princess Alexandra Home 11/09/07

The Princess Alexandra Home 16/01/07

The Princess Alexandra Home 06/02/06

The Princess Alexandra Home 03/03/05

The Princess Alexandra Home 14/09/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE The Princess Alexandra Home Common Road Stanmore Middlesex HA7 3JE Lead Inspector Bernard Burrell Unannounced 12 July 2005, 10:00h00 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. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Princess Alexandra Home Address Common Road Stanmore Middlesex HA7 3JE 020 8950 1812 020 8421 8202 info@jcare.org Jewish Care 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) Ms Gaby Wills CRH N Care Home with nursing only 72 Category(ies) of OP Old Age 65 Years and over registration, with number of places The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31 March 2005 Brief Description of the Service: Princess Alexandra Home is registered to provide residential and nursing care accommodation to up 72 elderly people, including one respite bed. The home is a large detached property set within extensive grounds in Stanmore, North Harrow. The home offers two rooms suitable for couples and the rest of the rooms are single occupancy, many with en-suite facilities. There are several communal rooms including lounges, dining areas, a library, an activities room, two medical consulting rooms, four lifts and a multi-faith prayer room. Kashrut is strictly observed and is overseen by a Jewish Cares Shomer (religious) supervisor. The home has been in private ownership since 1952 but had a change of ownership in 2002 when it was taken over by Jewish Care. The new owners made a commitment of continued care to all existing service users and at the time of this inspection, the home still had non-Jewish residents. The home continues to respect and value the needs of all its residents. Special needs and diets plus individual preferences are catered for. Planning permission has been approved by the local council for Jewish Care to redevelop the site to include nursing, dementia and residential day care services The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out in one day with input from the staff, managers and residents. The inspector spoke to several residents and gained invaluable information about their varied experiences of life at the home. There were two vacancies in the nursing section of the home at the time of this inspection and 3 residents were in hospital. The inspector examined various staffing, administrative, general maintenance, operational records and other documents as part of the inspection process. In addition, there was written input provided by the manager about the range of services provided plus an inspection of the medication administration and records carried out by the CSCI pharmacy inspector. The home was adequately staffed with a core of permanent staff, many of whom have been working at the home for several years. There was plan to recruit more bank staff to supplement the current permanent staffing cover. The home does not use agency staff. The inspector was satisfied the home continues to offer satisfactory levels of services to the residents as well as meeting their individual and collect care needs. Work has started to replace the care plan system to make each one more person centred but progress has been slow in this area. The home has a multi-faith prayer room that meet the diversified religious needs of its residents. What the service does well: The staff at the home are committed to providing care to the residents that is matched to their individual needs and preferences, while promoting independence, choice and dignity. The weekly operational meeting incorporates workers from the various units at the home. This has helped to build a unified staff team and development of their knowledge, awareness and understanding of the operation of the home and needs of the residents. Residents are able to exercise individual choices where they spend their time, the activities they engage in and where they choose to have their meals. The home has cultivated and encouraged good communication links and open forum with the residents, their relatives and other stakeholders. The Residents and relatives Forum are held regularly and provide the opportunity for open The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 6 discussions and debates about issues at the home and those concerning residents. The home has a transparent and effective complaints system that appeared to be working effectively to the benefit of residents and other stakeholders. A good range of training and professional development opportunities are available to staff, including mandatory training in key health and safety matters such as adult protection, safe handling and lifting, food hygiene and NVQ qualifications. Staff are well supported by each other and senior managers and there was good supervision planning system in place. The home has adequate procedures and monitoring systems in place to help promote health and safety of residents and all who work at the home. Appropriate risk assessments are carried out and reviewed regularly. In addition, the home has a well resource administrative staffing team, including a range of leisure and social activities to interest residents. What has improved since the last inspection? The new format of care planning has been finalised and work has started to implement these. Staff have commented on the improvements and that they are more accessible, user friendly and easier to use. A new telephone system has been installed to replace the previous one that malfunctioned. All staff on duty now have access to a cordless handset phone and are more readily contactable. This has reportedly helped to improve the communication among staff and the links between the different areas of the home. Support and supervision has been increased during meal times and more meal choices are offered to residents, including the introduction of a salad bar. Improvements have started and have been carried out to the grounds and walk/drive ways of the home. There’s also been improvements and installation of new seating area by the lake and gardens. The carpets in several resident’s bedrooms have also been replaced. The former NOMAD system used for the administration of medication has been replaced by a blister system. Staff have been given training and are finding the new system easier and safer. The weekly GP surgery has now been regularised and takes place on Wednesdays. In addition, a radio microphone is now been used in meetings for the benefit of residents with sensory impairment. The library now has a stock of books in large print and there are plans to get additional support from The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 7 the Royal National Institute for the Blind (RNIB), in addition to providing an audio version of the Service Users’ Guide. 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 Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 8 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 The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 9 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) 1,3,5. The home has adequate and updated information, systems and procedures in place that are used to carry out appropriate care needs assessments plus enable prospective residents to make informed choices whether to move in or not. EVIDENCE: The inspector examined a number of printed booklets and leaflets and was satisfied they provided invaluable information and guide to prospective residents. These included a service users’ guide, statement of purpose, relatives’ handbook, introduction to Jewish Care and a guide about preparing and paying for residential and nursing care. The inspector was informed that the service users’ guide would soon be available in audio format to meet the needs of people with visual impairment. The inspector had discussions with several residents about their initial experiences when they were planning to move to the home. Each resident reported satisfaction with the admission procedures and the fact they were invited to visit the home, spend time meeting residents and staff plus experience some of the activities on offer, including meals. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 10 The assessment records examined by the inspector indicated that the home carries out its own pre-admission needs and dependency assessment for each prospective resident. This is in addition to assessments provided by placing authorities such as hospital discharge units. There was evidence of the input and contribution from the relatives and next of kin of residents who currently live at the home. A formal letter is sent to either the prospective resident, next of kin or placing authority about the forthcoming admission. The following documents are also sent tp prospective residents: copies of the relatives handbook, service user’s guide, property, money and valuables disclaimer, weekly menu, home staffing structure, calendar of activities, laundry service explanation and disclaimer. In addition, when a new resident moves to the home, they meet with their keyworker who assists with completing the ‘Getting to know you’ form. This aims to gather more personal and biographical information about each new resident. Some of this information is then incorporated into care planning. The inspector was satisfied that new residents are therefore provided with adequate information about the services, facilities and support systems to help them make informed decision about whether their needs can be adequately met at the home. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 11 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 residents benefit from invaluable support from staff plus good access to a range of medical and nursing care services. Many residents are proactive in monitoring their health care needs and medication administration. EVIDENCE: There was recorded health and nursing care assessment for each resident at the home. These included risk assessments, details of prescribed medication, health and nursing care guidance for care workers and nursing staff, plus details of medical appointments. The inspector noted that a new format of person centered care planning is being developed for each resident but only a few were completed at the time of this inspection. When this exercise is completed, there should be more comprehensive and up to date health and social care information for each resident. Four general practitioners (GPs) provide a weekly surgery at the home plus a 24-hour call out service. Residents also have the choice of remaining with heir own GP or transfer to a GP at the home when they move in. The home also has services provided by a visiting physiotherapist, chiropodist, optician and The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 12 dentist. Other specialists such as dieticians and tissue viability nurses are also available to residents. These are all NHS services, but residents have the option to make their own arrangements to consult private practitioners. There was evidence of staff training in a range of health care matters, including manual handling, prevention of falls, Parkinson disease, MRSA, medication administration and various NVQ level courses. The CSCI pharmacy inspector carried out an inspection at the home in July 2005. The findings indicated the homes’ medication policy was available in each clinical area and covered areas of good medicine management and practice. The home also had a policy on self-administration of medication for those residents who self-medicate. They also had lockable cupboards to store their medication plus risk assessments were in place. The administration of medication was found to be generally satisfactory, but several shortfalls were identified. These have been outlined in the medication inspection report findings, requirements and recommendations sent to the registered manager by the CSCI pharmacist. A copy is also available at the CSCI Harrow office for inspection. Among some of the findings were: No evidence of regular checks of oxygen to include valves and leaks. The fridge used to store certain medication needed defrosting plus routine checks and better monitoring, including the need for a new digital thermometer. There was need for closer monitoring of recordings when medication is received, including signatures on record for auditing purpose. The records also needed to be maintained for medicines deposited whole without outer packaging. Excess stock of insulin cartridges needed reviewing plus monitoring of the expiry dates. The gaps in the recording of medication received for new residents needed improving plus closer attention to medication dosage instructions, including days and times. The lead inspector had discussions with several residents about their experiences of life at the home. The general consensus was that people felt respected and satisfied with the care and support they received from staff. The home has recognised the need that more work is needed to get the views and wishes of residents about how they would like their end of life managed, including funeral arrangements. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 13 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) 12,13,13,15. The residents live a varied, fulfilling and culturally rich lifestyle at the home and in the local community. Most residents lead varying degrees of independent living. Others who are less able are assisted to exercise choices. The residents benefit from variety and choices in the nutritional provisions. They are also reflective of Jewish culture, traditions and customs plus the special dietary needs of some residents. EVIDENCE: The inspector spoke with several residents and a few relatives about their experiences and views of life at the home. The inspector also examined minutes of the relatives and residents’ forums and meetings plus had discussions with the manager and some staff about the range of cultural, social and recreational activities offered to residents. The findings indicated a general level of satisfaction among residents with their life experiences at the home. Most residents reported that their expectations have been partially to fully met and they continue enjoy many of the activities offered, including ones that are reflective of individual interests. The resident’s and relative’s meetings are held each month and well attended. The recordings of the minutes showed that a range of issues have been discussed, including: catering, health and safety, recruitment of volunteers, The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 14 evening and social clubs, budgets and fundraising, refurbishment and general maintenance, arrangements for visitors and provision of adequate staffing cover to all areas of the home. At the time of this inspection, the activities manager was on sick leave. The receptionist and a senior carer have been coordinating social and leisure activities programmes for residents. Other staff have also been making contributions to the development of the recreational and activities programmes. These included: production of a Purimspeil performed by staff and volunteers, outings, day trips, VE Day celebrations, church and Shabbat services, film shows, quiz games, talk and relaxation classes, library facilities and personal grooming. The inspector met and had discussions with a few relatives of residents on the day of this inspection. The discussions indicated that good effort is made to cultivate and maintain links with relatives, next of kin, advocates and agencies in the Jewish and wider communities. The inspector’s discussions with some residents indicated many are independent in exercising choices and leading semi-independent lives at the home. Residents reported they felt valued and respected by staff and their views listened to. Those residents with more dependency needs received additional support from care staff, relatives, volunteers and other stakeholders. The menu and catering planning were discussed at various forums/meetings and generated changes that included a new salad bar plus plans for the catering staff to receive training in the preparation of Jewish food and Kosher meals. The inspector was impressed with the range of dishes offered to residents on the day of this inspection. Some residents reported they were generally satisfied with the quality and presentation style of meals. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 15 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) 16,18. The views and concerns of the residents, their relatives, advocates and next of kin are listened to and taken seriously by the management and staff. The home’s complaint policy and procedure guidelines are transparent with appropriate systems in place, including sound operational practices and advice to help protect residents from abuse. EVIDENCE: The home had an up to date complaints policy and procedural guidelines with full details about its usage are printed in the service user’s guide and given to each resident. The inspector noted there were additional notice posted at various places at the home giving information about resident’s right to complain and how they can do so. The notice informed residents of the various external agencies, including the CSCI, police, primary care trusts and local authority adult protection departments where complaints can be referred. The home also maintains a complaints logging system that is kept updated. The inspector was satisfied that the recorded complaints examined were dealt with according to the home’s procedural guidelines with satisfactory investigation and outcomes. The residents who spoke to the inspector indicated they use the residents’ meeting and relatives’ forum to register their views, concerns and general complaints. There were examples of complaints made about the quality, choices and taste of foods. The Food Quality and Standards Executive officer visited the home, had meetings with the residents and offered the necessary support and training opportunities to the catering staff to help improve the problems. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 16 There was example of the manager writing to residents to apologise for the delay in the start of work scheduled to replace old carpets in their bedrooms. There was also example of one resident complaining about the noise of a television set from a neighbour’s room. The matter was dealt with by the manager and a satisfactory resolution was offered. The training records examined plus discussions with the manager and some staff indicated training has been offered in adult protection issues. This is in addition to the appropriate pre-employment checks undertaken when new staff are recruited to work at the home. Information received by the CSCI and records examined by the inspector during the inspection process, indicated there have been incidents of thefts of the personal items from residents’ rooms in recent months that have also been reported to the police. The management have advised residents they can take the preventative options of locking their rooms when they are out and keep valuables in the lockable facility in their rooms. The use of the main safe was also offered to residents as a preventative option. The management has also advised relatives that personal loss of valuables suffered by residents is not covered by the home’s insurance and that personal insurance policies can be taken out by individuals to cover losses. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 17 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 & 26. Various areas of the home’s environment were undergoing minor improvements to enhance its appearance and the safety for residents, with future plans to carry out major renovation and rebuilding. The overall appearance of the home was clean and pleasant but work is needed to replace worn carpets and modernisation of the kitchen area and facilities. EVIDENCE: The inspector met with the home’s maintenance manager who gave a detail update about the areas identified in a site review inspection carried out in March 2005 by Jewish Care. The report identified 25 areas as needing upgrading and repairs, including refurbishment of the reception area, asbestos remedial work, repair work to the main dining room and roof, new alarm systems to doors and conversion of smaller rooms into larger ensuite bedrooms. The inspector noted work has already been carried out to clear the lake and build new pathways and seating areas around the property. There were also new hanging baskets displayed on terraces outside the reception areas. Refurbishment and new carpets have been carried out to several resident’s The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 18 bedrooms. Several residents commented to the inspector about their satisfaction with these improvements. The inspector was of the view, the improvements have helped to enhance the overall look of the home and provide better comfort for residents and visitors. During the inspection visit, work was in progress to improve and relay communal access pathways and repair external fencing and fill pot holes in the main driveway. The inspector noted that the main corridor leading from the library area to the main dining room was hard flooring and partly sloped. This corridor is used as a main thoroughfare and can become slippery when wet. One person has already suffered an accident using this walkway. The manager assured the inspector that the risk assessment carried out for this area should help to minimise the risks. In addition, the following shortterm measures are now in place. The use of anti slip material that is applied regularly, installation of grab rails, caution signs posted on the walls and staff have been instructed to clear spillages immediately preferable by sweeping rather than wet cleaning. The long-term solution plan according to the manager is to have this area carpeted. The manager assured the inspector this problem would be dealt with as a matter of urgency. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 19 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) 27,29, 30. The home is managed and operated by staff who are competent with the appropriate skills, experience and supervisory support. There were appropriate recruitment policy and practices in place that help to ensure the protection of residents. EVIDENCE: The manager provided evidence of the staff allocation for each shift. At the time of this inspection, there were 39 residents in the nursing section and 30 in the residential care, plus 1 respite. Personal and nursing care is provided over 24 hours daily by a team of nurses and care assistants. Personal residential care is provided in Newland House and personal care with nursing is provided in Edmond House. All communal areas are accessible to residents of both houses. A senior nurse and carer supervised each shift and the deputy manager has responsibility for overall supervisory monitoring. Other services are provided by the administrative, recreational and catering/housekeeping staff. The inspector reviewed the home’s recruitment policies, procedures and training records. The evidence indicated satisfactory procedures are in place to help ensure that only staff with the appropriate professional experience and skills are recruited. There was evidence of relevant references including employment, CRB checks and Nursing and Midwifery Council (NMC) verification taken up for each for each staff, including volunteers. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 20 Each new staff is given induction across all shifts led by experienced carers or nursing staff. Each new staff is also given a 12 weeks probation before permanent confirmation of their employment. Supervision is also offered every two months. There were adequate examples of a range of training programmes on offer to staff, including NVQ, health & safety, manual handling, adult protection, care planning, administration of medication and other relevant areas related to their roles and responsibilities. The inspector discussions with several residents indicated they are satisfied that staff are committed to provide them with good quality care and support. The keyworker system also helps residents to feel their individual care needs and concerns can be addressed individually, promptly and satisfactorily. There was recorded evidence of staffing issues and disputes being managed professionally and in line with the policy and procedural guidelines of the home. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 21 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, 33, 34, 35, 36, 38. The home is being managed properly with sound leadership, support and guidance from the manager. This help to ensure residents receive consistent quality of care. There were good examples of operational practices that help to promote and safeguard the welfare, health and safety of residents. EVIDENCE: The home is managed appropriately and the manager has relevant professional experience in residential and nursing care. The manager is supported by a deputy manager who is also a qualified nurse. Additional support is also received from senior managers at Jewish Care. The residents and staff who spoke with the inspector gave examples of positive practices and approaches adopted by the manager and deputy manager They listed issues such as supervision, training, public forums and meetings. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 22 Staff also reported they felt supported and are able to carry out their roles and responsibilities with confidence. The administrator provided written evidence of the home’s accounting and financial matters, including the management of resident’s money. Residents who are self-funding received contracts and Jewish Care have corporate contracts with several local borough social services departments. There were also individual contracts arranged with other local authorities. At the time of this inspection, there were 8 residents who have continuing care funding by Harrow Primary Care Trust (PCT). The financial documentation reviewed by the inspector showed that the families of 36 residents have power of attorney over their financial matters. There were 4 residents who managed their financial matters independently, 3 residents have solicitors and 61 residents have pension accounts managed by their relatives. Most residents have personal accounts for hairdressing, newspapers and other expenses. These are kept topped up by their families who receive statements of expenditure on a regular basis from the home. Jewish care also makes available to each resident or their relatives/next of kin a written explanation of charges as part of the terms and conditions of residency at the home. There was recorded evidence of adequate programme of supervision for each staff. The manager also gave satisfactory verbal updates to the inspector of how the supervision and appraisal system works. In addition, the inspector reviewed minutes of the home’s operational business meetings held in June and July 2005. The information recorded indicated comprehensive discussions and planning were looked at; including general maintenance testing and updates, renovation and repair work, health and safety issues, risk assessments and individual and communal residential matters. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 23 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 4 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION 2 3 4 3 3 4 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 3 1 4 4 3 3 3 4 3 2 The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 24 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 7 Regulation 15 Requirement The registered provider must ensure the care plans are updated and reflective of each residents individual care needs as identified in their assessments. The registered provider must ensure that the home consult with each resident or their next of kin and agree arrangements to be considered in event of death and funeral plans. The registered provider must ensure that more effective procedures are put in place to help minimise and reduce the incidence of theft of residents personal items at the home. The registered provider must ensure that appropriate monitoring and remedial action is put in place to minimise potential risks to residents at various areas of the home, including outdoors steps leading to the garden areas and the communal corridor from the library to the main dining room. The registered provider must submit to the Commission the The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 25 Timescale for action 30 October 2005 2. 11 12, 37 Schedule 3.3 30 October 2005 3. 18 & 38 10, 12, 13, 37 30 September 2005 4. 19 16, 23. 30 September 2005. action plan for the replacement of worn carpets, including plans for repairs and other redevelopment of the home. 5. 9 13 Schecdule 3 The registered provider must 30 October ensure the requirements outlined 2005 in the CSCI pharmacy inspection report are complied with by the required timescales. Copies of the action plan must be sent to the Lead Regulation Inspector. 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 12 Good Practice Recommendations The registered provider should ensure more effort is made to seek information and accurately record the daily life expereinces of residents in their individual care plans or personal diaries. 2. The Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 4th Floor, Aspect Gate 166 College Road Harrow, Middlesex HA1 1BH 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 Princess Alexandra Home G62-G11 S22938 Princess Alexandra Home V238097 120705 Stage 4.doc Version 1.40 Page 27 - 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!