Care Home: Alexander House (Clifton Road)

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What the care home does well People who use the service told us; "I like living here", "I am very comfortable here", "I would not like to live anywhere else" and I am "very content". Visitors told us that they always felt welcome by staff whenever they visited and that they felt their relatives were well looked after. We observed good interactions between staff and people who use the service. Staff were seen to be discreet in offering support and joined with people who use the service in activities. We saw lots of smiles and good humour between staff and the people they were supporting. People told us they "enjoy" the food and that they "never go hungry". Two people told us they felt there was a good choice of meals. There are plans in place for a refurbishment of the service which will start in July of this year. This show a commitment by the organisation to improve the facilities available to people who use the service. The home is well managed. People who use the service told us the manager was "always there if you need her", that the manager "shows an interest in what is going on" and "her door is always open". Staff have good opportunities for training which ensures that people who use the service are supported by a well informed and skilled staff group. What has improved since the last inspection? A new manager has been appointed who along with the staff group has made significant improvements in the service. People who use the service told us that the main recent improvement was the approach of staff and in particular the approach of the manager. We were told the manager "had the right touch" and they felt confident that they would be listened to if they have any comments or complaints. Real improvements have been made in care planning which assists in ensuring the needs and wishes of individuals are known and met. The management of medication has improved which supports the health and welfare of people who use the service. Health related assessments are carried out which ensures that health problems are identified and addressed. An administrator is available to support the manager. The frequency of health and safety checks have improved CARE HOMES FOR OLDER PEOPLE Alexander House (Clifton Road) 12 Clifton Road Wimbledon London SW19 4QT Lead Inspector Liz O`Reilly Key Unannounced Inspection 10th June 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Alexander House (Clifton Road) DS0000027217.V365056.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 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. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexander House (Clifton Road) Address 12 Clifton Road Wimbledon London SW19 4QT 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) 0208 946 7147 020 8879 1110 Ruthe@keychange.org.uk Keychange Charity Manager post vacant Care Home 21 Category(ies) of Dementia (21), Old age, not falling within any registration, with number other category (21) of places Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 21 19th December 2007 Date of last inspection Brief Description of the Service: Alexander House is a registered care home for up to twenty-one older people including nine people who may have dementia. The home is owned and managed by Keychange Charity, a Christian organisation which has ten other residential services in England. The service is in a residential area off the Ridgeway in Wimbledon, close to bus routes with links to rail services. It is fairly close to Wimbledon Village, Wimbledon Common and churches of different denominations. Alexander House is a three-storey domestic style property which has been extended to accommodate the current residents. A lounge, sun lounge, dining room, office, kitchen, toilets, bathroom and bedrooms are available on the ground floor. Bedrooms, bathrooms and toilets are available on the first floor of the extension, and on the first and second floor in the original house. A stair lift is provided on the staircase to the first floor in the original house. All bedrooms are single. People have access to a large well-maintained garden to the side of the home. Fees for this service are £511.00 per week. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 5 Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means people who use this service experience good quality outcomes. This unannounced inspection was carried out by one regulation inspector over one day. At the time of this visit sixteen people were making Alexander House their home. We had the opportunity to speak with six people who use the service, care staff and one visitor to the service. We received one completed survey from a health care professional who visits the service. What the service does well: What has improved since the last inspection? Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 7 A new manager has been appointed who along with the staff group has made significant improvements in the service. People who use the service told us that the main recent improvement was the approach of staff and in particular the approach of the manager. We were told the manager “had the right touch” and they felt confident that they would be listened to if they have any comments or complaints. Real improvements have been made in care planning which assists in ensuring the needs and wishes of individuals are known and met. The management of medication has improved which supports the health and welfare of people who use the service. Health related assessments are carried out which ensures that health problems are identified and addressed. An administrator is available to support the manager. The frequency of health and safety checks have improved What they could do better: The checks carried out before staff start work in the service need to be up dated. These need to include a full employment history and information from previous employers. Staff need to be checking and recording the temperature of the water before they support anyone into a bath. Once the refurbishment of the home is completed a new Service User Guide should be produced. This should be available in a more easily accessible format to make sure that people who use the service and those thinking about moving in are provided with good information on what they can expect. Care planning should continue to develop with the inclusion of information on how the social, emotional and or cultural needs and wished of individuals will be met. Records should show how much medication is in the home at any one time. A review of the activities available should be carried out to make sure that these meet the needs and wishes of people who use the service. Care should be taken to make sure that people are not prevented from making their own choices by adhering to a task based care approach. Improvements could be made in making sure that the individual needs and wishes of people who use the service in relation to food are recorded and communicated with the catering staff. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 8 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 summary of this inspection report can be made available in other formats on request. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are carried out to make sure that the needs of individuals are known, and can be met by the service. The information available for people to make an informed choice about the service is adequate but will need updating. EVIDENCE: The new manager is aware of the need to update the Service User Guide and Statement of Purpose to include her details. These documents will need alteration once the planned refurbishment is completed. We have recommended that these documents be made more accessible and informative for people new to the service. Consideration should be given to including photographs of the service and making the documents available in large print and or audio tape. The views of people who use the service should be included in the Service User Guide. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 11 As no admissions other than respite care is planned in the near future we would advise that a temporary update to include the details of the new manager is produced. Once the work on the building is completed new documents could then be produced. Copies of the new documents should then be sent to the Commission. Before anyone moves into the service an assessment of their individual needs and preferences is carried out. Where people are supported by a local authority a care management assessment is carried out with the home receiving a copy of this document. Senior staff from the home will also meet with people and carry out their own assessment before they move in. This assists in ensuring that this is the right place for them and that the service can meet their needs and expectations. Information gathered through these assessments will be used to compile an initial care plan which assists staff in providing the right type of support from day one. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with an individual care plan. Real progress has been made in producing more person centred care plans. The health care needs of people who use the service are generally met and medication is well managed. EVIDENCE: People who use the service felt they were “well looked after” and told us “you just have to ask and the staff are there”. We looked at a sample of care plans and found significant improvements in the quality and quantity of information which assists in providing more individualised care. Staff have included the strengths as well as the needs of individuals which will help staff in supporting people to maintain as much independence as possible. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 13 We saw that care plans were signed by staff and the person using the service or their representative. This provides evidence that the care plan has been shared and agreed with the person. Each person using the service is allocated a keyworker. Staff had made good records of meetings with individuals which showed increased communication between staff and people using the service. Staff have included, in the long term care plan, some good information on the social needs and wishes of individuals. This should be carried forward to the day to day care plan so that information on how these needs will be met can be recorded. Further work could be done on expanding the social, cultural and emotional needs and wishes of individuals which supports a more person centred approach. We found a small number of entries in the daily recording which were not appropriate. Staff had used expressions such as “lots of wandering”, “wandering in afternoon” and “had to give her a shower” as well as inappropriate language in one instance where someone had been incontinent. The recording of ‘wandering’ is not in line with current good practice in dementia care and the use of “had to give a shower” is not a person centred approach. People who use the service have access to health care services. Staff are carrying out assessments to check that individuals are receiving the right level of nutrition, keeping a record of weight and systems are in place to obtain the advice of health care professionals if needed. A dentist visits the service every six months, chiropodist every two weeks, optician every six months and an annual health check is carried out by the district nursing service once a year. All of the people who use the service are registered with a local GP who visits when required. Individuals can also use community health care facilities if they wish. The management of medication has improved since the last inspection of the service. The record of medication given was up to date and completed with staff signatures. To make sure that medication can be audited any medication still in use when new supplies are received needs to be carried forward on the records. This will make sure that the manager can calculate the amount of medication which should be in the home at any one time. People who use the service felt their privacy was respected when they were supported with their personal care. We observed staff offering support in a discreet and sensitive manner. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People using the service are given the opportunity to take part in a variety of activities but this area could be improved upon. People who use the service like the food provided and feel more choice is now available. EVIDENCE: A volunteer activities organiser visits the service twice a week and supports people in painting, flower arranging and baking. We observed staff engaging people in throwing a soft ball between each other. Board games, cards, books and puzzles are available in the main lounge. One person told us they enjoyed their daily newspaper and completing crosswords. This person informed us that the administrator was a “great help” with the crosswords. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 15 We are aware that a significant proportion of the people using the service have some short term memory problems to varying degrees. Consideration should be given to tailoring activities to the needs of this group of people. We would recommend keeping more tactile objects in ‘rummage boxes’ and domestic activity items in lounges. Consideration should be given to providing more tactile care such as hand and or foot massage. This area was discussed with the manger at the time of this visit. Further information could be accessed through organisations such as the Alzheimer’s Society. We found instances where staff have started to work with people in more meaningful activities. Where a care plan had stated that a person should be encouraged to do polishing entries in the daily notes confirmed that this person was engaged in polishing items. Staff have worked with people who use the service and or their relatives to gain some good information on individual life history. This is an area which could be expanded. Consideration should be given to working with people, particularly those with short term memory difficulties, to produce life story books. These can be used to engage people and assist staff in offering more person centred meaningful activities. On the day we visited the television was on in the lounge area but was not being watched by anyone. The television had been positioned to one side of the room so anyone sitting on that side had difficulty in watching should they wish to do so. The manager informed us that she was working towards offering more opportunities for people to get involved in activities in the local community. To assist with this applications are being made for taxi cards for individuals. People who use the service told us that they enjoyed the food on offer and “never” felt hungry. Two people told us that the choices available had improved recently and that the supper menu had been improved. One person said they would like to have more spicy food and they suggested they would like a bottle of Tabasco sauce to add to their meals. The cultural needs and wishes of individuals in relation to food should be addressed at the pre admission assessment stage and provided for. Two people told us that if they wanted to go back to their room they were often interrupted by staff or asked to leave so that rooms could be cleaned. In order to respect the privacy of individuals and provide a more person centred service these working practices should be reviewed. Consideration should be given to agreeing cleaning times with individuals and the use of ‘do not disturb’ notices for doors. These type of notices should be used in conjunction with risk assessments and mutual agreement with individuals and or their representatives. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 16 Health care professionals told us that they felt the service had improved since the new manager arrived but that further improvements could be made through staff listening more to what people who use the service want. For many people who use this service religion is an important part of their lives. Once a month members of a local church visit and provide tea with home made cakes. A communion service is held each month and individuals are supported to attend religious services and events outside the home. One person attends church each Sunday and Thursday and another person attends three times a week. There are no set visiting times. Visitors to the home gave positive comments on the service and told us they were made to feel welcome by staff. Families felt they were kept well informed of any concerns or changes. People told us that they felt their relatives were well cared for and happy. We were told by visitors that the recent changes in management had made a positive difference in the service. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Concerns about the care provided are listened to and acted on. The home understands the procedures for safeguarding adults and trains staff in how to do this. EVIDENCE: People who use the service told us that they were confident that the manager and staff would listen to them and take action if they had a complaint or concern. Systems are in place to record any complaints along with the actions taken and outcomes. The new manager is aware of the importance of acting on any complaints made and ensuring that people are informed of any outcome. The manager is also aware of the need to maintain the privacy of individuals who may raise concerns. To make sure that staff are well informed on safeguarding people who use the service from abuse training has been arranged to be carried out in June of this year. This will ensure that staff are aware of their own role and responsibilities in reporting any allegation or concern they may have about the welfare of individuals. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 & 26 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People living at the home generally enjoy a comfortable, safe and clean living environment. The planned refurbishment of the building will up date and improve the facilities available. EVIDENCE: People who use the service told us that they liked their own bedrooms. One person told us that although their room was small this was compensated by the view from their window where they could look out over the wildlife which visit the garden. One person felt that it was “not easy for everyone to get around” due to the differing levels on the ground floor and the lack of a passenger lift. The refurbishment planned should address these issues. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 19 The manager informed us that work would commence in July of this year to build a new boiler room, start the installation of a passenger lift and a new laundry. These works are all planned to be carried out externally and so should not cause significant disruption to day to day life for people who use the service. A new wireless call system is planned to be installed in advance of the rest of the refurbishment to ensure the security and safety of people who use the service. We found all areas of the home seen were cleaned to a good standard. People who use the service told us the home was always clean and fresh. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Enough staff are available to meet the needs of the present number of people living at the service. Staff are provided with good opportunities for training. In order to safeguard people who use the service checks are carried out on staff before they start working in the home and these need to be expanded. EVIDENCE: People who use the service made positive comments about the staff and their approach. Staff were described as “kind”, “very patient” and “very nice”. One person described particular staff as “good listeners”. Positive comments were also received about the administrator for the service who was described as “very approachable” and “most pleasant and helpful”. We observed good interactions between staff and people who use the service. Staff were seen to take time to talk with individuals and we observed staff using a good humoured approach, laughing with people who use the service. Three care staff are available throughout the day and two staff are on duty at night. These staffing levels are sufficient to meet the needs of people who use Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 21 the service. Future work with the staff group should focus on less task based care and more on a person centred approach. We looked at a sample of staff files and these were generally in good order. Criminal Records Bureau checks are carried out before staff start work in the service which assists in safeguarding people. As noted at the last inspection staff must provide details of a full employment history with an explanation of any gaps in employment. In addition, where the individual’s last employment was with vulnerable adults or children, checks must, if at all practicable, be made with this employer as to why they left their post. These checks will further assist in safeguarding people who use the service. Staff are provided with good opportunities for training which ensures that people who use the service are supported by a well informed and skilled staff group. At the time of this inspection a number of staff were taking part in a variety of distance learning training including dementia awareness , equalities and diversity, medication and infection control. Ten staff have taken part in training on care planning and we observed that this had resulted in real improvements in the quality of care plans. The manager informed us that any staff who have not taken part in the distance learning training on dementia would be booked onto courses with a local authority. Seven staff have completed NVQ level 2 training in care, two staff have completed NVQ level 3 and three staff are enrolled on level 3 training. The housekeeper and domestic staff have commenced NVQ level 2. Future training plans include, infection control, the mental capacity act, first aid and moving and handling. The records of training were backed up with certificates on individual staff files. The training carried out assists in making sure that staff have the right skills and knowledge to provide good quality support for people who use the service. Staff told us they felt well supported, offered good training opportunities and worked well as a team. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The new manager has the skills and experience to run this service and has made real improvements in the short time they have been in post. People who use this service feel they are listened to. Staff make regular checks to ensure the health and safety of people who use the service and visitors. EVIDENCE: Since the last inspection of the service a new manager has been appointed. People who use the service and visitors told us that the manager had made a positive difference in the way the home was operating. Individuals said that there was “good communication now” and that the manager was “more Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 23 approachable”. People who use the service said that “the new manager is lovely” and that she “has the right approach”. We were told that the manager “sees you every morning, asks how you are and that makes all the difference”. One health care professional informed us that they are very impressed with the new manager and that they have already seen improvements. Although the manager has been in post for only a few weeks real improvements have been made in care planning, communication and record keeping. A part time administer has commenced working in the service since the last inspection. This support allows the manager to spend more time working with staff and people who live at the home. The manager completed an assessment of the service (AQAA) for the Commission. This assessment was completed to a good standard and showed the manager had a real understanding of some of the strengths and weaknesses of the service. We saw that action had been taken to address these areas of weakness. All staff have received an appraisal which has included an assessment of training needs. We found that this information had been used to set up the training programme. The Quality monitoring and assessment system is not in full operation yet. Surveys have been received from people who use the service. The information gathered through the quality monitoring needs to be used to review the care provided and produce a development plan for the next twelve months. The manager is planning to set up regular meetings for people who use the service. This will assist in making sure that individuals are kept informed and offers opportunities for people who use the service to contribute towards the future plans for the service. People did inform us that they were being kept up to date about the building work scheduled. Systems are in place for people who use the service to deposit small amounts of money for safekeeping. We looked at a sample of these records kept from the time the new manager took over. The records were found to be well maintained up to date and accurate. Staff carry out regular checks on the building and equipment to ensure that safety of people who use the service. The fire alarm system is tested each week and regular professional maintenance checks are carried out. Fire drills are being carried out on a regular basis. Regular checks are made on the temperature of hot water. In order to ensure the safety and welfare of people who use the service a record of the water Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 24 temperature needs to be taken before anyone is assisted into a bath. A record of these temperatures should be kept. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 OP29 Regulation 19 Schedule 2 (4)(6) Requirement To assist in ensuring the safety of people using the service the following information must be sought and recorded for any new staff member: • Where a person has previously worked in a position which involved contact with children or vulnerable adults, written verification of the reason why they ceased to work in that position unless it is not reasonably practicable to obtain such verification. • A full employment history, together with a satisfactory written explanation of any gaps in employment. 20/07/08 Timescale for action 20/08/08 2. OP38 13(4) • The temperature of the water must be taken and recorded before anyone is assisted by staff into a bath. Timescale of 01/03/08 not met Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 27 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 OP1 Good Practice Recommendations The Service User Guide and Statement of Purpose will need to be up dated and made more accessible to people who use the service and those considering moving in. This will ensure that people have good information on what they can expect from the service. 2. OP7 In order to provide a more person centred service information on how the social, cultural and or emotional needs and wishes of people will be met should be included in the day to day care planning. 3. OP7 To ensure that records do not contain any inappropriate or persistent negative comments the daily records should be regularly monitored. 4. OP9 To ensure the health and welfare of people who use the service records of medication should be sufficient to allow for an audit of medication held in the service. 5. OP12 A review of the activities on offer should be carried out to ensure that the range and opportunities for meaningful activities meet the needs of the people who use the service 6. OP14 To make sure that people who use the service are provided with choice regarding where they spend their time a review of how people are afforded privacy and access to their rooms should be carried out. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 28 5. OP15 To make sure that the food provided meets the preferences and or cultural needs and wishes of people who use the service a review of meals should be carried out. 6. OP33 To ensure that the service is run in the best interests and in consultation with people who use the service information gained from surveys should included in a review of the care provided. Once the review of care is completed a development plan, for the following twelve months should be produced The results of surveys from people who use the service should be included in the Service User Guide. Alexander House (Clifton Road) DS0000027217.V365056.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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