Care Home: Alexander House Private Nursing Home

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Annual service review Name of Service: Alexander House Private Nursing Home The quality rating for this care home is: The rating was made on: two star good service 0 2 1 2 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Carolyn Delaney Date of this annual service review: 1 2 0 3 2 0 1 0 Annual Service Review Page 1 of 8 Information about the service Address of service: 25-27 First Avenue Westcliff On Sea Essex SS0 8HS 01702339635 01702431096 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: Health and Home Limited Number of places (if applicable): Under 65 Over 65 25 25 0 0 0 25 The maximum number of service users who can be accommodated is: 25 The registered person may provide the following category of service only: Care home only - Code 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. Dementia - Code DE. Mental disorder, excluding learning disability or dementia - Code MD. Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Alexander House is a three storey private home situated in a quiet residential area of Westcliff on Sea, close to the seafront. The home is registered to a small company, Health and Home Ltd. The home is close to local bus routes. Alexander House is Annual Service Review Page 2 of 8 0 2 1 2 2 0 0 8 registered to provide personal care, nursing care and accommodation for 25 Older people who have dementia or other mental health conditions. Accommodation is provided on three floors in nine single and eight double rooms. Two bedrooms have en suite facilities. Other facilities include two communal lounges and a dining area on the ground floor. A passenger lift provides access to all levels within the home. Visitors parking is available at the front of the property. There is a well-maintained garden to the rear for residents to use. The fees range from: £535.47 - £836.40 per week There are currently no extra charges for hairdressing, chiropody or toiletries. The registered person has advised that the service does reserve the right to charge for additional goods and services. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We carry out an Annual Service Review for services which have 2 star good, or 3 star excellent ratings and who provide good outcomes for people they serve. In carrying out this review we looked at all of the information that we have received about the home, or asked for since the last key inspection. We last inspected the home on 2nd December 2008. . We reviewed the information in the homes Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment in which the manager is legally required to tell us how well outcomes are being met for people who live in the home. It also provided some numerical information about the service including numbers of staff who work there, the number of complaints received etc. We sent surveys to 15 residents, 8 staff and 6 health care professionals to complete. At the time of completing the review we had received six surveys from people who live in the home, eight surveys from staff and one surveys from social and health care professionals. The comments made have been included in this final report. We also reviewed any information we have received about how the service has managed any complaints or safeguarding (protecting people) issues. We looked at the information that the manager told us about things that have happened in the home such as illness or injury or any other event which would affect people who live there. These are called notifications and the manager must legally inform us of them. What has this told us about the service? The manager told us in the Annual Quality Assurance Assessment about the ways in which they obtain the views of people who live in the home and use these to make changes and improvements to the service. They told us that they worked very closely with the residents, their families, health professionals and other interested parties and that where possible they involved the residents, their families and representatives into the care planning process. They said that they periodically prepared a Progress Report on all residents. They told us that these reports were available to the residents, their families, representatives and other professionals and that families were invited to attend care reviews. The manager told us that residents, families and health and social care professionals were invited to complete surveys annually to make comments and express views about the home and what they felt the home did well and any improvements which could be made. The manager told us of the improvements made as a result of listening to what residents told them. They told us that they responded more promptly to issues raised and had invested money in the homes infrastructure so as to improve the homes environment. They told us that they planned to improve communication with residents relatives in the future. The manager told us in the Annual Quality Assurance Assessment about the arrangements for providing information about the home to interested parties and assessing the needs of people before they move into the home. They told us that there was detailed information available to people wishing to use the service, their families Annual Service Review Page 4 of 8 and commissioning bodies (those who purchase places in care homes). They told us that a detailed assessment of each person was carried out before individuals were offered a place in the home and that people were invited to visit to help them decide tat it would be the right place for them. We received completed surveys from six people living in the home. Of the six, three people told us that they had received enough information to help them decide if the home was the right place for them. Two people said that they didnt know and one person said that they had not. Five of the six people told us that they had received a written information about the homes terms and conditions (sometimes called a contract). One health care professional returned a survey and they told us that the homes assessment arrangements usually ensured that accurate information was gathered and that the right service was planned for people. There had been no breakdown in placement (where a person would have to move out of the home because their assessed needs could not be met) within the previous twelve months. The manager told us about the arrangements for planning and delivering care and support for residents in relation to their health and personal care needs. They told us that they spend time assessing residents needs and that the delivery of care and support was flexible to meet the needs of people who may exhibit behaviours considered to be antisocial. The manager said that wherever possible that residents were supported to make choices and decisions about how they were cared for. The health care professional who completed a survey told us that peoples social and health care needs were properly monitored, reviewed and met by the home. They also said that staff sought advice and acted on it to meet peoples health care needs and to improve their wellbeing. Four of the six residents who completed surveys that they always received that care, support and medical attention they needed. The other two told us that they usually did. Eight members of staff completed surveys and they told us that they felt they usually had enough support, experience and knowledge to meet the needs of residents and that they ways in which they shared information about residents needs with each other and the manager usually worked well. We looked at notifications we had received about the home within the previous twelve months. We were informed of three expected deaths of residents. There had been no incidents of serious injury, outbreak of infectious diseases or other incidents, which affected the welfare of people who lived in the home. The manager told us of the arrangements in place for supporting residents to engage in daily and social activities. They told us that they tailored activities to meet the needs and changing wishes of people living in the home. They told us that they celebrate every occasion such as birthdays, religious or other holidays and that they always try to engage all residents in group activities. They told us that they also try to encourage and to engage with the community and supported residents who were able and willing to go into town for shopping or walks at the sea front. They told us that they have visiting entertainers coming to the home as well as representatives of other local institutions such a churches etc. The manager said that in terms of group and organised activities the results were very limited. They said that although they may get an initial interest from a large group the focus, concentration and interest disappears very quickly. This is due primarily to the mental state of the residents, most of whom are confused, disoriented, no short memory, no retention of new information etc. Five Annual Service Review Page 5 of 8 of the six residents who completed surveys told us that there sometimes were activities, which they could take part in and one person said that there always were. Some staff commented on the difficulties in engaging residents in occupational and social activities within the home. The manager told us about the arrangements for receiving and dealing with complaints and for safeguarding vulnerable people from harm and abuse. They told us that there was a comprehensive Complaints Policy and all complaints were investigated thoroughly and timely followed by written report. They said that some of the more trivial or informal things were dealt with by the management promptly without the need to involve a formal complaint. They told us that all staff had been trained on safeguarding issues and one of the staff within the company is a qualified trainer. They told us that staff had access to a vast amount of reference material such as the No Secrets and the Southend on Sea Adult Protection Guidelines. They said that staff were trained to deal with challenging behaviour and that the home had no record of having to apply formal restraint. Each of the eight members of staff who completed surveys told us that they knew what to do if anyone expressed concerns about the home or wished to make a complaint. Four of the six residents who completed surveys told us that there was someone they could speak with informally if they were unhappy and that they knew how to make a complaint. The manager told us how they provided a safe, secure and comfortable environment for residents. They told us the location of the home is good and appropriate to the needs of residents. They said that they provided sufficient indoor and outdoor communal space and facilities suitably laid out, equipped and furnished to meet the needs of our residents. They said that they have adequate supply of specialist equipment which are serviced on a regular basis. One resident who completed a survey told us that the home was always fresh and clean and three said that it usually was. The other people did not answer this question. One relative commented that some of the furniture and decor was old, dated and looked tired. They said that the lounge area was in need of redecoration to make it more comfortable for residents. The manager identified in the Annual Quality Assurance Assessment that work was needed in this area of the home and planned to address this as soon as it was practicable. The manager told us about the arrangements for recruiting and training staff so that they could meet the needs of people living in the home. They told us that they have stringent and recruitment policies and procedures for recruiting staff to work in the home. They told us that staff were trained to meet the assessed needs of residents and that they ensured that staff were employed in appropriate numbers to meet the needs of people living in the home. Each of the eight members of staff who completed surveys told us that all of the checks including references and Criminal Records Bureau disclosures before they started working in the home. They told us that their induction covered everything they needed to know about their job and that they received training, which was relevant, helped them meet the needs of the people living in the home and kept them up to date with new ways of working. Staff told us that the manager gave them enough support and met with them to discuss work. They told us that there were usually enough staff to met the individual needs of people living in the home. Annual Service Review Page 6 of 8 Residents who completed surveys made positive comments about staff. They told us staff are very helpful and nice. One resident commented that staff are always busy and cannot take me out as much as I would like. As part of carrying out this review we asked people what they felt the home could do better. Some people commented about the homes decor and staffing levels. However overall people indicated that they were satisfied with the care and support they received in the home. What are we going to do as a result of this annual service review? We are not going to change our inspection plan, and will do a key inspection by 2nd December December 2010. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a copy of the findings in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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