Care Home: Alexandria`s Residential Care Home

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What the care home does well There is very good communication within the home. Residents say that they are kept well informed. Relatives say that they are contacted when necessary and staff praised the way in which the registered manager communicates with them. The home is well managed and run in the best interests of the residents. Residents say that they are kept informed of changes and are consulted about their wishes. The care at the home is very good. Residents and their relatives praised the staff and the management for high standard of care they give. They say that the staff are very helpful and caring There is good nutritional monitoring and food services in the home are very good. Residents say that they look forward to their meals and that the food is tasty. There is a pleasant and homely environment. Residents say that they enjoy spending time in the lounge and that their rooms are pleasant and kept very clean. There are very good quality assurance systems in place to ensure that the views of the residents are listened to and acted upon and that the home is well maintained. What has improved since the last inspection? Although the home is newly registered, it has been running for a number of years and therefore this section is based on the improvements assessed since the new providers took over the running of the home. There have been some significant improvements to the environment, in particular in respect of infection control. A new laundry room is being provided and new, industrial machines have been installed. Staff training has improved. There is more specialist training and there are better systems for monitoring training that has been undertaken. Staff supervision is now recorded and is kept on individual staff files. There is now regular one-to-one staff supervision that gives staff an opportunity to discuss their training needs, put forward their ideas and talk about a variety of issues with their supervisor in private. Nutritional monitoring in the home has always been good but this continues to improve. Activities at the home have increased and are more carefully monitored and recorded. What the care home could do better: Although the care plans are comprehensive and describe the needs of the residents and how they should be met, more attention to detail is needed to ensure entries are legible and correctly dated. As several residents have lived at the home for some years, there are a lot of records on their care plans. These care plans would benefit from a review, reorganisation and archiving of old records. The home provides care and support for very frail and elderly people. As time goes on their needs are increasing and therefore the likelihood of falls is also increasing. The home should consider setting up a clear system for monitoring of falls so that action to prevent falls can be concentrated on areas of high risk. There has already been some progress made with environmental improvements and the home has an improvement plan. It would be helpful if the development plan contained more detail. This would enable clearer decisions to be made about those areas that should be given priority for attention. CARE HOMES FOR OLDER PEOPLE Alexandria`s Residential Care Home 147 Wrotham Road Gravesend Kent DA11 0QL Lead Inspector Wendy Mills Unannounced Inspection 11th February 2009 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 Alexandria`s Residential Care Home DS0000072632.V373868.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. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandria`s Residential Care Home Address 147 Wrotham Road Gravesend Kent DA11 0QL 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) 01474 534539 Mr Pathmanathan Nackeeran Dr Neelani Nackeeran Mrs Christina Dennis Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 18. 19th June 2008 under previous registration New Registration as there are new registered providers. Date of last inspection Brief Description of the Service: Alexandria’s is a residential care home providing care and support for up to eighteen older people. It was registered to new owners in October 2008. The new registered providers are Mr P Nackeeran and Dr Mrs Neelani Nackeeran. The registered manager, Mrs Christina Dennis, continues to manage the home. The home is situated on Wrotham Road, a main road leading to Gravesend town centre, close to all local amenities. There is a designated car park for five cars. This is accessed from a side road, Essex Road, where there is unrestricted on street parking. The railway station is approximately ten minutes walk away and buses run along Wrotham Road. The accommodation is arranged over two floors. There is plenty of communal space with a pleasant and airy lounge, a well-lit dining room and a conservatory. Outside there is a small patio and garden that is accessed from the conservatory via a ramp. There are twelve single and three double bedrooms. All rooms have hand basins, TV points and a call bell system. There is a passenger lift that connects the ground floor to the first floor and a stair lift that connects the first floor to a mezzanine floor. The weekly fees for this home range between £331 and £400. Additional charges are made for hairdressing, chiropody and newspapers. Further information can be obtained from the Registered Manager, Mrs Christina Dennis. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit formed part of the inspection process of the Commission for Social Care Inspection (CSCI) under The Care Standards Act. This was the first inspection of the home under the new registration. The visit was unannounced and lasted six hours. Wendy Mills, Regulatory Inspector, in company with Charlene Taljaard, business administrator from the CSCI, made the visit. This report is complied using evidence gathered during this visit and information that we received prior to the visit. This includes information that other health and social care professionals have given us; information the home has sent us, such as notifications and the home’s self assessment quality assurance information – the Annual Quality Assurance Assessment (AQAA), required under the Act; and information we have received from relatives and supporters of the people who use this service. A star quality rating will be given as a result of this inspection. During this visit we spoke to nearly all of the residents throughout the time we were in the home. Some were spoken to in private, some during a tour of the home and some over lunchtime. We also spoke to relatives and other visitors, visiting health care professionals and staff in private. We spent time in discussion with one of the registered providers and the registered manager. We looked at important documentation such as staff files and care plans and made a tour of the home. The people who use this service were all very positive about the care and support they receive. Their relatives spoke highly of the way in which the new registered providers have kept them informed of changes in the home. They made many positive comments about the registered manager and her staff. The people who use this service refer to themselves as, “Residents”, and have asked that this term be used when referring to them in this report. No requirements were placed as a result of this visit. However, some recommendations were made and can be found at the end of this report. The residents, their relatives and supporters, the staff, visiting health care professionals, the registered manager and the registered provider are all thanked for the welcome they gave and their help throughout the course of this visit. As result of this inspection the home has been given a 2 Stars quality rating. This means that is that people living in this home experience a good service. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Although the home is newly registered, it has been running for a number of years and therefore this section is based on the improvements assessed since the new providers took over the running of the home. There have been some significant improvements to the environment, in particular in respect of infection control. A new laundry room is being provided and new, industrial machines have been installed. Staff training has improved. There is more specialist training and there are better systems for monitoring training that has been undertaken. Staff supervision is now recorded and is kept on individual staff files. There is now regular one-to-one staff supervision that gives staff an opportunity to discuss their training needs, put forward their ideas and talk about a variety of issues with their supervisor in private. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 7 Nutritional monitoring in the home has always been good but this continues to improve. Activities at the home have increased and are more carefully monitored and recorded. 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 summary of this inspection report can be made available in other formats on request. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters with the information they need so that they can make an informed decision about their choice of home Residents are properly assessed before a place at the home is offered. This ensures that only those people whose needs can be met are cared for in the home. EVIDENCE: The home has a comprehensive statement of purpose and service user guide. The statement of purpose was carefully examined by the CSCI at the time the home was registered in October 2008. It was found to contain all relevant information and to meet the required standard. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 10 The home provides good information for prospective residents, existing residents and their supporters. There are notice boards around the home telling people what activities are planned. The new owners have hosted two events to which residents and relatives have been invited so that they could meet them. There is good evidence that residents meetings are held and that the views of the residents are being recorded and acted upon. No new residents have come to live at the home since the last inspection under the previous owners. However, there are comprehensive pre-admission assessments on file for all residents. These assessments clearly identify care needs and contain good information about cultural and lifestyle needs and choices. The home has clear pre-admission assessment policies and procedures. Prospective residents and their supporters are encouraged to visit the home and trial stays can be arranged. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 &11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care is delivered in a way that respects the individuality of the residents as well as their privacy and dignity. This supports autonomy and promotes health and well-being. EVIDENCE: During this visit we spoke to nearly all the residents. Some were spoken to in private whilst others were spoken to as we toured the home. All spoken to said that they receive very good care. One said, “I couldn’t ask for more, they look after us really well and I have a lovely room, my friends and family can visit whenever they want and I feel safe.” Another said, “I especially like the night staff, they are very kind, well they’re all very kind and helpful – day and night staff”. It was also possible to speak to relatives and friends who were visiting the home. They also said that they believe the care at the home to be very good. They praised the way the manager and the assistant manager communicate Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 12 with them and keep them informed about what is going on in the home. They said the staff are courteous and respect the privacy and dignity of the individual resident. Visiting health care professionals were very positive about the way the home promotes the health and independence of the residents. They said that the home communities well with them and that their advice and intervention is sought appropriately. They praised the home for the way their advice is followed and the way the staff co-operate with them. A sample of care plans was examined in detail. There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which the residents and their supporters can be tell that they will be supported in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. The care plans are in good order and contain sufficient detail to enable care staff to understand and meet the needs of each resident. The plans note the diverse needs of the residents and contain brief life histories, where residents have chosen, to enable staff to help residents make decisions when necessary. In addition, there is good evidence in the plans to show that the home seeks appropriate medical advice. All residents are registered with General Practitioners and records are made of their visits and those made by other health and social care professionals such as District Nurses, Chiropodists and Care Managers. New residents are screened for nutritional problems and this is then monitored on a regular basis. Weight, skin condition, oral problems and general health are all carefully monitored and the frequency of this monitoring is adjusted according to identified need. Many of the residents have lived at the home for some time and their care plans are becoming very bulky. These documents would benefit from some reorganisation and archiving. This would make the parts of the plans that are used on a daily basis easier to access. Because many of the residents have lived in the home for some years, their frailty is increasing. This means that the risk of falls in the home is also increasing. There is diligent recording of falls in the accident book and care plans but it is suggested that more detailed monitoring of falls is now indicated. Falls monitoring schedules should be set up for individual residents. The home should record a number of details such as the times that falls occur; the situation at the time, for example was this after medication had been given, was the resident upset of confused, which staff were on duty and so on; and any other relevant factors. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 13 There were some entries in the care plans that were not dated or not dated correctly. Also some entries in the daily record were difficult to read. More attention to detail is needed when completing and reviewing these documents. It may help to ask staff to always make entries in black pen and to ensure that they only use the printed record forms. There are sound policies and procedures for the management and administration of medicines in the home. The recording and storage of medicines were examined in detail. Medicines are stored securely and safely and there are sound arrangements made should controlled drugs be needed in the home. The Medicines Administration Records (MARs) were examined. These were well maintained and there is a record of staff signatures. There have been no medication errors. Staff administering medicines have received training to help them do this safely. The home has clear policies to deal with end of life issues. The stated aim of the home is to care for the residents for as long as possible, so long as their needs can be met. There was good evidence that this is done. The home has continued to look after those nearing the end of their lives and made allowances for additional needs and support. Relatives are enabled to visit as much as possible during the last weeks. The manager described how a recent, expected death was coped with. Accommodation was provided for a relative and extra care was given to the resident. Other residents, who faced losing a friend, were given support and the home has planned a wake, following the funeral, to celebrate the life of the resident who sadly passed away. Alexandria`s Residential Care Home DS0000072632.V373868.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in this home are able to make choices about their lives and involve themselves in the activities of the home if they wish. This allows them to maintain as much independence as possible and live interesting and meaningful lives. Nutritional services at the home are very good, special wishes and diets are catered for and the people who live in this home enjoy their mealtimes. EVIDENCE: The residents say that the have enough to do and that they are able to make choices about what activities they take part in. Visitors told us that they are always made very welcome and that there are no restrictions on visiting times. They say that they can visit in private or in the main communual areas. Since the last inspection there have been two main events, a Halloween party and a Christmas party. The residents said that they were delighted to meet Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 15 the new owners and their family. On a day-to-day basis, staff encourage the residents to join in activities such as board games, word searches, puzzles and music and movement. Some residents say they enjoy these sessions a lot whilst others were not so keen to join in and say they prefer to spend time in their rooms. In consultation with the residents, the home is currently trying out a number of visiting entertainers. There was evidence to show that a session of music and movement was to take place the day after this visit. Residents told us that there had been a recent meeting where they were able to put their views and ideas forward. We were shown notes of this meeting and it is clear that the residents’ views are being listened to and acted upon. There were some menu suggestions and some suggestions for outings when the weather improves. The registered provider told us that there are plans to hire a minibus to take the residents out to places of local interest once the weather improves. Nutritional services at the home are good. Produce is purchase locally and the new owners have ensured that milk is delivered to the home daily. The main meal is taken at lunchtime when there were delicious aromas coming from the kitchen. We took spent and enjoyable lunchtime with the residents. We found that the food was tasty and very well cooked. Residents said they enjoyed their meal. We observed that staff gave help discretely was given discretely when needed. The dining room is well decorated and light and airy, the tables are attractive and nicely laid with linen napkins and a selection of condiments. The home is commended for the way it promotes a healthy diet and good nutrition. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures for handling concerns, complaints and safeguarding. This protects the residents, in so far as possible, from all forms of harm and abuse. EVIDENCE: The residents we spoke to said that they have no complaints but know who to talk to if they have concerns. There have been no formal complaints received by the home in the last eighteen months. We can also confirm that no concerns or complaints about the home have been raised with the CSCI in that time. However, there was one concern raised by a relative. We saw evidence that his was properly dealt with by the home. Day-to-day concerns expressed by residents are dealt with as they occur. The new registered providers make thorough checks on the home in accordance with Regulation 26 of the Care Standards Act. This requires the providers of the service to make a formal monthly visit to talk to residents and staff to find out if they have any concerns or complaints. We were given the most recent reports under this Regulation and found them to be very thorough and to take note of the views of the residents and their supporters. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 17 The relatives we spoke to said they are very happy about the way the home communicates with them and deals with any worries they may have. Staff have received training in the safeguarding of vulnerable people. Those spoken to understood the home’s policies and procedures for safeguarding and had no hesitation in saying that they would report any concerns to the manager. They said that they trusted the manager to deal with any concerns immediately and properly. They said that the manager and the assistant manager are easy to talk to and that they feel comfortable discussing any concerns with them. Alexandria`s Residential Care Home DS0000072632.V373868.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, 20, 23 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There home is safe, well maintained, clean and welcoming. This gives the residents a pleasant and homely place in which to live. EVIDENCE: The home’s Annual Quality Assurance Assessment (AQAA) told us that all policies and procedures required to ensure the home is safe are in place. There is a regular maintenance programme and the registered manager and providers make regular checks on the safety of the home. No health and safety hazards were noted on the day of this visit. There is plenty of communual space in the home with a good-sized lounge, conservatory and pleasant dining room. All areas are well furnished and decorated. There is an ongoing redecoration programme and individual rooms have been decorated to suit the tastes and ideas of the residents. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 19 Residents have been able to personalise their rooms and to bring in items to reflect their personalities and to make their rooms more homely. Residents are able to lock their doors if they choose. Since the new providers have taken over the home industrial laundry machines have been installed and the home is in the process of creating a new laundry room. This room is much bigger than the previous one and allows for much better management of laundry. There are sound infection control measures in place throughout the home. Staff said they had received training in infection control and the training matrix and staff files confirmed this. The home employs two domestic assistants. They are commended for the way in which they kept the home clean and fresh. Alexandria`s Residential Care Home DS0000072632.V373868.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to meet the needs of the residents, recruitment practices are robust. There is good team working and staff morale is high. This means that the residents receive care and support from a carefully vetted and cheerful staff team. There is a structured training programme in place but the home must ensure that all staff receive statutory training in key areas. EVIDENCE: Staff rosters show that there are sufficient staff on duty at each shift to meet the needs of the residents. Residents said that the staff are very supportive and that they do not have to wait long if they need attention. The care staff are well supported by a team of ancillary staff who ensure meals are of a high quality and that the home is kept clean. A sample of staff files was examined. There is good evidence that there is a staff training programme that ensures both statutory and specialist training is being undertaken. The training matrix was examined. This showed that nearly all staff training is up-to-date; however, there were some gaps in statutory training for some of the longer serving ancillary staff. In particular, some had not received infection control and moving and handling training. The Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 21 home must ensure that all staff receive training in these key areas in a way that is appropriate to their learning needs. Staff training has improved significantly in recent months. One to one staff supervision has been introduced and training needs are identified during these sessions as well as by using the training matrix. The home is commended for the progress that has been made in promoting the National Vocational Qualification (NVQ) awards. All care staff either now hold the NVQ in care at level two or currently working towards this award. The home’s administrator holds the NVQ in business administration at level two and three care staff are now working for the level three award in care. All staff have recently received training in Equality and Diversity. There are robust recruitment policies and procedures in place. We found good evidence on the staff files to show that all appropriate pre-employment checks are made. These include Criminal Records Bureau (CRB) and POVA First checks as well as two written references that are then verified by making telephone enquiries. In addition prospective employees are required to complete a comprehensive application form and a health questionnaire, and to attend an interview. Alexandria`s Residential Care Home DS0000072632.V373868.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, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the views of the residents and their supporters are listened to and acted upon. This means that the home is run in the best interests of the residents. EVIDENCE: New providers took over the home in October last year. However, Mrs Christina Dennis has been the registered manager of the home for some fifteen years. Mrs Dennis gained the National Vocational Award in Care at level four and the Registered Manager’s Award approximately four years ago. Since then she has Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 23 maintained her continuing professional development and has recently undertaken training in specialist areas such as dementia and palliative care. Residents, their relatives, staff and visiting health care professionals speak very highly of Mrs Dennis and are confident that she deals with any concerning the running of the home in an efficient and kindly way. Communication in the home is good. The residents praised the way in which the new owners have kept them informed of any changes and have consulted them about decisions to be made, such as menu changes, activities and life in general at the home. One resident said, “We had a residents’ meeting the other day, it was very good, they asked us what we want and came up with some ideas about activities. We are going to give some of them a try to see if we like them. There are sound quality assurance measures in place. The home has recently sent out a questionnaire to relatives and supporters and a few responses had been received at the time of this visit. Once all responses have been received these will be collated to see if there are any trends and if there is a need to change anything to improve the service the home gives. The registered providers visit the home frequently. Every month they ensure that they speak more formally to residents and staff to seek their views, and makes a safety check of the home. The reports of these visits were available for inspection on the day of this visit. They were found to be comprehensive and to identify any areas of the home that require attention. There is a development plan for the home and a maintenance book is kept to note any day-to-day repairs that may need doing. The development plan would benefit from having more detail added. For example, it would be useful to know what improvements are planed and target dates for completion of work. This would provide more clarity for budget allocation and ensure that there is as little disruption as possible to the day to day life of the home. The home does not act as an appointee for any resident but does keep small amounts of money on behalf of most residents so they can access it should they wish to purchase sundry items. Residents said that they prefer the home to keep their money safe for them although they know they can have a lockable facility in their rooms if they wish. There are sound accounting systems for these monies. Relatives said that the system works well and means that they can be confident that money is available but kept safely. One said, “I’m pleased that mum can keep her bit of independence and buy things like special toiletries or sweets when she wants, without me having to worry about her losing it or not having enough”. No heath and safety hazards were noted on the day of this visit. Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Alexandria`s Residential Care Home DS0000072632.V373868.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations The care plans would benefit from re-organising so that information is easier for staff to find. Archiving of old records would be beneficial. More detailed falls monitoring should be undertaken as many of the residents have lived at the home for a long time and are now becoming much frailer and therefore at greater risk of falling. More attention to detail is needed in some instances when staff make entries in the care plans. Writing should be more legible and all entries dated. The home should consider other ways of providing the necessary statutory training for ancillary staff who find more formal training difficult to undertake. More detail, such as exactly what work is planned and target times for the work to be carried out should be added to the development plan for the home. DS0000072632.V373868.R01.S.doc Version 5.2 Page 26 3 OP7 3 4 OP30 OP33 Alexandria`s Residential Care Home Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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