Care Home: Alston Lodge

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What the care home does well Residents were well cared for, and had all the health care they needed. Residents spoke very positively about the care in the home. One resident said, "It`s a nice place; we can do what we like and we count our blessings", and another said, "The staff are excellent". Two relatives spoken with were also very satisfied with the care at Alston Lodge. One said, "It`s a brilliant place". The residents` medication was managed and given to people safely, and this helped to keep people healthy.Alston LodgeDS0000072871.V375048.R01.S.docVersion 5.2Visitors were made welcome in Alston Lodge and the staff made themselves available to speak to them. The home was part of the local community and most residents knew the home before moving in. It had a good reputation in the community. Residents were satisfied with the food served. One said, "The food is excellent", another said, "The food is very good on the whole". There was sufficient choice for people to make sure that people usually had what they wanted to eat. The home was clean and fresh throughout. It was decorated, furnished and maintained to a high standard. There were extensive gardens, which were also well maintained, and with pleasant views across open countryside. Residents enjoyed being outside in warm weather. A high proportion of staff had appropriate qualifications that would help them understand the needs of older people and to carry out their work. There were systems for finding out the views of the residents and the home could show how they had listened to residents and developed some aspects of the service accordingly. Residents benefited from a stable management and staff team. Many of the staff had worked in the home for a number of years. This helped to make sure that the residents were looked after people who knew them and their preferences. The home was a safe place for the residents and staff and there were policies and procedures and training to help protect people from harm. What has improved since the last inspection? There had been some improvements since the last Key Inspection. The written information about the care that people needed when they were admitted to the home had further improved. This helps the manager to make a decision as to whether or not the home can meet people`s needs, and enables staff to understand the care needed. The written plans for care were improved so that most matters of health and social care were written in sufficient detail to inform care staff what needs to be done and how. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 The management and administration of medicines had improved, and been made safer, and all medicines were being given at the right time. The manager was undertaking regular checks on the procedures to help identify when mistakes had been made and so that they could be rectified. The activities available to the residents had improved since the previous inspection. The staff were spending more time with the residents and organising more activities to entertain and occupy them. The training that staff were undertaking had improved, and staff were better trained and qualified to help them look after people. For example staff were better trained in fire safety and protection of people from abuse. What the care home could do better: The manager needs to make sure that she obtains information from the social services about people when they move into the home. This would give the staff useful details about people and what care they need. Care plans could be further improved to include all the matters of health, social and personal care, including oral care and more detail about people`s preferences. The bathing facilities need to be improved so that all residents have a choice of whether or not to have a bath or a shower. New members of staff that have no relevant experience or qualifications should undertake Induction training that is in accordance with the Skills for Care guidance to make sure that they have the skills they need to begin working with older people. Key inspection report CARE HOMES FOR OLDER PEOPLE Alston Lodge Alston Lodge Lower Lane Longridge Preston Lancashire PR3 2YH Lead Inspector Mrs Pat White Unannounced Inspection 22nd April 2009 09:30 DS0000072871.V375048.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alston Lodge Address Alston Lodge Lower Lane Longridge Preston Lancashire PR3 2YH 01772 783290 01772 783248 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) Alston Lodge Residential Home and Community Care Limited Mrs Pamela Judith Mace Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Alston Lodge DS0000072871.V375048.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 - Code PC To people 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 The maximum number of people who can be accommodated is: 17 Date of last inspection Brief Description of the Service: Alston Lodge is a Georgian House, located on the outskirts of Longridge in a quiet residential location. The house is detached and set in its own grounds, comprising of extensive lawns, flowerbeds and a patio to the rear. There is car parking at the front. Access to the town is within walking distance, or public transport is available. There are thirteen single bedrooms and two double bedrooms; five of the single bedrooms have ensuite facilities. Communal facilities consist of two lounges, a dining room and a conservatory with entrance to the staff office. Assisted bathing is provided for by a ‘medic bath’. Other aids include raised toilet seats and grab rails; a stair lift ensures ease of access to the upper floor. The weekly fees charged in the home were £470 and covered all the costs of care and accommodation. Extra charges are made for papers, hairdressing, magazines and chiropody. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owner and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide is issued to all prospective residents and their relatives/representatives as part of an information pack. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means that people who use the service experience good outcomes. This inspection site visit to Alston Lodge was carried out on the 22nd April 2009. The site visit was part of an inspection to assess all the important areas of life in the home that should be assessed against the National Minimum Standards for Older People, and checking the progress made on the matters that needed improving from the previous key inspection. This inspection also determined an overall rating of the quality of service provided by the home and this is stated above. The inspection included: talking to residents, touring the premises, observation of life in the home, looking at residents’ care records and other documents and discussion with the manager. Nine residents spoken with gave their views on the home and a member of staff who was spoken with also gave her views. In addition survey questionnaires from the commission were sent to some staff asking them for their opinion of the home. Some of the views of these people are included in the report. On this occasion we were unable to send survey questionnaires to residents due to administrative difficulties. In addition the home provided the commission with written information about the residents, staff and services provided, including their own assessment of the service provided, and some of this information is also included in the report. What the service does well: Residents were well cared for, and had all the health care they needed. Residents spoke very positively about the care in the home. One resident said, “It’s a nice place; we can do what we like and we count our blessings”, and another said, “The staff are excellent”. Two relatives spoken with were also very satisfied with the care at Alston Lodge. One said, “It’s a brilliant place”. The residents’ medication was managed and given to people safely, and this helped to keep people healthy. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 6 Visitors were made welcome in Alston Lodge and the staff made themselves available to speak to them. The home was part of the local community and most residents knew the home before moving in. It had a good reputation in the community. Residents were satisfied with the food served. One said, “The food is excellent”, another said, “The food is very good on the whole”. There was sufficient choice for people to make sure that people usually had what they wanted to eat. The home was clean and fresh throughout. It was decorated, furnished and maintained to a high standard. There were extensive gardens, which were also well maintained, and with pleasant views across open countryside. Residents enjoyed being outside in warm weather. A high proportion of staff had appropriate qualifications that would help them understand the needs of older people and to carry out their work. There were systems for finding out the views of the residents and the home could show how they had listened to residents and developed some aspects of the service accordingly. Residents benefited from a stable management and staff team. Many of the staff had worked in the home for a number of years. This helped to make sure that the residents were looked after people who knew them and their preferences. The home was a safe place for the residents and staff and there were policies and procedures and training to help protect people from harm. What has improved since the last inspection? There had been some improvements since the last Key Inspection. The written information about the care that people needed when they were admitted to the home had further improved. This helps the manager to make a decision as to whether or not the home can meet people’s needs, and enables staff to understand the care needed. The written plans for care were improved so that most matters of health and social care were written in sufficient detail to inform care staff what needs to be done and how. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 7 The management and administration of medicines had improved, and been made safer, and all medicines were being given at the right time. The manager was undertaking regular checks on the procedures to help identify when mistakes had been made and so that they could be rectified. The activities available to the residents had improved since the previous inspection. The staff were spending more time with the residents and organising more activities to entertain and occupy them. The training that staff were undertaking had improved, and staff were better trained and qualified to help them look after people. For example staff were better trained in fire safety and protection of people from abuse. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 8 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Alston Lodge DS0000072871.V375048.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 Alston Lodge DS0000072871.V375048.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. Standard 6 not applicable People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information was available to help people make a choice about whether or not they wanted to live at Alston Lodge. People’s needs were assessed prior to admission to help ensure the staff could understand these needs and look after people properly and people felt their needs were met. EVIDENCE: Information was available to all residents and families that included the Service User Guide, the complaints procedure and a standard copy of the home’s Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 11 terms and conditions. Thee documents had been updated since the previous inspection and provided useful information about the home. Records viewed, and discussion with the manager, indicated that residents were seen by the manager or the owner prior to admission to the home, and had their needs assessed. These needs were written down to assist the manager to make a decision about whether or not the home could meet their needs, and to give staff information about the care needed. However written information was not obtained from the social workers responsible for the admissions so some useful details could have been missing. There was evidence from talking to residents and from observation, that residents and relatives felt their needs were met in the home. Some residents who were able to give their views said that they always got the care and support they needed. Alston Lodge DS0000072871.V375048.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents had care plans that included useful detail on most matters of health, personal and social care. Residents’ health care needs were monitored and addressed and medication was managed and administered safely. Residents felt staff treated them properly, and with respect. EVIDENCE: All residents had written care plans to instruct staff on the care needed, and the management team was developing these to ensure that there was sufficient detailed and accurate information for staff. Some improvements had been made since the last key inspection and for example now included information about continence. Also each resident had a good written personal Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 13 history, information about nutrition and how the risk of falls should be managed. However at the time of the site visit some care plans did not contain sufficient written information about personal care needed, mental health and behaviour issues, leisure activities and preferences of how residents would like their care to be provided. Though there was no evidence at the time of the visit that this was affecting the care of the residents it could mean that residents did not get the care they needed. The manager subsequently provided evidence that this was being rectified. There was also evidence that the care plans were being reviewed appropriately and that residents and relatives were involved in this process. There was evidence that residents’ physical and mental health needs were monitored and addressed, and records showed that residents attended doctors, hospital appointments, nurses, chiropodists and dentists as necessary. Preventative and treatment measures were used for residents at risk of, and with, pressure sores and these were now being written on the care plans. Areas of risk associated with care and everyday life were underpinned by risk assessments, such as for pressure areas, the risk of falling, bathing and nutrition. However at the time of the site visit the use of bed rails for one resident was not underpinned by a risk assessment that gave guidance to staff in how to make sure they are used safely. This was rectified immediately following the site visit. Residents spoken with said that they were well looked after and received all the personal and health care they needed. The management and administration of medication in the home had improved since the previous Key inspection, and following a visit by the pharmacist inspector. Overall good records were kept of medication being received in the home, administered to residents and returned to the pharmacist. This provided an audit trail of medicines and helped to prevent mishandling of medicines. The manager was carrying out regular audits to check if procedures were being carried out properly, and was also assessing staff competence. This had ensured that improvements had been maintained and that residents in general received the right medication at the right time. However for some residents whose records were viewed there was insufficient written instructions to staff about when “when required” pain killers should be given. The rights of residents to privacy and dignity were respected. Most rooms were single and one of the two double rooms was used for a married couple. There were locks on bedroom doors and some residents had their own key. Residents stated that staff treated them kindly and respectfully and provided personal care in a professional manner. However people’s choice was restricted with respect to the bathing facilities (see “Environment). Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 14 Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Leisure activities were being improved and developed in order to suit the needs and preferences of the residents. Residents had sufficient choices in their everyday lives and were enabled to maintain contact with their relatives and the community. The food served was wholesome and varied and suited the taste of most of the residents. EVIDENCE: Daily routines and activities suited individual’s preferences. Residents could go to bed and get up when they wanted and had a choice of some activities. Since the previous inspection the activities programme had been developed and improved and staffing changes had resulted in care staff having more time to organise activities. According to the manager and information supplied by the home there were trips out, e.g. to local villages and meals out, card games, quizzes and crafts and trips out with relatives. At the time of the site Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 16 visit some residents were playing dominoes and preparing for an evening trip to the theatre. Events were held in the home’s pleasant grounds in the Summer time. The residents’ care plans included some information about peoples’ interests and hobbies and people could pursue any religious interests. The relatives spoken with said they were made welcome in the home at any time and that staff were friendly and helpful. The care and accommodation reflected the culture and expectations of people living in the Longridge community, and the home was a well - known resource in the area. Residents spoken with felt there was sufficient choice of such things as rising and retiring times, leisure activities and whether or not residents could spend time in their rooms. One resident said, “We can do anything we want here”. Residents were able to bring small items of furniture with them. Residents meetings were held to give residents an opportunity to express preferences and choices, and views expressed in the meetings had partly led to the development of the social activities. The food served on the day of the site visit, and the meals on the written menus viewed, appeared appetising and wholesome. Meals were eaten in the pleasant dining room, though residents could choose to eat in their rooms. Most residents in conversation spoke highly of the food served. One resident said, “The food is marvellous”. Residents could have a cooked breakfast if they wished, and there were choices of cooked meals at lunch – time and choices for the snack meal at tea - time. The cook kept appropriate records of the food served and stated that menus were changed every few weeks according to residents’ wishes and requests. Appropriate assistance and encouragement was given to those who required it. Alston Lodge DS0000072871.V375048.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure was available to residents and visitors, people knew who to speak to if they had any concerns and were confident that their concerns would be taken seriously. There were policies and procedures to help protect the residents from abuse. EVIDENCE: The home had a complaints procedure that was given to residents and families. Residents spoken with stated they had “no complaints”, and no complaints had been recorded in the home or made to the commission in recent years. Residents and relatives who completed the survey questionnaires at the last inspection all said they knew how to make a complaint and who to speak to if they were not happy with anything. There had been no recent allegations or suspicions of abuse. Policies and procedures to protect residents from abuse had been developed in accordance with Government guidance and gave sufficient instruction to staff about what to do in the event of an incident. Since the previous inspection most staff had Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 18 completed training in protection of adults from abuse, and other staff were to complete this training in the near future, and this further helped to protect residents. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 25 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained and furnished and provided pleasant, comfortable and clean accommodation. However the bathing facilities were not suitable for all the residents. EVIDENCE: Alston Lodge is an older style property situated on a main road running through the village of Longridge. Accommodation is on two floors with a stair lift providing access between the two floors floor. There were extensive gardens at the back of the house, with patio furniture, and an orchard, all of which were well maintained and attractive. There were extensive views across Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 20 the open countryside from the back of the house. Residents enjoyed being outside in the Summer time. Communal areas consisted of a dining room, a two - part lounge, conservatory and a “private” lounge for visitors. All parts of the home were well maintained, decorated and furnished. We were informed that the bathing facilities were now not suitable for an increasing number of residents who needed considerable assistance due to lack of mobility. These residents were unable to use the current assisted bathroom for safety reasons. Therefore the choice for a number of residents in this aspect of their personal care was limited. As at the last inspection the owner and the manager were still reviewing these facilities. Subsequent to the site visit we were informed that an assisted shower facility was being considered. Hot water taps had safety valves fitted to help prevent residents being accidentally scalded. These were now being monitored and water temperatures recorded and action taken to control the temperatures if need be. Central heating radiators had guards to protect residents from hot radiator surfaces. A good standard of hygiene was seen throughout the home and all areas were free from offensive odours. The residents appreciated this and some commented on it in conversation. The Laundry facilities were situated in the cellar and appeared to be suitable for the laundry needs of the residents. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of staff with the right skills and training to meet the needs of the residents. The staff recruitment procedures were not always sufficiently thorough to ensure that unsuitable staff did not commence work in the home. EVIDENCE: On the day of the site visit the home’s staffing arrangements were suitable for meeting the needs of the residents, and we were told that this was typical of the arrangements. Also since the last inspection there had been an increase in domestic hours so that care staff were able to spend more time with the residents. The owner also spent considerable time in the home. Residents spoken with praised staff for the way they carried out their duties. The records of 2 recently appointed members of staff showed that one of these members of staff had commenced work in the care home before the Criminal Records Bureau and Protection of Vulnerable Adult checks, had been received. Also there was only one reference available in the records for this person. For Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 22 the other member of staff there was a gap in employment that had not been explained and one of the references was not the most appropriate as it was not employment or college based. Staff records viewed showed that these staff had completed an in - house induction training when they first commenced work. An in depth induction in accordance with Government guidance was being developed for those new members of staff without previous skills and qualifications in care. The information supplied by the home prior to the site visit and discussion with the manager indicated that 61 of care staff had completed relevant NVQ training. Records also showed that the home’s training programme had developed since the previous inspection and staff had completed moving and handling training, food hygiene and medication training. This was ongoing to ensure all staff carried out this training. Most staff had also completed training in dementia and adult abuse. Only 2 staff completed questionnaires so a representative view of staff was not obtained. However these 2 members of staff suggested that they didn’t always feel they had the right skills and training to help them do their job. Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 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 was managed by experienced, long serving people who were committed to caring for the residents and had the right qualifications and experience. There were quality assurance measures that took into account the views of residents and relatives, and health and safety procedures helped to protect the residents and staff from harm. EVIDENCE: Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 24 There was a stable management team that benefited the home and the residents. This comprised of the registered manager, an assistant manager and a deputy manager. All senior staff had been in post for a number of years. The registered manager had the appropriate management qualification. Computer facilities were to be installed to improve some administration and communication facilities. There were quality monitoring systems in place. These involved collecting the views of the residents and relatives through questionnaires and residents meetings. Residents had therefore been able to make their views known about such matters as the menus and leisure activities. Staff meetings were held every few months to assist communication. The home looked after the personal spending money of some residents when this was necessary, or when relatives requested it. This money was stored safely in the office safe. Records were kept of the money received, given to residents, and the dates, and appropriate signatures obtained to give evidence that the money had been given and received. The health and safety of the residents and staff was promoted to help ensure the wellbeing of all the people in the home. A rolling programme of moving and handling, first aid and food hygiene training was in progress and some staff had undertaken a course in infection control. The home’s fire precautions were satisfactory and staff had undertaken more suitable fire training since the last inspection. The homes gas and electrical appliances, fire equipment, and stairlift, had been serviced and maintained within required timescales, to ensure their safety. Two new hoists had been purchased to assist staff transfer residents safely. Alston Lodge DS0000072871.V375048.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 3 x 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 2 x x 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP21 Regulation 23 (2)(j) Requirement Suitable bathing facilities must be provided so that all residents have a choice in this aspect of their personal care Staff must not commence work in the home until the criminal records bureau and protection of vulnerable adults checks and two suitable written references have been obtained. Timescale for action 31/08/09 2 OP29 19 31/05/09 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 OP3 OP7 Good Practice Recommendations When people are admitted to the home under care management arrangements the social work assessment should be obtained. The care plans should include sufficient information in all aspects of personal care and support, including what people can and can’t do for themselves, mental health matters and leisure interests. An assessment of risk for the use of bed rails should DS0000072871.V375048.R01.S.doc Version 5.2 Page 27 3 OP8 Alston Lodge 4 OP9 5 OP30 always be completed which clearly demonstrates if there are any risks and gives guidance to staff on how to minimise the risk and prevent injury. There should be sufficient written instructions to staff about when to administer “when required” medication which includes what the medication is for and when it should be given. The induction and training should be developed to meet the needs of the staff and residents Alston Lodge DS0000072871.V375048.R01.S.doc Version 5.2 Page 28 Care Quality Commission Care Quality Commission Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 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 summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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