Care Home: Princess Alexandra Home For The Blind

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What the care home does well Training opportunities and development of staff skills continue to be excellent, so that people have the confidence and competencies to provide the care and support people who live at the home need. Some members of staff have exceeded the required qualifications to work in a care home to ensure they continue to develop their skills. One member of staff said, "Training opportunities here are excellent".The manager promotes development of staff through training". In the AQAA the manager explains how each staff member has a development training record to progress and acquire the competencies to help the people who live at the home with confidence. One staff member wrote, "The training really helps". Our time at the home found routines relaxed with people allowed unrestricted access to communal areas and outside gardens, people watching the television and staff chatting to residents. We spoke to a relative who said, "Its always nice and peaceful when I come ". A person who lives at the home spoken to said, "I come and go as I please". Comments from people who live and work at the home highly recommended the quality of food provided, with varied meals and choices available if people don`t like the main meal on offer. People are allowed meals in there own room if they choose to, however staff try and encourage residents to eat in the dining room. One member of staff spoken to said, "It helps residents to mix with each other and provide stimulation". The cooks prepare home baked food and all cooks have received training in `Food and hygiene`. Comments included, "The quality is excellent". Also, "There is always an alternative". The manager tells us in the AQAA, The home has achieved the `International Standards Organisation (ISO) award for setting high standards of staff training and development including the recruitment of staff and systems they have in place to ensure people are protected and provided with care and support they need. One staff member said, "Its nice to achieve this". What has improved since the last inspection? We looked at previous inspection reports and found checks for employment were not all in place. However recruitment procedures have been improved and are more robust to ensure suitable people are employed at the home. What the care home could do better: From comments received, watching routines during the day and talking to people who live and work at the home, that a small increase of staff should be on duty at peak times of the day, to allow more time to be spent with the residents. Comments included, "More staff at times would help", also, A survey returned said, "If there was one area we could improve it would be to have extra staff on duty at times". We advised the manager to identify in staff files the date when their employment commenced. This would make it easier to identify if the recruitment processes have been completed prior to commencement of employment. Key inspection report Care homes for older people Name: Address: Princess Alexandra Home For The Blind Bosworth Place Squires Gate Blackpool Lancashire FY4 1SH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Kevan Royston     Date: 2 3 0 9 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 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. 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 Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Princess Alexandra Home For The Blind Bosworth Place Squires Gate Blackpool Lancashire FY4 1SH 01253403091 01253407010 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Blackpool, Fylde & Wyre Society For The Blind care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: 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: Sensory Impairment - Code SI The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home The Princess Alexandra home for the Blind is registered for 40 people aged 60 and over who are visually impaired. The home is situated in its own grounds close to the sea front and south shore shopping centre. Local bus and tram routes are near by. All the rooms are single occupancy and provide en-suite facilities. Communal lounges are located on both floors. There is a large dining area on the ground floor. Communal bathrooms and toilets provide aids and adaptations. The outside of the building provides seating for residents, and has well kept garden areas available. Ramp access is provided at the front of the building. There is a Statement of Purpose/Service User Care Homes for Older People Page 4 of 25 Over 65 0 40 Brief description of the care home Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees for the home are £364.20. Extra charges at the home are for Hairdressing and chiropody, which vary. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit was part of the key inspection process and took place on the 23/09/09. We spoke to people who live at the home, staff, the manager, relatives visiting and a group of residents in the lounge. Care, maintenance, previous inspection reports and other records were looked at, as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who live at the home were invited to pass their opinions to us if they wish. We received responses from surveys/ questionnaires sent to people who live at Princess Alexandra home for the Blind and staff for their views on how the home is run. Few responses were received, however those we did were positive and some are included in this report. Care Homes for Older People Page 6 of 25 Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 25 following this report, you can contact them using the details on page 4. 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. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures were clear and precise, to ensure care needs of people who live at the home are met and people can make an informed choice before moving in. Evidence: Two people we case tracked who live at the home had comprehensive personal information obtained by the manager and from social services to develop a care plan. Input from relatives in the assessment process was evident by speaking to staff and a relative, who said, They made me feel relaxed at an early stage and involved us in my dads care from the outset. We spoke to a person who lives at the home about the time he moved in and he said, First impressions were, the staff are really nice. One staff member wrote in a survey, The admission procedure is thorough. A care plan had been developed from the information to ensure social, welfare, physical and mental health needs are identified and the care and support needed can Care Homes for Older People Page 11 of 25 Evidence: be met. There was evidence of family involvement to gather information so that all needs of people who come to live at The Princess Alexandra home are looked at. One member of staff spoken to about the assessment said, We have a good process of admission to make sure we can meet the needs of people who come here. The manager informs us in the AQAA how the process for assessing people is undertaken prior to them moving in and a plan of care developed as soon as they are admitted to ensure they give the right care and support. The manager tells us in the AQAA the potential resident and family are given a Service User Guide (brochure) when an inquiry is made to ensure they have all the information about the home to make an informed choice. A relative spoken to about the initial admission stage said, We were given an up to date brochure which was informative. Standard 6 was not assessed as the home does not provide intermediate care. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home have their health and personal care needs met by staff who respected their privacy and dignity. Evidence: Care records looked at for people we case tracked were comprehensive and set out a plan of care monitoring all health, mental health, social hobbies and interests. Relatives and people who live at the home have a say in care plans and in the way they are supported. This was evidenced by signatures of care records by residents and relatives. Also the manager tells us in the AQAA how they involve key people in care planning that the resident may wish to be present. One relative spoken to said, They keep us informed of dads progress. We discussed with staff the needs of people we case tracked they had an awareness of peoples needs and were able to discuss the care provided. One staff member said, Care plans are up to date and easy to follow. Each person has a risk assessment in place to ensure their safety. We confirmed these are updated when necessary to reflect any changes that may have occurred in the building or individually ensuring people are protected and safe. The care records checked have been reviewed and are looked at every month and reflect any changes. Care Homes for Older People Page 13 of 25 Evidence: One person who lives at the home spoken to said, They discussed what support I need every month. We looked at the medication procedures with a senior member of staff. Medication of people we case tracked had safe practices in place to ensure people receive the right medicine at the right time and they are protected by the procedures in place. One member of staff spoken to said, Strictly trained staff only give out medicine. The manager explained to us in the AQAA they have good a good relationship with the pharmacist who visits the home to instruct staff on medication issues. We looked at records and confirmed nutritional screening of people who live here is monitored so that any health issues are identified and acted upon. This was confirmed by information contained in the AQAA. Records show people who live at the home have access to health professionals and where possible a doctor (GP) of their choice. One relative spoken to said, We were very happy his doctor would travel to the home following a request from the manager. During our visit we talked to people who live here in the lounge, individually and watched staff caring for people and helping them in a sensitive, dignified way. One person who lives at the home said to us, No favorites they treat everyone the same. The manager tells us in the AQAA how it is important for staff to care for residents with respect, dignity and equality, staff spoken to confirmed training is provided in relation to these issues during there induction. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. Evidence: We saw breakfast and lunch meals being prepared and served. They looked wholesome, fresh and nutritious to ensure people who live at the home receive a balanced diet. We had a talk to the person in charge of the kitchen and a look around the kitchen area which we found clean and tidy. We asked about training and the response was, We have fully trained cooks available. The cook confirmed they provide food for diabetics and are able to provide meals if required from any religious cultures. We looked around and found fresh fruit and vegetables stored in the kitchen and plenty of stocks in the fridge and cupboards, to ensure people who live here receive a healthy diet with plenty of choice. A person who lives at the home spoken to about meals and set times said, Nothing is to much trouble for the cook. Comments about the quality of meals we received were very good and included, The food is excellent, good home made meals. Also, We use fresh produce and bake daily. One relative spoken to about the food provided said, The quality of the meals from what I have seen is excellent. The manager explains in the AQAA people who live here have a choice of meals, and food is on the agenda for resident meetings so that any Care Homes for Older People Page 15 of 25 Evidence: suggestions in respect of meals and snacks can be discussed and preferences provided. Routines watched during the day looked relaxed, some people were sat in the different lounges, staff were carrying on with their daily routines, we noticed staff chatting to residents and generally supporting people in a dignified way. Records show at the assessment stage hobbies and interests of people who live at the home are written down, staff spoken to said they try and help residents individually follow their hobbies and interests. We spoke to people who live and work at the home about activities and social events, comments included, Activities are advertised around the home. We have something going on from outside entertainers monthly. Also a person who lives at the home said, We have events going on all the time. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The manager tells us in the AQAA how all staff are provided with a handbook of the home which gives simple instruction to the complaints procedure. One member of staff spoken to said, Complaints instruction is provided in the societys handbook given to us. Every person who lives at the home is given a copy of the complaints policy to ensure they and there families are aware of how and who to complain to if they had any issues or concerns. One person who lives at the home spoken to said, I never have any issues, but would talk to the manager if I had. There has been no complaints since the last inspection. All staff are trained by attending safeguarding adults courses in house so that any issues or concerns can be identified and procedures followed by trained staff. This was confirmed by information provided in the AQAA and talking to staff. One member of staff spoken to said, Abuse awareness courses are provided by the home which I have attended. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 premises is safe and clean maintained to a good standard providing comfortable surroundings for people who live at the home. Evidence: The home is purpose built and was re-opened in 2002 after extensive refurbishment and is designed to fit the purpose for supporting people who are visually impaired. On the day of the visit it was clean and tidy and maintained to a high standard with domestic staff employed to ensure the home is kept clean. One person who lives at the home spoken to said, The cleaning staff do a great job. One relative spoken to said, Its a beautiful home, spotless I wouldnt mind living here myself. The manager informs us in the AQAA two maintenance staff are employed to deal with any day to day repairs and records are kept daily to ensure repairs are attended to quickly. One staff spoken to said, Repairs are recorded so maintenance staff can attend quickly to fix any problems. There are policies in place for laundry processes and for the control of infection ensuring the home is kept clean and hygienic. Information in the AQAA informs us of how staff are trained in infection control, this was confirmed through talking to staff. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Access to training and staff development is excellent, this helps to develop skills and competencies. Recruitment procedures are robust to ensure all checks had been carried out on staff members. Evidence: Access to and training of staff is excellent which ensures people are cared for by competent skilled staff. We looked at training records, received positive comments from surveys and spoke to staff about training. One staff member said, The attention to staff training is excellent. Another staff member wrote in a survey, Management keep on top of relevant training. The manager tells us in the AQAA, 75 of care staff have a recognised qualification in care which helps develop skills when supporting and caring for the people who live at the home. Some staff are being supported to achieve a higher level of qualification in care to enable them to develop their skills and competencies. Staffing levels were sufficient in numbers to care for the people who live at the home. However from speaking to staff and people who live at the home, watching routines during the day and comments made in staff surveys it was clear a small increase of staff in the evenings should be beneficial for the residents to ensure their needs are being met and enough time is spent caring for them. One person who lives at the home wrote, The staff are busy, more help would enable more time spent with us. Care Homes for Older People Page 19 of 25 Evidence: Other comments included, Evenings seem busy. Also, Staff shortages are always an issue. We looked at recruitment procedures for the home and checked staff records to see if all checks for employment had been completed to ensure suitable people are employed. We confirmed, application forms, Criminal records Bureau (CRB) checks and references had been obtained prior to any member of staff starting work. One staff member spoken to about the recruitment procedure said, The induction and recruitment checking process was very good. Another staff member wrote in a survey, Management were very efficient in regards to my CRB check. We advised the manager to put dates when staff start employment on the front of recruitment files. This is so that dates when references, CRB checks, applicaton forms and medical declarations are returned, can be cross checked to the start date of employment, to ensure they are all in place before staff commence work. It was clear from watching staff with people during the day and speaking to staff they are clear about their role and work well as a team to ensure the individual and collective needs of people who live at the home are being met . One person who lives at the home said, They are all so nice and helpful. A relative visiting spoken to said about the staff, They are very good with the residents. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 is managed well and systems are in place for the protection and safety of staff and people who live at the home. Evidence: The manager is highly qualified and as a wealth of experience over twenty years in running care homes. Information in the AQAA confirms the manager has completed all the necessary qualification required to run a care home. One person who lives at the home spoken to said, It is run extremely well. A member of staff wrote in a survey,The management are very efficient. We checked records of health and safety looked at information in the AQAA and confirm regular tests are carried out to emergency lighting, fire procedures, gas appliances and electrical equipment, ensuring the safety of people living at the home is maintained. Financial records looked at were in good order, systems are in place for people to Care Homes for Older People Page 21 of 25 Evidence: control their own money where possible and ensure safeguards are in place for their protection. Records of finances for people who live at the home were accurate and up to date. The manager tells us in the AQAA The home has achieved an award, the International Standards Organisation (ISO) for setting high standards of staff training and development including the recruitment of staff and systems they have in place to ensure people are protect and provided with care and support they need. Other systems to gather views on how the home is run from residents and stakeholders include questionnaires sent out, staff meetings and residents meetings to ensure the home continues to run smoothly and any suggestions to improve the home are implemented. One staff member spoken to said, Communication with people is the way to keep improving the service. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 27 The ratio of staff should be determined by the needs of the people who live at the home, consideration should be given to increase the numbers of staff on duty at peak times. Care Homes for Older People Page 24 of 25 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 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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