Alphington Lodge Residential Home

1 St Michaels Close, Alphington, Exeter, Devon, EX2 8XH

(01392) 216352
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Type of service
Care home without nursing

Specialisms/services
Caring for adults over 65 yrs

Local Authority Area
Devon

Our inspector's description of this care service (last updated 10 April 2013)

Alphington Lodge is registered to provide accommodation with personal care for up to 28 people. The service is intended to be for people over 60 years of age.

These are the results of our most recent checks showing whether this care service is meeting each of the standards that the government says you have the right to expect.

1
Standards of treating people with respect and involving them in their care
Overall

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)
Meeting this standard
Our latest inspection of this standard was:
on 22 February 2013 during an inspection in response to concerns
See our inspector's full report about this standard published 10 April 2013
Before people are given any examination, care, treatment or support, they should be asked if they agree to it (outcome 2)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.

2
Standards of providing care, treatment and support that meets people's needs
Overall

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)
Meeting this standard
Our latest inspection of this standard was:
on 22 February 2013 during an inspection in response to concerns
See our inspector's full report about this standard published 10 April 2013
Food and drink should meet people's individual dietary needs (outcome 5)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.
People should get safe and coordinated care when they move between different services (outcome 6)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.

3
Standards of caring for people safely and protecting them from harm
OverallImprovements
required

People should be protected from abuse and staff should respect their human rights (outcome 7)
Meeting this standard
Our latest inspection of this standard was:
on 29 March 2012 during a check to make sure that the improvements required had been made
See our inspector's full report about this standard published 2 May 2012
People should be cared for in a clean environment and protected from the risk of infection (outcome 8)
Meeting this standard
Our latest inspection of this standard was:
on 22 February 2013 during an inspection in response to concerns
See our inspector's full report about this standard published 10 April 2013
People should be given the medicines they need when they need them, and in a safe way (outcome 9)
Improvements required
What does this mean?
Our latest inspection of this standard was:
on 27 November 2012 during a routine inspection
See our inspector's full report about this standard published 16 January 2013
People should be cared for in safe and accessible surroundings that support their health and welfare (outcome 10)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.
People should be safe from harm from unsafe or unsuitable equipment (outcome 11)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.

4
Standards of staffing
OverallImprovements
required

People should be cared for by staff who are properly qualified and able to do their job (outcome 12)
Improvements required
What does this mean?
Our latest inspection of this standard was:
on 22 February 2013 during an inspection in response to concerns
See our inspector's full report about this standard published 10 April 2013
There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)
Meeting this standard
Our latest inspection of this standard was:
on 22 February 2013 during an inspection in response to concerns
See our inspector's full report about this standard published 10 April 2013
Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)
Meeting this standard
Our latest inspection of this standard was:
on 8 August 2012 during a check to make sure that the improvements required had been made
See our inspector's full report about this standard published 17 September 2012

5
Standards of quality and suitability of management
OverallImprovements
required

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)
Improvements required
What does this mean?
Our latest inspection of this standard was:
on 27 November 2012 during a routine inspection
See our inspector's full report about this standard published 16 January 2013
People should have their complaints listened to and acted on properly (outcome 17)
Meeting this standard
This check was based on declarations and evidence given by this care service when they registered with CQC on 27 September 2010. We have not yet carried out an inspection.

When we inspect this standard we will publish a full report.
People's personal records, including medical records, should be accurate and kept safe and confidential (outcome 21)
Meeting this standard
Our latest inspection of this standard was:
on 27 November 2012 during a routine inspection
See our inspector's full report about this standard published 16 January 2013

Inspection Reports

Carried out on 22 February 2013 during an inspection in response to concerns

Summary of the inspection

This inspection was carried out in response to concerns we had received. The concerns related to respecting people who used the service, care and welfare, hygiene and infection control, recruitment, and staffing levels. A new manager had started working in the home a few weeks before this inspection took place. A member of staff had been promoted to the post of head of care. We saw evidence to show they had worked closely to identify the areas where improvements were needed. Plans had been drawn up to address the problems they had identified and we saw actions were in the process of being carried out. We found that people were treated with respect and dignity. One person told us ‘’ I always get a choice. If I rang a call bell and asked to get up, then they will help me’’ and ‘’I have never seen the staff be grumpy with people; they are so patient with the people’’. People received care and support that met their needs. Some care plans did not provide sufficient information to staff about people’s personal or health care needs but we saw that these were in the process of being reviewed and improved. People told us they were satisfied with the care they received. All areas of the home were found to be clean and hygienic. New staff had not always been recruited following safe recruitment methods.

Download report:

Inspection Report published 10 April 2013

92.96 KB

Carried out on 27 November 2012 during a routine inspection

Summary of the inspection

We spoke in some depth with nine of the 22 people living at the home when we visited, and with one person's visitor. We met others who were less able to give us their views in detail because of their physical or mental frailty. We observed some of the support people received, such as at lunchtime. We spoke with care and ancillary staff, and with the newly appointed manager (who was yet to apply to be registered with us). The accommodation looked clean and orderly yet homely. Senior staff told us about recent improvements made to the décor, furnishings and fittings. People’s privacy, dignity and independence were respected. They experienced care and support that met their needs and protected their rights, with qualified, skilled and experienced staff available to meet their needs. People’s comments about their care included “They look after us very well.” One told us the night staff were “very punctual”, and that the service was much better than their recent experience of a stay in hospital. Another person said “Everyone seems to be very kind.” People’s views and experiences were taken into account in the way the service was provided regarding their care. However, we found the provider did not have fully effective systems to regularly monitor the quality of the service that they received. We also found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements to manage medicines.

Download report:

Inspection Report published 16 January 2013

95.89 KB

Carried out on 8 August 2012 during a check to make sure that the improvements required had been made

What people told us during the inspection

We carried out an inspection in March 2012 and found that the service needed to make improvements with regard to care and welfare of people, training of care workers and quality assurance systems. We carried out an inspection of Alphington Lodge on 9 August 2012 to monitor whether improvements had been made. We looked at people’s experiences with regard to care and welfare of people, training of care workers and quality assurance systems. In addition to these areas, we also looked at infection control systems and the management of people’s medicines. The provider had achieved compliance in all of the outcomes that we previously had concerns about. This was supported by the comments people made about their experiences and what we observed. There were 16 people living at the home when we visited. We looked at the records of four people in detail; and spoke with four people about their experiences at the service. However, most people were not able to comment directly on their care so we spent time with them to help us understand what life was like at the home. This meant we spent time observing care and people's interactions with care workers to see whether they had positive experiences. To do this we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us about their experiences of care. We used SOFI for one and half hours in the lounge and spent another hour with people there. We spoke with six care workers, two relatives, the manager and a professional who visited the home. People were involved in all aspects of their care, treatment and lives at the home. For example, we saw care workers respond quickly to a person’s request to have their hair washed. We saw that the team had found out a lot of information about people so that they gave person centred care. We heard that people’s needs were met. For example, one person said “They meet my needs”. Another person told us “I’m very comfortable here”. Two relatives told us they were happy with the care. For example, one person speaking about their relation said “She’s been cared for to both her and my satisfaction”. Another person told us “He needs two people to help him and he gets that help”. We saw that people were mentally stimulated and this had a positive effect on their wellbeing. For example, during the afternoon we saw people doing a range of activities: cake decorating, watching the Olympics, doing puzzles or being encouraged to join in conversations. In terms of general cleanliness, people had mixed views. For example, two people told us they were satisfied with the level of cleanliness, with comments like “My room cleaned at least once a day and the bed linen is spotlessly clean”. Conversely, two relations told us that an area for improvement was deep cleaning in the home and commented “Attention to detail could be improved”. People said that the manager had listened and was making changes to improve the service. Two relatives told us that they were “Always made welcome” and “Kept up to date with developments at the home” and about their relations wellbeing. They also remarked that in their opinion the management of the home would improve because “The manager is hands on”. At this inspection, we made a compliance action about record keeping to ensure that detailed evaluations of care delivered for people was documented and always accurate. We also made the provider aware of an area that they might improve, with regard to their own monitoring of maintenance and planned refurbishment of equipment for people to use.

Download report:

Inspection Report published 17 September 2012

67.67 KB

Carried out on 29 March 2012 during a check to make sure that the improvements required had been made

What people told us during the inspection

This inspection of Alphington Lodge took place on 29 March 2012. The inspection was carried out by two Compliance Inspectors. The inspection was prompted by concerns we received about the health and welfare of some of the people living in the home that indicated that they may not have received adequate care. During our visit we also followed up on compliance actions issued at the last inspection of the home that took place in October 2011. The compliance actions covered the following essential outcome areas – • Outcome 4 – Care and welfare of people who use services • Outcome 7 – Safeguarding people who use services from abuse • Outcome 9 – Management of medicines • Outcome 14 – Supporting staff • Outcome 16 – Assessing and monitoring the quality of service provision At the time of this inspection there were 18 older people living in the home. When we arrived there was one senior care assistant and three care assistants on duty, plus a cook and a domestic. In the afternoon there was also a cleaner on duty. Since our last inspection the registered manager had resigned. A new deputy manager had been recruited and the providers had started the process of recruiting a new manager. The deputy manager was not expected to be on duty on the day of our visit but, after being contacted by the staff, they arrived at the home shortly after we arrived. This meant they were available to provide us with the information we required and answer our questions. During the afternoon the person employed as the temporary acting manager (part time) also arrived. During our visit we looked at how the care needs of seven people were managed. We wanted to find out if they had received care and support that met all of their health and personal care needs. One of the people we chose had recently been admitted to hospital and therefore we were unable to talk to them but we were able to talk to the other six people. We looked at their care plans and the records of the care they had received. We also talked to six members of staff plus the deputy manager and the acting manager. Every member of staff we spoke to confirmed they thought the home had improved over the last few months. When asked to describe some of the improvements, one care worker told us that there were regular staff meetings where staff were encouraged to contribute ideas and those were acted on. Other improvements identified were changes to the care plans which have become simpler and more person centred, changes to the breakfast routine to free up staff to spend more time giving personal care to people. One care worker told us they would like to spend more time with people and would like more help in the office to answer the phone as that takes them away from caring for people. Five people told us the staff were very kind and helpful and one person said “people are treated quite well here”. Another person said “The staff are lovely. They can’t do more for you.” Records we looked at showed there had been improvements made to the care planning system, including the introduction of new assessment forms to be used before new people move into the home. The staff team had received training and updates on all required health and safety topics, and on some important topics relating to people’s health and personal care needs. Meetings had been held with relatives and with staff and we were given copies of the minutes of these meetings. The meetings had given people opportunity to raise concerns, and we saw evidence to show that the managers had taken the concerns seriously and had started to take actions to address some of the issues raised. A new cook had recently been recruited and at the time of our visit she was in the process of drawing up new menus. Five people we spoke to told us the food was very good with lots of choice and fresh fruit and vegetables. We were told that there had been a high staff turnover since

Download report:

Inspection Report published 2 May 2012

75.54 KB

Carried out on 5 October 2011 during an inspection in response to concerns

What people told us during the inspection

We carried out this review because of concerns raised through safeguarding processes. These were regarding the meeting of people's health and welfare needs, particularly those who spent most of their time in their bedroom (rather than in the communal day rooms). On the day we visited, there were 23 people living at the home. We spoke with 10 people who were sitting in their bedrooms when we first looked around the home, and with a visitor to another person. We followed up four of these people and looked at the support they received. We met other people in communal areas, who we spoke with more briefly. One person we spoke with about the home told us 'I've no fault with it and I'm as happy as my ailment will let me be.' We asked another person if they felt that staff treated them as an individual and they replied 'The staff are very good here.' When we asked a third person if there was anything the home could do better, they replied 'If I wanted anything special, they would do it for me. For example, if I said someone was coming in to see me they'd help me get ready in time.' People told us that their visitors were made to feel welcome. A couple of people went out independently, and people were enabled to be part of a wider community in other ways. All felt they got the support they wanted. They generally felt staff were respectful, although one person also commented that some staff could be off-hand, and another felt they were spoken to like a child on occasion. We heard some good interactions, and we saw that staff did not rush people when they engaged with them or assisted them to walk. We observed that people were given choices, and their decisions were respected - such as about when they retired for the night or got up in the morning, and if to join in the table games played during our visit. It was not clear, however, that the programme of activities was based on people's interests, previous hobbies and so on. There was little evidence of people's involvement in the planning of their daily or longer term care, and they said they hadn’t been asked about their care plan. People told us that the staff called a doctor if needed or if the person wanted to see one, and that a GP visited routinely every week who people could ask to see on such visits. People said staff were sympathetic regarding their disabilities and needs, allowing people time if they had mobility or communication difficulties and so on. However, risks to their health and welfare had not always been properly identified or assessed. We also found some issues relating to how people's health needs were being met, regarding hydration needs, catheter care and care of wounds. This appeared partly due to a lack of staff training and supervision. Most people told us that they got their medications on time, but we found medications were not managed well enough to ensure people would receive medications they were prescribed. People said no-one asked them, as we were, how things were generally at the home or what they thought about the service they received. Two added that the home expected people to speak up. The manager told us she went around the home to speak with everyone each day she was on duty. One person remembered being given a survey to complete, and we saw completed copies of the 2010 survey. Many people had responded positively to the questions asked. Where three people had made suggestions or requests, we saw that the service had written a response to them, although this was not often positive in tone. For example, lack of a budget being given as a reason for a cleaning issue raised. The manager told us the home was currently recruiting, to increase staffing for all care shifts and for the housekeeping team. A visitor told us they had no issues with the home or the care provided to their relative. They added that if there was a problem, they just spoke to the staff about it and it was addressed.

Download report:

Inspection Report published 21 November 2011

73.38 KB

Reports under our old system of regulation (including those from before CQC was created)

Report from 08 January 2010

429.32 KiB

Report from 10 March 2009

211.01 KiB

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What our icons mean

	All standards were being met when we inspected the service. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service.
	At least one standard in this area was not being met when we inspected the service and we required improvements.
	At least one standard in this area was not being met when we inspected the service and we have taken enforcement action.

What does a grey cross mean

At least one standard in this area was not being met when we inspected the service and we required improvements.

What happens next

The service will tell us how it is making improvements. Once we are happy that the improvements have been made, we will update our judgement to show a green tick. Other times, we may have to carry out a 'follow-up' inspection to check improvements.

How can I get more information

Our inspector's report will give you more information about why the service received a grey cross. You can also contact the service directly or visit its website for more details on any improvements it has made.

What does a red cross mean

At least one standard was not being met when we inspected the service and we took enforcement action.

What happens next

The type of enforcement action we take depends on the seriousness of our inspector's findings, and the service must make improvements before we update the judgement on our website.

How can I get more information

Our inspector's report will give you more information about why the service received a red cross. You can also contact the service directly or visit its website for more details on any improvements it has made.

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Alphington Lodge Residential Home

1
Standards of treating people with respect and involving them in their care
Overall

2
Standards of providing care, treatment and support that meets people's needs
Overall

3
Standards of caring for people safely and protecting them from harm
OverallImprovements
required

4
Standards of staffing
OverallImprovements
required

5
Standards of quality and suitability of management
OverallImprovements
required

Inspection Reports

Carried out on 22 February 2013 during an inspection in response to concerns

Carried out on 27 November 2012 during a routine inspection

Carried out on 8 August 2012 during a check to make sure that the improvements required had been made

Carried out on 29 March 2012 during a check to make sure that the improvements required had been made

Carried out on 5 October 2011 during an inspection in response to concerns

Reports under our old system of regulation (including those from before CQC was created)

Need this report in a different format?

What our icons mean

What does a grey cross mean

What happens next

How can I get more information

What does a red cross mean

What happens next

How can I get more information

Help with finding and choosing your care

More about Alphington Lodge Residential Home

For people from organisations we regulate

New and featured

About us and our work

Reports, surveys and reviews

News

Hospitals

Care homes

Dentists

Care in your home

More

GP services

Alphington Lodge Residential Home

1Standards of treating people with respect and involving them in their careOverall

2Standards of providing care, treatment and support that meets people's needsOverall

3Standards of caring for people safely and protecting them from harmOverallImprovementsrequired

4Standards of staffingOverallImprovementsrequired

5Standards of quality and suitability of managementOverallImprovementsrequired

Inspection Reports

Carried out on 22 February 2013 during an inspection in response to concerns

Carried out on 27 November 2012 during a routine inspection

Carried out on 8 August 2012 during a check to make sure that the improvements required had been made

Carried out on 29 March 2012 during a check to make sure that the improvements required had been made

Carried out on 5 October 2011 during an inspection in response to concerns

Reports under our old system of regulation (including those from before CQC was created)

Need this report in a different format?

What our icons mean

What does a grey cross mean

What happens next

How can I get more information

What does a red cross mean

What happens next

How can I get more information

Help with finding and choosing your care

More about Alphington Lodge Residential Home

For people from organisations we regulate

New and featured

About us and our work

Reports, surveys and reviews

News

1
Standards of treating people with respect and involving them in their care
Overall

2
Standards of providing care, treatment and support that meets people's needs
Overall

3
Standards of caring for people safely and protecting them from harm
OverallImprovements
required

4
Standards of staffing
OverallImprovements
required

5
Standards of quality and suitability of management
OverallImprovements
required