Inspection on 14/12/09 for Eric Morecambe House

This is the latest available inspection report for this service, carried out on 14th December 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Eric Morecambe House 16/11/05

Eric Morecambe House 02/08/05

Eric Morecambe House 19/10/04

Eric Morecambe House 04/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for older people Name: Address: Eric Morecambe House Harrow Grove Torrisholme Morecambe Lancashire LA4 6ST     The quality rating for this care home is:   three star excellent 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: Lesley Plant     Date: 1 4 1 2 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 32 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 32 Information about the care home Name of care home: Address: Eric Morecambe House Harrow Grove Torrisholme Morecambe Lancashire LA4 6ST 01524831104 01524416709 rosalyn.davis@anchor.org.uk www.anchor.org.uk Anchor Trust care home 34 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 34 Date of last inspection Brief description of the care home Eric Morecambe House is registered to provide personal care for up to 34 older people. The home is situated in a residential area of Torrisholme near to local shops and close to public transport links to both Lancaster and Morecambe. The building is arranged over three floors, with resident bedrooms and communal rooms on the first and second floors. The layout of the building gives direct access to the garden from the first floor and there is also a main entrance door on this floor. There is a call bell system in place and the corridors are wide, with handrails, providing good access for people in wheelchairs or for people who need assistance when walking. A lift and a stair lift allow Care Homes for Older People Page 4 of 32 Over 65 34 0 Brief description of the care home access throught the building. Residents bedsit rooms are on the first and second floors. All have their own ensuite facilities of a toilet and wash basin, with a small number having a full bathroom. Each bedsit has a kitchenette area, allowing residents to make their own snacks and drinks. A small number of bedsits have a full kitchen. There are also bathrooms on each floor, fitted with baths or showers suitable for people with mobility problems. Details of the current fees can be obtained by contacting the manager of the home. Care Homes for Older People Page 5 of 32 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: three star excellent 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 key inspection focused on the outcomes for people living at the home and involved gathering information about the service from a wide range of sources over a period of time. The site visit for this inspection was unannounced. There were 31 people resident at the home at the time of the visit. All of the key national minimum standards, plus the standards relating to information provided to prospective residents and staff supervision were assessed. Time was spent talking to people staying at the home and observing staff as they went about their duties. Discussion also took place with the manager, kitchen staff and care staff. Records were viewed and a tour of the building took place. Care Quality Commission surveys, inviting feedback about the service provided at Eric Morecambe House were received from 11 relatives, 5 members of staff, 2 residents and a district nurse who regularly visits the home. Telephone contact was also made Care Homes for Older People Page 6 of 32 with 2 relatives who had requested to speak to the inspector. The AQAA (annual quality assurance assessment) completed by the manager of the home, also provided some useful information. This is a self assessment focusing on how well positive outcomes are being achieved for people using the service. Service reviews took place in November 2007 and November 2008, with the last full key inspection being conducted in December 2006. Care Homes for Older People Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: The care planning paper work was discussed with the manager, as different staff were recording reviews on different forms used by the home. For some residents it was difficult to evidence that monthly reviews were taking place, even though elements of care plans had been amended and in some cases new care plans put in place. There should be clear records of all elements of the care plan being reviewed at least once each month. Each element of the care plan is numbered and it is advised that the numbers are consistently applied, as the current system appears to be confusing for staff to follow. It is also advised that the process of risk assessing is reviewed as their appears to be unnecessary repetition in this area. It was noted that handwritten medication records are usually checked and signed by Care Homes for Older People Page 8 of 32 two members of staff. However, this double check had not been carried out on one record viewed. It is recommended that all handwritten medication records are checked by two members of staff, as this helps to ensure that mistakes are not made. Some parts of the home are due for updating and it is important that the refurbishment of the en suite areas continues. 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. 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 32 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 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is provided to prospective residents and assessments take place helping to ensure that people are not admitted to the home unless their needs can be met. Evidence: A useful list of questions has been developed for anyone looking around the home, guiding people regarding what to look for and questions to ask, which may help people decide if Eric Morecambe House is where they want to be. Copies of this are placed in the entrance hall. Anchor Trust, the provider organisation has produced a DVD about the service they provide. This is currently being updated. On looking around the home, service user guides were seen to be available at the entrance to each bedsit. Information from the CQC surveys completed by residents confirms that individuals received enough information to help them decide if if this was the right home for them. Care Homes for Older People Page 11 of 32 Evidence: An initial assessment is carried out for residents prior to agreeing a move into the home. The manager, care manager and or one of the team leaders carry out all initial assessments, with two of these senior staff visiting the individual in their place of residence, such as at their home or in hospital. Information is also gathered from other professionals, such as social workers, as appropriate to each individual.The initial first weeks of residency are classed as a trial period for both the resident and the home. During this settling in period further information is gathered about the strengths and needs of the individual and the care plans are put in place. Care Homes for Older People Page 12 of 32 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. Health and personal care needs are met and the dignity and privacy of residents is promoted. Evidence: Care plans are in place and address a variety of needs including, mobility, personal care and social activities. Each care plan shows the identified need, the desired outcome and what staff need to do to achieve this. There is a system of monthly reviews taking place, with care plans being amended if the residents needs have changed. As well as the monthly review there is a six monthly review, which involves relatives, with a pre review questionnaire being completed by the resident. This asks questions regarding satisfaction or otherwise, with the service being provided. The records of six monthly reviews seen show that a person centred approach is taken, with the individual resident being very much at the core of the process. Files contain good information about the individuals life history, which helps staff to get to know the person and what is important to them. Each resident has a key worker who spends time with the individual, helping to build up this life history Care Homes for Older People Page 13 of 32 Evidence: information. Residents views are taken into account when allocating a key worker and one resident explained that they had requested a change of key worker and that this had been accommodated. There is also information regarding lifestyle choices, including preferred daily routines, such as times for getting up and going to bed and this feeds into the care planning process. Each person also has a night care plan, detailing any support required during the night and there are signed agreements regarding the checks needing to be done by night staff. Risk assessments are in place and address potential risks such as using the stair lift, pressure sores, falls, moving and handling and the use of equipment, including the use of bed rails. Alterations are made to care plans and risk assessments as needs change or if new risks are identified. One person is of frail health and was being cared for in bed. The records for this person showed that the care plan for nutrition had been changed to show that full assistance with food and drink was now required and a new moving and handling risk assessment had also taken place. Good records were being maintained of the intensive support being provided to this resident. For one resident, who is very deaf the care plan regarding activities includes the importance of making sure that this individual is made aware of any planned activities each day. There is also a specific fire emergency plan in place for this person, with a laminated sign kept at the entrance to her bedsit, which staff would use to quickly communicate the need to evacuate the building, as a verbal explanation would take some time. The care planning paper work was discussed with the manager, as different staff were recording reviews on different forms used by the home. For some residents it was difficult to evidence that monthly reviews were taking place, even though elements of care plans had been amended and in some cases new care plans put in place. There should be clear records of all elements of the care plan being reviewed at least once each month. Each element of the care plan is numbered and it is advised that the numbers are consistently applied, as the current system appears to be confusing for staff to follow. It is also advised that the process of risk assessing is reviewed as their appears to be a great deal of repetition in this area. Good records are maintained of any health care issues or visits from health care professionals such as GPs. This helps to ensure that any health problem and associated treatment is monitored and that clear information can be provided to health professionals such a district nurses. Records are kept of each persons weight with any significant changes being responded to. One district nurse who has regular contact with the home, completed a CQC survey, stating that health care needs are Care Homes for Older People Page 14 of 32 Evidence: monitored, reviewed and met and that staff seek appropriate advice regarding health concerns. The majority of CQC surveys completed by relatives confirmed that they are kept informed of important events affecting their relative. Medication safes are available in the bedsits for those who want to and are able to manage their own medication. Self medication agreements and risk assessments were seen. For the majority of residents, senior staff take on this responsibility, with medication being kept in a locked store room and put into a lockable medication trolley when it is to be administered. Medication is dispensed into cassettes by the dispensing pharmacist who has visited the home to check that the system is being used properly. The care manager also does a monthly audit, which helps to ensure that all staff are following agreed procedures. The team leader on duty administers medication and all staff at this level have received appropriate training. The medication administration records for three residents were checked and all had been completed correctly, with no omissions. The controlled drugs register was viewed and the medication and records for one resident who takes such medication were checked, with the amount recorded corresponding correctly with the amount stored. A dedicated fridge is available for medication, such as eye drops which require cold storage. Unused medication is returned to the pharmacy each month. It was noted that handwritten medication records are usually checked and signed by two members of staff. However, this double check had not been carried out on one record viewed. It is recommended that all handwritten medication records are checked by two members of staff, as this helps to ensure that mistakes are not made. During the inspection visit staff were observed talking to residents respectfully and feedback from CQC surveys endorsed this. Comments included; Support and assistance provided in a friendly and caring manner and staff are always helpful and very pleasant. The induction programme for new staff includes how to treat residents with respect and dignity at all times. The large bedsits and kitchenette facilities give good opportunity for residents to entertain visitors in the privacy of their room. Each bedsit has a lockable door, telephone point and post box for mail to be delivered which help to promote the privacy of individuals. The staff training programme includes training regarding dining with dignity and some staff at the home have been awarded the dignity champion status, having completed specific training in this area. Care Homes for Older People Page 15 of 32 Evidence: Residents records include their preferences and wishes during ill health and where possible this includes end of life decisions. This may include where the person wants to be, who the home should contact, if a will has been made and any funeral plans that the person wishes to be put in place. Care Homes for Older People Page 16 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good range of activities are provided and community contact is given a high priority. Residents are able to retain some independence and prepare their own drinks and snack meals if they wish. The good quality meals and choice of meals are enjoyed by those living at Eric Morecambe House. Evidence: Residents are able to spend time in their bedsit or in the large communal lounge area. Several people spoken to said that they liked to have a lie in and spend time in their bedsit, but would join in the afternoon activity in the lounge. Details of planned activities are displayed on noticeboards. The large lounge is split into different areas which are used for different activities. On the day of the inspection visit a quiz took place, which appeared to be enjoyed by those who took part. An activities organiser is in post and regular activities include quizzes, shopping, manicures, exercises and bingo. The activities organiser also spends one to one time with residents who prefer to stay in their bedsit or those who dont receive many visitors and had accompanied a new resident shopping during the morning of this inspection. Trips out are also arranged and have included visiting a garden centre and going to Happy Mount park in Morecambe. Care Homes for Older People Page 17 of 32 Evidence: A lunch club, inviting people from the local community takes place. This is not vigorously marketed and tends to involve the same small group of participants. There are also links with Anchor Trust, the provider organisation, sheltered housing provision in the area and some joint events such as bingo and hot pot suppers take place. Residents said that they enjoyed these events and the opportunity to meet new people. Family and friends are invited to events such as concerts, the annual bonfire party and cheese and wine evenings. Posters advertising these events were seen and regular newsletters are distributed to keep residents and relatives informed of forthcoming activities. Residents handle their own financial affairs according to their ability and wishes. For some people a relative or other representative takes on this responsibility. Advocacy information and information regarding other sources of advice is made available. One relative commented that; Administration is of a high standard with excellent communication and consultation on matters to do with finance, pensions etc. Each residents bedsit is ready furnished, however residents are also able to bring in their own possessions and have familiar things around them. The size of the individual accommodation means that there is plenty of room for personal effects. The dining room is a pleasant place to eat. Main meals are served in two sittings and the residents spoken to were happy with this arrangement. There is a choice of two hot meals for lunch and the evening meal, plus a further range of choices available on request. These include omelet, salads and jacket potato with various fillings. The days menu is displayed in the hall. Residents are asked what they would like at each meal time, and are able to see the meals before they make their choice. There is also a good choice available at breakfast time, including cereals, toast and a cooked breakfast. Fresh fruit is made available in bowls in the lounge area. Residents can keep food in the fridge in their bedsit and several residents were seen collecting food from the kitchen for this purpose. One resident spoken to explained that he liked to prepare his own breakfast, keeping fruit juice and cereal in his bedsit and that he would go to the kitchen with a shopping bag to get his supplies. The chef explained that she is aware of likes and dislikes as she meets with all new residents to discuss their preferences and also attends residents meetings. At present their are residents who are diabetic and also one person who requires a fat free diet and the chef is able to cater for these needs. Within the staff team there are nominated dignity champions, who have completed Care Homes for Older People Page 18 of 32 Evidence: specific dementia training and have then lead the staff team in looking at how the dining experience can be improved. The focus has been on how support at meal times can be provided in a discrete way which promotes the dignity of the individual. There is a comments book in the dining room, where residents can write their views about meals or ask staff to write on their behalf and the kitchen staff read this daily and respond to any suggestions made. Excellent feedback was received regarding the meals provided at the home. Comments included; enjoyable well cooked food, good on food and Excellent food. People are able to choose what they have to eat and are also able to retain some independence by keeping food and drinks in their bedsit. Discrete and dignified support is provided to those who need help in this area. Care Homes for Older People Page 19 of 32 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. Staff training, policies and good practise mean that concerns are responded to and residents are protected. Evidence: Copies of the complaints procedure are displayed in the home and there are useful leaflets for people to take away with them asking, how are we doing?. These invite people to share any views regarding compliments, concerns and complaints. Anchor Trust has a telephone free phone number displayed on posters in the home. Any person, including staff and residents can ring this number, anonymously if they wish, to raise any concern and this is dealt with directly by a senior staff member at Anchor Trust. Records are kept of all concerns and complaints, with how this has been addressed and the outcome. One resident spoken to said that she goes to the regular residents meetings and although happy with the care at the home, could voice her concerns if necessary. Feedback from resident and relative CQC surveys confirmed that concerns are listened to and acted upon. Polices are in place relating to safeguarding, adult protection and whistle blowing. The staff training programme includes training regarding protection and abuse and this is also addressed within NVQ (national vocational qualification) programmes which most care staff have completed. The manager is aware of reporting procedures and the role Care Homes for Older People Page 20 of 32 Evidence: of other agencies in addressing any adult protection issue. Robust recruitment practises help to ensure that only suitable staff are employed at the home. Care Homes for Older People Page 21 of 32 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 home is suitable for the needs of the residents, who value the bedsit accommodation provided. Evidence: Eric Morecambe House is situated in a residential area of Torrisholme near to local shops and close to public transport links to both Lancaster and Morecambe. The building is arranged over three floors, with resident bedrooms and communal rooms on the first and second floors. A new lift has been installed at one end of the building and a stair lift installed at the other end. The layout of the building gives direct access to the garden from the first floor and there is also a main entrance door on this floor. There is a call bell system in place and the corridors are wide, with handrails, providing good access for people in wheelchairs or for people who need assistance when walking. Residents bedsit rooms are on the first and second floors. All have their own en suite facilities of a toilet and wash basin, with a small number having a full bathroom. Each bedsit has a kitchenette area, allowing residents to make their own snacks and drinks. A small number of bedsits have a full kitchen. There are also bathrooms on each floor, fitted with baths or showers suitable for people with mobility problems. Each bedsit has a telephone and residents are given a front door key which doubles as Care Homes for Older People Page 22 of 32 Evidence: a key to their bedsit. The residents spoken to were all very happy with their accommodation, with several mentioning that they liked to be able to make their own drinks, store food and snacks in their own fridge and generally enjoy the independence of having their own self contained bedsit. The main lounge is spacious, with the layout and furnishings splitting the room into different areas suitable for different activities, such as watching television, chatting with friends or doing board games or reading at tables. There is a water dispenser in the lounge, meaning that residents can help themselves to cold drinks at any time. The dining room is well presented and although meals have to be taken in two sittings, the residents spoken to were happy with this arrangement. A maintenance worker is employed for 15 hours each week, helping to ensure that any small repairs are attended to swiftly. There is a large and well equipped laundry and a useful storage room for wheelchairs and equipment. New lounge and dining furniture has been provided and improvements have been made to the outdoor seating area. The hairdressing room is currently being decorated. Improvement plans for the future include a total refurbishment of this room and making the staff sleep in room into a training room. Some of the en suite toilets have been refurbished, with new modern fittings installed. There are plans to gradually upgrade all the en suites as they are quite dated and due for renewal. The lounge ceiling also needs redecoration and this is going to be attended to. Housekeeping and laundry staff are employed and the home appeared very clean. A number of relatives who completed CQC surveys commented that the home is always clean and fresh smelling. Staff undertake training regarding infection control, food hygiene and handling potentially hazardous substances such as cleaning materials. Care Homes for Older People Page 23 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by competent staff who have excellent opportunities to gain qualifications in their work role. Robust recruitment practises help to ensure that only suitable staff are employed. Evidence: At the time of this inspection visit their were 31 people resident at the home with the manager, a team leader and three care staff on duty. There are separate kitchen, laundry, housekeeping, administrative, maintenance and activities staff, meaning that care staff can focus on their support role. At present there are two staff on working duty throughout the night, with another staff member sleeping in and available for emergencies. This arrangement is soon to change and their will be three staff on working duty throughout the night, with a team leader on duty at all times, including during the night. A key worker system is in operation, with details of each persons key worker at the entrance to each bedsit. Details of the staff on duty each day is displayed in the lounge, helping residents to know who will be helping them each day and when their key worker is on duty. This information acts as a useful prompt and is also helpful for visitors and relatives. The manager was advised to consider displaying staff photos as well as the names of staff on duty each day as some residents may find it difficult to remember staff just by their name. This suggestion was also made by a relative who Care Homes for Older People Page 24 of 32 Evidence: completed a CQC survey. Regular staff meetings take place and minutes of these were seen. The care manager, who acts as deputy manager is a qualified NVQ (national vocational qualification) assessor, as is the manager, who is also a qualified NVQ verifier. This has helped a large percentage of the care staff to gain NVQ qualifications. 15 of the 19 care staff, including night staff, are qualified at NVQ in care at level 2 or above. This means that they have had their work practise assessed and have been deemed competent in their work role. The high number of qualified staff indicates that residents are supported by capable and skilled staff. The recruitment records for a recently appointed member of care staff were viewed. Documentation includes an application form, health questionnaire, a record of the interview questions and responses, two references and confirmation that a criminal records bureau disclosure had been obtained. This disclosure included a check against the nationally held list of people who have been deemed unsuitable to work with vulnerable people. These robust recruitment practises help to ensure that only suitable staff are employed at Eric Morecambe House. Staff training is given a high priority. A number of senior staff have undergone specific training which means that they are able to deliver training to staff regarding both fire safety and moving and handling, which includes instruction in using equipment such as hoists. Some parts of the staff training programme are delivered by training staff from the provider organisation, some by distance learning and some by senior staff at the home. The training matrix for the staff team shows that care staff undertake a range of courses, including moving and handling, fire safety, food hygiene, health and safety, dementia and safeguarding. Catering staff have their own training programme called cater craft which is run by the provider organisation Anchor Trust. The five staff who completed CQC surveys all responded that they are kept up to date with new ways of working and that relevant training is provided. To the question what does the home do well? one staff member stated; Provides good care for its residents and looks after its staff. The induction of new staff is well organised. Anchor Trust provide an induction work book which covers agreed induction standards, with the induction period being overseen by the care manager at the home. The induction workbook for a new member of staff, in post for two months was viewed. This staff member confirmed that her induction had included working through the induction standards, specific Care Homes for Older People Page 25 of 32 Evidence: training sessions and shadowing experienced staff. Care Homes for Older People Page 26 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Strong leadership and excellent quality assurance and quality monitoring help the home to maintain high standards. Staff training and good practise help to promote the health and safety of those living and working at the home. Evidence: The manager has worked at the home for 15 years, has held the post of manager for 5 years and is registered with the Commission. Qualifications gained include NVQ (national vocational qualification) level 3, the NVQ assessors and verifier awards and the Registered Managers Award at level 4, which is the appropriate management qualification for managing a registered care home. Anchor trust, the provider organisation arrange regular meetings and training sessions for their managers, which has included training regarding Deprivation of Liberty Safeguards. The care manager, who acts as deputy manager of the home and the team leaders, also carry out certain management duties, such as staff supervision. The management team have regular meetings and minutes of these were viewed. These meetings help to ensure that the management team are working together and are providing consistent leadership to Care Homes for Older People Page 27 of 32 Evidence: staff working at the home. Feedback from staff confirmed that they received good support from the management team, with one member of staff describing the manager as; caring, approachable and listens. There are good quality assurance and quality monitoring systems in place. Feedback surveys are regularly given to residents and relatives and some of these returned surveys were viewed. Friends and relatives are invited to social events, such as a cheese and wine evening, where the manager ensures that she is available to receive any feedback about the service provided. The six monthly reviews for each resident include a pre review questionnaire which addresses areas such as if the person feels their needs are being met, how do they find the attitude of staff and are they satisfied with the meals. Relatives are also invited to these review meetings and are able to voice their opinions about the quality of the service. Regular newsletters keep all parties up to date with any changes or developments. There is a comments book in the dining room, where residents can write their views about meals or ask staff to write on their behalf and the kitchen staff read this daily and respond to any suggestions made. The chef also meets with all new residents and attends residents meetings, giving good opportunity for residents to make suggestions about the menu. Anchor Trust has a telephone free phone number displayed on posters in the home. Any person, including staff and residents can ring this number, anonymously if they wish, to raise any concern and this is dealt with directly by a senior staff member at Anchor Trust. The organisation also has a system of regular checks and audits which the manager at Eric Morecambe House carries out. The strong management of the home and the good quality assurance systems have been consistently applied and maintained since the last key inspection, all helping to ensure that high standards are delivered. Where possible people take care of their own finances, or a relative or representative may take on this responsibility. The provider organisation has clear policies and procedures regarding any money held in safekeeping for those living at the home. Clear records were viewed, showing all income and expenditure and a receipt is always given regarding any money left by a relative. Regular checks and audits take place, which help to ensure that the agreed procedures are followed and that any money is securely held. A system of formal, recorded staff supervision is in place. The team leaders and the care manager conduct supervision meetings with care staff approximately six times a Care Homes for Older People Page 28 of 32 Evidence: year. Regular informal supervision also takes place as part of day to day management of the home. A new member of staff was spoken to and confirmed that they had been well supported during their introduction to care work and that advice from senior staff is always available. The induction and staff training programme includes training relating to health and safety issues. The training matrix for the staff team shows that refresher training is also provided. Recent health and safety visits by Lancaster City Council have not highlighted any areas for improvement and this includes an inspection of the kitchen by environmental health staff. Reports from these visits were viewed. All radiators are guarded to prevent any accidental contact with the hot surface and water temperatures are thermostatically controlled and regularly checked. The kitchen staff take responsibility for health and safety in the kitchen and monitor fridge and freezer temperatures to ensure that food is safely stored. Each month one of the health and safety policies becomes focus of the month with an audit for the manager to complete. This helps to ensure that agreed policies are put into practise and are being consistently adhered to by staff. Anchor Trust the provider organisation carry out a thorough health and safety check of the home every two years. A medication audit is carried out each month. Individual fire evacuation plans are in place for each resident at the home and records of the emergency lighting system and fire alarm being regularly tested were seen. Portable electrical appliances at the home have not been tested for some time as a new contractor has been commissioned to do this work. It is important that this check takes place as soon as possible. Care Homes for Older People Page 29 of 32 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 30 of 32 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 7 There should be clear records kept of the monthly review of care plans as this will help to ensure that all identified needs have been reviewed. Two staff should check and sign all handwritten medication records as this will help to ensure that the record is correct. 2 9 Care Homes for Older People Page 31 of 32 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). 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