CARE HOMES FOR OLDER PEOPLE
Across The Bay 479 Marine Road Morecambe Lancashire LA4 6AF Lead Inspector
Mr Ajam Auckburally Unannounced Inspection 13th December 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Across The Bay Address 479 Marine Road Morecambe Lancashire LA4 6AF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01524 410625 01524 410625 info@acrossthebay.co.uk Mr John Graham Haslam Mrs Jennifer Mary Bailey Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th April 2005 Brief Description of the Service: Across the Bay is a registered home for older people and is situated in Morecambe. The home faces the sea front and is close to Happy Mount Park. Other amenities such as shops and the post office are nearby, but still too far for most of the residents to reach due to their frailties. The home can accommodate a maximum of 24 residents in 14 single and 5 double rooms. The double bedrooms are mostly used as singles unless people wish to share. The home is a five-storey building and a passenger lift is available to access all the floors. Communal facilities include two lounges on the ground floor and a dining room on the lower ground floor. There were 18 residents at the home at the time of the inspection. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This statutory inspection was the second of two to be carried out this year. The inspection took place on 13th December 2005 and was an unannounced one. It lasted for 4 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection was carried out in a relaxed atmosphere with the full cooperation of the owner, the staff and all the residents. The inspection took the form of looking at some of the records, talking to the residents and the staff and checking the building. There were 18 residents at the home and they said that they were well cared for and that all the staff were kind and helpful. What the service does well: What has improved since the last inspection?
A new disabled toilet has been installed on the ground floor. The residents and the staff said that the toilet is easy to use with plenty of room. New carpets have been fitted to the lounges and hallway. All the central heating radiators have now been fitted with low heat covers. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The home does not provide intermediate care. The other core standard was assessed during the previous inspection and was met. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 10 Medication policies and procedures are robust. Practices to respect residents’ privacy are good. Residents have their privacy respected and their medications are dispensed in a safe manner. EVIDENCE: The residents said that the staff respect their privacy by allowing time on their own. They said that when they are in their rooms, the staff always knock before entering. The staff were observed providing personal care like toileting behind closed doors. The staff spoken to said that they treat all the residents with respect and dignity. They were heard speaking to the residents with kindness and patience. The inspector observed the senior care staff dispensing medications to the residents. This was done according to procedures.
Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 10 The records of medications were examined and they were found to be correct. An audit trail of the medications of one resident was done and this was found to be accurate. The owner was aware that medications following the death of a resident should be kept for a week in the event that a post mortem is carried out. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 There are good practices to encourage residents to remain active and afford them choices. Food and nutrition are important aspects of the home. Residents are given choices in their daily activity and have good food. EVIDENCE: The residents said that they can have as much independence as they want and that the staff help them when they need assistance. The owner said that the policy of the home is to encourage residents to remain as independent as they want. Residents were observed doing their own things. Some were in the lounge and others were in their rooms. They said that they are able to remain as independent as they want or able to. They said that staff are helpful and will provide assistance when required. The staff spoken to said that although residents are encouraged to retain their independence, they are not forced to do anything. They can choose when to go to bed and when to get up. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 12 The records of meals served were examined and they show that a variety of food is provided. A choice of food is not provided at lunchtime when the main meal of the day is served. However, the owner said that if a resident does not like something, a substantial alternative is provided. She said that she knows the likes and dislikes of all the residents. A choice of food is provided for breakfast and teatime. The owner was advised to widen the choice of food provided at teatime. Although residents can have what they want at teatime, the record of meals examined showed that sometimes only toasted teacakes are offered. The resident said that the food is good and that they get plenty to eat and drink. There is no cook in post and the owner has to do the cooking at the moment. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Policies and procedures on abuse are thorough. Residents feel safe and protected. EVIDENCE: The owners have produced a stringent and detailed written policies and procedures on adult abuse. The owner and the staff have had training on adult abuse. The owner was able to describe accurately the steps she would follow in the event of an abuse to a resident. The staff spoken to said that they would never abuse any resident in their care and that they would report if they saw any form of abuse. The residents said that they feel safe and secure living at the home and that everyone treat them well. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Both core standards were assessed during the previous inspection and were met. EVIDENCE: New carpets have been fitted in the two lounges and hallway. A new disabled toilet has been fitted on the ground floor. The residents said that they found it easier to access and use. All the central heating radiators have now been fitted with low heat surface covers. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30 A well-selected and caring team of staff care for the residents. Residents feel safe and are well cared for. EVIDENCE: Most of the staff have been working at the home for a long time and the residents said that they feel safe and well cared for by them. One resident said “ the staff listen to you when you speak to them. They are a great bunch and will do anything for you.” There is always a good atmosphere in the home and residents and staff get on well together. The residents said that the staff care for them with respect and that they feel safe with them around. They said that they do not feel afraid to speak up or to ask for anything. All new staff are given induction training, which provide them with basic skills to care for the residents with respect and dignity. The level of care staff that have completed their NVQ level 2 and above has reached 37 . This should reach 50 . Other training courses staff have attended are:
Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 16 First Aid Medications Stroke Awareness Food Hygiene Health and Safety Moving and Handling Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 A team of competent staff manage the home. The home is run to serve the best interests of the residents. EVIDENCE: The owners of the home have worked at the home for several years and are very experienced in caring for the residents and managing the home. One of the owners is currently doing her NVQ 4 and the Registered Manager’s Award. The staff said that the owners are very supportive and help them do their work efficiently. The residents said that the owners are kind and helpful and that they are always available to see them. The residents said that they feel safe living at the home. They said that the staff are very caring.
Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 18 Staff training such as Moving and Handling, Fire Safety, First Aid, Food Hygiene and Infection Control are given to ensure the health and well being of the residents. Risk assessments of the building are carried out to ensure that the home is safe and that there are no hazards which could hurt the residents. Every resident is risk assessed to ensure that care provided is tailored and safe. Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP28 OP31 Good Practice Recommendations 50 of care staff should achieve NVQ level 2 One of the owners should complete the Registered Managers Award Across The Bay DS0000009668.V270313.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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