CARE HOMES FOR OLDER PEOPLE
Across the Bay 479 Marine Road Morecambe Lancashire LA4 6AF Lead Inspector
Ajam Auckburally Unannounced 19th April 2005 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 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 F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Across the Bay Address 479 Marine Road, Morecambe, Lancashire. LA4 6AF Telephone number Fax number Email 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 Mr Haslam and Mrs Bailey CRH 24 Category(ies) of OP Old Age 24 registration, with number of places Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th November 2004 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 within walking distances. The home can accommodate a maximum of 24 residents, 14 single and 5 double rooms. Most of the bedrooms are 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. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on 19th April 2005 and lasted for 4.5 hours. The inspection was an unannounced one and was the first of two inspections to be carried out this year. At the time of the inspection there were 3 care staff, a cook and the owners of the home on duty. There were 18 residents at the home at the time. The inspection was carried out in friendly manner and with the full cooperation of the providers, the staff and the residents. Some of the residents who have been at the home for a few years welcome the inspector. They said that they were well cared for and were treated with respect and dignity. The home was inspected against the National Minimum Standards for all the people as set out by the Care Standards Act 2000. What the service does well:
The owners complete a form when someone wants to come to stay at the home. The form has questions about the person’s details such as name, address, doctor, medications, next of kin. This form include information about the type of care and how much help someone may need. The home has a group of staff who have worked at the home for many years. They are very experienced in caring for the residents and provide familiar faces in the home. The residents spoken to said that they like all the staff as they are kind and helpful. There are enough staff on duty at the home to make sure that all the residents needs are met. In the morning, there is an extra member of staff on duty to make that no one is rushed. There is always a minimum of three care staff on duty. The staff rotas were looked at and they confirmed that staffing level is good. A varied programme of activities is provided. It includes weekly exercises, film shows, entertainers and other activities as requested by residents.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 9 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 standard(s) 3 The arrangements for admitting residents to the home are good. When possible, the staff will visit people in their own homes or in hospital before they come to stay at the home. Details of their requirements and personal information are recorded. If the staff of the home feel that they would not be able to provide all round care for a person then they would not admit this person. This could be because the person needs nursing care and the staff are not experience in providing nursing care EVIDENCE: The staff use an ‘admission booklet’ to record information about the person who is coming to stay at the home. This will include personal information and details of the care required. Once a new resident has been admitted, then more detailed information about specific needs and strengths of the resident is taken and recorded. The records of three residents were examined and they showed clearly that as much information as possible is recorded and progress is reviewed regularly.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 10 The staff spoken to were able to describe how they meet the needs of the residents. They said that all the residents are treated as an individual and that they provide care to meet assessed needs. Some of the residents spoken to said that they remember being asked questions when they were admitted. The staff said that families and other health professional such as doctors, nurses also provide information where appropriate. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 11 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 standard(s) 7 and 8 Care plans are kept up to date and in good order meaning that the residents are provided with care that is individual to their particular needs. Any person living at the home has access to all Health Care Professionals and their needs are met. EVIDENCE: The records of 3 residents were looked at and they showed clearly that care provided is according to assessed needs. The staff said that they are involved in writing in the care plans and also in reviewing them. Some of the residents said that they do not understand about care plans but said that they are very well looked after and that all their needs are met. One resident said “ I have lived here for many years and I am so happy. Everyone is so kind.” Another resident said that she came in for short term care several months ago and decided to stay permanently. The residents’ files clearly show when other health care professionals have been involved. Doctors and nurses visits are recorded.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 12 The owners said that in most instances, the doctors, opticians, dentists will visit the home to see their patients. They said sometimes, a resident may wish to go the surgery to see the doctor and when this happens, a member of staff will accompany the resident if he/she wishes it. Unless residents insist on going to hospital appointments unaccompanied and they have been assessed as being safe to do so, they are always escorted by a member of staff. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12 and 13 There is a range of social activities arranged for the residents. Families and friends of the residents can visit without restrictions. Visits to and from local churches of all denominations are actively encouraged. Residents at the home can live as active a life as they want and also as independent as they want. EVIDENCE: One resident who was going out during the inspection, thought that she would miss the weekly session of light exercises, but was pleased to learn that the exercise class was to be held the next day. Other residents said that they enjoy the weekly exercises sessions. There was a poster on the wall next to the lounge informing residents of the film to be shown this week. The staff said that the film shown are mainly old musicals and that the residents enjoy them. Residents are involved in choosing from a selection of films. Other activities include bingo, card games and a singer who visits every 6 weeks. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 14 Some of the residents said that the staff will help them do what they want. As the home is right opposite the sea front, some residents like to sit out and watch the sea and the people go by. The owners have bought new chairs and tables for the patio area at the front of the home. They also said that they are in the process of purchasing a camper van which can be used to take residents out. The van will have a tail lift which will enable residents with mobility problems to go out. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 16 Complaints are handled with sensivity and residents appeared to be at ease with staff. Residents felt safe and able to talk to the staff if they have any worries. EVIDENCE: The home has a detailed complaint’s procedure and a copy is displayed in each bedroom. One resident said “ I have nothing to compare with, but I have no complaints and I am very happy living here. Comments from two relatives who were visiting the home were positive. They said that they couldn’t fault the home in any way. They added that everyone was kind. One complaint was received by CSCI last year and it was upheld. This was regarding the poor procedure for recruiting staff. This procedure has now been tightened. The owners had started a new member of staff without doing the necessary police checks, taking up references and following their own recruiting procedures. Most of the residents spoken to were not fully aware of the complaint’s procedure but said that if they had any complaints, they would speak to the staff. They said if they have had any worries, that staff have sorted them out.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 16 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 standard(s) 0. Taking into account the age and type of the building, the home provides an adequately safe environment for the residents to live in. Some improvements are still required. The home is clean and free from hazards. Residents live in a safe and clean home. EVIDENCE: There is an ongoing programme of redecoration of the bedrooms and communal areas. Bedrooms are usually redecorated when they become empty. Carpets have been ordered for the lounge area. The chairs in the lounges are to be reupholstered. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 17 Residents’ bedrooms and communal areas were found to be clean and free from hazards. Low heat covers have been fitted only to a few radiators. There is a requirement that all the heating radiators are fitted with these covers as soon as possible. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The home provides an adequate number of experienced staff to care for the residents. The procedures for employing new staff has been tightened and ensure that all checks are done. Residents are cared by a dedicated team of staff and by new staff who have been recruited according to stricter checks EVIDENCE: The home employs a total of 15 staff and some of them have been working at the home for many years. The residents were very positive in their comments about the staff and it was evident that there is a good atmosphere in the home and that everyone gets on well together. The duty rotas were checked and they showed that during all the shifts, there is an adequate number of staff on duty and one of whom is a senior staff. The owners of the home also work at the home. The morning shift has one more acre staff than recommended and the staff said that this help them do their job without rushing the residents. There were 3 care staff, the owners and a cook on duty at the time of the inspection. The residents spoken to said that there is always a member of staff around when you need one. They added that the staff are kind and helpful.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 19 The policy for employing new staff has been tightened up following an incident of poor practice last year. The owners now make sure that new staff fill an application form, are interviewed, references taken and police checks done before they start work at the home. The records of the last member of staff employed at the home were examined and they showed that POVA (Protection Of Vulnerable Adults) and CRB (Criminal Records Bureau) checks were made before the staff started work. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 There was a good ambiance in the home and residents appeared to be happy and content. Financial procedures protect the residents and their money and property. Residents can look after their own financial affairs if they want otherwise the owners can do this for them and will keep appropriate records. EVIDENCE: The residents spoken to said that they can do what they want and that the staff will provide assistance if they need it. They said that nothing is too much trouble for the staff. They said that if they want to go out or go shopping, the staff will take them.
Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 21 The residents said that there are no rules and that they can get up or go to bed when they want. Their visitors can visit at any reasonable time. The owners said that if the residents want see them to discuss anything, they are always available to talk to them. Residents are encouraged to look after their finances. Most of the fees due to the home are paid by direct debits or by families. Small amount of money is held by the owners on behalf of some of the residents. These residents are not able to handle any money due to their poor mental state. Monies held are used to pay the hairdresser or purchase items as required by the residents. Appropriate records of monies held are kept and these were checked and found to be accurate. Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION x x x x x x 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 3 x 3 x x x Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 23 yes 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. 1. Standard 25 Regulation 25 Timescale for action All central heating radiators must 30/11/05 be fitted with low heat surface covers Requirement 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. 3. Refer to Standard 28 31 23 Good Practice Recommendations 50 of care staff should achieve NVQ level 2 by 2005 One of the owners should complete the Registered Managers Award by 2005 Some areas of the home need to be upgraded Across the Bay F57-F09 S9668 Across the Bay V219071 190405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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