CARE HOMES FOR OLDER PEOPLE
Assessment and Rehabilitation Centre Assessment and Rehabilitation Centre Clifton Avenue Blackpool Lancashire FY4 4RF Lead Inspector
Mr Kevan Royston Unannounced Inspection 10th December 2005 09:30 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 Assessment and Rehabilitation Centre DS0000033553.V263583.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. Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Assessment and Rehabilitation Centre Address Assessment and Rehabilitation Centre Clifton Avenue Blackpool Lancashire FY4 4RF 01253 477855 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) Blackpool Borough Council Judith Anne Buffham Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The service should provide assessment and rehabilitation (intermediate care) for persons over 65. Staffing to be provided in accordance with the residential forum staffing guidance by April 2004. The service should at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 2nd August 2005 Date of last inspection Brief Description of the Service: The Assessment and Rehabilitation centre provides care and support for 25 older persons to enable people to live as independently as possible following a rehabilitation programme. The staff team consists of health and social work professionals to assess and rehabilitate persons over a period of approximately six weeks. The home consists of two floors with a passenger lift for access. There are lounges situated on both floors and treatment rooms with aids and adaptations to assist the staff to rehabilitate the residents. All the rooms are single occupancy with shared bathroom and toilet facilities on both floors in sufficient numbers to meet the needs of the residents. There is a dining area and spacious grounds to the front and rear of the building with seating available and wheelchair access. Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on the 10/12/05 over 4 hours and was unannounced. The Inspector spoke to the manager in charge, staff, three residents individually and a group of residents together. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these people are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection. What the service does well:
The staff team consists of health and social care professionals available at the home daily ensuring the residents get expert care and support. One resident said, “Its good we have a physio at the home all the time.” Staffing levels at the home are high enabling more time to spend with each individual. A resident spoken to said, “The other day there was more staff in the dining room than residents.” Residents spoken to said the food was very good and a choice is given. Meals at lunchtime contained fresh meat and vegetables to make sure a healthy diet was provided. The chef spoken to said, “I always use fresh vegetables.” Comments from residents included, “The food is great we are lucky to have good cooks.” “Good home made meals and always a choice.” Another commented, “We get good lots I have put weight on since arriving here.” A member of staff was observed baking home made cakes and appropriately dressed for cooking ensuring proper hygiene and food safety procedures were being followed. . Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Assessment and Rehabilitation Centre DS0000033553.V263583.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 Assessment and Rehabilitation Centre DS0000033553.V263583.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): This section of standards was not assessed. EVIDENCE: Assessment and Rehabilitation Centre DS0000033553.V263583.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): 7,8,9 and 10. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. EVIDENCE: Records of three residents spoken to were examined and accurately reflected the individual’s health and social care needs. Care plans were up to date and regular reviews taking place every two weeks outlining any changing health needs required. And records of the residents were easy to follow with risk assessments completed and aims and objectives set out throughout the programme ensuring the residents are aware of their progress during there stay. One resident spoken to said “I know how much I can do with my walking and the staff are so helpful, my daily exercise programme will improve me so I will feel more confident when I leave here”. Medication practices observed were safe and good records had been kept ensuring residents health is maintained. Medication was being administered and the inspector observed the procedures were being followed ensuring the correct medication is being administered. The manager spoken to said, “Only trained staff administers medication.” Records examined confirmed self
Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 10 medication forms had been signed by some residents enabling them to be responsible for there own medication needs. Observation, examination of records and speaking to residents confirmed they are encouraged to control their own lives with help if required. And have access to their own preferred GP. A resident commented, “The staff are great if you want to be left alone thy respect that”. Assessment and Rehabilitation Centre DS0000033553.V263583.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): 12, 13, 14 and 15 Contact with families and friends is encouraged and supported by staff to maintain relationships. Activities suit each individual. Meals are varied and wholesome with choice provided ensuring residents dietary needs are met. EVIDENCE: Lunchtime meals served were seen to be wholesome, home baked with fresh vegetables providing a nutritious meal. Menus examined are balanced and interesting. Meal times are set although flexible enough to accommodate preferences. Residents spoken to commented on the high quality of food at the home. One resident said, “The food is excellent”. Observation at breakfast time and discussion with the chef confirmed cooked breakfast is available. The chef said, “Every morning they can have bacon and eggs”. A resident spoken to said, “Its nice having a proper cooked breakfast in the morning”. The home has a separate kitchen area which residents can use to make snacks and drinks for themselves and visitors. And it is used as part of their rehabilitation programme. Activities are centred on each individual’s preferences and are recorded ensuring flexibility and residents can enjoy their own personal interests. One resident spoken to said “ I enjoy quizzes and try and organise them for the others to play”. Another said, “We have our daily exercise programme which I enjoy”. There was evidence of special events taking place and Christmas
Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 12 activities programmes on notice boards. Staff spoken to said “We go out for a coffee morning every week if the residents want to”. Examination of the homes visiting policy and residents spoken to confirmed visitors are allowed at any time of the day or night. One resident said,” My friends are welcome to come and see me anytime”. Resident rooms seen had evidence of personal belongings, and provided residents with a homely and comfortable environment. Assessment and Rehabilitation Centre DS0000033553.V263583.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): This section of standards was not assessed. EVIDENCE: Assessment and Rehabilitation Centre DS0000033553.V263583.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): This section of standards was not assessed. EVIDENCE: Assessment and Rehabilitation Centre DS0000033553.V263583.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): This section of standards was not assessed. EVIDENCE: Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 16 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): This section of standards was not assessed. EVIDENCE: Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Assessment and Rehabilitation Centre DS0000033553.V263583.R01.S.doc Version 5.0 Page 19 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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