CARE HOMES FOR OLDER PEOPLE
Assessment & Rehabilitation Centre Clifton Avenue Blackpool Lancashire FY4 4RF Lead Inspector
Kevan Royston Announced 2 August 2005 10:00 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. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Assessment & Rehabilitaion Centre Address Clifton Avenue Blackpool FY4 4RF 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) 01253 477855 Blackpool Borough Council Judith Anne Buffham CRH Care Home 25 Category(ies) of OP Old Age 25 registration, with number of places Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: The service should provide assessment and rehabilitation (intermediate care) for person 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 experineced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 23 November 2004 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 & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection and took place on the 02/08/05 over a period of 5.00hrs. Discussion with the registered manager senior carer, health and social work professionals, care staff and residents contributed to the inspection process. Questionnaires were sent to relatives, staff, social workers and GP surgeries to comment on the standard of care provided by the home. A tour of the premises took place and examination of documentation formed the basis of the visit. Records of three staff were examined. What the service does well: What has improved since the last inspection?
All the requirements from the previous inspection in relation to recruitment procedures and availability of documentation for inspection has been addressed, ensuring proper checks are now in place and recruitment records are available for examination. All pipework has now been guarded to make sure the residents are safer from accidents. The responsible individual of the home now visits monthly and provides a report to both the manager and CSCI (Commission for Social Care Inspection) on the standard of care provided by the home. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 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. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 The admission and assessment procedures were clear to ensure the care needs of residents are met and residents are assessed properly for intermediate care in order to rehabilitate to live an independent life as possible. EVIDENCE: The records of residents admitted had full assessment information and what support they required in order to return to independent living. Staff members confirmed they had access to this information and could describe in detail the care needs of residents. One staff member spoken to said “The initial assessment indicates what health care is required to support the individual during their stay at the centre” A resident commented on the programme by saying “Its really helped me and made me feel confident again” Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 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 standard(s) The core standards were not assessed. EVIDENCE: Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 10 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) The core standards were not assessed. EVIDENCE: Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 11 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 and 18 The arrangements for recording and reporting of complaints are good ensuring people feel listened to. Staff has good knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure and staff and management spoken to are aware of the complaints process ensuring the complaint is properly investigated. Records of complaints investigations with outcomes are up to date there have been two internal complaints since the previous inspection. One resident spoken to knew who to complain to and said, “I know the process for complaints here at the centre”. There is a procedure in place for dealing with allegations of abuse. The registered manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff spoken to confirmed they had received training in there induction. One commented “I covered abuse when I was on my induction training.” Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 12 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) 19,25 and 26 The home was clean and tidy and maintained to a good standard ensuring the residents comfort and safety. However further redecoration and refurbishment is required to provide a homely environment. EVIDENCE: A tour of the building found the home to be clean and tidy. The home is maintained to a good standard and examination of maintenance records and discussion with the maintenance person showed there is a rolling programme of general repairs and renewal of the premises ensuring the safety of the residents is maintained. A staff member commented, “All the radiators are now covered and general upkeep of the building is ongoing.” The water temperature is checked every two months; the maintenance person ensuring the safety of the residents is maintained confirmed this. The home has a separate laundry with policies and procedures in place to control the risk of infection. Domestic staff is employed to ensure the home is kept clean.
Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 13 Observation of some resident rooms and communal areas found further redecoration and refurbishment is still required with some call bell systems in need of replacing to make sure the residents feel comfortable and safe. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 14 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) 27,29 and 30 The procedures for the recruitment of staff are robust therefore provide the necessary safeguards to offer protection to the residents. The numbers of staff on duty were satisfactory to meet the needs of residents. Professional health and social care staff well trained provide the support to offer the residents the Care required to return to independent living. EVIDENCE: Records show training is ongoing and the home now has over 50 staff that has completed NVQ (National Vocational Qualification) level 2 in care to meet the required standard and provide staff with the necessary skills to carry out there role at the home. Staff spoken to commented on the extensive induction training given One staff member said, “training is very good at the home and we have good access to any courses relating to our job we wish to attend” A resident spoken to added, “There are trained physiotherapists here who gives me the confidence to attempt to get better when they are helping me” The recruitment procedures had been reviewed and any staff would not commence employment without the necessary recruitment checks being undertaken to ensure the protection of residents living at the home. Three staff records examined confirmed all the necessary checks are in place including references, a CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) being received before the staff member could commence working at the home. Staff photos are on each file. Staff records are now available for inspection ensuring examination of the proper employment procedures are in place. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 15 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) 33,35 and 38. The home is well managed and run in the best interests of residents ensuring their safety and protection. EVIDENCE: The registered manager has completed the necessary qualifications required by the National Minimum Standards in management and care therefore has the necessary competences to manage and support the staff and residents. One staff member said, “The manager is very understanding and helpful” Another commented “I have regular supervision and the management are approachable at any time.” A resident said, “ The manager is nice you can always talk to her” Inspection of records indicated regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety of residents and staff is maintained. This was confirmed by discussion with the maintenance person who said, “Fire checks are done weekly”
Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 16 The registered manager has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. Visits required by regulation are now taking place and a report sent to CSC1 (Commission for Social Care Inspection). This means a responsible individual of the home must visit monthly and comment on the care and support provided to staff and residents and a report to CSCI and the manager. Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 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 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 4 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x 3 3 Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 18 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 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. Refer to Standard Good Practice Recommendations Assessment & Rehabilitation Centre F57 F09 S33553 Asessment & Rehab V169560 020805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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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