Inspection on 07/11/07 for Assessment and Rehabilitation Centre

This inspection was carried out on 7th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Assessment and Rehabilitation... 27/09/06

Assessment and Rehabilitation... 10/12/05

Assessment and Rehabilitation... 02/08/05

Assessment and Rehabilitation... 23/11/04

Assessment and Rehabilitation... 25/05/04

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 08/07/2008.

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 7th November 2007 10:00 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.V347629.R01.S.doc Version 5.2 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.V347629.R01.S.doc Version 5.2 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), Physical disability (3) of places Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 25 service users to include Up to 25 service users in the category of OP (Older Persons over 65 years of age) Up to 3 service users over the age of 60 years in the category of PD (Adults with Physical Disabilities) 27/06/07. 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. There is a statement of Purpose/Service user Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to stay at the home. There are no charges at the home as this is a Social Services Assessment and Rehabilitation Centre. Extra charges are made for hairdressing and personal items that may vary. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit that took place on the 07/11/07 over a period of approximately 6 hours as part of the inspection process. The Inspector was accompanied by an expert by experience who is a person, who because of their shared experience of using services, visits a service with an Inspector to help them get a picture of what it is like to live in or use the service. The expert by experience observed routines within the home and spoke to a number of residents and staff members. The views of the expert by experience and comments received during the visit have been included in the report. We also spoke to the manager, carers; health professionals employed at the home and resident’s to get their views. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, care records and daily notes this is called case tracking. Other residents are invited to pass their opinions to us if they wish. We had responses from surveys/questionnaires sent to relatives, staff and residents for their views on how the home is run. Comments were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. We use this information, in part, to focus our inspection activity. We looked at recruitment and training records of staff members. We also walked around the building and watched people living and working to see how everyone supported and talked to each other. Looking at documentation, policies and procedures formed the basis of the inspection process. What the service does well: The assessment procedures for admission to the home were very thorough and care plans had been structured to ensure the staff recognise the needs and what is required to ensure each individual has the best opportunity to complete the rehabilitation programme and return to independent living. One resident Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 6 wrote “Overall excellent service”. A relative commented, “I find they do everything possible to assist with the individuals needs that follows on when they return home also”. There are plenty of staff both social and health care professionals working at the home daily and supporting each resident on their individual programme ensuring they get expert care and support. One relative said, “I think it is a marvellous place the staff are second to none”. The manager provides good updated written information they make available to people about the programme and service they provide ensuring potential residents can make an informed choice about going on the programme and what services they provide. Training opportunities for staff is excellent ensuring they are well trained and receive the skills and competencies to provide support for the residents during their stay. Comments from staff included, “No problem to go on any courses”. and, “The manager is always giving out information on training events”. What has improved since the last inspection? What they could do better: Recruitment procedures would be improved if start dates of staff were made clearer on records to ensure all required employment checks were in place prior to commencement of employment. One area identified during the inspection was activities should be improved so residents as well as there individual daily programme of rehabilitation they can enjoy other forms of entertainment and social events. A resident wrote, “More activities would be better”. Also several resident’s spoken to would like extra activities during the day to provide some stimulation. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 7 Medication recorded did not have the name of the medicine administered next to the time of day or night, this should be written in to ensure a further safety check and make sure the correct medicine is being given at the right time to the resident. 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. The summary of this inspection report can be made available in other formats on request. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear and precise to ensure the care needs of residents on the rehabilitation programme are suitable for them to complete the programme and live as independent life as possible. EVIDENCE: Care plans of three residents admitted to the home had full assessment information including the religious/cultural and relationship needs, all accurate assessment information had been provided by health and social care professionals to ensure the suitability of individuals to complete the rehabilitation programme, and return to independent living. One staff member Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 10 spoken to said, “Major input from the health and social work team gives everyone every chance to return home”. We looked at programmes for residents and confirmed staff are deployed from relevant health and social professional backgrounds including, Occupational therapists, physiotherapists, Social workers and care workers supporting the residents during the six week programme to ensure each individual has every chance to return home to manage independently or with support services. One resident nearing the completion of her programme said, “I feel a lot better than when I came”. One member of staff spoken to said, “We try and ensure all individuals have the best support to manage at home”. The rehabilitation facilities looked at are excellent and enough space for aids, equipment and treatment to ensure residents mobility difficulties and confidence building is catered for. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously, resident’s welfare is closely monitored and health needs were met. EVIDENCE: We looked at individual records kept for each resident with a plan of care setting out the action that is needed to be taken by health professionals and care staff to ensure all aspects of health, personal and social care needs are identified and being met throughout the six week programme. Every two weeks a review of care is held outlining any changing health needs required and how the individual is progressing through the programme. Staff members spoken to said, “It works well”. And, “The recent clients admitted are more in need of residential care and rehabilitation is difficult”. One relative wrote, “I find they do everything possible to help the residents”. Records looked at confirm risk assessments are recorded and reviewed to update any changes during the individuals programme. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 12 We saw a qualified member of staff giving out medication and went through the procedure and looked at documentation at lunchtime. Medication practices were safe and good records had been kept ensuring residents health is maintained. One of the documents for resident’s medication did not have the name of the medicine administered next to the time of day, this should be written in to ensure a further safety check and make sure the correct medicine is being given at the right time to the individual. Residents spoken to said the staff team respected their privacy and they could spend time on their own if that was their wish. One relative wrote, “They give each person special and cheerful care that helps them to keep their independence”. Although the resident’s are only staying for a six-week period, we looked into some bedrooms and found some personal belongings such as pictures and ornaments around the room to make it feel like home. One staff member spoken to said, “We like residents to bring things in during there stay”. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed. Activities could be improved to provide further stimulation for residents during their stay. EVIDENCE: Breakfast and lunches were seen being prepared and looked wholesome with fresh produce being used to suit individual tastes. The chef responsible for the preparation of meals and menus was able to confirm they had information about residents with special diets and personal preferences. When spoken to one of the cooks said, “I have done my training in catering and food preparation and I am aware of specialised diets”. Residents have choices at meal times and the chef is prepared to ensure the resident’s eat food they prefer. 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. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 14 Each resident has there own individual programme of rehabilitation that includes a falls and mobility improvement plan, a kitchen is provided with aids for staff to encourage residents to get used to being independent again, and a stairs rehabilitation exercise. These and other rehabilitation programmes are part of the activities for residents and are the responsibility of the health professionals employed at the home. This can sometimes limit the time for structured activities due to each individuals programme, one relative said, “More activities for residents would be good”. The manager and staff should look at ways to improve social events and extend activities to provide more stimulation. Most residents handle their own financial affairs or these are handled by their relatives/representatives. Records being kept in respect of residents unable to manage their own finances were being well maintained. Residents spoken to confirmed visitors are allowed at any time of the day or night. One resident said, “They don’t mind what time my family come”. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: There is a detailed complaints procedure, which is made available to all residents on admission and written in the Statement of Purpose and Service User Guide to ensure they feel protected. Residents and relatives in surveys returned confirmed are aware of the complaints procedure and who to complain to, however have not needed to do so. We looked at records and found there is a procedure and policy for dealing with allegations of abuse and safeguarding adults to protect people living at the home. Records confirmed training was in place for staff to attend safeguarding adult’s courses. One member of staff spoken to said, “I have covered abuse awareness in my training”. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensures residents live in a comfortable, homely, clean and safe environment. EVIDENCE: The home has been well maintained and decorated for the comfort of residents. The maintenance person said, “It is the same system, repairs get reported daily and I keep a check on the building”. Walking around the building we found it to be clean and kept tidy and found some bedrooms have been redecorated. One staff member spoken to said, “ All the bedrooms will be refurbished”. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 17 Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. There are policies and guidance for laundry processes and for the control of infection ensuring the home is kept clean, pleasant and hygienic. The manager is looking into ways to improve the laundry so resident’ clothing does not go missing as some residents spoken to said articles of clothing had been mislaid. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment of a well-trained professional staff team throughout the day is sufficient to meet the needs of residents. Recruitment procedures are robust to ensure suitable staff are employed. EVIDENCE: We looked at the staff rota and observations made throughout the day confirmed staffing levels were sufficient for the number of residents living at the home who require support to complete the rehabilitation programme. Staff members spoken to said, “We have expert staff to help the residents”. And, “There is more than enough staff on duty at any time”. One resident commented, “The staff are very good at what they do”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met throughout the rehabilitation programme. One resident said, “The falls programme run by the staff is good they are well trained in what they do”. Training records confirm all staff members have access to a structured training and development programme linked into Social Services training programmes ensuring the residents are being cared for by a well trained, professional and competent staff team. In addition over 50 of staff members have achieved National Vocational Qualifications (NVQ) to level 2 ensuring the residents are in Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 19 the safe hands of qualified and competent staff. Staff spoken to said of the excellent training opportunities, “There is lots of courses and training on offer”. Also, “We are provided with a lot of training”. One member of staff wrote, “We are offered regular training on all aspects of our job”. The manager has improved recruitment policies to have documentation available for inspection. There are now robust recruitment policies and procedures when employing staff. However to improve records further if start dates of staff were made clearer on records it would ensure all required employment checks were in place prior to the commencement of employment. We looked at records of two staff members and there was evidence of a thorough procedure and checks in place such as application forms, medical checks, Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) disclosures to make sure all staff are suitable to work with people who may be vulnerable. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well, with systems and policies in place for the protection and safety of staff and residents. EVIDENCE: The manager has the necessary skills, qualifications and experience required to support the staff and residents and enable the home to meet its stated aims, purpose and objectives. The manager is well supported by Social Services to run the programme of rehabilitation. Records seen confirmed the manager has access to training to ensure her knowledge and skills are updated. Comments from staff were positive in the way they are supported by the manager one Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 21 said, “She is always willing to discuss things with you, a very supportive manager”. Records show the manager has good systems to gather staff; residents and relative’s views to enable ongoing improvements to the home and any suggestions to improve the rehabilitation programme are taken seriously. Records of residents were comprehensive, well written and up to date ensuring the correct information is available and health and welfare needs are continuously monitored throughout the six week programme. We looked at records and found regular tests to emergency lighting, fire procedures, electrical appliances, the lift and fire extinguishers had been carried out ensuring the safety of residents and staff is maintained. Monthly reports provided by a representative of Social Services are now being completed and kept on file for examination during inspections to ensure there is an overview of the management of the home that can show any developments that are taking place and comment on the running of the home. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 23 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. 1 2 Refer to Standard OP9 OP12 Good Practice Recommendations Medication administered should be recorded accurately to safeguard residents. The routines of daily living and activities should be made available and are varied to suit residents expectations, preferences and capabilities. Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Assessment and Rehabilitation Centre DS0000033553.V347629.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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