CARE HOMES FOR OLDER PEOPLE
Cleveleys Nursing Home 19 Rossall Road Thornton Cleveleys Blackpool FY5 Lead Inspector
Ruth Edgington Announced 8 June 2005 9.30am
th 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. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Cleveleys Nursing Home Address 19 Rossall Road, Thornton Cleveleys, Lancashire, FY5 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 865550 01253 866589 Manor Homes (Poulton) Limited Mrs Elaine Lowe Care Home with Nursing 32 Category(ies) of OP 20, PD 6, TI 6 registration, with number of places Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1) The home is registered for a maximum of 32 service users to include: Up to 21 service users in the category of OP( Older Persons over the age of 65 years) Up to 6 service users in the category of PD(Physically Handicapped) Up to 6 service users in the category of TI (Terminally Ill) 2) The service should employ a suitably quailified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 7/12/04 Brief Description of the Service: Cleveleys Nursing Home is registered to accommodate a maximum of 32 elderly persons. 6 beds may be used for residents with a physical disability and 6 beds may be used for residents with a terminal illness. The home is situated in a residential area of Cleveleys and is close to local amenities and within walking distance of the seafront. The home was purpose built and the accommodation consists of 3 double bedrooms and 26 single bedrooms, 8 of which have ensuite toilet facilities.There are lounge and dining room areas on the ground and first floor and there is a no smoking policy throughout the home. A passenger lift is available and aids are provided throughout the home to assist residents as required. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and started at 9.30am and took place over 6 hours. The Inspector spoke to numerous staff members, the management and two visitors. The Inspector spoke at length to five residents and many more during the tour of the home. Comment cards were received from four residents and a GP. One resident also wrote a very complimentary letter to the Inspector before the inspection. Resident’s care records and staff files were examined and a tour of the home was undertaken. The Inspector also used the information provided by the homeowner in the pre-inspection questionnaire, to gain evidence of the care and service provided. What the service does well:
This is a care home where residents are well looked after. The staff team work well together and show a good understanding of the needs of the people living at the home. Care documentation was well written and very comprehensive. A number of the residents spoken to have lived in the home for many years and they said that they would not want to live anywhere else. One resident said that their relative had chosen the home for them and the resident felt that they could not better it. The assessment and ongoing review of care is thorough, which makes sure that the residents’ care needs are being met. The care plans are well written and contain details of any specific intervention required. All care plans are reviewed monthly or more frequently if there are changes to the needs of the residents. Residents spoken to said that they were involved in any decisions that affected their care and daily living. Meals are based on good home cooking, they are varied with an alternative available if required. Residents were pleased with the choice and variety available. One resident commented that, ‘nothing was too much trouble for the staff, you only have to ask’. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Visitors spoken to during the inspection said that the management and staff were very supportive and made sure that they were kept up to date with any changes.
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 6 The staff team are well trained and confirmed that they are supported by the management and felt valued. 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
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 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 Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 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 admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of three residents were examined and were found to contain full assessment information that had been obtained prior to admission, therefore ensuring that the home could meet these needs. Residents confirmed that they had been involved in their assessment and were happy that their needs were being met by the home. The staff spoken to were well aware of the care needs of the individual residents and this was confirmed during the inspection through observations of the care practices being carried out. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 10 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, 8 and 10 Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident and contain very comprehensive information relating to all aspects of health, personal and social care needs of the residents. From this information an individual plan of care is drawn up with the involvement of the resident or their relative to ensure that the care needs are met. Significant events had been recorded and daily entries made setting out the care given. The records of three residents were looked at in detail and these very clearly described the healthcare needs of the residents. Evidence was seen of the monthly reviews carried out to ensure that the care plans continue to meet individual needs. Residents spoken to confirmed that they were involved in all aspects of their care and that the staff were very good and anything they wanted they only
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 11 had to ask for. A relative spoken to during the inspection also confirmed that they were kept informed of anything that affected the care and that the staff were very supportive and caring. During the inspection the Inspector observed the caring approach of all the staff towards the residents and was able to confirm that the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. At the time of the inspection the condition of one resident deteriorated and medical attention was required urgently. The Inspector was able to observe the steps taken by the management and staff to obtain medical assistance and the transfer of this resident to hospital. All this was done in line with good care practices. The Inspector was also able to confirm that the relative of this resident was contacted immediately and offered support by the management and staff. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 12 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) 12,13,14 & 15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact promoting personal relationships. EVIDENCE: The resident’s involvement in social activities varies greatly according to their abilities and nursing needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The Inspector spoke to residents who were being taken out shopping by staff. This was arranged on an individual basis and the residents confirmed on their return to the home that they had enjoyed their outing and were eager to show off what they had purchased. One resident said that they were looking forward to going to a Mario Lanza concert that was due to take place locally. The Inspector spoke to the cook and looked at the menus in operation, which were varied and provided a balanced diet. The cook confirmed that she was informed at the time of admission of any dietary needs that residents had and this was recorded and available at all times.
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 13 The residents spoken to said that they enjoyed their meals and that if they wanted something special it was got for them. One resident had requested fillet steak and this had been provided. One relative informed the Inspector that they visited every day except for one and that on a Sunday they are given their lunch, which they enjoy. They stated that they had been offered lunch on other days but declined. Visitors are made very welcome and the Inspector was able to observe a large number of visitors coming and going freely and the friendly way in which they related to the management and staff. One relative who visits daily spoke very highly of the staff and the care provided. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 14 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 & 18 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents and relatives spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. There have been no complaints received since the previous inspection. The home has a procedure in place for dealing with allegations of abuse. The management 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 are encouraged to attend appropriate training course to help them understand all areas that could be seen as abuse. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 15 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, 20, 21, 22, 23, 24, 25 &26. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely and safe environment. EVIDENCE: This was the first inspection to the home by the Inspector therefore a full tour of the home was undertaken. The home which is purpose built was found to be accessible, safe, maintained to a high standard and free from any offensive smells. Since the previous inspection the ground floor bathroom has been updated and re-tiled, five en-suite toilets have been upgraded. Since the previous inspection the management have spoken to the Tissue Viability Nurse from the hospital who visited the home and offered advise about beds and pressure relieving mattresses and pillows. As a result a full
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 16 audit was carried out and two new electronic beds have been purchased and numerous mattresses and cushions have been replaced. The majority of bedroom floors are fitted with wooden flooring, which is easier to keep clean and free from smells. One resident spoken to said that the wooden floors were better, but that they had been asked if they would like a carpet, which they declined. A large number of residents have been in the home for many years and this was evident by the individuality of the rooms and the possessions in them. The Inspector noted that one bedroom contained very few possession and pictures had been taken down, but was informed that this was their choice. Aids are provided around the home to assist the staff with caring for the resident and also to encourage independence where ever possible. A passenger lift provides access between all three floors and the inspector observed residents using this independently. The Inspector also noted that a very small lift operates between the floors specifically for the transportation of meals to those resident who prefer or need to have their meals in their rooms. Radiators throughout the home have a guaranteed low temperature surface to protect residents from the risk of burning. Hot water temperatures throughout the home are checked and delivered at a safe temperature in line with health and safety guidelines. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 17 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, 28, 29 and 30. Staff are well trained to ensure they have the competencies to meet residents needs. The deployment of staff throughout the day is sufficient to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: The Inspector examined five staff files and found that they contained all the information required, confirming that the recruitment procedures had been followed. The Inspector examined the rotas and found that the staffing levels were sufficient for the number of residents in the home and to meet their needs. Training is very high on the agenda and very comprehensive records are kept of the training undertaken by staff. Staff spoken to informed the Inspector of the training that they had done. They stated that they are encouraged to attend courses and given the time and support to do this. The Inspector observed the positive manner of the management in their reaction to staff who had just completed their (National Vocational Qualification) NVQ training and was able to read the feedback from the NVQ Assessors in relation to individuals who had completed the course. Staff spoken to said that they were clear about their role and work well as a team to ensure the individual and collective needs of the residents are met.
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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) 31, 33, 36 and 38 The home is well managed and run in the best interests of residents. EVIDENCE: Since the previous inspection the manager has been registered with the Commission for Social Care Inspection. She is a qualified nurse who has many years experience in caring for residents. Throughout the inspection the Inspector was able to evidence the professional, capable and approachable manner in which the manager undertook her role when dealing with residents, staff and visitors. The manager is aware that she must obtain a management qualification and enquiries have been made in order that she can commence an appropriate course in the near future. Residents, relatives and staff spoke well of the management team and the care and support that they give. Staff said that the manager provided a clear sense of leadership.
Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 20 As part of the inspection residents and relatives were provided with questionnaires to complete it they wished. The comments received were very positive and complimentary. One resident also wrote a letter to the Inspector, which was very complimentary about the care provided by the management and staff. The home has good systems in place to gather staff, residents and relative’s views as part of the monitoring of quality. Staff spoken to had a clear understanding of their role and what was expected of them. The Inspector saw documentation that confirmed that staff received regular supervision and annual appraisal. Residents, relatives and staff spoke well of the management team and the care and support that they give. The Inspector was able to witness their approach to the residents and staff and confirm that comments made. Inspection of resident’s records found that they were comprehensive, well written, up to date and reflected the care being given.. Information provided in the pre-inspection questionnaire stated that all safety equipment is regularly serviced. The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 21 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 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 2 x 3 x x 3 x 3 Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 22 No 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 None 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 31 Good Practice Recommendations The registered manager should hold a qualification to NVQ level 4 in management. Cleveleys Nursing Home F57 F09 S6032 Cleveleys Nursing Home V184585 V3 080605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Unit 1 Tustin Court Portway Preston, PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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