CARE HOMES FOR OLDER PEOPLE
Horncliffe House 35 Horncliffe Road Blackpool Lancashire FY4 1LJ Lead Inspector
Mr Kevan Royston Unannounced Inspection 2nd August 2007 09:00 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 Horncliffe House DS0000066898.V342439.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. Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Horncliffe House Address 35 Horncliffe Road Blackpool Lancashire FY4 1LJ 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) 01253 341576 Monami Care Ltd Janet Stemburski Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27/07/06 Brief Description of the Service: Horncliffe House is situated in the south of Blackpool near Highfield Road shopping centre in a residential area close to local bus routes. The home is registered for 24 older people age 65 and over. The building is set in its own grounds with garden areas to the front and back of the premises. Seating is provided for the residents and a ramp is available for wheelchairs at the front of the building. The bedrooms are all en- suite with one double room. There are two lounges and a conservatory with a separate dining area. A lift provides access to the first and second floors and there are toilet and bathing facilities with aids and adaptations fitted for the residents use. The fees at the home range from £344.50 to £370. There are additional charges made for hairdressing and chiropody, which may vary. Horncliffe House DS0000066898.V342439.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 inspection that took place over two days the 02nd and 03rd of August 2007. The Inspector spoke to the manager in charge each day five staff, four residents and a group of residents sitting in the lounge area. The inspection visit was undertaken over a period of two days. 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 persons are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. The response from surveys sent to residents for there views on how the home is run was good, seven completed questionnaires received. Comments were positive about the standard of care and support provided by the staff and management team. No relative surveys were returned at the time of the inspection. Records of two members of staff were also examined. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well:
The home continues to have a settled staff team with little change in staffing since the previous inspection, enabling relationships to develop between staff and residents and provide a better understanding of resident’s wishes and needs. One staff member spoken to said, “The core of the staff have been here for years which helps”. A resident who has lived at the home for a number of years said, “It’s nice most of the staff have been here for a long time you become friends”. Comments and returned surveys from residents said the food at the home was very good with plenty of choice, good home cooking and quality fresh produce used to ensure residents dietary needs are satisfied. Comments included, “No complaints excellent food and plenty of it”. Also, “If you ask for something Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 6 different you get it nothing is to much trouble”. And, “I like fresh fruit and always get it”. Observation of staff helping and talking to residents was good, with staff members helping the residents in the lounge with there nails and sat talking ensuring staff and residents interact and provide a good atmosphere in which to live in. A staff member spoken to said, “Some like to have there nails done they feel better”. And one resident said, “I like to sit and chat the girls are always patient and available”. Surveys sent to residents to comment about the home were all positive. Residents said, “Very satisfied with all the attention”. And “Staff do all they can to make you feel at home”. Also, “The time I have been here I have been helped by all the staff high and low times”. What has improved since the last inspection? What they could do better:
Recruitment procedures would be improved if start dates of staff were made clear on records to ensure all required employment checks were in place prior to commencement of employment to ensure the safety of the residents is maintained. Risk assessments need to be undertaken for two radiators in the home which are not covered or have guaranteed low temperature surfaces. Control measures need to be inplace to ensure the residents are safe and protected from any potential accidents.
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 7 Further redecoration of communal areas and outside of the building should be completed to provide pleasant comfortable surroundings for people to live in. Monthly reports provided by a representative of the Company are required by regulations. These must be 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. There remains a recommendation for the manager to undertake the necessary qualification in management and care which should be completed. Discussion with the manager confirmed this should be achieved this year. 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. Horncliffe House DS0000066898.V342439.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 Horncliffe House DS0000066898.V342439.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were very clear and precise to ensure the needs of the residents are met. EVIDENCE: The records of three residents were examined and had full assessment information recorded in detail. Two of the residents had been funded by social services and been assessed by social workers with information on file for the care staff at the home to develop a care plan to ensure all health, welfare and social needs are identified and recorded. One resident was visited at home and assessed by the management. The resident spoken to said, “The manager came to see me and my daughter and was very nice going through everything”. A staff member spoken to said, “The management take care of assessing new residents.
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 10 Standard 6 was not assessed, as The Ambassador does not provide intermediate care. Horncliffe House DS0000066898.V342439.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 are identified and met. EVIDENCE: Records of three resident’s case tracked were accurate and had good information about their health and social care needs that supported the staff to maintain and promote each individuals daily needs. Care plans were up to date and regular reviews and risk assessments updated with involvement of the residents and relatives and good information of care provided, ensuring the welfare and general wellbeing of residents is continuously monitored. One of the staff members spoken to said, “We go through the care plans monthly”. . A resident spoken to said, “ They do a check on my health every month or so”. Medication practices examined with the manager and observed at lunchtime were safe and records are kept ensuring residents health is maintained.
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 12 Members of staff spoken to said, “Staff with medication training administers medicines”. And, “Only trained staff do residents medicines”. The manager said, “The pharmacist comes into the home regularly to check on the medication and talk to staff”. The three medical records looked at were being accurately maintained to ensure the safety of the residents. Resident’s dignity and privacy was observed to make sure they are treated with respect. Evidence of this was done by observing staff members knocking on doors before entering rooms and helping at mealtimes in a sensitive way. One resident spoken to said, “Very caring staff”. A staff member said, “Equality, respect and privacy of residents is important”. Horncliffe House DS0000066898.V342439.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 and15. 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, creative and provide daily variation and interest for people living in the home. EVIDENCE: Lunchtime meals were seen being prepared, and were wholesome, home baked with fresh produce used providing a nutritious meal. The cook was spoken to and said, “As much as possible we use fresh food”. Comments from residents and surveys completed all confirmed the high quality of meals. Comments included, “There is a great effort for variation of meals”. And the food is excellent”. Meal times are set although flexible enough to accommodate preferences. One resident spoken to said, “I prefer my meals alone and that is ok here ”. Activities are centred on each individuals preferences ensuring flexibility and enable residents to enjoy their own personal interests, which are recorded on individual care plans. A resident survey said, “ I look forward to going to the illuminations and fish and chips on the way home”. One resident spoken to
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 14 said, “We have entertainers come along for a sing song which is good”. A member of staff spoken to said, “We try and accommodate the residents interests”. The home has a visitor’s policy, which allows friends and relatives to come any time of the day. One resident confirmed this and said, “My family come to see me at all sorts of different times”. Another said, “The staff are lovely they always offer a drink to my family when they come”. Horncliffe House DS0000066898.V342439.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. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The management team and staff have good knowledge and understanding of safeguarding adults issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission and contained in the Statement of Purpose and Service User Guide to ensure they feel protected. One comment from a resident, “There is an office and there is always a member of staff you can speak to”. Staff spoken to said. “Complaints procedures are contained in our policy list on induction training. There have been no complaints since the previous inspection. There is a procedure in place for dealing with allegations of abuse and safeguarding adults so the residents feel protected. One staff member spoken to said, “My training for National Vocational Qualification (NVQ) covered abuse”. Horncliffe House DS0000066898.V342439.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): 19,25 and 26. 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is clean and maintained, however more redecoration and refurbishment of parts of the home is required to provide residents with pleasant surroundings. EVIDENCE: A tour of the building found it to be clean and tidy. One comment from a residents survey said, “I could not be in a cleaner place”. The home has a maintenance programme and records are kept to ensure the safety of the building. There have been some improvements to the premises with redecoration of hallways and bedrooms. However further redecoration and refurbishment to
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 17 communal areas and the outside of the building should be undertaken to provide comfortable pleasant facilities for the residents to live in. One member of staff spoken to said, “Yes some parts of the building is looking tired and could do with painting”. A resident spoken to said, “They have done some work but it doesn’t look nice when wallpaper is coming off the walls”. Most radiators are covered or have been risk assessed to ensure the safety of the residents. However risk assessments need to be undertaken for two radiators in the home which are not covered or have guaranteed low temperature surfaces. Control measures need to be inplace to ensure the residents are safe and protected from any potential accidents. There are policies and guidance for laundry processes and for the control of infection ensuring the home is kept clean, pleasant and hygienic. Horncliffe House DS0000066898.V342439.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 procedures for the recruitment of staff are good ensuring the safety and protection of the residents. Training for staff is good and enables staff to have the skills and competencies for their roles. EVIDENCE: Observation of staff on duty, examination of rotas and discussion with staff and residents confirmed there were sufficient numbers on duty to ensure the resident’s needs are being met. Comments from staff included, “We now have more domestic staff to make things better”. And, “Things have improved with more staff around”. A resident commented, “Lots of people whom I can speak to”. Examination of two staff files confirmed the recruitment procedures of the home are good ensuring the protection of the residents is maintained. Staff records include, application forms, Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA) disclosures and references, all in place prior to employment. To improve recruitment procedures start dates for staff on records would help check references and other required information has been obtained prior to employment commencing.
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 19 Records show training is ongoing and the personnel has over 80 of care staff that has completed National Vocational Qualification (NVQ) level 2 in care. Discussion with staff confirmed training is accessible and the management team encourage staff to attend courses to develop their skills. Records are kept of staff training. Comments from staff included, “I have just completed my NVQ through the home”. And, “Very thorough induction”. Also “The manager does keep us informed of courses for us to go on”. Horncliffe House DS0000066898.V342439.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): 31,33,35,37 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 and systems and policies in place for the protection and safety of staff and residents are good. EVIDENCE: The manager has the necessary skills and experience required to support the staff and residents and enable the home to meet its stated purpose and objectives. However there remains a recommendation for the manager to complete the Registered Manager’s Award qualification. Discussion with the manager confirmed training is ongoing following difficulties accessing the course.
Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 21 Residents and staff spoke positively about the management team and how the home is managed comments included, “Very supportive”. And, “Willing to muck in if we have staff shortages”. Examination of records for residents confirmed they are comprehensive, well written and up to date ensuring the correct information is available and health and welfare needs are continuously monitored. Records show the management has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. Staff and resident meetings are held and examination of records confirmed they take place on a regular basis ensuring there views are listened to and implemented if agreed it would and improve the home. Relative surveys are sent out annually for there views and opinions on how the home is run and to ensure they feel the home is run smoothly and any suggestions for improvements are put in writing. Monthly reports provided by a representative of the Company are required by regulations. These must be 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. Horncliffe House DS0000066898.V342439.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 3 X X N/A 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 3 17 X 18 3 2 X X X X X 2 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 2 X 3 X 3 X 2 3 Horncliffe House DS0000066898.V342439.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. 1 Standard OP37 Regulation 17,26 Requirement A responsible person monthly must undertake visits to the home, with records required by regulation kept, under Regulation 26. Risk assessments need to be undertaken for two radiators in the home which are not covered or have guaranteed low temperature surfaces. Control measures need to be inplace to ensure the residents are safe and protected from any potential accidents or risks. Timescale for action 30/09/07 2 OP25 13 and 23 30/09/07 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 OP31 Good Practice Recommendations The registered person should complete the registered managers award or equivalent to level 4 NVQ in management and care. Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 24 2 OP19 The renewal and decoration of the premises should be implemented to ensure resident live in pleasant surroundings Horncliffe House DS0000066898.V342439.R01.S.doc Version 5.2 Page 25 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
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