CARE HOMES FOR OLDER PEOPLE
King Edward Care For The Elderly 7-9 Warbreck Drive Blackpool Lancashire FY2 9JX Lead Inspector
Jackie Riley Unannounced 6-09-05 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. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service King Edward Care For The Elderly Address 7-9 Warbreck Drive Blackpool Lancashire FY2 9JX 01253 354785 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) Mrs Sarah Pitman Mr D Wheeler Mrs Naden Johnson Care home only 11 Category(ies) of DE Dementia (11) registration, with number of places King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. The service is registered to accommodate a maximum of 11 service users in the category DE (Dementia). Date of last inspection 14th June 2005 Brief Description of the Service: King Edward care home provides residential care for 11 service users suffering various levels of dementia. The care home is situated in a residential area close to amenities and public transport services. There are nine single rooms and one double, three of which are on-suite. Service users have a range of aids and adaptations in place to enable them to remain as independent for as long as possible. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a two-day period. It was the second annual statutory inspection and was unannounced. During both days the registered manager was available and assisted the inspector with the inspection process. The main focus on this inspection was the environment, Privacy and Dignity, resident’s finances and health and safety. The inspector spoke to staff on duty, as well as speaking to staff who were not available at the time of the inspection. Resident’s comments were limited due to the level of dementia suffered by those living at the care home. An official letter has been served to the registered owners requiring them to carry out Monthly inspections and to provide a report to CSCI following those visits. The registered providers have not complied with these requirements since being raised in reports since September 2003. The care home did not provide an action plan for previously identified requirements during the inspection of 14 June 2005. What the service does well: What has improved since the last inspection?
Observation of a recent admission to the care home confirmed there is now a health needs assessment in place, in order to meet the health care needs of residents admitted to the care home. Staffing levels have been increased during daytime hours to ensure domestic tasks do not interfere with the care provided to residents.
King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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 King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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) Not inspected. EVIDENCE: King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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) 8,10 There are now systems in place, which record the assessed health care needs of residents, and make sure they are met. Privacy is generally upheld for residents however there is a requirement to make sure locks are on all bathroom doors so that residents feel safe and secure. EVIDENCE: There is now a full health care plan for residents being admitted to the care home, so that their individual healthcare needs can be fully met, by healthcare professionals, and records of this make sure their needs are being met. There is a requirement to make sure locks are in place on the first floor bathroom door, so that people using this facility are sure that their Privacy is upheld. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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) Not inspected EVIDENCE: King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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) Not inspected. EVIDENCE: King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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, 21, 22 & 26 The home is being refurbished to make it a homely and comfortable environment in which to live, however there is a requirement to make sure there are adequate bathing facilities with adaptations to meet the needs of residents living at the home. EVIDENCE: There has been recent development in replacing carpets and furniture in communal areas of the home. Staff members commented on how much nicer the home looked, and how much easier it was to keep furniture clean and hygienic. The refurbishment programme is on going and will continue throughout the home including resident’s rooms. There is a requirement for the first floor bathroom to have in place a hoist, in order for this facility to be used, for the benefit and comfort of residents living at the home. Staff spoken to said it was sometimes difficult bathing all residents in the one ground floor medic bath, which does not necessarily suit all residents needs and wishes. Observation of the homes environment confirmed there are two rooms without sink plugs. Through discussion with some staff it was confirmed this is due to
King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 13 some residents leaving taps running resulting in flooding. To overcome this the use of `push down taps, which are in place in most other rooms should be used to resolve this problem. The inspector had been informed there are often no flannels or soap in resident’s rooms, resulting in towels being used for washing. This situation is not acceptable, and must not continue. At the time of the inspection it was observed new flannels and soap had been put in place in all rooms. The home must ensure there are sufficient and appropriate washing materials for residents at all times. The inspector had been informed there has previously been a problem with the supply of hot water in the home, resulting in difficulty in supplying sufficient levels of water for washing, bathing and hairdressing. At the time of the inspection water was tested at residents sinks and the medic bath. It met the minimum requirements of water temperatures as laid down by health and safety executive. Water temperatures must at all times meet the requirements of legislation, so that washing, bathing can be undertaken at any time of the day or night for the comfort of residents. There must be evidence that there are appropriate numbers of blankets and Kylie sheets available for residents living at the home, as the inspector was informed there are problems during the night time period on occasions when additional blankets or kylie sheets are required, for the comfort of residents. The inspector was informed there have been occasions when some residents have accessed the kitchen, alone putting them and others at potential risk of harm or injury. There must be evidence the registered owners are taking steps to ensure access to the kitchen area is made safe for all persons living and working at the care home. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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 Staffing levels had been increased during the day to make sure domestic tasks can be undertaken without affecting the level of care needed for residents living at the care home, however night time staffing levels need to be re assessed based upon meeting the needs of residents during the night time period. EVIDENCE: The inspection recognised there was an additional member of day staff on duty, to make sure domestic and other tasks were being met without affecting the level of care required by residents living at the care home. The inspector was informed an advert had been placed to recruit an additional staff member specifically to carry out domestic tasks in the care home. Staff said “nights were really difficult working alone, as some residents need to have a lot of time spent with them, whilst there are others who sometimes need assistance due to wandering during the night”. This could result in a potential injury or event, which may put other residents at risk. The registered owners should therefore consider what steps they may take to ensure residents are protected during the nighttime period. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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) 32, 35 & 38 The home is run on a day to day basis by the registered manager for the protection and safety of residents and staff, however there is little direction or support from the registered owners, which result in some instances in a lack of resources which have the potential to adversely affect residents living at the care home. EVIDENCE: The registered manager is shortly to go onto maternity leave, there are two senior care staff, who will manage the home during this period in order to make sure the service is managed for the benefit of residents living there. Through discussion with the registered manager and staff members it was noted there are times when the relationship between manager, staff and the registered owners breaks down, resulting on some occasions, with a lack of
King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 16 resources including previously raised issues of flannels and soaps, additional blankets, kylie sheets, and delays in repairing water temperature control. The registered owners, must endeavour to forge positive relationships with the manager and staff team, and to provide all essential resources identified as needed by the registered manager and staff, for the safety and comfort of residents living at the care home. The registered owner manages Resident’s finances. The inspector was informed by the registered manager all residents’ personal allowances are managed between the registered owner and family or solicitors acted on behalf of residents living at the care home. There should be evidence available for inspection of any financial records maintained on behalf or residents living at the care home, in accordance with Care Homes Regulations, Schedule 4. There must be evidence available in the care home of all system appliance servicing records, which must be up to date, for the health and safety of residents and staff. King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 2 x 2 2 x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 2 x x 2 x x 2 King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 18 yes 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 10 Regulation 12(4)(a) Requirement There must be appropriate locking mechanisms on all bathroom/toilet doors to ensure the privacy and dignity of residents at all times. There must be evidence the registered providers is taking steps to ensure all parts of the home are reasonably free from any hazards for the safety of residents and staff. There must be evidence of a sufficient number of bathing facilities for residents living at the care home. Bathing adaptations must be in place for residents choosing to use the first floor bathing facility. There must be appropriate levels of staff on duty at any thime of the day or night for the needs of residents. The registered provider must at all times maintain a good professional relationship with the registered manager and staff. The registered providers shall maintain records in the care home as required by Schedule 4 The registered providers must provide evidence of current Timescale for action 30.10.05 2. 19 13(4)(a) 30.10.05 3. 21 23(2)(j) 30.10.05 4. 5. 22 27 23(2)(m) 18(1)(a) 30.10.05 30.10.05 6. 32 12(5)(a) 30.10.05 7. 8. 35 38 17(2) 23(2) 30.10.05 30.10.05
Page 19 King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 service certificates for gas systems in the care home. 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 King Edward Care For The Elderly F57 F09 S29626 King Edward V247110 010905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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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