CARE HOMES FOR OLDER PEOPLE
Mariner`s Court 44/46 Laidleys Walk Fleetwood Lancashire FY7 7JL Lead Inspector
Christopher Bond Unannounced Inspection 21st October 2005 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 Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 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. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Mariner`s Court Address 44/46 Laidleys Walk Fleetwood Lancashire FY7 7JL 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 872493 01253 872493 Century Healthcare Limited Mr Dennis Frain Care Home 24 Category(ies) of Dementia (23), Physical disability (1) registration, with number of places Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. A suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection, must be employed at all times. All future admissions to the home must be service users from the Dementia (DE) category. The home must comply with the Action Plan provided by Century Healthcare Ltd and the Commission should be advised when each stage of the action plan is achieved. The home is registered for a maximum of 24 service users to include: Up to 23 service users in the category of DE Up to 1 service user in the category of PD 3rd May 2005 4. Date of last inspection Brief Description of the Service: Mariner’s Court is a home that is registered to provide care for 24 service users who have dementia. The home is detached and overlooks the boating lake on Fleetwood promenade. This is a three- storey property and has 24 single rooms. Ten of these rooms have en-suite facilities and there is a through floor lift. There are four lounge areas on the ground floor, one of which is a smoker’s lounge. There are shops and services in the local area and bus services operate from a short distance away. Fleetwood sea front is a short walk away and the town centre is within half a mile. There are garden areas to the side of the home and a yard to the rear. Residents have access to these areas and can sit out in good weather. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over four hours. The inspector spoke to three residents, one visitor and one staff member. Care records were looked at along with the personal files of care staff. The home’s manager gave the inspector a full tour of the building. What the service does well: What has improved since the last inspection?
The home has introduced new care plans, which contained much more information regarding the needs of residents. Care staff have more written details regarding each resident and are able to know more about their needs and abilities. The home has introduced more detailed and current information for prospective residents and families. People are now aware that this is a home for those who have dementia. Activities for those with dementia have improved. People now had specialist activities that helped revive memories. These need to be developed and new activities and therapies introduced. Training had taken place in the care of
Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 6 those with dementia and changes to the home have been planned to make it a friendlier environment for those with dementia. The hot water pipes on the first floor have been insulated to make sure that residents are not put at risk. The complaint procedure is available for all to see in the entrance hall of the home. People now have all the information they need if they have a concern. Some of the staff had been trained in the recognition of abuse and more staff were due to attend this training. Care staff are now being supervised appropriately and evidence of this was found within staff files and on a wall chart in the office. This meant that care staff could discuss important issues and self- development with the managers of the home. 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. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 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 the following standard(s): 1, 3, 4, and 5 All new residents have a full assessment completed prior to moving into the home, ensuring that the home can meet their needs. EVIDENCE: The home now had current information that it could give to prospective residents and their families to tell them all about the service. This information stated the purpose of the home and the category of resident that it was registered to admit. This meant that those wishing to come and live at the home could make an informed choice about whether or not the service was right for them. There had been several people admitted to the home since the last inspection and detailed assessments were seen for each of these people. This meant that the information gained could be used to make sure that the home could care for their needs. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10. Promotion of health was taken seriously. Resident’s welfare was closely monitored and health needs were met. EVIDENCE: The home had introduced new care plans, which contained much more information regarding the needs of residents. Individual records were kept for each resident with a plan of care setting out in detail the action that needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Each resident had his or her care plan reviewed monthly so that the information contained could be updated to reflect their changing needs. Residents were invited to their reviews. None of the residents were responsible for their own medication. Medication practices observed were safe, and good records had been maintained. There was plenty of evidence on the six care plans that were seen to show that the health care needs of the residents were being attended to. The care plans
Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 10 also contained risk assessments, which helped to ensure that areas of risk had been considered. This meant that the residents were safer within the home. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 13, 14 and 15. Activities for those who had dementia were good which improved the delivery of their care. Meals were well managed and varied. Family and friend were encouraged to visit therefore ensuring personal relationships are maintained. EVIDENCE: Mariner’s Court was registered to admit those who had dementia. It was clear that appropriate activities had been arranged to ensure that the residents with Dementia were stimulated and kept active. Some residents enjoyed horticultural therapy and there were reminiscence sessions. There was a folder where articles and photographs had been kept from the local paper for people to discuss. The meal being prepared looked appealing and wholesome and fresh vegetables were being delivered during the inspection. The menus confirmed that a balanced choice was offered and there was information in the care plans about special diets that people had. There were several visitors to the home during the inspection. One visitor confirmed that they were made welcome and that they were offered privacy within the home. The visitor commented, “I always enjoy coming to the home, its so relaxing and they always look after us.” One of the residents had a
Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 12 drawing done by her granddaughter on her bedroom door to help her identify her room. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16 and 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 complaints procedure was available in the Service User Guide and Statement of Purpose and the procedure was available to residents and visitors in the main part of the home. Training had been accessed regarding the recognition of abuse, and staff were aware of what action to take should abuse be suspected. A further training event regarding this important issue was due to take place a few days after the inspection. The organisation (Century Healthcare) had shown a good awareness of the correct procedures to follow should abuse be suspected. The home had good procedures and guidance for staff, as well as a ‘whistle blowing’ policy that protected staff when voicing their worries. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 25 Safety issues had been addressed. Residents lived in a safe and comfortable environment. EVIDENCE: During the last inspection it was found that some of the hot water pipe work on the first floor had been left without lagging and posed a risk to residents. This had been dealt with promptly by Century Healthcare and had now been insulated. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30. Training provided by the company is regular and appropriate. EVIDENCE: There was written evidence to show that care staff were receiving the correct training to do their jobs properly. There was a list of all the training that had been accessed and the people who had attended. This included advice in the moving and handling of residents and first aid. Good training ensures that care staff have the skills to do their jobs correctly and that residents are better cared for. There is still a need to ensure that 50 of the care staff are trained up to National Vocational Qualification level 2 or 3 by the end of 2005. Several staff members were either in the process of achieving this or would be enrolled in January 2006. Seven Care staff had achieved this qualification. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 and 36 The manager’s duties are sometimes confused which affects the way the home is run. Staff are now supported appropriately to do their job. EVIDENCE: The manager of the home had not yet achieved the National Vocational Qualification level 4 in Management and Care that is required for all those who manage care homes. This training would give him the skills to help ensure that the home is run correctly. Care staff were now being supervised appropriately and evidence of this was found within staff files and on a wall chart in the office. This meant that care staff could discuss important issues and self- development with the managers of the home. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 17 It was still evident that the manager of the home was involved regularly in directly caring for the residents. It is important that the manager gives all of his time within the home to actually managing the service and that there is a clear distinction between management and care duties. This was a busy care home and all of the manager’s time should be directed towards its administration. It was now clear that residents meetings were being held and that their views were being sought on the care that was being offered. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 18 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 3 X 3 3 3 X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X 3 X STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X X 3 X X Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP31 Regulation 9 Requirement The manager must complete the management and care element of National Vocational Qualification level 4 by December 2005. The manager must ensure that he is given sufficient time to manage the home to ensure that his role is clear. (Timescale of 30/06/05 not met). Timescale for action 31/12/05 2 OP31 12 30/11/05 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 OP28 Good Practice Recommendations The manager must ensure that 50 of the care staff team have National Vocational Qualification level 2 by December 2005. Mariner`s Court DS0000009674.V260857.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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