Inspection on 16/01/06 for Middlesbrough Intermediate Care Centre

This inspection was carried out on 16th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Middlesbrough Intermediate Care... 30/08/07

Middlesbrough Intermediate Care... 04/10/06

Middlesbrough Intermediate Care... 30/08/05

Middlesbrough Intermediate Care... 15/02/05

Middlesbrough Intermediate Care... 27/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Middlesbrough Intermediate Care Centre Homerton Road Pallister Park Middlesbrough TS3 8PN Lead Inspector Derek Stow Unannounced Inspection 16th January 2006 10:30 X10029.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 Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 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 and Care Homes for Adults 18 – 65*. 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. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Middlesbrough Intermediate Care Centre Address Homerton Road Pallister Park Middlesbrough TS3 8PN 01642 513120 01642 513126 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) Middlesbrough Council Miss Margaret Ann Mett Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23), Physical disability over 65 years of age of places (23) Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home can take 10 service users age 40 years plus. These 10 service users can be either of the two categories, for which the Home is registered. 30th August 2005 Date of last inspection Brief Description of the Service: Middlesbrough Intermediate Care Centre is a large detached two-storey purpose built home that has been completely refurbished to provide personal care and accommidation for 23 older people and older people with physical disabilities, up to 10 of whom could be 40 years plus. The home provides intermediate care, with physio and occupational therapy available as part of the rehabilitation process. The home is located near to a shopping complex which enables service users to have access to a wide variety of shops, a public park, post office, leisure centre and public transport. Middlesbrough Intermediate Care Centre has an enclosed garden, to the rear of the building, that is lawned and there are plant pots, it provides a safe seating area during warm weather. All bedrooms are for single occupancy and there are two flatlets to provide for the monitoring of independent living. All bedrooms have an en-suite with bath or shower, WC and wash basin. The home has communal bath/shower rooms and WCs. There are also lounges, dining rooms, meeting/training rooms, a therapy room, a main kitchen and two domestic training kitchens. There is a separate access to the first floor of one wing at the home, that is office accommodation for: the domiciliary care service, therapists and associated staff, the Stroke Association, mobile response team and the reenablement officer. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six hours and forty minutes, with the inspector examining a number of records; speaking to four residents, one relative, the manager, the service manager, the cook, clinical co-ordinator and a senior member of the Care staff. This inspection looked at those key standards, which were not examined at the last inspection in April 2005. Any issues identified as requiring action or recommendations for improvement are to be found at the back of this report. Direct quotes from residents and relatives include the following; “I think its marvellous here and the staff are lovely ”. “I feel safe and I’m not worried when I’m ill ”. “Long days with not a lot going on “. “Its really useful to me and doing me good “. What the service does well: 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 contacting your local CSCI office. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This section was not looked at during this inspection as the key Standards were examined at the last inspection in August 2005. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 9 &10 (older people) and 16,18 & 20 (Adults 18-65) Arrangements are in place so that service users who are assessed as being able to manage their own medication are asked if they wish to do this. The home has appropriate policies and procedures for dealing with medicines. Residents feel that they are treated with dignity and respect and their rights protected. However telephone facilities must be improved to provide easy access with privacy. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 9 The manager and clinical co-ordinator nurse told the inspector that appropriate polices and procedures are in place for the ordering, the giving to residents and for the return of any unused medication. Observation of the facility for the storage of medication and controlled drugs was appropriate. The record of returned medicines was checked and found to be appropriate. There are currently five residents who wish to manage their own medication and the residents who were spoken to confirmed this. Locked cabinets are used to store medicines in resident’s bedrooms. The inspector spoke to two staff who are trained to administer medication and both gave a good practice account of the procedure for giving medication to residents. Residents spoken to stated that they felt that they were treated with dignity and respect. The service must make available easy access to private use of telephone facilities. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 &15 (older people) and 7 & 17 (Adults 18-65) Residents are encouraged to exercise choice and control over their lives. A varied and balanced menu is provided, however fresh fruit must be made more readily available to the residents and the tea meal should be reviewed. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 11 Residents were seen to be freely using their own rooms, which are all en-suite and include televisions. Relatives and friends were also seen to be visiting in privacy. The service provides a two-week menu and on the day of inspection the choice of main meal was meat pie/lasagne with a range of vegetables and a pudding. This meal looked well presented and appetising. The inspector spoke to the cook who said that they ensure that five portions of fruit and vegetables are provided daily. However several residents said that they would welcome fruit being available in the dining areas and a change from soup and sandwiches every teatime. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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(older people) and 22 (Adults 18-65) Residents and relatives are confident that their views and concerns are listened to and acted upon by staff and managers EVIDENCE: The Councils complaint policy and procedure is in place together with the NHS system as the service is joint funded with the primary Care Trust. There are complaints information notices around the home, which also tell people that they can contact the Commission for Social Care Inspection. All complaints and quality issues are recorded on the NHS incident report form and these are analysed and reported on as part of clinical governance. The inspector examined these. Residents and relatives interviewed were confident that if there was anything that they were not happy with they could go to staff and managers where issues would be dealt with. The views of residents are also sought on an exit survey, which was looked at, and the service manager said is due to be reviewed and strengthened. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This section was not looked at during this inspection as the key Standards were examined at the last inspection in August 2005. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 (older people) and 35 (Adults 18-65) Staff are trained and competent and there is commitment to ongoing joint training between the NHS and Middlesbrough Borough Council. EVIDENCE: The manager told the inspector that she has NVQ 4 in care and is awaiting verification of the registered managers award. The clinical co-ordinator is a registered nurse. Over 90 of the care and rehabilitation staff are trained to NVQ2 or above. The care staff all attend the Councils induction training within one month of starting work following completion of the workplace induction pack. Statutory training is certificated and a training matrix is in place to identify training completed/needed. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 38 (older people) and 8,39 & 42 (adults 18-65) The service is run in the best interests of service users, however the homes quality assurance survey needs to be strengthened. Residents and staff are safe and their welfare is promoted. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 16 A number of quality assurance systems are in place and further audit tools are being developed across areas of joint health and social care working including multi-disciplinary care planning. Wider feedback should be sought from stakeholders and the customer survey should be strengthened to include more specific areas of service experience. Health and safety policies and procedures and monitoring systems were seen to be in place. Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X ENVIRONMENT Standard No Score 19 X 20 X 21 X 22 X 23 X 24 X 25 X 26 X STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 2 34 X 35 X 36 X 37 X 38 3 Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 18 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 OP19 Regulation 16 Requirement The main kitchen must have a water boiler. Previous timescale not met. The service must make available easy access to private use of telephone facilities. Fresh fruit must be made more readily available to the residents and the tea meal should be reviewed. Strengthen the customer feedback survey, analyse and publish the results making them available to interested parties including CSCI. Timescale for action 31/03/06 OP10 2 3 OP15 16 31/03/06 16 28/02/06 4 OP33 24 31/03/06 Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Middlesbrough Intermediate Care Centre DS0000036142.V278431.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. 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