Inspection on 30/08/07 for Middlesbrough Intermediate Care Centre

This inspection was carried out on 30th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Middlesbrough Intermediate Care... 04/10/06

Middlesbrough Intermediate Care... 16/01/06

Middlesbrough Intermediate Care... 30/08/05

Middlesbrough Intermediate Care... 15/02/05

Middlesbrough Intermediate Care... 27/05/04

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Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

The Gardens Care Home

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 Brenda Grant Unannounced Inspection 30th August 2007 10:00 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.V348277.R02.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 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.V348277.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Middlesbrough Intermediate Care Centre Address Homerton Road Pallister Park Middlesbrough TS3 8PN 01642 513120 01642 513126 margaret_mett@middlesbrough.gov.uk 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.V348277.R02.S.doc Version 5.2 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. 4th October 2006 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 accommodation 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; physiotherapy and occupational therapy are 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, at the back of the building, part of the garden has a lawn and there are trees and 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, toilet and washbasin. The home has communal bath/shower rooms and toilets. There are also lounges, dining rooms, meeting/training rooms, a therapy room, a main kitchen and two domestic training kitchens. There is separate access to the office accommodation for: the domiciliary care service, therapists and associated staff, the Stroke Association, mobile response team, Carelink (community alarm call service) and the re-enablement officer. On the date of this inspection there was no fee for care at Middlesbrough Intermediate Care Centre. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. We assessed the information from: the Annual Quality Assurance Survey, Survey Forms that had been completed by residents and their relatives and we carried out a visit to the home. The visit took place over one day, six hours and forty five minutes in total. Discussion took place with residents, staff, an Occupational Therapist, the operations manager and the manager. We looked around the home and gardens as well as examining a number of records which included; residents and staff files, health and safety and maintenance checks, Complaints, accidents, staff meetings and kitchen documentation. The findings from the inspection were of the home providing an excellent service; with the manager and staff creating a homely atmosphere and making every effort to meet the individual needs of residents. The home called people who used the care service ‘residents’ therefore they are called residents in this report. What the service does well: The outcome of the unannounced inspection was that Middlesbrough Intermediate Care Centre had continued to deliver good performance and manage improvements. Where areas for improvement emerged, the service recognised them and managed them well. Management and staff made the best use of resources; so that residents benefited from an excellent quality care service. Residents, spoken with, were very complimentary about all aspects of the home. Comments were, “Everything is satisfactory”, “Staff are always friendly and helpful” and “The staff are very caring and professional”. Residents we spoke with, were fully informed and involved with their Care Plans and all plans were regularly reviewed. Middlesbrough Intermediate Care Centre aimed to have as many people returning back to living in the community, in their own homes. When people were due to be discharged, plans were made for people to be provided with support services and equipment, to help people to remain independent. The home provided a pleasant, comfortable and homely environment that was well maintained. There was plenty of equipment, to help residents to be as independent as possible. Staff were assisted and encouraged to complete basic and additional training; to improve upon their knowledge and skills when caring for the residents who stayed at the home. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 7 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.V348277.R02.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 3 & 6 Resident’s needs were assessed before moving to the home and they were assured those needs would be met. People who stayed at the home, only for intermediate care, had a clear assessment that included a plan on what they hoped for and wanted to achieve when they returned home. EVIDENCE: Most residents were admitted to the home immediately after being discharged from hospital. The home also had some residents who came from their own homes as they had been assessed as needing some form of rehabilitation. All residents had assessments, completed by a care manager, Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 9 which were shared with the home. The assessments included details of: health, social and personal needs. Three residents said, they were involved with the assessment process. Before being admitted, residents said, there was no opportunity for them to look around the home but they were given full details about the care service. In a survey, a resident commented, “I was given enough information by the hospital staff”. A resident who spoke to us said, “This is the best place to be. I am getting physiotherapy and they are going to help me to get some equipment when I go back to my own house”. The expected time anyone would stay at the home was up to six weeks. If a person wasn’t quite ready to return home, after six weeks, the manager said, “A resident might stay a bit longer”. Soon after admission, Middlesbrough Intermediate Care Centre carried out a further assessment. It identified how care needs would be met and a rehabilitation programme was planned. The service aimed to provide intensive occupational therapy and physiotherapy, to help people to be as independent as possible. There were dedicated healthcare professionals who carried out the therapy treatment. The home had plenty of equipment in a physiotherapy room, two domestic kitchens and a bathroom. In those rooms, residents were supervised and supported with all activities of daily living and with them being able to achieve maximum mobility. The home’s staff supported residents, with making plans, for resident’s returning to their own homes. That included identifying and arranging for specialist support services and equipment before the person was discharged from the home. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 7, 8, 9 & 10 Resident’s health, personal and social care needs were met and recorded in Care Plans. Residents were protected by the home’s policies and procedures for dealing with medicines. Residents were treated with respect and their right to privacy was upheld. EVIDENCE: Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 11 A sample of resident’s Care Plans was examined. The home developed a Care Plan for each resident and a copy was available in each resident’s room. The plans gave details about the person’s care needs and how those needs would be met. Care Plans were reviewed on a regular basis and residents we spoke with said, they were fully involved with the reviews. The sample of Risk Assessments was examined. Risk Assessments were included with the Care Plans and informed how risks would be managed; to reduce those risks to an acceptable level. Resident’s files included information of the therapy being delivered at the home as well as healthcare visits and appointments. The records detailed the progress of the therapy treatment and how therapy was delivered. There was also information of visits for treatment from: doctors and District Nurses and other healthcare specialists. The home had equipment to assist staff when they were moving residents in addition to the specialist equipment for resident’s use. The manager said, “We can quickly get equipment by referrals made through the home’s Physiotherapist and Occupational Therapist”. In a survey a resident commented, “They (the staff) take care of everyday needs”. A resident we spoke with said, “Everyone is helping me so that I can get back home. They are great”. The home took appropriate measures for managing medicines. The storage and recording was found to be satisfactory, showing staff followed strict procedures for looking after resident’s medication. Residents were assessed, for their ability to look after their own medicines. Staff monitored and recorded resident’s progress when residents had control of their medicines; to make sure residents managed their medication in a satisfactory manner. A pharmacist called to the home most days, to give advice and monitor the store of medicines. The home had a book for recording staff’s queries about medication and the advice given by the pharmacist. The medicines, in a trolley, were checked and recorded twice weekly. It was important to have such stringent monitoring of medicines as there were regular admissions and discharges, of residents, at the home. Staff’s details confirmed staff had completed ‘safe handling of medication’ training and staff were regularly updated with managing medicines. We saw staff being respectful to residents and knocking on bedroom doors before entering bedrooms. The relationship between staff and residents was very relaxed and residents, spoken with, confirmed they were treated with respect. All comments from residents, about how staff treated them, were very complimentary. One resident said, “Staff are always friendly and helpful”. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 12, 13, 14 & 15 Residents lived their lives as they wished and residents maintained contacts with families and friends. Residents had choice and control over what they do. The home provided an adequate balanced diet. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 13 EVIDENCE: Resident’s records confirmed staff tried to make sure individual needs were met. The home did not have a regular activities programme but staff occasionally arranged group activities. Most of the recreational activities, that residents were involved with, were as part of their individual rehabilitation programmes. The programmes took account of resident’s interests, age, abilities and disabilities. The main focus, for the activities, was of staff assisting and encouraging residents with being independent and making choices. The manager said, there were no religious services offered at the home but staff would support residents who wished to attend church services. Staff said, they sometimes accompanied residents to the local shops or they just went out for a walk. Residents and staff said, relatives and friends were always made to feel welcome when they visited the home. One resident told us that his/her relative called every day and said, “Staff are always friendly and make time to have a chat with everybody”. Residents said they agreed with, and kept to, their rehabilitation programmes. This gave residents control of their lives and they lived their lives as they wished. Residents said, they were able to bring some of their personal possessions. As residents were staying, at the home, for a short time they brought only a few personal belongings. We saw that one of flatlet had two beds. The manager told us, this would allow a relative to be able to stay with a resident, if it was necessary. That would be part of the rehabilitation programme, where a relative could experience looking after a person who was due to be discharged and return to their own home. Middlesbrough Intermediate Care Centre accommodated for residents who wished to: get up early or late, stay in their bedrooms or go to communal rooms. The home’s menus were examined; the two-week menu had a variety of food and there was a choice of meals offered to residents. Three residents said, the food was very good and tasty. One resident said of the food, “It is five star food and can’t be compared with what I had at the hospital”. All of the food arrived at the home already prepared for cooking. The cook said she had tried many different ways of cooking this type of food before residents informed her it was satisfactory. The cook told us, if different foods were needed, because of religious or cultural requirements, then she would order meals from the Women’s Royal Voluntary Service. She informed us they had a good range of foods for different people’s needs. One the day of the inspection ‘site’ visit, the lunch was well presented and the dining areas were very pleasant. The food stored at the home was of there being a variety of fresh, dried, tinned and other foods. The cook kept a record of the food that had been served to residents and there were completed records for: the cleaning rota, fridge, freezer and food temperatures. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 16 & 18 Residents were confident their complaints would be listened to, taken seriously and acted upon. Residents were protected from abuse by the home’s policies and procedures. EVIDENCE: The home had a satisfactory Complaints Procedure. Residents spoken with informed, they did not have anything to complain about but they were confident complaints would be appropriately dealt with. Since the last inspection, the home received one complaint and there was a record showing it had been properly investigated and appropriate action had been taken. The home had procedures for protecting residents from abuse and followed the Middlesbrough Inter-Agency Policy for ‘No Secrets’ for safeguarding adults. Staff records confirmed staff had completed training for safeguarding vulnerable adults. For some staff the training had been a long time ago. The manager told us, she would make arrangements for staff to have an update of the training. Staff said, they knew of the procedures to follow if there was an Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 15 allegation of abuse on a resident. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards 19 & 26 Service users live in a safe and well-maintained environment. The home is clean, pleasant and hygienic and free from offensive odours. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 17 EVIDENCE: Middlesbrough Intermediate Care Centre had various communal lounges and dining rooms. All parts of the building and the garden were accessible to wheelchair users. Every room had a ‘loop system’; to assist people who had hearing impairment with listening to the television. There was suitable equipment to assist people who had physical disabilities. The manager said, the home had the advantage of having Physiotherapists and Occupational Therapists who could make referrals for extra equipment that was not already available at the home. There were two ‘training’ kitchens where residents, under supervision of a member of staff, could make themselves meals and drinks. The kitchens were used as part of resident’s rehabilitation programmes. The home had an ‘assessment’ bathroom. It was as an ordinary domestic bathroom, with equipment, so that residents could see how they might be able to manage, having a bath, when they returned home. Additionally, there was a physiotherapy room where residents were encouraged and assisted, with using the equipment, to gain maximum mobility. There was a corridor that had a stained carpet, the manager said it would be cleaned as soon as possible. A resident said, “It is lovely here and we have everything we need” and another resident commented, “The home is always kept clean and tidy”. The neat and well-maintained garden, at the back of the home, had various structures. There were walkways and steps with handrails that had been built to help people with their mobility. There was also a patio and a lawn, with seating, and tall trees provided a shaded area for residents who sat outside in warmer weather. The home had a small laundry, with enough equipment for washing residents clothing. All other laundry, such as bedding, was sent to an external contractor. The building complied with the requirements of the local fire service and the environmental health department. The manager said, there were plans for the installation of a new call alarm system (Telecare). It had facilities extra to the existing call alarm system. The Occupational Therapist said, the new system could provide facilities, such as a sensor alarm and electronic aids. For example, to cut off a gas appliance that had accidentally been left on and open doors and curtains. It was the same system that will soon be available to people living in their own homes. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 27, 28, 29 & 30 The skill mix and numbers of staff was satisfactory, to care for the residents at the home. Staff were competent to do their jobs and residents were protected and supported through the home’s recruitment procedures. EVIDENCE: The numbers and skill mix, of staff on duty, was satisfactory. During the day there was always one senior care assistant and four care assistants. At night, there were two or three staff on duty to meet the care needs of residents. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 19 It was commendable that the home had almost 85 of care staff qualified to at least National Vocation Qualification at Level 2. That was above the minimum standard of 50 . In addition, care staff had completed specialist training courses, that were specifically for caring for people at the home. Staff said, they were encouraged to attend extra training courses, resulting in residents benefiting from being cared for by a skilled workforce. The home also made sure basic staff training was regularly updated, such as training for; First Aid, Fire Training, infection control and Manual Handling. The manager kept a chart of all staff training that showed when refresher training was needed. The manager said she was going to change the chart. There were so many courses, offered to staff, that the record had become too complicated and needed to be simpler to read. The home had male as well as female care assistants, giving residents a choice of the gender of care staff who looked after them. The home had a staff group who had worked at the home for many years. For the last few years no new staff had been recruited at Middlesbrough Intermediate Care Centre. All new staff, at the home, had been redeployed from other Middlesbrough Council owned homes that had closed. The manager said, she thought it would be a long time before any new staff would be recruited but, if new staff were needed, the home would follow the recruitment policies and procedures, for the protection of the residents. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 31, 33, 35 & 38 Management and administration systems ensure the home is run in the best interests of the residents. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 21 EVIDENCE: The manager had many years of experience with running a care home. Her qualifications include the National Vocational Qualification at Level 4 in Care and she is working towards successfully achieving the Registered Manager’s Award, for managing a care service. Residents and staff said they thought the home was well run. Staff said, the manager included everyone when decisions were made to improve and develop the service. The manager said, “There are no resident’s meetings because residents do not stay at the home for very long. However, the manager had a quality assurance system, where residents and relatives could comment on what was good about the home and where they thought improvements could be made. Middlesbrough Intermediate Care Centre had good feedback from the surveys. After being discharged, from the home, most residents had managed to return to their own homes. Comments from the survey were included in a report and they were taken into account when the manager developd the home’s plans for the year. There were regular staff meetings, when staff had the opportunity to give their views and comments about the service. Minutes of those meetings were available at the home. Residents were encouraged to look after their own finances but the home held some monies, on behalf of residents. A sample of resident’s monies was examined and found to be correct. A sample of maintenance records was examined for: water temperature checks, portable appliance tests and maintenance of hoists and the passenger lift. They were all found to be satisfactory and up to date. The home kept a suitable record of all accidents and appropriate Risk Assessments were in place. All checks were to make sure staff and residents benefited from a safe environment. Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.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 Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 23 CHOICE OF HOME Standard No Score 1 X 2 X 3 4 4 X 5 X 6 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 4 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 24 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 OP26 Regulation 23 Requirement The stained hall carpet must be cleaned, to keep the good standard of cleanliness at the home. Timescale for action 15/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 25 Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Middlesbrough Intermediate Care Centre DS0000036142.V348277.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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