Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Morecambe Bay Care Home Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marie Cordingley
Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home
Name of care home: Address: Morecambe Bay Care Home Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN 01524400255 Telephone number: Fax number: Email address: Provider web address: morcambe.bay@sshc.co.uk Name of registered provider(s): Name of registered manager (if applicable) Four Seasons (No 7) Limited Type of registration: Number of places registered: care home 87 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home is registered for a maximum of 87 service users to include up to 40 service users in the category of DE (Dementia) up to 30 service users in the category of OP (Older person) up to 17 service users in the category of PD (Physical Disability) Date of last inspection Brief description of the care home Morecambe Bay Care Home is owned and managed by Four Seasons, a company that operates a number of care services at various locations throughout the United Kingdom. Morecambe Bay Care Home is a Care Home with Nursing; it consists of 4 self-contained units. Torrisholme House and Bare House each offer care for 20 older people with Dementia. All bedrooms are single and located around a landscaped courtyard. Grange House offers 30 ensuite bedrooms to older people who require nursing care. Cartmel House is registered to care for up to 17 adults with a physical Care Homes for Older People
Page 4 of 32 Over 65 0 30 0 40 0 17 Brief description of the care home disability. Each of the 4 units are staffed separately, with a qualified nurse in charge of each unit There is an overall manager in post at the home who is currently going through the process of registration with the Commission. Morecambe Bay Care Home is situated relatively close to the Promenade in Morecambe. Each of the units/houses within the centre have their own lounge and dining room and other facilities, for example, bathrooms and toilets. Each unit is on the ground floor offering easy access to all the facilities. Only the central part of the home has a first floor where the Managers office is located and the administration office for the home. The staff room is also located on the first floor. Care Homes for Older People Page 5 of 32 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection of this home included a site visit which was carried out on an unannounced basis. This meant that the manager and staff did not know the visit was to take place until we arrived. During the visit we spent time with residents, talking to them and observing their daily routines. We also held discussions with staff at the home and the acting manager. We carried out a tour of the home looking at communal areas and a selection of residents private accommodation. We also viewed a variety of paperwork including residents care plans and staff personnel files. Care Homes for Older People
Page 6 of 32 Prior to our visit we wrote to the manager and asked her to complete a very comprehensive self assessment. This gave us a lot of information about how the home is managed. In addition, we wrote to a selection of residents and staff and asked them to take part in a written survey about their opinions of the service provided. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 32 Following the last inspection of the home a number of concerns were identified and the homes management reacted positively to this by creating a comprehensive improvement plan. The acting manager and area manager from Four Seasons have worked closely with us to keep us updated about their progress. We found during this inspection that a number of improvements had been made although there were still some issues outstanding. Since the last inspection the homes Service User Guide has been made available in a number of different formats including large print and braille. Work is ongoing to produce the documents in audio. Making the guide available in various formats helps ensure that everyone has equal access to the information. In line with requirements made following the last inspection, the home have improved care planning processes. We found that the care plans we viewed were more comprehensive and in some cases contained a good level of information about peoples personal preferences and the way they wanted their care to be provided. However, we have made some recommendations about how care plans can be developed further. Systems for managing residents medication have been improved to enable the manager to keep a closer check in this area. This has resulted in better protection for residents health and well being. However, we have made some recommendations about how systems can be improved further. Work has been ongoing to provide more activities on a more regular basis. Some residents we talked with told us that they had noticed more activities being provided such as theatre trips for example. However, work needs to continue to ensure that all residents benefit from these improvements. A number of residents we spoke with told us that the variety of food had improved and that they were being offered more choice in the type of meals they ate. One resident commented that menus seem a bit more exciting recently. A number of improvements have been made to the environment including refurbishment of some areas and the provision of a bigger TV lounge for people on the younger adults unit. Further improvements are planned in the coming months and will continue until all areas in the home are updated. Discussion with staff and residents and the viewing of staff rotas confirmed that staffing levels have been improved since the last inspection. However, we made a recommendation that these be kept under constant review to ensure that they are kept in line with residents changing needs. The manager has carried out a lot of work to introduce personal development plans for every staff member. This means that their individual training needs can be monitored and checks can be made to ensure that all staff have received their mandatory training at the correct intervals. Processes for the induction of new staff have been improved and there is now a more Care Homes for Older People Page 9 of 32 coordinated approach to induction. All new staff complete a comprehensive workbook which is in line with Skills for Care standards. A number of staff members we spoke with told us they felt their induction had been very useful. What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 10 of 32 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 11 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 12 of 32 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are carried out for each person before they move into the home which means their care can be planned effectively. However, more attention to the social aspects of peoples lives during assessment would help ensure that care is provided in line with their individual preferences. Evidence: A Service User Guide is available for people who are considering a move to the home. This document includes various information such as the facilities available and the service provided. It also gives a picture of daily routines in areas like mealtimes and activities. Since the last inspection the acting manager has carried out some work to ensure the Service User Guide is available in a variety of formats to meet peoples individual needs. The acting manager confirmed that it can now be made available in Braille and
Care Homes for Older People Page 13 of 32 Evidence: large print and work is currently ongoing to have the guide converted to an audio format. Unless people have to move into the home very quickly because of an emergency situation, an assessment of their needs is carried out before their admission. This means that the manager can be sure that a persons needs can be met at the home and that the home is the right one for them. It also means that staff have a good understanding of the persons care needs and can provide the right level of care straight away. We viewed a number of residents pre admission assessments and found that in general, they were well detailed in terms of medical and personal care needs. However, some assessments lacked detail about the social aspects of peoples lives such as relationships, hobbies and preferred daily routines. These are important areas that need to be explored so that peoples care can be planned in a person centred way. Person centred planning means recognising and valuing peoples individuality and providing their care accordingly. We discussed this area with the acting manager who advised us that work was ongoing to improve assessments. In addition, we were advised that all staff were being provided with additional training in this area. Care Homes for Older People Page 14 of 32 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures for managing peoples medication have been significantly improved, although further improvements will help protect peoples safety and wellbeing. Evidence: As part of our case tracking exercise we viewed a number of residents care plans. We found that care plans were generally very comprehensive in terms of peoples physical and health care needs. Some examples were particularly good and provided a good deal of information about peoples preferences in relation to their daily routines and how they would like their care to be provided. We noted that efforts had been made to make care plans more person centred and in most cases, particularly on the unit for people with dementia, their care plans addressed areas such as social activities, relationships and emotional wellbeing. However, we did view some examples where this sort of information was still missing. This was discussed with the acting manager who advised us that work was ongoing to ensure the improvements were carried on throughout the whole of the home.
Care Homes for Older People Page 15 of 32 Evidence: There are good procedures in place to assess the risk people face in areas such as developing pressure sores or falling, for example. We looked at some examples and found that where people had been assessed as being at risk, detailed guidance was in place for staff to ensure that the correct measures were taken to keep people safe. As part of the visit a pharmacist inspector checked how medicines were being handled because previous visits had found some medicines were not being recorded and given to people correctly. This was putting the health and wellbeing of people at unnecessary risk. We found some general improvements in the way medicines records and stock were organised. Records of medicines received, given to people and disposed of were much clearer and a better system of stock control had been developed that made accounting for medicines much more straight forward. We checked a sample of medicines and found they usually added up showing they had been given correctly. However, we found some discrepancies in the stock and records that showed several doses may have been missed and we found some examples of medicines not being given at the right time in relation to mealtimes. One person was given one tablet instead of the prescribed three on numerous occasions and they missed another two medicines on at least two occasions in the last three weeks. A new resident did not have their medicines properly checked when they came into the home, which resulted in them missing one of their tablets for the previous four weeks. Giving medicines at the right time and the right dose helps make sure they work correctly. We looked at a sample of care plans and records and found some general improvements about how when required medicines were to be given. However, we found several examples of missing information, notably for a person that was looking after some of their own medicines and for a person suffering with anxiety. Lack of information about medicines can result in them being given to people incorrectly. We checked how controlled drugs (medicines that can be misused) were stored and recorded. Records of handling were accurate and suitable secure storage arrangements were in place to make sure they are not mishandled. We looked at how medicines were stored and found the arrangements were clean, tidy and secure. Suitable fridges for storing medicines that required cold storage were available and these were regularly checked to make sure they were at the right temperature so that medicines were not spoilt. Care Homes for Older People Page 16 of 32 Evidence: We looked at how medicines were checked and audited. The manager said and we saw evidence of, regular and detailed checks of the medicines, these checks had found mistakes and discrepancies that the manager had then acted upon to try and prevent them happening again. The manager also said that daily checks of the records were carried out to make sure that staff were completing them correctly. Since our last visit all nursing staff had completed an in house training program for medicines handling and we saw the paperwork to support this. Efficient recorded checks of the medicines, competency checks on staff and regular training help to make sure staff have the necessary skills to handle medicines safely. Care Homes for Older People Page 17 of 32 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provision of activities has improved but still needs further development to ensure people have regular opportunity to spend their time in an enjoyable way. Evidence: We spoke with both residents and staff about daily routines at the home and found that efforts are made to ensure that peoples individual needs are met. One resident told us how she preferred to stay in bed and watch her television in the mornings. She said They bring me breakfast in bed when Im ready for it. I just let them know. The majority of people we spoke with during our visit told us that the provision of activities had improved over recent months in terms of both variety and frequency. One resident said We have been out to the theatre which is something new and there are quite a lot of things happening that we havent done before. Another resident said there seems to be more going on but it does depend how many staff are on duty. Through discussion we were able to confirm that people have the opportunity to take part in activities within the home such as arts and crafts and watching visiting musicians. There are also trips out organised, the home has access to a minibus at
Care Homes for Older People Page 18 of 32 Evidence: certain times, and residents where possible, are supported to go out on a one to one basis. Whilst most people did report an improvement in this area we did receive some feedback that improvements were not yet consistent throughout the home. One resident said Its better, but still a bit hit and miss. This was confirmed when we looked at records of activities that people had taken part in on a daily basis. Records showed that some residents had not taken part in any activities for periods of up to several weeks. The area was discussed with the acting manager who advised us that work was ongoing to make further improvements. The manager advised us that some staff have received training in Dementia Care Mapping which is a useful tool that helps carers to support people to engage in their environment and with other people in a meaningful way. In addition, the home are still in the process of recruiting an activities co-coordinator. Once appointed, the activities coordinator will oversee this area and ensure that all residents have the chance to take part in various activities on a regular basis. Most people we spoke with said that they were satisfied with the standard and variety of food, although one resident said the standard varied depending on which catering staff were on duty. A number of people we talked with commented that the menus had recently become much more varied. One resident said We had curry last week which I really enjoyed. Written menus confirmed that people are offered a varied diet and that there are a number of alternatives available at each meal time. We observed staff members discussing the options available with residents and recording their choices. There are written menus available in each dining room for the residents information. However these are written in small print and not accessible to a number of people. We have recommended for some time that consideration be given as to how information about menus can be provided to people in a more accessible way. Care Homes for Older People Page 19 of 32 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live and work at the home are confident that any concerns they raise will be taken seriously and dealt with properly. Evidence: The home has a complaints procedure which is written in a clear and easy to understand manner. Recently the acting manager has made the complaints procedure available in a number of formats including large print and braille and is in the process of producing the procedure in an audio format. People we spoke to told us that they were aware of the complaints procedure and that they would be happy to raise any concerns they had. A number of residents commented on the approachability of the acting manager. One resident said She is always helpful and I feel like I can talk to her. Processes are in place to ensure that all complaints are recorded along with the outcome of any investigation and subsequent action taken. We viewed records that showed that all complaints raised since the last inspection had been dealt with appropriately. All homes are required to have written procedures in place that must be followed if it is alleged or suspected that a resident has been the victim of any kind of abuse. These
Care Homes for Older People Page 20 of 32 Evidence: are generally referred to as safeguarding procedures. We found that the acting manager and the staff members we spoke to had a good understanding of the procedures. We also noted that the acting manager had taken appropriate action where any such concerns had been identified previously. We were also able to confirm that the majority of staff members had received training in safeguarding and were aware of their responsibility to report abuse or bad practice in line with the homes whistle blowing procedures. In addition, staff members told us that they felt they would be supported by their manager in the event that they made any such report. Care Homes for Older People Page 21 of 32 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are provided with safe, comfortable accommodation. The ongoing improvement plan will help ensure all areas of the home are maintained to a good standard. Evidence: Morecambe Bay Care Home is a large home which is arranged in four separate units. All residents accommodation is provided on a single room basis and the majority of people living there have en suite facilities. All residents living accommodation and facilities are located on the ground floor. We carried out a tour of the home and found that all areas of the home were clean, warm, and comfortable. We also noted that the home was furnished and maintained to a satisfactory standard although there were some areas that would benefit from a general update. We did see evidence of some improvements that had been carried out following our previous inspection. These included the provision of a larger television lounge for people living on the unit for younger adults, the improvement of garden areas and the replacement of kitchen facilities. The acting manager advised us that plans were in place to continue the refurbishment until the whole home has been updated.
Care Homes for Older People Page 22 of 32 Evidence: The home has clear guidance in place in relation to infection control and staff we spoke with were aware of the procedures to be followed. In addition, records confirmed that all staff receive training in infection control at the start of their employment. Care Homes for Older People Page 23 of 32 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The thorough recruitment procedures followed by the home help protect residents safety and wellbeing. Evidence: We viewed personnel files for several staff members which confirmed that the home follow thorough recruitment procedures. Records confirmed that all potential staff members are asked to attend a formal interview and complete an application form which includes a full employment history. At least two references are obtained, one being from the most recent employer where possible. In addition, no staff member is allowed to start work until Criminal Records Bureau and POVA (protection of vulnerable adults) clearance has been obtained. The home has recently changed their processes for providing new staff members with induction. As part of their induction, staff members are supported to work through a comprehensive work book which covers all the relevant areas in line with Skills for Care standards. People we spoke with told us that they had found their induction very useful. One staff member said It was very thorough and covered everything I needed to know. Ongoing training includes all the mandatory health and safety areas such as moving
Care Homes for Older People Page 24 of 32 Evidence: and handling and infection control, as well as additional areas including caring for people with dementia. At the time of our visit, the acting manager had recently carried out an audit and as a result had implemented personal development plans for all staff to ensure that they all receive the training they need. Records viewed showed that some staff members had not received all their mandatory training or that they were in need of updates. However, we were satisfied that the acting manager was taking appropriate steps to address this. All staff members are encouraged to obtain National Vocational Qualifications in care. We found that the home were falling short of the national target which is that 50 of staff hold the qualifications. However, the manager assured us that work is ongoing to increase the number of qualified staff. Following our last inspection we raised concerns about staffing levels within the home and made a requirement that staffing levels be adequate to meet the needs of residents at all times. We viewed rotas, talked with residents, staff and the acting manager and were able to confirm that staffing levels had been improved, although they were still inconsistent at times. In addition, we were also advised that the use of agency staff had decreased significantly, resulting in improved consistency for residents. We advised that staffing levels should be kept under constant review to ensure that they are in line with residents changing needs. In general the feedback we received from staff was very positive. A number of staff told us that they thought standards at the home had improved in a number of areas since the appointment of the new manager. One carer said The team is working much better, it seems like everyone is more motivated now. All staff members should have formal supervision at least six times each year where they have the opportunity to meet with their manager on a one to one basis and discuss areas such as training or personal development, for example. From discussion with staff and viewing supervision files we were able to confirm that staff were not receiving supervision as often as is recommended. However the manager had identified this and was taking steps to address the issue. Care Homes for Older People Page 25 of 32 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the necessary skills and experience to ensure that improvement continues in all aspects of the service. Evidence: At the time of our inspection the home was without a registered manager. However an acting manger has now been in post for several months and is currently going through the process of registration with the Commission. The acting manager is a registered nurse with extensive experience in managing care homes. In addition she holds the Registered Managers Award. Following the last inspection the home were requested by the Commission to submit an improvement plan to address numerous areas of concern that had been identified. The acting manager complied with this request and we found during this inspection that improvements had been achieved in number of areas. However, there are still areas which require development and throughout the inspection the acting manager
Care Homes for Older People Page 26 of 32 Evidence: demonstrated that she was aware of these outstanding issues and taking appropriate steps to address them. There are a number of systems in place to assist the manager in assessing quality within the home and the acting manager has introduced new ways to involve residents and their families in these processes. Regular meetings now take place with residents and their relatives and a residents committee is being developed. Some people who live at the home need assistance to manage their day to day finances. We viewed samples of records relating to residents finances and found these to be well maintained and in good order. The home has a comprehensive health and safety policy in place which is supported by a number of separate procedures in areas such as fire safety and COSHH (control of substances hazardous to health). We also viewed a number of certificates during our visit confirming regular inspection and maintenance of equipment and utilities within home. Training records viewed confirmed that not all staff members had been provided with training in the key health and safety areas such as moving and handling. However, following discussion with the manager we were satisfied that she was taking appropriate steps to address this issue. Care Homes for Older People Page 27 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 32 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 All residents care plans 31/01/2009 must provide an holistic picture of their care needs including care needs relating to social aspects of their lives. This is so people have a greater say in the way their care is provided. 2 9 18 It must be ensured that all 31/01/2009 staff members who deal with residents medication are competent to do so. This is to help ensure that peoples medicines are managed correctly. 3 12 16 It must be ensured that all 31/01/2009 residents have regular opportunity to take part in activities they enjoy both inside and outside the home. This is so people are able to spend their time in a meaningful and fulfilling Care Homes for Older People Page 29 of 32 way. 4 28 18 At least 50 of carers should hold National Vocational Qualifications in care at level 2 or above. This is so that people receive their care from well trained staff. 5 30 18 All staff members must be provided with adequate training. This is to help ensure that people carry out their roles well and work with people in a safe manner. 6 38 18 All carers must be provided 31/03/2009 with training in the key health and safety areas. This training must be updated as necessary. This is to help ensure that staff know how to work in a safe manner. 31/03/2009 31/03/2009 Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 It is recommended that where possible, information relating to social aspects of peoples lives is obtained during assessment. This is so that care can be planned in a more person centred way. It is recommended that staff be employed specifically to coordinate activities to help ensure that all residents are provided with activities in line with their individual preferences. It is recommended that information regarding menus be provided in formats that are accessible to residents. 2 12 3 15 Care Homes for Older People Page 30 of 32 4 19 Consideration should be given as to how outdoor space on the Cartmell Unit can be made more accessible to residents. Planned improvements to the environment should continue to help ensure that people are provided with a good standard of accommodation. It is recommended that staffing levels are kept under constant review to ensure that the number and skill mix of staff meets residents changing needs. It is strongly recommended that staff working unusual shift patterns, for example, 12 hour shifts, are closely monitored and consulted through supervision. All staff members should be provided with formal one to one supervision at least six times each year. 5 19 6 27 7 27 8 36 Care Homes for Older People Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 32 of 32 - 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. You have been warned!
