Inspection on 07/11/06 for Morecambe Bay Care Home

This inspection was carried out on 7th November 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 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

Morecambe Bay Care Home 22/03/10

Morecambe Bay Care Home 06/01/10

Morecambe Bay Care Home 03/11/09

Morecambe Bay Care Home 12/11/08

Morecambe Bay Care Home 27/05/08

Morecambe Bay Care Home 29/11/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Morecambe Bay Care Home Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN Lead Inspector Mrs Jennifer Dunkeld Unannounced Inspection 7th November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Morecambe Bay Care Home DS0000068322.V315976.R01.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. 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. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morecambe Bay Care Home Address Gleneagles Drive Off St Andrews Grove Morecambe Lancashire LA4 5BN 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) 01524 400255 Four Seasons (No 7) Limited Mr John Robert Thomas Care Home 87 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (30), Physical disability (17) of places Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 87 residents to include up to 40 residents in the category of DE (Dementia) up to 30 residents in the category of OP (Older person) up to 17 residents in the category of PD (Physical Disability) 2nd November 2005 Date of last inspection Brief Description of the Service: Morecambe Bay Care Centre 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 Centre is a Care Home with Nursing, it consists of 4 selfcontained units. Torrisholme House and Bare House each offer care for 20 older people with a 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 disabilty. Each of the 4 units are staffed seperately, with a qualified nurse in charge of each unit The homes manager is currently Mr John Thomas who has applied to be registered with the Commission for Social Care Inspection. Morecambe Bay Care Centre 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. The current fees across the units for older people are £438.50 to £750 per week. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 5 Fees for Cartmel House, which is the unit for young physically disabled people, are £457. to £819. per week according to individually assessed needs. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Four Seasons are the registered providers of this service and have identified some of the improvements that are required to ensure the home meets the needs of the people who live there. They have appointed a manager Mr. John Thomas, who is registered with the Commission for Social Care Inspection. Grange House, Bare House and Torrisholme House were inspected against the National Minimum Standards for older people. Cartmel House was inspected against the National Minimum standards for younger adults. This inspection focused on the key standards. This Inspection was unannounced, that is neither the manager, staff nor residents knew the inspection was to be carried out this on 7/11/06. As there are 4 separate units within this home 4 Inspectors took part in this inspection, one to each unit. Mrs Noreen Hasledon who is an Expert by Experience assisted in the inspection. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social care inspection, to take part in the inspection of services for older people. The inspection involved; • • • • • Observations of care practices Discussions with the residents Discussions with visitors to the home Interviews with the staff and the manager. Examination of records that are required to be maintained including plans of care. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 7 Throughout the report there are references to the “tracking process” or “case tracking” this is a method whereby the inspectors focus on a group of residents within each unit. All records relating to these individuals are examined, along with the rooms they occupy in the home. Residents are invited to discuss their experiences of the home with the inspector; this is not to the exclusion of the other residents who contributed in various ways. A similar approach was taken in respect of the staff group. This was a positve inspection, where there was much evidence of improvements such as increased activities and an enthusiasm from the management team to continue to improve , for the benefit of the people who live in the home. What the service does well: What has improved since the last inspection? There is a mini bus at Morecambe Bay Care Centre, which has enhanced the opportunities for people to access the local and wider community. The activities organiser has injected a positive attitude into the home in relation to activities within and out of the home. Residents spoke of trips to see musicals, ballet etc as well visits to the pub. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 8 There have been a number of physical improvements to the home such as a wooden floor laid in Grange House entrance hall and dining room to make it easier for people to propel/be propelled in their wheelchair. Some areas of the home have been decorated and others have decorating plans in near future. The advice offered during the last inspection in November 2005 in relation to the storage and administration of medication has been acted upon resulting in a much safer practice. 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. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is good, providing residents and prospective residents and their families with details of the service the home provides, enabling an informed decision about admission to the home. EVIDENCE: There is detailed information available about the home for all residents, or possible residents, which has been developed into a very clear and robust description of the services provided, and who provides them. There is a set procedure for admitting someone to the home, including a visit to the home by the individual and/or their family. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 11 Three residents’ files on Bare unit were viewed as part of the case tracking process. Each file contained a pre admission assessment outlining the needs of the individual. These assessments are used by management to check that staff can meet the needs of the individual, before agreeing to the admission. Comment cards received from residents contained the following: ‘I decided for myself to live here’ and ‘My family helped me find this home and we chose it together’ The expert by experience noted that there appeared to be good interaction between the residents and staff. She reported that she had spoken with to 3 sets of relatives during the visit and they all seemed to be happy with the way their loved ones are looked after in the home. The 2 comment cards received from relatives confirmed there contentment in the care offered in the home and that the needs of their relative are satisfactorily met within the home. The staff spoken with were aware of the needs of the individuals and spoke in a respectful manner about the residents. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care people receive meets their needs. EVIDENCE: Care plans are written records that describe the care that is given to each resident. Six of these were looked at on Cartmel Unit and were found to be in need of review and updating. The plans themselves were quite informative, but they were difficult to audit and information was not always clearly recorded, and some changes in care or new treatments were not followed up. Records of social history and theraputic/social activites were sparse. These plans need to be reviewed and organised so that a clear picture of the resident, their strengths and needs. None of the residents were able to say that they knew about their care plans There was little evidence of resident or relative involvement in the care plans. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 13 Risk assessments were seen in the six sampled care plans, and again some of these needed to be reviewed and show what risks were identified and the action that was to be taken to protect the resident. Some of the pre-admission risks assessments were not always fully completed. The three residents files viewed on Bare Unit were well-organised and comprehensive and provided detailed information over the care and nursing needs of the three people concerned. The Care plan forms provided by Four Seasons are headed “problem number” which would be more accurately worded as “area of need”. This would ensure staff recognise the care required as a need and not a problem. Care plans included the following documents: Assessment information Residents choice form – which were completed but had not been reviewed Dependency rating assessments – reviewed General risk assessment form – reviewed Falls risk assessment – reviewed Handling profile Pressure Sore Risk assessment and Waterlow score chart – reviewed Nutritional Assessment and weight chart – ongoing Various consent forms – bed rails, use of homely medicines, oxygen use Some information contained in the care plans needs more information. For instance for one person it states “Shouts out” explanation is needed as to whether this indicates pain, distress, hunger, loneliness, isolation, etc. Daily records record appropriate and sensitive interventions such as ‘reassured her and she seemed to settle afterwards’. The homes manager explained that all care plans are being reviewed and will be ‘Person Centred Plans’ in the near future. The staff spoken with were aware of the needs of the residents and the manner in which the needs were to be met. The expert by experience noticed that one resident seemed to be distressed on being moved from a wheelchair to a chair however a member of staff calmed her down by speaking to her before any transfer happened. This reflects the staff understanding of this residents needs. The 6 ‘Have your say’ questionnaires completed by residents reflected that the carers are aware of their needs and act upon their views. However it was commented in relation to Cartmel Unit/House that ‘it depends who is on duty Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 14 and the dynamics between the staff.’ The nursing sister on that unit is aware of the current difficulties and is resolving the issues for the benefit of the residents. The medication trolley on Bare House was left open at the time the inspector arrived. This is a poor practice, which contravenes section 13 (2) of the Care Home Regulations. MARs (Medication Administration Records) were viewed– there was some evidence that records are not being signed when medication is administered. The pestle and mortar being used to crush a tablet was dirty with remains of previously crushed tablets. On Torrisholme House/Unit the following observations were made: The treatment room was locked and every time the nurse went in he had to unlock it and the room was tidy. A sealed container is used to dispose of unused medications. An authorised company empties this. The records of medications disposed were checked and found to be accurate. The Controlled Drug cupboard was found to have lottery tickets kept in it; this cupboard should only be used for its stated purpose. Medications, both in the controlled cupboard and the ordinary cupboards were checked and were found to be secure. Each resident prescribed Lactulose had his own bottle. 2 residents medications were audit trailed and found to be accurate. A new refrigerator has been placed in the treatment room and only medications needing refrigeration were stored in it. Cartmel House The medication system was looked at and found to be basically satisfactory. However there were a number of gaps in the recording of tablets that had been refused or not given. All records of controlled drugs were accurate. The drugs fridge needs to be recalibrated. The temperature of the medication room should also be recorded to make sure that the ambiant temperature is kept for drugs, lotions and creams that must be stored below 25 degrees centigrade. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 15 Some medications are being crushed for those residents who have difficulty swallowing. It was advised that GPs be contacted about which tablets can be crushed and which can’t, because tablets can have different affects if they are crushed before being taken. It was also advised that policies and procedures for this be developed so that all nurses are aware of the risks. General advice was given about keeping eye drops in the fridge when they shoud be stored in a warmer cupboard. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 16 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can choose from a variety of activities ensuring people have a fulfilling lifestyle. The meals in this home are good, offering both choice and variety. EVIDENCE: The Expert by experience made the following observations on Grange House. On arrival at Grange House the resident’s were still at breakfast. • Table covers would have been good to see with the ages of the residents. • Residents were fed by the staff if they required help • Menu for the day had a choice of menu for each meal. • Most residents were in wheelchairs in the dining room • Some of the residents preferred to have their meals and stay in their rooms most of the time. Rather than interact with the other residents and that is their own personal choice. • Residents were asked if they had finished their meal, hands and faces were then wiped with a moist tissue before leaving the dining room. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 17 • • Wheelchair footrest for 1 resident had to be found, before transfer into the lounge could happen. Some residents seem to have to wait a long time before they were moved either into the lounge or their rooms. During the time spent talking with the manager he explained that Grange House has just received new tall dining tables that can facilitate people in wheelchairs. As a consequence the old tablecloths are not large enough and new ones have been ordered. At lunchtime while dining with the residents it was noted that the meal was well presented and tasted good. It was observed that a number of people require assistance to eat their meal. Of the 6 staff on duty one was giving out medication, another was serving the meals through serving hatch and 4 people were endeavouring to feed 12 people. Some of who were in the dining room and some in their own rooms. It was noted that one resident’s meal was put in front of her but she was not assisted to eat the meal for 15 minutes, by which time the meal would have been cold. Her pudding was also in front of her. Lunchtime was stated to be 12.30 however staff were offering personal care and this resulted in the meal not being served until 12.45. It was evident that the staff were struggling to meet the needs of the residents at this time of day. There is a need to seek a resolution to this situation. The homes manager agreed to try to use additional staff at lunch time for a trial period and then review the outcome with the service providers Cartmel House Observations of lunchtime included: Meals provided were according to needs and included small, large, finger, diabetic, pureed. Portion sizes seemed to me to be OK and provided the required amount for each nutritional area. However, those given finger diets were not provided with any vegetables – should be easy to provide cauliflower, carrot sticks, for example, to meet this need. Staff confirmed that people can eat what they want and there are drinks and snacks available during the day and night. Staff have a lot of work to do at lunchtime to support people. There are approximately 11-12 people who require full support, which is provided by 3 staff (including nurse in charge). The third person is responsible for giving the meals to people who are in bed or in their own rooms. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 18 Bare House At lunch time one resident while being fed was left on several occasions whilst the member of staff (nurse in charge) dealt with other things. The lady was left without any explanation and her food was left going cold. Another resident’s food was left as the member of staff assisted someone else During the latter part of lunch the hairdresser came to the unit and asked who was ready for hair being done. One lady spoken with said she enjoyed her dinner. Weight records examined indicate that most people are maintaining or putting on weight. One lady (not case tracked) has apparently put on over a stone since her arrival as (prior to admission) had been severely neglecting herself. The expert by experience spoke with the chef who had limited understanding of the dietary needs of someone who has coeliac disease. However there is currently no-one resident in the home with this disease. Activities The expert by experience made the following notes re Grange House: • • • • • • • • • • • Spoke to the newly appointed Activities Organiser who has been in post for 3 months. The home has a shared mini bus for outings although Dial-a-Bus is also used. Trips have been arranged for the residents. e.g. Ballet, Old Time Music Hall are 2 recent activities and others are planned. A Halloween party took place were the resident who were able carved pumpkins this was enjoyed by all. During the summer residents were taken for walks to get some fresh air and a change of scene. Residents if they are able can go out shopping by themselves or to the doctors. Most residents are not able to interact with some of the activities due to health problems One to one activities are also available for those who require this. There is at least one activity a day for all to join in with, for example, bingo and quiz Hairdressing is also available for all residents Facials and manicures are also done. The minutes of an Activities meeting were seen this included a comprehensive list of forth coming events here are an example: Dates of Xmas parties on each of the 4 Houses. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 19 Visits to the theatres to see Old time Music Halls, Ballet, and other musical entertainment including a Remembrance Band on 11/11/06. In addition to these events external of the home entertainers come into the home and visit each of the 4 houses. The provision of a mini bus and the use of Dial a ride has opened up a wealth of opportunities for the residents. The residents on Grange House made comments such as ‘It’s great here now she (activities organiser) has made things so much better’ and ‘We have outings I am going to the ballet tonight’ Bare House Examination of care plans do not evidence that specific area of activities/social interaction is given any precedence as part of holistic care. Staff spoken with all felt they did not have time to sit and talk with residents, as there was generally too much to do. Whole unit seems very task orientated and would benefit from some dementia awareness regarding activities. Torrisholme House The following observations were made: Timetable of activities displayed in the corridor. Some residents were going to The Dome (entertainment venue) on the day of the inspection. Activities include Bingo, Cards. Relaxation classes. The staff said that they sit and talk to the residents when they are not busy. There were good interactions between the residents and the staff. The relatives spoken with all had positive comments to make about the home and the staff. One said, “ There is always a good atmosphere in the home and the residents are well cared for.” The home has a quarterly newsletter that keeps the residents and families informed of forthcoming events. Some resident have had stories/ poems/ditties printed in the newsletter. Puzzles/quizzes are also included for residents to complete if they so choose. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 20 The residents are benefiting from a fulfilling lifestyle. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 21 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of safeguarding vulnerable people, which protect residents from abuse. EVIDENCE: Policies and procedures in relation to complaints have been produced. A procedure is displayed in the entrance hall. It gives information about who to complain to, for example; Person in charge. Manager, Commission for Social Care Inspection. 2 relatives present said that if they had any complaints, they would complain to the person in charge in the first instance. Spoke with the wife of one resident case tracked, generally very happy with the care provided and said that she would not want her husband to go anywhere else. The staff at the home responded very quickly and appropriately to a visitors concern about the size of the food portion being offered to her relative Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 22 The records of complaint were viewed and were seen to be up to date. The records contained the above concern, how it was investigated and the outcome. A detailed letter was sent to the relative. This is a good practice that reflects the openness of the manager and service providers. On Torrisholme House the ‘Abuse Procedure’ was available in the office. One of the care staff spoken to has attended a course on the Protection of Vulnerable Adults recently. The main entrance to the home was found to be unlocked on several occasions throughout this inspection and as such anyone could wander into Grange House potentially leaving people vulnerable. All the residents appeared to be well cared for and free from abuse. The staff were polite and considerate when dealing with residents. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 23 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a homely, comfortable and safe environment. EVIDENCE: A tour of Bare House revealed: The unit was very clean and tidy. Individual rooms are personalised with treasured possessions, pictures and the like. There were new carpets in corridor and in the small lounge. Small lounge also has been redecorated and waiting for new curtains. Concerns raised: The intercom was heard to be quite loud and may be quite confusing for people with dementia to hear a disembodied voice talking! Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 24 The telephone bell on the unit was loud and quite disturbing. Central courtyard was very untidy and full of weeds with upturned garden furniture scattered around. Large bathroom was cluttered with aids such as. The bathrooms are clinical although attempts have been made to make them more homely/inviting by having pictures in place. Grange House The main door to Morecambe Bay Care Centre has a sign stating ‘ If this door is locked please ring the bell’ This implies that there are times when the door is unlocked and as such anyone could walk into the home and leave people and their possessions vulnerable. The door was found to be unlocked during part of this inspection. Advice has been offered in relation to this. The sister on the unit stated that they are to have the decorators coming in 2 weeks time, which will give the house a much, needed face-lift. The entrance hall has been transformed with the reception high desk removed to reveal a more inviting environment. Wooden flooring has been laid in this area and the dining room making it easier for people to propel their wheelchairs. Bedroom doors have signs on them stating ‘Fire door keep closed’ A number of these doors were seen to be open, this has been done in the recognition of people in wheelchairs being able to freely use their rooms. However there is a need seek a resolution to this perhaps look to installing magnetic self-closing devices to the doors which hold them open but would be automatically released should the fire alarm be sounded. The unit was clean and tidy. The residents enjoyed having their own bedroom, which were personalised with their own belongings. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 25 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are offered an appointment. Training is provided and this means that residents receive appropriate care and attention. EVIDENCE: Good interactions between residents and staff were seen throughout the home. Torrisholme House The relatives spoken with had positive comments to make about the home. One said, “ There is always a good atmosphere in the home and the residents are well cared for.” Grange House The sister in charge of this unit is relatively new but has already had an impact on raising management awareness as to the staffing needs of the residents. Lunchtime was observed to have insufficient staffing to meet the needs of the residents this is reflected earlier in this report. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 26 The staff had a professional attitude to their work and spoke respectfully about the people they care for. The expert by experience spoke to 3 sets of relatives during the visit and they all seemed to be happy with the way their loved ones are looked after in the home. Bare House Generally staff were very respectful and caring for the people on the unit, with approaches being kind and sensitive. General comments from staff: Two staff said they had not had supervision for a while. They confirmed that staff meetings are held – last one is to be re-scheduled due to RDB (Residential and Domiciliary Benchmark) assessment taking place. Both staff have done NVQ II and a 2-hour dementia awareness course. Both seem to see activities as being “OT lady’s job” and do not see it as a holistic process as part of the care of the residents. Discussed care needs of the three people case tracked and both had a good understanding of their needs and abilities. General A selection of staff files were viewed and these revealed that the staff recruitment process is robust with all the required checks taking place. The manager confirmed that the procedures were robust, through written references, and Criminal Record Bureau disclosures. He stated that he would make sure any verbal references are followed up with written ones. All new staff are taken through a thorough induction process whereby they have a book to work through with a mentor and when they become competent in each area this is signed to verify capability. Staff have a booklet ‘Induction Standards for New Care Workers’ supplied by Four Seasons the service providers. 16 staff have achieved an NVQ National Vocational Qualification in care and 3 are currently undergoing training for this. Other training courses include; Moving and handling Fire safety Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 27 First Aid Health and Safety Infection Control Dying and Death Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 28 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The home has achieved a 4 star rating (top rate) from the Residential and Domiciliary Benchmarking 0rganisation. It is on the Local Authority Preferred Providers list, which is indicative of the good standard of care that is provided. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 29 Torrisholme House There are policies and procedures to protect residents and staff from harm. These include Infection Control, COSSH. Residents are risk assessed to ensure their safety. Doors are kept locked by the use of keypad locks. The domestic was seen taking good care of the cleaning materials she uses. All her cleaning materials are kept on a trolley and she does not leave it unattended. There are handrails alongside the corridors to help residents with their mobility. General The homes manager and deputy manager were seen to be working in a professional manner ensuring the service meets the needs of the people who live there. They spoke of the support they give to each of the units and the Sister or Charge Nurse to help them ensure their staff team are competent to provide a good service. The manager ensures that people who are unable to manage their own finances have a relative/solicitor to act on their behalf. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 30 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 15(1) Requirement Care plans must be reviewed regularly and reflect the care that is being given to each resident. Residents and relatives must be involved in the planning of care and the subsequent reviews. All residents must have fully completed and reviewed risk assessments both before and throughout their stay at the home. The service provider must ensure that 50 of the staff achieve the National Vocational Qualification level 2 The service provider must ensure there are sufficient staff at all times of day to meet the residents needs including meal times. The service provider must ensure the home is safe by not leaving access for intruders The service provider must ensure residents have easy access to their bedrooms without wedging fire doors open DS0000068322.V315976.R01.S.doc Timescale for action 30/12/06 2 YA2 13 30/12/06 3 OP30 18(1)(a) 01/04/07 4 OP27 18(1)(a) 30/11/06 5 6 OP19 OP19 13(4)(a) 23(4)© 21/11/06 31/12/06 Morecambe Bay Care Home Version 5.2 Page 32 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA20 YA20 Good Practice Recommendations Policie and procedure should be developed for the crushing of medication. Nurses should make sure that they record all refused or ommitted drugs on the medication record sheets. The drugs fridge should be recalibrated and if found to be faulty, should be repaired or replaced. 4 YA20 The temperature of the medication room should be recorded daily. 5 YA20 The suction machine should be checked and tested regularly. Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 © 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 Morecambe Bay Care Home DS0000068322.V315976.R01.S.doc Version 5.2 Page 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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