Inspection on 23/02/06 for Morecambe Re-enabling Unit

This inspection was carried out on 23rd February 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 Re-enabling Unit 22/11/07

Morecambe Re-enabling Unit 30/05/07

Morecambe Re-enabling Unit 13/10/05

Morecambe Re-enabling Unit 26/10/04

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 Re-enabling Unit 29 Morecambe Road Morecambe Lancashire LA3 3AA Lead Inspector Mrs Joy Howson-Booth Announced Inspection 23rd February 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 Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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 Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Morecambe Re-enabling Unit Address 29 Morecambe Road Morecambe Lancashire LA3 3AA 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) 01254 420303 Calderdean Ltd Mrs Margaret Smith Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home shall at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission The home is registered to accommodate a maximum of 11 service users to include: Up to 11 service users in the category OP (older persons). Up to 2 service users in the category PD (physical disability) aged 45 years or over. 13th October 2005 Date of last inspection Brief Description of the Service: The purpose of Morecambe Re-Enabling Unit is to work with older people discharged from hospital and, with support, return to their own homes. A fulltime Manager and a team of staff manage the Unit. Ordinary living facilities are available within the Unit to enable residents to regain their daily living skills. To enable people to develop the skills and confidence to return home, the staff at the unit work alongside a variety of professionals, including occupational therapists, physiotherapists, rehabilitation social workers and health visitors. The re-enabling programme normally lasts for a period of one to six weeks but this can be extended to meet the residents’ needs, if required. The Unit is situated in a residential area of Morecambe and is close to the shops and amenities in Torrisholme. It is situated on the main bus route into Morecambe town centre. Residents are encouraged to maintain their links in the community by attending Day Centres and Over 60’s Clubs and recommence their hobbies and interests. Opportunities are provided for them to engage in social activities both insides and outside the Unit. Visitors are made welcome at anytime. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was carried out by the inspector for the home. The inspection lasted 2 and a half hours. The services provided by the home were inspected against the National Minimum Standards and included the NMS not previously assessed and those with requirements or recommendations from the previous inspection. All but one resident was spoken with, along with two members of staff on duty and the registered manager. Documents were examined including care documents, menus, maintenance files and other associated records held by the home. No comment cards were received but a large number of comment cards and letters of thank you were seen on display in the hall of the home. All the residents spoken with said they felt very well cared for and were happy to have been given the opportunity to build up their confidence so that the possibility of returning to their own homes has become a reality. One resident said “if anyone can find fault with this home then there is something wrong with them”. Everyone spoken with enjoyed the atmosphere, friendship and felt it was a well managed home. What the service does well: The Unit continues to support people to re-learn their skills and build their confidence so that they are able to return to their own homes. The registered manager has described the service as being “dynamic” as residents have their own individual presenting needs, wishes and circumstances from the point of referral. The home continues to ensure there is a range of equipment and facilities available which can enable the residents to re-learn their skills and the home works alongside other healthcare professionals to make sure these are in place prior to admission. The staff also continue to work alongside a range of multi-disciplinary professionals to ensure residents are appropriately supported and encouraged to regain their life skills and confidence. Appropriate training is provided by these professionals. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 6 Residents spoken with continue to be very positive about the home, particularly the fact that the possibility of returning to their own homes seemed to be impossible. As mentioned earlier, one resident said “if anyone can find fault with this home then there is something wrong with them”. The service continues its involvement on an arms-length basis to ensure that, on returning home, the resident continues to receive support and input (as much as is required) to ensure they are not “set up to fail”. The environment is well maintained and provides a homely environment for the residents to live in. The registered manager continues to work hard and is committed to ensuring the service provided is to an excellent standard. This can mean acting as an advocate for the resident – a task the registered manager is well equipped to do. The high level of success of people returning to their own home is evidence that this is an excellent service. The registered manager continues to be open and willing in her dealings with the Commission and demonstrates a willingness to address issues raised. What has improved since the last inspection? What they could do better: The comments in the previous inspection report still stand as it is very hard to pin point an area where this service could improve. The registered manager continues to self-audit and review the service in light of the experiences of the residents who live there. It is recommended that the training for staff continue as this clearly of benefit to the service and means that staff are competent to care for the differing needs of the residents who are referred. The gas certificate was not available at the time of the inspection and the registered manager is requested to confirm this has been received. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 7 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. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 8 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 Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 were assessed and met at the previous inspection EVIDENCE: Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed and met at the previous inspection EVIDENCE: Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 There are no restrictions for families and friends of the residents to visit the home. Resident’s benefit by gaining in confidence to follow their own lifestyles and return to their community. Arrangements and planning to provide good nutritional food are good. The residents are provided with home cooked food to ensure healthy living. EVIDENCE: Discussion with residents at the home confirmed that they are able to follow their own daily routines and, as much as possible, their lifestyles. Any referral to the home is with the purpose of re-enabling people to live back in their own homes and often a task of the staff is to reassure people that they are to live their lives as if at home. Care plans are comprehensive and record likes, dislikes, etc. As mentioned above, a big part of the home’s ethos is to re-introduce people into independence and to do this access to the local community is vital. This normally takes the form of walking to the local shops – initially with staff support but, once confidence on both parts is gained, residents are free to walk Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 12 out as they wish. Often, as part of a rehabilitation programme, walking into the local community is encouraged, again once confidence has been built up. Residents spoken with confirmed they are able to see their visitors in private and visitors/relatives are welcomed at any time to the home. Information is provided over the home’s facilities, etc., prior to admission. This is usually by a personal visit by the manager who will also take written information, photographs, etc., with her to provide information to the prospective resident. All residents manage their own finances as they intend to do when the return to their own home. The home also provides information and practical support over advocates, benefits, etc. Residents are aware, via the information provided to them, of their personal records which the manager keeps in accordance with the Data Protection Act. Residents spoken with were positive about the meals provided and are given a range of choices at each meal. Again, it is part of the staff role to encourage residents to gain in confidence and this also includes residents preparing meals to eat. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There are systems in place, and training provided, to ensure that residents are protected from abuse. EVIDENCE: Discussions with the Registered Manager and staff on duty confirmed that there was a very good understanding of what may constitute abuse and this is also covered in the training provided. The home has a thorough recruitment procedure in place which means only people who are fit to work with vulnerable people are employed. Morecambe Re-Enabling Unit benefits from being a small home where the Registered Manager works full time and is ‘hands on’. As a result residents are seen constantly and any concerns would be highlighted and dealt with immediately. The registered manager is also aware of potential areas of abuse and gave examples of actions taken in the past. The re-enabling unit also ensures that residents are returned to their homes and community within a support package and maintains contact until confident the resident can cope. Residents spoken with all felt they were well treated and were respected by the staff team. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 14 Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 were inspection and met at the previous inspection. The registered manager confirmed that the recommendation over the odour in the shower room had been fully addressed. In addition, a recommendation over one carpet had also been temporarily addressed by having a repair carried out. However, the registered manager said there are plans to replace this carpet in the near future. EVIDENCE: Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 The level and calibre of staff is very good. Residents are cared for by a team of dedicated staff. Training is provided to ensure staff are competent to care for the residents. EVIDENCE: The staffing rota was examined and found to be appropriate for the needs of the residents. On duty is always either the registered manager or a senior person, along with two care staff. Night time is covered by one person on duty, with an on-call arrangement in place. This would seem adequate for the 6 people accommodated. A new assistant manager has been appointed and will take up her post in the coming week. Discussion took place with both the registered manager and the staff on duty over a recent episode when additional support had been needed. It was clear that the staff acted as a team, supporting each other and the resident concerned and ensuring the safety of each other. The registered manager also confirmed that she ensure a “de-brief” took place for staff once the situation had been resolved. There is a very low staff turnover at this home which means that the residents are cared for by a consistent team of staff. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 17 All but one member of staff have National Vocational Qualification Level II and the outstanding member has almost completed this qualification. No agency staff or trainees are employed at the home. Staff spoken with confirmed they had accessed a range of training and support was provided by the registered manager and each other. Residents spoken with felt there were sufficient staff on duty at all times and “could not speak highly enough” of the care and support provided. One resident said “if anyone can find fault with this home then there is something wrong with them”. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 38 Experienced management run the home. Residents live in a well managed and safe home. EVIDENCE: The home has the ISO 9001 Quality Assurance Award which was updated at a recent audit and used to continuously audit the service. The registered manager has also updated the ISO manual to reflect the ethos of the home as a re-enabling unit rather than a residential care home. Feedback is sought from residents once they leave the home and this is done via a questionnaire. Feedback is also sought from GP’s when they attend their patients. From the number of letters and cards on display it is clear very positive feedback is given by residents. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 19 The registered manager confirmed that policies and procedures are available for staff to read and are reviewed annually. Staff confirmed they are aware of the location of these policies and procedures and are familiar with them. Notices for inspections are put up but residents are at the home on a temporary basis they may have left before the inspection begins. However, comment cards were seen to have been left out. Most staff have completed the mandatory training. The registered manager confirmed there is an ongoing training programme and is aware of the need to update training. 3 staff are appointed first aiders, most have done infection control, food hygiene. Staff at the home do not lift or move residents and there is a policy in place that paramedics are called should someone fall or need lifting. Moving and handling is done on an individual basis based on the presenting needs of the potential resident. Staff are provided with health and safety information – staff have recently been retrained in the home’s fire procedure and been given a copy of this procedure for their personal use. Staff spoken with confirmed this had taken place. It is useful that the home has a reciprocal agreement with its sister home (The Alders) so that should a fire occur there is a safe place for residents to go to. The registered manager has submitted a pre-inspection questionnaire which confirms maintenance and equipment checks for the home. Risk assessments are carried out, both for residents and also on the environment. These were seen in place. The accident book was seen and maintained accurately. Water temperature checks are carried out on a monthly basis and records of these were also seen. A selection of maintenance certificates were seen – a new Gas Certificate has been sent but the registered manager felt this was with the owner and is to ensure this is put on file.. The maintenance log was seen. The hard wiring and PATT testing certificates were also seen. The employers liability insurance certificate was also on display in the office. Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 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 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP30 OP38 Good Practice Recommendations The home to continue with the training and National Vocational Qualification training and provide refresher training where indicated The registered manager should ensure the new gas certificate is obtained and filed and confirm this has been obtained to the Commission Morecambe Re-enabling Unit DS0000059653.V273342.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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