Inspection on 10/11/06 for New Monterey

This inspection was carried out on 10th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

New Monterey 18/11/05

New Monterey 14/07/05

New Monterey 26/01/05

New Monterey 21/06/04

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 New Monterey 20/22 North Promenade St Annes On Sea Lancashire FY8 2NQ Lead Inspector Denise Upton Unannounced Inspection 10th 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 New Monterey DS0000009910.V315869.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. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service New Monterey Address 20/22 North Promenade St Annes On Sea Lancashire FY8 2NQ 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) 01253 723392 Mrs Valerie Buckley Mrs Carole Thompson Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 Brief Description of the Service: The New Monterey is a large sea front hotel accommodating in the main, short stay hotel guests but is also registered to accommodate up to three older people who do not require nursing care. The hotel is privately owned and the two proprietors provide any support that may be required by the single service user accommodated. No care staff are employed, however ancillary staff are employed primarily in respect of the hotel, but who also provide a service to the resident in respect of meals. The proprietors have chosen to undertake domestic tasks in the service users private accommodation. The hotel is situated within reasonable distance of the main shopping centre of the town and in close proximity of community resources and facilities that the service user can access independently. All service user bedroom accommodation is provided with an en-suite facility and located on the ground floor of the building along with communal facilities that are shared with hotel guests. A passenger lift is provided for ease of access and two ramped accesses are available to the front of the building to enable those with mobility difficulties to gain access. A car park is provided and an extensive raised patio area with tables and seating is available to the front of the hotel that can be enjoyed by the service user in the warmer weather. The current cost of residential care is £263.50 per week. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during part of a midweek morning and in total lasted a period of approximately one and three quarter hours. Discussion took place with one of the homeowners and more limited discussion took place with the second homeowner. In addition, the only resident currently accommodated who has lived at The New Monterey for a considerable period time was also fully involved in the inspection. A number of records and policies and procedures were examined and a partial tour of accommodation used by the resident also took place. What the service does well: What has improved since the last inspection? Since the last inspection little has changed. The hotel cook who provides a direct service to the resident and hotel guests has recently been replaced and a Criminal Records Bureau clearance is required. The recommendations identified in the last inspection report have yet to be implemented. In consequence, they have been brought forward and again identified in this report. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 6 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. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 7 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 New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 8 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 Quality in this outcome area is good. The pre admission assessment form that is used by the home owner to identify what the prospective resident can do well and what help may be required is comprehensive. This ensures that the written information held is in sufficient detail to establish if current strengths, needs, wants and wishes could be met at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Currently The New Monterey accommodates only one resident who was admitted prior to the introduction of the Care Standards Act 2000. Although there have been no new admissions to the home since this time, The New Monterey has devised a pre admission assessment form that is compliant with recommendations. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 9 It is understood that this pre admission assessment form would be used to identify the strengths and needs of any prospective future resident in order to establish it their requirements could be adequately met. Any potential resident would also be invited to visit the home prior to admission in order to assess the accommodation and environment for themselves. This is particularly important as the accommodation is predominately a large seafront hotel accommodating short-term holiday guests rather than a residential care home accommodating older people. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. There is a clear and consistent care planning system in place that provides sufficient information to satisfactorily meet the current resident’s needs. The homeowners have a good understanding of the resident’s support needs. This is evident from the positive relationship, which have been formed between the owners and the resident. Support for the resident is offered in such a way as to promote and protect the resident’s privacy dignity and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current care plan is based on the outcome of a review process that takes into account current strengths, needs wants and wishes. In the main, the resident is self-caring, has no personal care needs and has elected to determine his own social needs independently. However, there have been changes to the way medication is administered and this is reflected in the current care plan. From discussion with the resident it was clearly evident that he was involved in the review of his care plan and has previously stated that New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 11 he would only sign the care plan when he was completely satisfied with the content. The resident, where possible, prefers to attend to his own health care requirements and is usually able to undertake these tasks as and when required. The homeowners place heavy emphasis on maintaining the psychological health of the resident and ensure he has sufficient funds to maintain his chosen life style. The New Monterey has a comprehensive medication policy and procedures that are compliant with requirements. In addition, one of the homeowners has undertaken a certificated medication course to increase her skills and knowledge regarding medication matters. Since the last inspection, and with the resident’s consent, changes have been made to the way medication is administered. Medication administration is recorded and the resident’s medication is now securely stored in a locked facility. From discussion with one of the homeowners, it is understood that the method of recording medication is to be improved and a more detailed administration record introduced. During the course of the inspection, the resident confirmed that he considered that his privacy and dignity were always promoted and respected. Consultation can take place in the privacy of individual bedroom accommodation or any communal area of the resident’s choice. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is good. The homeowners have a good understanding of the resident’s support needs. This is evidenced from the positive relationship that has been formed between the homeowners and the resident that includes supporting the resident to access and enjoy social contact. The meals and menus at this home are to hotel standard offering a wide variety and choice to the resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The resident’s routines of daily living and activities are self-determined to suit his own preferences. The resident accommodated again clearly stated that his needs, wants and wishes including social activities are met while living at the New Monterey and confirmed that he had opportunity to exercise individual choice in all aspects of his life. Leaflets, primarily for hotel guests, are available with regard to local community activities to supplement verbal information sharing. In addition the resident also enjoys participating in the programme of activities arranged for hotel guests including the ‘turkey and tinsel’ breaks currently taking place. The resident also enjoys the one to one support of the homeowners to maintain social contacts and social activities. This includes New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 13 outings in the local community and walking his dog with one of the homeowner’s and her dog along the beach that is a normal daily activity that they both enjoy. Social relationships are encouraged either through family/friends visiting at a time of the resident’s choice or the resident visiting relatives either independently or with the support of the homeowners. The resident’s personal allowance is well protected and the resident confirmed he remains financially independent. It was evident the from financial documentation and confirmed by the resident accommodated, that he received his personal allowance in excess of the minimum weekly amount to enable him to enjoy a lifestyle of his choice. The current resident enjoys a wide variety of meals and has elected to eat in the main dining room with hotel guests and selects from the hotel menu at breakfast and evening dinner. The lunchtime meal is of the resident’s choice and usually consists of a snack type meal. In addition drinks and snacks are available at any time as observed during the course of inspection. Although the current resident has no dietary needs or requirements, it is understood that specialist diets with regard to medical need could be accommodated and diets in respect of religious or cultural diversity addressed. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system and there is clear evidence that the resident accommodated has his views listened to and acted upon. Arrangements for protecting residents from abuse are in place in order to prevent against risk of harm or abuse. However further policies should be developed especially regarding residents monies to reinforce the informal procedure that is in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The New Monterey has available a complaint procedure that fulfils the requirements of this Standard. This information is also contained in the Statement of Purpose and Service User Guide. No complaints have been recorded for a considerable period of time and the resident stated that he “never has anything to complaint about” and if he did, he would speak with the homeowners straight away for the matter to be sorted about. An Adult Abuse Policy and procedures based on the Department Of Health ‘No Secrets’ document is available and compliant with the requirements of Regulation. In addition, one of the homeowners had undertaken an adult abuse-training course through alternative employment. Although policies in respect of physical aggression and service user gifts and wills were evidenced, further policies should be developed regarding service users money and New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 15 financial affairs, the safe storage of monies and valuables and advice on personal insurance. This recommendation has been identified in previously inspections and should be addressed. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 16 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. The standard of the environment is good and meets the needs and requirements if the current resident. However whilst the environment is attractive and welcoming, it is predominantly a large seaside hotel accommodating short-term holiday guests rather than providing a homely and permanent environment for older people who require a degree of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As at previous inspections, the current resident voiced his complete satisfaction with the facilities and services at the New Monterey and although this is a large residential hotel and public rooms reflect the requirements of hotel guests rather than providing a homely, domestic type environment, it suits his needs and requirements at this present time. There is a car park and large patio area to the front of the building that is provided with tables, seating New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 17 and umbrellas and a ramped access enables ease of access. It is evident that a programme of routine maintenance and renewal of the fabric of the building and decoration is maintained and the property complies with current requirements of the Fire Service and Environmental Health Department. Since the last inspection the resident has chosen alternative registered bedroom accommodation. However, the new bedroom door has not been provided with an appropriate locking mechanism that could be swiftly opened in the event of an emergency. It is strongly recommended that this be provided. Laundry facilities at the New Monterey are located in the basement area of the home and do not intrude on service users accommodated. However the current resident’s laundry is laundered in the proprietor’s own private accommodation rather than the hotel laundry. It is understood that the equipment used is compliant with requirements. To date only one policy is available in respect of health and hygiene and limited progress has been made with regard to the development of further policies. It is recommended that policies and procedures be developed for the control of infection including the safe handling and disposal of clinical waste, dealing with spillages, the provision of protective clothing and hand washing. The development of these policies has again been identified in previous reports and should be introduced. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 18 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): None of these standards were assessed, as The New Monterey Hotel does not employ care staff. However comments have been made in respect of the recruitment process of hotel staff. Quality in this outcome area is N/A Although the New Monterey does not employ care staff the registered providers work positively with the single service user to maintain or improve his whole quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although the New Monterey does not employ care staff, with any care needs and domestic care needs of the current resident provided by the homeowners, a structured recruitment process is in place in respect of cook and domestic staff. These staff members are predominately employed in respect of the hotel guests but the cook also provides a service to the single service user accommodated. Recently a new cook has been appointed for the hotel and although a Criminal Records Bureau (CRB) clearance is not required for the cook in this capacity, a satisfactory CRB clearance must be obtained to fulfil the requirements of the Care Standards Act 2000 as she/he provides a direct service to the resident. . New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 19 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 & 38 Quality in this outcome area is good. The homeowners are experienced in running a small care home where dependency needs are limited. In order to provide a good quality service, one of the homeowners has completed a nationally recognised qualification in care and is planning to undertake a more advanced care and management qualification. The system for consultation with the single resident is good with evidence that the resident’s views are sought and acted upon. Further policies and procedures need to be developed in respect of health and safety issues to ensure that the homeowners and other staff are fully aware of the of processes to be adopted. This judgement has been made using available evidence including a visit to this service. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 20 EVIDENCE: The homeowners are experienced to run the care home and meet the needs of the current service user. One of the homeowners has successfully completed a National Vocational Qualification (NVQ) Level 3 award in care and has more recently, achieved an A1 NVQ training qualification. Through discussion, it is understood that this homeowner is to commence a more advanced level NVQ Level 4 qualification in care and management in the New Year. Additionally, this homeowner has undertaken a variety of other relevant training courses through alternative employment in order to increase her skills and knowledge. Quality assurance and quality monitoring systems are in the main based on an informal process of verbally seeking the views of the resident. At present, this informal method of quality assurance suits the needs of the current resident and it is clearly evident that the resident is completely satisfied with the services and facilities provided. As previously stated in this report, care staff are not currently employed at the New Monterey and ancillary staff are supervised as part of the normal management process. However it is recommended that a formal recruitment policy and procedures be developed especially if it is anticipated that care staff may be introduced in the future. With regard the employment of care staff, these should include, induction, training, and supervision arrangements. The current resident remains financially independent and controls his own monies. Written records are maintained of all financial transactions that was evidenced at the time of inspection however as identified at the last inspection, this document should also clearly identify the amount that is retained in respect of residential fees from the resident’s benefit entitlement. It was also noted that the amount of residential fees paid by the Local Authority had been inaccurately recorded for a number of months. It is essential that all financial records are accurate in content to provide a clear audit trail. The resident stated that he was satisfied with the current financial arrangements in respect of fees/personal allowance at the home but complained that the personal allowance did not go very far. From discussion with one of the homeowners it is understood that a member of the hotel staff team has been given direst responsibility for health and safety issues within the hotel that includes the accommodation occupied by the single resident. In addition, one of the homeowners is to undertake an extended health and safety-training course in the New Year secured from alternative employment along with the extended ‘First Aid at Work’ first aid qualification New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 21 From observation of training certificates, it was evident that one of the homeowners has received moving and handling training and basic first aid training through alternative employment. It was also confirmed that all hotel staff receive fire safety training and that the Fire Service undertake an annual inspection in respect of the accommodation. Through discussion with one of the homeowners, it is understood that catering staff have food hygiene certificates. As identified in previous reports, a health and safety policy and COSHH guidance has now been provided, further policies and procedures in respect of safe working practices should be developed. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable 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 N/A 28 N/A 29 N/A 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation Sch 2 Requirement The cook who provides a service to the service user must have a satisfactory CRB clearance. (Previous date of 30/09/05 not met). Timescale for action 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP9 OP18 Good Practice Recommendations It is recommended that an alternative format be introduced to record medication administered. Further policies should be developed in respect of residents monies and financial affairs, the safe storage of residents monies and valuables and advice on personal insurance. It is recommended that an appropriate locking mechanism be provided to the resident’s bedroom door that can be quickly opened in the event of an emergency. Further policies and procedures should be developed to ensure hygiene is maintained in the home. At least one of the homeowners should obtain an NVQ Level 4 qualification in care and management or DS0000009910.V315869.R01.S.doc Version 5.2 Page 24 3 4. 5. OP19 OP26 OP31 New Monterey 6. OP35 7 OP38 equivalent. The financial records should also identify the amount of money retained from the resident’s benefit entitlement in respect of residential charges. All financial records should be accurate in content. Further policies and procedures should be developed in respect of all safe working practices and infection control training should be provided. Reference should be made to all aspects of this Standard to ensure compliance. New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 25 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 New Monterey DS0000009910.V315869.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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