Inspection on 14/07/05 for New Monterey

This inspection was carried out on 14th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 10/11/06

New Monterey 18/11/05

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 14th July 2005 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 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 F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service New Monterey Address 20-22 North Promenade St Annes On Sea Lancashire FY8 2NQ 01253 723392 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Valerie Buckley Care home only 3 Category(ies) of OP Old Age (3) registration, with number of places New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 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 within a residential care environment 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 resourses 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 service users in the warmer weather. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of four hours and during the course of the inspection, in depth discussion took place with one of the homeowners and the single resident that has lived at The New Monterey for a considerable period of time. A number of records and policies and procedures were also examined and a brief partial tour of the building took place. What the service does well: What has improved since the last inspection? The homeowners work hard to make sure that the needs and wishes of the resident are met. Since the last inspection, one of the homeowners has successfully completed a nationally recognised National Vocational Training Level 3 Award in care. This has provided the homeowner with increased skills, knowledge and understanding in order to provide a good quality service that meets the requirements of the current service user. As previously recommended, improvements have been made to the way any complaint would be recorded and a further policy and procedures has developed with regard to a resident’s wants and needs at the end of their life. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The pre admission assessment form that is used by the home owner to identify what the prospective service user 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. EVIDENCE: Currently The New Monterey accommodates only one service user who was admitted prior to the introduction of the Care Standards Act 2000. Although there have been no new admissions to the home for some considerable period of time, The New Monterey has devised a pre admission assessment form that has since been used to identify the strengths, needs, wants and wishes of the current service user that is compliant with recommendations. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 9 It is understood that this pre admission assessment form would be used to identify the strengths and needs of any prospective future service user in order to establish it their requirements could be adequately met. Any potential service user would also be invited to visit the establishment 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 F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 & 11 There is a clear and consistent care planning system in place that provides sufficient information to satisfactorily meet the current service user’s needs. The homeowners have a good understanding of the service user’s support needs. This is evident from the positive relationship, which have been formed between the owners and the service user. Support for the service user is offered in such a way as to promote and protect the service users privacy dignity and independence. EVIDENCE: The service user’s plan of care, based on the outcome of the holistic assessment of current strengths and needs was evidenced. This document is routinely reviewed on a monthly basis and clearly identifies the current situation in respect of the service user accommodated. However, as the current service user is completely self-caring, has no personal care needs and has elected to determine his own social needs independently, to date the existing care plan has required no amendment. From discussion with the service user it was clearly evident that he was fully involved in the development of the care plan and he stated that he had only agreed to sign the care plan when he was completely satisfied with the content. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 11 The current service user prefers to attend to his own health care requirements and is currently able to undertake these tasks as and when required. The homeowners place emphasis on maintaining the psychological health of the service user and ensure that the resident has sufficient funds to maintain his previous life style. It was observed at the time of inspection that the service user determines the social and physical activities of his choice. 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. The current service user however has elected to arrange and self administer his own prescribed medication and has been provided with a locked metal box in his bedroom accommodation to store medication safely. Through discussion with the service user, it was confirmed that the values of privacy and dignity are promoted and maintained to his satisfaction. Consultations take place in the privacy of individual bedroom accommodation or any area of the service user’s choice. The preferred term of address of the service user was established at the time of admission, identified on the assessment document and as observed, always respected. From discussion with the proprietor, it was established that service users wishes concerning terminal care and arrangements after death would be discussed and outcomes identified on the individual care plan. This was evidenced on the current service user’s care plan. Appropriate care, support and pain relief would be secured through the intervention of relevant medical professionals. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the four standards were assessed at this inspection. EVIDENCE: None of the four standards were assessed at this inspection. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 The home has a satisfactory complaints system and there is clear evidence that the service user accommodated has his views listened to and acted upon. Arrangements for protecting service users from abuse are in place in order to prevent against risk of harm or abuse. However further policies should be developed especially regarding service users monies to reinforce the informal procedure that is in place. 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. Although no complaints have been recorded for a considerable period of time, as recommended in the last inspection report an individual complaint form has now been devised that would detail the nature of any complaint raised, the process of investigation, any action taken as a result of the complaint and the date the complainant is informed of the outcome of the complaint. The current service user stated that he never has any complaints and if he did, he would speak with the homeowners straight away ‘to get the matter sorted out’. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 14 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 financial affairs, the safe storage of monies and valuables and advice on personal assurance. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 standard(s) 19 & 26 The standard of the environment is good and meets the needs and requirements if the current service user. 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. EVIDENCE: The current service user 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 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. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 16 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 service user’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 essential 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. Through discussion with one of the homeowners, it is understood that these policies and procedures will be developed in the near future. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 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. EVIDENCE: Although the New Monterey does not employ care staff, with any care needs of the current service user provided by the registered providers, a structured recruitment process was evidenced 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. Whilst the information and clearances required by regulation were available in respect of the home owners, it was unclear if all the requirements including a standard Criminal Records Bureau (CRB) clearance had now actually been obtained in respect of the cook who has worked at the New Monterey for some considerable period of time. Please advise in the Action Plan the date the CRB clearance was submitted and confirm if this document has now been received and deemed to be satisfactory. It is recommended that the existing documents held in respect of this person be evidenced against the requirements of Schedules 2 & 4 (6) The Care Home Regulations 2001 and Standard 29 Care Homes For Older People, National Minimum Standards to ensure compliance. It is essential that no newly appointed staff, that provide a service to the service user, take up employment until all the requirements in respect of staff recruitment are fulfilled. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36 & 38 The registered providers 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 recently completed a nationally recognised qualification in care and is planning to undertake a more advanced care qualification. The system for consultation with the single service user is good with evidence that the service user’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. EVIDENCE: The registered providers are experienced to run the care home and meet the needs of the current service user. Since the last inspection, one of the registered providers has successfully completed an NVQ Level 3 award in care. Through discussion, it is understood that this registered provider is to apply to undertake the Registered Managers Award in the near future. Additionally, this New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 19 provider has undertaken a variety of other relevant training courses through alternative employment in order to increase her skills and knowledge. Since the last inspection no further progress has been made in the development of further policies and procedures in respect of good practice principles, however it is understood that attention is to be given to this matter in the near future. It is important that the remaining policies be devised, introduced, and regularly reviewed in light of good practice and changing legislation. Quality assurance and quality monitoring systems are in the main based on an informal process of verbally seeking the views of the service user. At present, this method of quality assurance suits the needs of the current service user and it is clearly evident that the service user 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. With regard the employment of care staff, these should include, induction, training, and supervision arrangements. Formal supervision has not been introduced as no care staff are currently employed. Whilst it is acknowledged that the current service user has no care needs and is independent in respect of personal care tasks, it is recommended that consideration be given to introducing infection control training and a qualified first aider, who has undertaken additional first aid training should be on duty at all times. From observation of training certificates, it was evident that one of the providers 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 proprietors, it is understood that catering staff have food hygiene certificates. Although a health and safety policy was evidenced and COSHH guidance has now been provided, further policies and procedures in respect of safe working practices should be developed. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x 2 x x 3 x 2 New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 21 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 29 Regulation Schedule 2 The Care Homes Regulation s Requirement The cook who provides a service to the service user must have a satisfactory CRB clearance. (Previous date of 30/04/05 not met). Timescale for action 30th September 2005 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. Refer to Standard 18 Good Practice Recommendations Further policies should be developed in respect of service users monies and financial affairs, the safe storage of service users monies and valuables and advice on personal insurance. Further policies and procedures should be developed to ensure hygiene is maintained in the home. The registered proprietor/manager should obtain by 2005 a level 4 NVQ in management and care or equivalent. Further policies and procedures should be developed to promote and make proper provision for the health and welfare of the service user. It is recommended that consideration be given to developing employment policies based on equal opportunities. Further policies and procedures should be developed in F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 22 2. 3. 4. 5. 6. 26 31 33 36 38 New Monterey respect of all safe working practices. Infection control training should be provided and a qualified first aider should be on duty at all times. Reference should be made to all aspects of this Standard to ensure compliance. New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 1, Tustin Court Portway 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. Extracts may not be used or reproduced without the express permission of CSCI New Monterey F57 F09 S9910 New Monterey V191948 080705 Stage 4.doc Version 1.40 Page 24 - 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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