Inspection on 27/11/06 for North Shore Care Home

This inspection was carried out on 27th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

North Shore Care Home 22/05/07

North Shore Care Home 13/06/06

North Shore Care Home 15/11/05

North Shore Care Home 05/07/05

North Shore Care Home 11/11/04

North Shore Care Home 27/04/04

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

CARE HOMES FOR OLDER PEOPLE North Shore Care Home North Shore Care Home 3 St. Stephens Avenue North Shore Blackpool Lancashire FY2 9RG Lead Inspector Mrs Jackie Riley Unannounced Inspection 27th November 2006 09:30 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 North Shore Care Home DS0000006065.V321867.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. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service North Shore Care Home Address North Shore Care Home 3 St. Stephens Avenue North Shore Blackpool Lancashire FY2 9RG 01253 351824 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) Mrs Brenda Christine Bell Mr. Keith Bell Care Home 25 Category(ies) of Dementia (25) registration, with number of places North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A qualified nurse must be on duty at all times in the home. Date of last inspection 13th June 2006 Brief Description of the Service: North Shore care home with nursing is an establishment providing residential and nursing care for up to 25 residents, who suffer from dementia. The home is situated in a residential area of Blackpool. There are three floors and a rear extension. There are twenty-three single rooms of which sixteen are en-suite. The home is equipped with an appropriate range of aids and adaptations suitable to meet the needs of residents living at the care home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home, however it should be noted that due to the level of understanding of most residents due to dementia, most of the information is used by relatives or advocates of the resident. At the time of the inspection the fees ranged from £357.34 to £500.00 per week. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second Key Inspection for the inspection period of 2006-2007. It was undertaken over a six and a half hour period of the day. Some of that time a second inspector was making direct observations of residents and staff in order to contribute to the outcome of the inspection process. The owner, manager and three members of staff were on duty and spoken to throughout the inspection process. In addition a number of residents and one relative was spoken to and their comments can be found in the main body of this report. In the previous twelve months the Commission has investigated one complaint. It was found to be partially substantiated and related to the general running of the care home. The issues have been fully investigated in conjunction with the management team and the areas of concern have been addressed with action taken to improve areas identified. What the service does well: What has improved since the last inspection? There is attention given on a daily basis to the care of hair and nails of residents, so that a resident’s appearance maintains their dignity. There is an improved quality monitoring system in place so that the management team know how the home is operating for the best interests of users of the service. There are systems in place so that all areas of infection control are in place for the health and welfare of users of the service. All new staff have in place criminal record disclosures (CRB) prior to commencing work in the home for the protection of users of the service. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 6 All necessary records regarding the running of the home are in place for inspection. The safe management of resident’s monies has improved so that the system protects users of the service. 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. North Shore Care Home DS0000006065.V321867.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 North Shore Care Home DS0000006065.V321867.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): 1,2,3 Quality in this outcome area is adequate. This quality judgement was made using available evidence including a visit to the service. Prospective residents have information to make an informed choice about living in the home. The lack of complete assessments potentially leaves residents at risk. EVIDENCE: The home provides information relating to the home and the services it offers to prospective residents and relatives prior to and during the admission process so that they know what to expect when they live in the home. One comment received confirmed relatives know what to expect from the home. A comment included, “ We were given all the information we needed, so that we knew mum would be cared for”. Three residents files were seen, they included information about the residents, and the level of care to be provided, however in one instance a resident had been admitted without a full assessment and did not provide enough information, which would inform staff of this persons individual needs. In all instances where an admission is to take place there must be evidence of a full North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 9 assessment so that the home knows it has the skills, knowledge and services to meet the individual needs of a resident. All residents have in place contracts with the home laying out the terms and conditions of their residency there, so that they know what to expect form what the service is to provide and what it wont provide. North Shore Care Home DS0000006065.V321867.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 adequate. This judgement has been made using available evidence including a visit to this service. Healthcare needs are met by the home, however they could be compromised due to a lack of information on some records. Medication practices are safe for the protection of residents. Resident’s privacy is recognised and respected at all times. EVIDENCE: The home focuses on the specific needs of residents, with evidence of access to healthcare professional including, dentists and opticians. At the time of the visit one resident was being assisted to a hospital appointment. It was noted through observation of three resident files that in one instance there was no record of a residents specific healthcare needs, and the service user plan was not complete thereby having the potential for staff to be misguided in what the specific needs of this person are. The staff team are motivated and demonstrated a good sound knowledge of residents living in the home. They gave examples of some of the idiosyncrasies North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 11 demonstrated by residents. There was no evidence of staff being judgemental in any way. One staff member said, “ this is new for me but I’m really enjoying it and have learnt a lot about how people with dementia need to be cared for”. Medication practices are taken seriously by the home. Only trained staff are responsible for medication, and they would benefit from regular updated training so that they are familiar with current good practice guidelines so that practices are safe and protect residents. Medication storage, administration and records were found to be satisfactory. The home takes residents rights to privacy and dignity seriously, in that residents are assisted in personal tasks in a sensitive manner. Staff spoken to said “we always make sure doors are closed”. Due to the dementia suffered by some residents staff commented how this is particularly important. North Shore Care Home DS0000006065.V321867.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 adequate. This judgement has been made using available evidence including a visit to this service. There are limited activities available in the home to meet the specialist needs of an elderly resident group with dementia. Contact with family and friends is encouraged by the home. Residents receive a healthy and varied diet according to their needs and choice. EVIDENCE: There was no evidence the home has further developed the activity programme seen in place during the inspection of June 2006. Whilst the home recognises there is a need to make sure residents living in the home have access to activities, there was little evidence of this occurring. Staffing levels were seen to be an issue in the development of such programmes, in that there were minimum staffing levels on duty therefore their deployment was task focused with little time for additional therapeutic time for residents. This issue was discussed with the provider and manager of the service at the time of the site visit and it was agreed the staffing ratio would be increased to allow for the therapeutic development of activities. There are no restrictions to visitors coming into the home. A visitor was spoken to and commented positively about coming to the home and said North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 13 “there are no restrictions and the staff team are really helpful”. A resident spoken to had their spiritual needs met at the home, and assisted by staff to visit church. Diet and nutrition is taken seriously by the home. Residents have choice of meals on a daily basis. Staff spoken to know what residents they like and don’t like. The chef was spoken to and has a good knowledge and understanding of the nutritional needs of residents as well as the special diets required by some residents living at the home. North Shore Care Home DS0000006065.V321867.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by a satisfactory complaints system in place. Staff training in safeguarding adults is limited thereby having the potential to put residents at risk. EVIDENCE: Residents ability to make independent complaints is hindered due to the dementia conditions suffered by them. Information regarding how to make a complaint is provided to relatives and friends so that they know how to make a complaint to the home or independently of the home. One comment reviewed during the site visit suggested relatives have been given information about how to make complaints or raise concerns with the home. There has been one complaint investigated by the commission since the site visit in June 2006. The complaint related to the general running of the home. This was fully investigated in conjunction with the management team and the outcome was partially substantiated. The home had addressed the issues and improvements have been made. The home has safegarding adults policies and procedures in place. Training for staff in this area is not consistant. Staff spoken to said” its covered in induction”, however there is a requirement to ensure all staff working in the home receive training to make sure they are competent in the knowledge of how to recognise abuse, and what action must be taken, this includes access to a whistleblowing policy, so that staff feel they are protected. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 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. 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. The premises provide an environment in which residents can feel comfortable. The home is well maintained both externally and internally. EVIDENCE: There is a continuing commitment by the home to make sure the environment is comfortable for residents to live in. Rooms seen are personalised and homely. A number of residents and visitor spoken to praise the way the individual rooms are decorated and said they “feel comfortable in the home”. There is a passenger lift in place for the use of residents with reduced mobility. There are a number of other aids and adaptations in place, which meet the specific needs of users of the service. There has been a change of floor covering throughout the ground floor communal areas, which is of a” non slip” laminate. It reduces the probability of offensive odours and was commented on positively by both visitors and staff. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff on duty is insufficient and has the potential to provide only limited support to residents. Recruitment practices make sure residents are protected. Training is in place but staff do not always receive training for the needs and protection of the client group. EVIDENCE: Staffing levels seen at the time of the site visit were being operated on minimum levels in that one manager and two carers were on duty during the afternoon period. This meant there was no additional time to provide residents with therapeutic activity. Through observations made during the inspection process it was noted carers, whilst committed to provide a high level of care were task focused due to the staffing levels and the needs of residents in the home. Through discussion with the provider and the manager it was agreed the levels of staff would be increased so that there is additional time available to provide additional activities for the benefit of people living in the home. Staff recruitment has improved since the site visit in June 2006, in that three records seen had in place all “fitness” checks in place to make sure residents and users of the service are protected. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 17 The home has a training programme in place for all levels of staff, however through observation of some training files and discussion with staff it was found there is a need to make sure all staff have up to date training in essential areas including safeguarding adults, dementia care and up dated medication training so that the staff team are competent and feel confident in providing care to a specialist client group. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is provided with insufficient time to undertake her management responsibilities. Monitoring systems are in place to oversee the running of the home. Users of the service are protected by the systems of health and safety in the home. EVIDENCE: The home has developed a system whereby monthly reports are made available to the Commission showing the providers of the home are making monthly unannounced visits and reporting of the running of the home. This has been a positive development, however through the time spent on the site visit it was noted the manager of the home has limited time to complete the North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 19 management tasks necessary for the smooth running of the home, due to time needing to be spent working “hands on”, as part of the care team. Discussion with the provider and the manager identified the need for the manager to be able to undertake management tasks in time specifically made available for this, so that the records and management administrative tasks are carried out. The system for maintaining residents finances has been reviewed with security improvements being made for the safe keeping of resident’s money. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 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 3 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP31 Regulation 8 Requirement There must be a suitably qualified, competent registered manager to operate the care home. Previous timescales of 31/01/06 and 31/08/06 not met. There must be evidence of a full assessment of care needs prior to a person entering the home. Previous timescale of 31/08/06 not met. The identified healthcare needs of individual residents must be adhered to. The home must ensure there is an activity programme in place to meet the needs of people with dementia. Previous timescale of 31/10/06 not met. Staff must receive training in Adult protection and whistle blowing for the protection of users of the service. Previous timescale of 31/08/06 not met. There must be sufficient levels of staff on duty including additional staff at the busiest times to meet the needs of residents. Previous timescale of 14/07/06 not met. The manager must be able to DS0000006065.V321867.R01.S.doc Timescale for action 31/01/07 2. OP3 14 31/01/07 3. 4. OP8 OP12 12 16(2)(n) 31/01/07 31/01/07 6. OP18 18 31/01/07 7. OP27 18(a) 31/01/07 8. OP31 10 31/01/07 Page 22 North Shore Care Home Version 5.2 discharge the necessary time for carrying out management tasks. 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 OP36 Good Practice Recommendations The home should continue to develop its supervision programme in order to support individual staff members in their role and for their personal development and training. North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 Page 23 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 North Shore Care Home DS0000006065.V321867.R01.S.doc Version 5.2 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. 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