Inspection on 05/07/05 for North Shore Care Home

This inspection was carried out on 5th 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 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 27/11/06

North Shore Care Home 13/06/06

North Shore Care Home 15/11/05

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 3 St Stephens Avenue North Shore Blackpool FY2 9RG Lead Inspector Jackie Riley Announced 5 July 2005 9:30am th 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. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service North Shore Care Home Address 3 St Stephens Avenue North Shore Blackpool FY2 9RG 01253 351 824 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 Brenda Bell l Care home with nursing 25 Category(ies) of DE Dementia (25) registration, with number of places North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. A qualified nurse must be on duty at all times in the home. 2. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 11th November 2004 Brief Description of the Service: North Shore Nursing Home 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 extention. There are twenty-three single rooms of which sixteen are en-suite. Security pads are in place at the fromt door and between the ground floor corridor and the extention area, this is for the safety of residents. The home is equipped with an appropriate range of aids and adaptations susitsable to meet the needs of residents living at the care home. There is a requirement for a registered manager to be in post in order to meet the condition of registration. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. It took place on the 5th July 2005 and was conducted for approximately 6 hours. Discussion took place with the homeowner and temporary manager. Two staff interviews took place and three staff files were tracked in addition to informal discussion with staff members. Discussion with a number of residents took place however there thoughts and comments are not included in the report due to their limited understanding relating to their dementia conditions. There was one professional comment card received which reflected favourably on the homes provision of care. Six other comment cards were received prior to the inspection, which were generally favourable however three of the comments referred to levels of staff on duty, and the report reflects the findings of staffing levels in the main body of the report. Questionnaires were handed to residents and staff. In addition questionnaires were sent to a number of social workers and GP surgeries to comment on the standard of care provided by the home. There is a requirement for the home to employ a suitably qualified registered manager. What the service does well: What has improved since the last inspection? Recording systems in the home have recently been reviewed and improved upon, to include all areas of healthcare and review. Medication systems have recently been reviewed following the pharmacy visit. Requirements and recommendations identified are being acted upon. Training is now in place for all care staff with responsibility for medication dispensing. The distribution of staff has improved upon, in that they are working in both front lounges. Meals are now taken in the rear dining area and front lounge, North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 6 and staff breaks are taken in stages ensuring there are at all times sufficient staff available for residents. 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. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 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 North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 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) 1, 3. Residents have an assessment plan in order to ensure their needs can be met by the care home, however residents transferred from other homes must have a full assessment in order to ensure their needs can be met. Relatives are encouraged to visit the home prior to the admission of a relative in order to ensure the services in place meet the needs of residents. EVIDENCE: Individual professional assessments were generally complete and contained information relating to the needs of that person. However there was evidence some residents admitted from other care homes had limited information provided by the previous care home as to the needs of that person. There is a requirement for the home to get information relating to the person prior to admission to the care home in order to ensure the persons needs can be met. Staff spoken to are fully informed of the needs of people living in the home. There were no visitors available but one staff member commented, “we encourage relatives or friends to have a good look round before making a decision, and we give them written information”. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 9 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 Records recording the health care needs of residents must be consistent and reviewed regularly to ensure they can be fully met do not present significant risk to the resident. Medication management is being improved upon to ensure the safety of residents in the home. EVIDENCE: Individual records are kept for each resident with a plan of care setting out action necessary by care staff to ensure all aspects of health, personal and social care needs of the residents were met. However the records were not complete on three files examined. Risk assessments, have now been included in all care plans, including activities, and recording individual preferences. Reviews are not taking place regularly and must be addressed. One staff member spoken to commented on how well they work with district nurses and other professional in meeting the health needs of residents living at the home. The daily records were clear and provided good recording of events for individual residents and action taken to resolve issues. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 10 There has been a recent review of medication practices in the home following a visit by the Pharmacy Inspector. New systems have been introduced which will now ensure the safety of medication practices. Staff have also been enrolled on a two-day course with the pharmacist, to update their knowledge and skills in this area. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 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 standard(s) 12, 13 Social activities are in place but could be further developed to meet the specialist needs of residents living at the home. There are no restrictions for visitors, who can see their relatives and friends at any time therefore promoting personal relationships. EVIDENCE: There is a limited activity programme in place. This includes games and some reminiscence and recall therapy, as well as staff encouraging residents to join in singing and dancing. The home would benefit from researching other forms of activity specifically designed for people suffering from dementia. One staff member said, “I would like to do more reminiscence and recall therapy for them, as they seem to like that sort of thing”. Staff were enthusiastic to develop activities specifically for the specialist needs of residents living at the home, to ensure they are suitable and stimulating for them. Residents have various limits on their ability to make choices, however staff were seen to help and gently guide them in all areas of their daily lives. Staff spoken to commented, “we recognise what they like from watching their actions, and following the care plans, if they don’t want to join in they don’t have to”. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 12 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 arrangements for recording and reporting of complaints are in place, however there is a need to ensure all complaints are recorded and acted upon ensuring people feel listened to. Staff demonstrated knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a complaints procedure in place and staff spoken to were able to explain the process. There was a lack of records recording recent complaints and investigations at the home. There must be records completed in all instances where complaints or investigations are carried out, in order to demonstrate action taken to protect staff and residents. There has been two complaints investigated in the last twelve months, one by the Commission, which was partially substantiated and one investigated by the home which was found to be unsubstantiated. The home has a procedure in place for dealing with allegations of abuse. Two staff members spoken to were able to communicate the procedures involved when abuse is suspected including reference to the homes whistle-blowing policy. Staff spoken to have received training in relation to complaints and abuse in their NVQ (National Vocational Qualification) training. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 13 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) The standards were not inspected during this inspection. EVIDENCE: North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 14 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) 27, 29, 30 The procedures for the recruitment of staff are in place but do not adequately provide safeguards to offer protection for people living in the home. The numbers of staff on duty were satisfactory to meet the needs of people living in the home, however there should be adequate staffing numbers on duty at times when additional activities are taking place due to the high level of care required by residents. Staff have access to training to ensure they are competent and qualified to meet the needs of residents. EVIDENCE: The staff recruitment records showed there is a requirement to ensure police checks have been carried out prior to staff commencing work at the home, to ensure the safety and protection of residents living at the home. This has been a requirement on the last two inspections and the issue remains of serious concern to the Commission. There were a number of staff files, which showed references had been put in place after commencement of employment at the care home. The home must adopt appropriate recruitment practices to ensure the safety and protection of residents at all times. An immediate requirement notice was issued for the home to ensure that proper checks are taken up prior to people commencing employment Staff training is available to all levels of staff. Two staff spoken to, have attended a number of courses relating to the needs of residents living in the North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 15 home. One member of staff commented on how the training is helping her to do her job. The numbers and skill mix of staff was generally adequate, however there are times when staffing levels must be appropriate when additional activities are taking place. There has been a recent review of the distribution of staff in the home, which now ensures there are staff available at all times in the front lounge areas. Staff breaks are now staggered ensuring there are appropriate levels of staff available to meet the needs of residents at all times. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 16 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, 32, 33 Staff support is limited due to the lack of a registered manager, which may result in lack of motivation and could have the potential of a high turnover of staff. The staff team are focused on ensuring residents needs are met in full, although there is a need for a manger in place to provide leadership and management in the day to day running of the care home. EVIDENCE: There is a requirement for a registered manager to be in place in order to provide the home with leadership and management support. Application has been made to the Commission but is presently on hold due to the manager being on sick leave. Staff gave examples of the high level of service they provide, although this needs to be supported from a direct level of guidance and management support, to ensure the smooth running of the home. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 17 There has recently been management support put in place on a temporary measure, which is ensuring all aspects of management responsibility in the smooth running of the home, whilst providing staff support at all levels. Staff spoken to commented on how they now feel supported by the temporary manager. This will have to be reviewed when the manager returns to work. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 18 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 3 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 2 3 x x x x x North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 19 yes 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 3 Regulation 14 Requirement The home must ensure a full assessment of the resident is received by the home at the time of admission. All healthcare records must be complete with evidence of review The medication procedures must be in place and managed by people trained and competant to administer medicaiton in the home. Records must be made of all complaints investigations carried out by the home. All staff employed at the care home must have satisfactory police checks and references in place prior to commencement of employment at the care home.(Timescal of 27.4.05/22.22.05 not met) There must be a suitably qualified, competant registered manager to operate the care home. Timescale for action 31.8.05 2. 3. 7 9 17 13(2) 31.8.05 31.8.05 4. 5. 16 29 17 19 31.8.05 5.7.05 6. 31 8 30.9.05 North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 20 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 12 32 Good Practice Recommendations Activities should be further developed to meet the needs of a dementia group. There should be clear leadership and management of the care home. North Shore Care Home F57 F09 S6065 North Shore Care Home V167936 050705 Stage 4.doc Version 1.40 Page 21 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. 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