CARE HOMES FOR OLDER PEOPLE
Princess Alexandra Home For The Blind Bosworth Place Squires Gate Blackpool Lancashire FY4 1SH Lead Inspector
Kevan Royston. Unannounced Inspection 17th August 2006 14:00 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 Princess Alexandra Home For The Blind DS0000009733.V299913.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. Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Princess Alexandra Home For The Blind Address Bosworth Place Squires Gate Blackpool Lancashire FY4 1SH 01253 403091 01253 407010 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) Blackpool, Fylde & Wyre Society For The Blind Miss Elaine Wright Care Home 40 Category(ies) of Sensory impairment (2), Sensory Impairment registration, with number over 65 years of age (38) of places Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered numbers to include two (2) named person between 50 and 65 years of age. 19/11/05 Date of last inspection Brief Description of the Service: The Princess Alexandra home for the Blind is registered for 40 people aged 60 and over who are visually impaired. The home is situated in its own grounds close to the sea front and south shore shopping centre. Local bus and tram routes are near by. All the rooms are single occupancy and provide en-suite facilities. Communal lounges are located on both floors. There is a large dining area on the ground floor. Communal bathrooms and toilets provide aids and adaptations. The outside of the building provides seating for residents with large lawned areas available. Ramp access is provided at the front of the building. The fees for the home are £320.00. Extra charges at the home are for Hairdressing £5.50-£15.00, and chiropody £15.00 Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days on the 18th of August and 8th of September and was over a period of 7 hours The Inspector spoke to the manager, five staff, five residents and a group of residents in the lounge area. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. The response from surveys sent to relatives, residents and GP surgeries for their opinions on how the home is run were good .17 completed questionnaires were received from relatives and residents, and one from a GP. All comments were positive about the standard of care provided by the home. Records of two staff members were also examined. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well:
Training opportunities for staff are good, accessible and they are encouraged to attend courses to develop their skills and competencies ensuring residents are receiving the care and support required. Staff spoken said, “I have done my NVQ training and I really feel it helped me” Another said, “I can’t believe how much training they put on its very good”. Examination of personal training records confirms training of staff is a priority and ongoing to ensure they are confident in providing care to the residents. The Manager spoken to said, “We always are looking at training”. Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 6 The inside of the building is set out purposely and decorated to consider partially sighted and blind people. And this ensures the residents are familiar with the surroundings and provide a safe environment. A resident spoken to said “I can find my way around the home without to much difficulty “. Another said, “The bright colours help me”. Observation of interaction between staff and residents confirmed staff displayed a caring, supportive and patient attitude ensuring the resident’s welfare is maintained and relationships can develop. Staff were observed laughing and joking with residents, one staff was supporting a resident at breakfast time discretely. Residents spoken to said, “The staff are great they know how to look after me and what I like”. Another said, “They are very patient “. Monthly reports provided by an independent person required by regulation are sent to the Commission for Social Care Inspection (CSCI) and ensure the smooth running of the home and demonstrate any developments that are taking place. Discussion with the manager informed the inspector a General Practitioner (GP) visits the home every month and holds a surgery for any residents who are suffering health problems ensuring residents receive medical attention on a regular basis and health needs are monitored. The manager spoken to said, “It works well for the residents and any health problems are sorted out “. The home is clean and tidy with attention to cleanliness taken seriously. Comments from surveys returned from relatives /residents included “Very clean home”. And, “Very high standard achieved”. One staff member spoken to said “I am responsible for a section of the home and we always have enough domestic staff to keep it clean”. What has improved since the last inspection?
There are now over 60 of staff with a recognised qualification in care required by National Minimum Standards ensuring care staff have the competencies and skills required to work in a care home. A new recording system has been introduced for all residents needs, care plans and general running of the home ensuring accurate, thorough information is recorded and improve the monitoring of the residents requirements and general development of the home. The manager said, “It’s a much better, easier quality assurance system to follow once its up and running”.
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 7 Activities are more structured to suit the residents with entertainment arranged by staff on three days a week to make sure residents social interests are being provided. Residents spoken to said, “I enjoy the sing-a-long each week”. Another said, “Its nice we go on outings”. A member of staff spoken to said “We go through with each resident and see what they like and try to accommodate them”. 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. Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of two residents were examined and all had full assessment information. Both residents are self funded and had been assessed by the registered manager and contained the information required to develop a care plan to ensure all health and welfare needs are identified and recorded. One resident spoken to said, “I came here for lunch before being admitted and the manager went through health problems”. Princess Alexandra Home For The Blind DS0000009733.V299913.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. EVIDENCE: Records of two residents were examined and accurately reflected the individual’s health and social care needs. Care plans were up to date and regular reviews taking place ensuring the welfare of residents is continuously monitored. Records examined confirmed risk assessments have been completed and are constantly reviewed and updated reflecting any changes that have occurred individually and in the environment ensuring the resident’s needs are being met. A resident spoken to said, “We go through with staff what I require when I come here”. A new system of recording is being developed which will ensure accurate easier to follow monitoring of residents
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 11 needs. The manager spoken to said, “The new system will be good and once staff are trained it will be better”. Medication practices observed were safe and good records had been kept ensuring residents health is maintained. A member of staff spoken to said, “Only trained staff administers”. Another member of staff said, “Any medication not used is returned”. Resident’s dignity was observed and ensures there privacy is respected. This was confirmed by observing staff members knocking on doors before entering rooms. One resident spoken to said, “One thing the staff are very polite and respectful”. Staff spoken to said “In induction privacy and dignity is covered”. Princess Alexandra Home For The Blind DS0000009733.V299913.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: As of previous inspections a catering agency makes meals on the premises and employs staff. Meals were seen to be wholesome, with menus balanced and interesting. Meal times are set although flexible enough to accommodate preferences. Special diets are accommodated and chefs provide diabetic and liquidised meals to suit the resident’s needs. Resident surveys and residents spoken to commented on the high quality of food at the home. Comments included “Meals are wonderful”. Lovely milky coffee”. And, “cannot fault the food they are good chefs”. The registered manager said there is often “theme days” which means special food and meals are provided to coincide with the particular theme of the day. Notices around the home of special menus evidenced this. One resident said, “We had French food the other day lovely”.
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 13 Activities are centred on each individuals preferences ensuring flexibility and residents can enjoy their own personal interests, which are recorded on their care plan. One resident spoken to said, “ I enjoy the trips out”. Structured entertainment planned by staff throughout the week, which residents join in is popular. Residents spoken to said, “I enjoy the music they put on”. Another said, “The entertainment they do is good”. Observations of residents rooms showed personal belongings are allowed into the home so to provide a homely atmosphere for each individual. Princess Alexandra Home For The Blind DS0000009733.V299913.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The management and staff have good knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents and relatives on admission and is included in the homes brochure ensuring the residents feel protected. Staff spoken to are aware of the complaint and abuse procedures. Members of staff spoken to said “Abuse issues is covered with the NVQ (National Vocation Qualification) course. A resident spoken to said, “If I have a problem I know who to speak to”. Resident surveys indicated they are aware of the complaints procedure ensuring they feel protected. Princess Alexandra Home For The Blind DS0000009733.V299913.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. EVIDENCE: The layout of the home is purpose built and decorated to support partially sighted and blind residents ensuring their needs are met and provide a safe environment. A tour of the building found the home to be clean and tidy. The home is maintained to a good standard and examination of maintenance records showed there is a rolling programme of general repairs and renewal of the premises ensuring the comfort and safety of the residents is maintained. A staff member spoken to said, “The home is kept clean each of us is responsible for a section “. A domestic staff member said, “I have done my NVQ which was
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 16 helpful”. Residents commented on the cleanliness of the home, Comments included “Very clean”. And, The girls are always cleaning the home”. The laundry area is situated in an area away from the dining room so that soiled items and clothing are not carried through where food is prepared, cooked or eaten. And the management has policies and guidance for laundry and the control of infection ensuring the home is kept clean, pleasant and hygienic. Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures and recording for the recruitment of staff are adequate. Further information checks are required on staff records to provide the necessary safeguards for residents. Training for staff is very good ensuring they have the skills and competencies for their roles. EVIDENCE: Observation of duty rotas and discussion with management and staff confirmed there were sufficient numbers of staff both domestic and carers on duty to ensure the resident’s needs are met. One member of staff spoken to said, “We are never down on staff”. Residents spoken to said, “There is always someone to help if needed”. Another resident said, “They don’t seem short of staff to me they are always around”. Examination of two staff files confirmed the recording procedures of the home are adequate. Staff records include, application forms, CRB (Criminal records
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 18 Bureau), POVA (Protection of Vulnerable Adults) checks and references were in place to ensure the residents are protected. Photographs of staff members must be on record as a means and proof of identification. The application form for potential staff must ask for a full employment history with any gaps explained to ensure the protection and safety of the residents is maintained. Examination of training records and staff spoken to confirmed the good training opportunities on offer. Staff members spoken to said “The number of courses you can go in is good”. Another said, “Training is a priority with the management”. Records show training is ongoing and the home now has 60 of staff that has completed NVQ (National Vocational Qualification) level 2 in care, which exceeds the 50 , required by the National Minimum Standards. Princess Alexandra Home For The Blind DS0000009733.V299913.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and good systems are in place for the protection of staff and residents. EVIDENCE: The registered manager has completed the necessary qualifications needed to meet the National Minimum Standards in management and care ensuring she has the skills and competencies to provide the support to staff and care to the residents. The manager said, “Two more seniors are taking the RMA (Registered managers Award”). Staff members said they found the management supportive and provided a clear sense leadership. Staff members said,“Good to work for “. Other
Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 20 comments included “Elaine is approachable I feel you can talk to her”. And, she always tries to help us develop through training”. Examination of records confirmed regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety of residents and staff is maintained. Inspection of records for residents were comprehensive, well written and up to date ensuring staff are aware of residents needs. Records show the management team has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. Staff and resident meetings are held regularly and recorded. Also informal discussions with residents occur on a regular basis ensuring there views are known and implemented if needed and improves the running of the home. Relative surveys are sent out has a quality assurance system to gather the views of friends and relatives to ensure they feel the home is run smoothly and any suggestions to improve the home are noted and put into practice. Regulations require a visit monthly which has been done from an appointed person and a report sent to CSCI to explain any developments and monitor the care provided to ensure the home is managed properly and continues to develop to provide the care and support for the residents and staff. Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 21 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 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Princess Alexandra Home For The Blind DS0000009733.V299913.R01.S.doc Version 5.2 Page 22 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 2 Standard OP29 OP29 Regulation 4 schedule (1) 19 Requirement Staff records must include a recent photograph as proof of identity. A full employment history must be obtained with any gaps explained before staff are employed. Timescale for action 31/10/06 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Princess Alexandra Home For The Blind DS0000009733.V299913.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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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