CARE HOMES FOR OLDER PEOPLE
Princess Alexandra Home For The Blind Bosworth Place Squires Gate Blackpool Lancashire FY4 1SH Lead Inspector
Mr Kevan Royston Unannounced Inspection 19th November 2005 09:00 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.V251971.R01.S.doc Version 5.0 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.V251971.R01.S.doc Version 5.0 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.V251971.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered numbers to include two (2) named person between 50 and 65 years of age. 7th June 2005 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. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on the 19/11/05 over a period of approximately 6 hours and was unannounced. The Inspector spoke to the manager in charge, staff, six residents individually and a group of residents together. 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. Records relating to these people are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. On this inspection the records of two residents were case tracked. Records of three 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. What the service does well: What has improved since the last inspection?
Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 6 Staff now receive regular supervision at the required times and the management are supportive and approachable. And this was confirmed through staff comments, which included, “The management seem more available if we need them.” Another said, “I have regular supervision but they would see me any time if I had a problem”. Staff supervision records are now up to date and show how each staff member is developing and identifies any problems or concerns. 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.V251971.R01.S.doc Version 5.0 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 Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 the following standard(s): This section of standards was not assessed. EVIDENCE: Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 and 10. Promotion of health is taken seriously. Residents welfare and health needs are identified and met. However more detail is required recording monthly reviews of care plans, ensuring residents care needs are identified and monitored. . EVIDENCE: Records of one of the residents spoken to were examined and accurately reflected the individuals health and social care needs. Care plans were up to date and regular reviews taking place. However more detail is needed in the reviews outlining any changing health needs required. The care plan for one resident showed how care needs had changed and the action taken by staff to support the resident. The resident said, “I need a lot of care the girls do there best”. A staff member said, “We make sure we involve the residents in the reviews where possible”. Discussion with the senior manager and examination of records show risk assessments are constantly reviewed and updated reflecting any changes that have occurred individually and the environment. Medication practices observed were safe and good records had been kept ensuring residents health is maintained. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 10 Observation and speaking to residents confirmed residents are able to control their own lives with help if required. And have access to there own preferred GP. One resident spoken to said, “ I let them know if I need the doctor or dentist. I have my own doctor”. Another commented “The girls do respect me if I need help dressing I ask but I can manage mainly on my own”. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 the following standard(s): This section of standards was not assessed. EVIDENCE: Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 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 on admission and is included in the homes brochure ensuring the residents feel protected. One resident spoken said, “Don’t worry I know who to speak to, but I am not sure about you lot”. Staff spoken to are aware of the complaint and abuse procedures. Members of staff said “I did complaints in my induction training”. Another staff member said, “ NVQ training coves abuse procedures”. Examination of complaint records highlighted a recent incident. The procedure and investigation conducted by the management followed the home’s policies which gave good details of the incident, how it was dealt with and the outcome ensuring complaints are taken seriously, investigated thoroughly and protect the residents and staff. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 the following standard(s): 19,25 and 26 The home was clean and tidy and maintained to a high standard ensuring the residents comfort and safety in pleasant surroundings. EVIDENCE: The layout of the home is purpose built for the residents accommodated. And was found to be clean and tidy providing a safe and well-maintained environment. Staff spoken to said, “It’s quite a big place but we keep it as clean as possible and we have routines for cleaning which we stick to”. A resident commented, “They work hard to keep it spotless”. Examination of maintenance records showed there is a rolling programme of general repairs and renewal of the premises. The manager commented, “We make sure any repairs or maintenance is logged and attended to as soon as possible”. Water temperatures were regulated and recorded providing protection for residents and ensuring appliances are in working order.
Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 14 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.V251971.R01.S.doc Version 5.0 Page 15 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. The procedures and recording for the recruitment of staff are good. However further information is required on staff records to provide the necessary safeguards and offer protection to the people living at the home. EVIDENCE: Examination of staff files confirmed the recording procedures of the home must be improved to ensure all staff records include individual photographs on each of their file as a means of identification. CRB (Criminal records Bureau), POVA (Protection of Vulnerable Adults) checks and references were in place to ensure the residents are protected. Observation of staff rotas and discussion with staff confirmed there were sufficient numbers of staff on duty. And there was a mix of staff both care and domestic to ensure the needs of the residents are being met. A resident spoken to said “If you need someone they never keep you waiting long.” Records show training is ongoing, further staff should achieve NVQ (National Vocational Qualification) training to meet the 50 required by legislation. Staff spoken said they were happy with the training provided by the home. And records of staff confirmed courses are available for staff to attend and there is a thorough induction for new staff ensuring staff feel confident and of the skills to support the residents. Comments from staff included “I have done level 3 NVQ and it has given me more of an insight”. Another said, “My induction training was good we went through everything to do with care”
Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 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): 31,33,35,36 and 38. The home is well managed and good systems are in place for the protection of residents. EVIDENCE: Residents and staff members were very positive in their comments about the homes management. And they found the manager to be approachable, supportive and helpful. Staff members commented that they found the manager was supportive and provided a clear sense leadership. Staff members said, “The management are supportive” and “We have a clear structure of staff and management”. A resident said “Elaine is very nice always cheery”. Staff records examined confirmed staff receive regular supervision ensuring the constant monitoring and development of each member is ongoing. One staff member said, “I have recently started and have had one supervision session and a date for my next one”.
Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 17 Inspection of records for residents were comprehensive, well written and up to date ensuring staff are aware of residents needs. Inspection of records indicated regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety of residents and staff is maintained. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x 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 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 19 No 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 OP29 Regulation 19 schedule 2 Requirement The registered person must ensure all the information required on staff records are in place Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations 50 of care staff should complete level 2 NVQ in care by 2005. Princess Alexandra Home For The Blind DS0000009733.V251971.R01.S.doc Version 5.0 Page 20 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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