CARE HOMES FOR OLDER PEOPLE
Promenade Rest Home 10/12 The Promenade Southport Merseyside PR8 1QY Lead Inspector
Mrs Elaine White Unannounced Inspection 15th March 2006 10:15 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 Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 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. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Promenade Rest Home Address 10/12 The Promenade Southport Merseyside PR8 1QY 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) 01704 538553 Midplant Limited T/A Care Link Mrs Susan Elizabeth Astley Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 49 OP Date of last inspection 5th October 2005 Brief Description of the Service: The Promenade Rest Home is a registered care home and provides personal care and support for up to 49 older people. Nursing care is provided directly through the district nursing services when required. Most rooms provide single occupancy, some with en-suite facilities. There is one shared room. The home is owned by Care Link and is managed by the home manager, Mrs Susan Astley. The home is located on the promenade of Southport and is close to all the amenities of the town, which includes a large selection of shops, cinema, theatres and restaurants. Private rooms range from 5.17sq m to 20.63sq m. Communal rooms comprise of a large dining room and lounge on the ground floor. A bar/lounge area/library is located in the basement with a small chill out room at the rear. This room enables residents to receive aromatherapy treatments, meet visitors and enjoy listening to music in peaceful surroundings. All shared areas are accessible by two lifts, with the exception of 4 bedrooms. There is a large enclosed garden to the rear of the building. Both front and rear entrances have disabled access. A call system with an alarm facility operates throughout and there are adapted bathing facilities. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day. It was an unannounced visit and was carried out as part of the regulatory requirement for care homes to be inspected at least twice a year. There has been no cause to visit the home since the last inspection in October 2005. For this inspection a partial tour of the home was conducted and care records and other home records were viewed. Discussion took place with the manager, care staff, activity organiser, maintenance staff, administrator, visiting relatives and residents. Case tracking was completed on several residents to assess the care provided. 46 residents were resident at the time of the inspection and nine of the National Minimum Standards were assessed. What the service does well:
The home provides an up to date statement of purpose, which provides detailed information for prospective service users and residents. A copy of this is available in each resident’s room and contains all the information on the services provided. Included are menus, a list of all staff, their qualifications, training programme, contracts and terms of residency, most recent inspection report and letters of thanks from relatives and residents. Information is displayed on notice boards and in the reception area for the residents to view and includes, list and photos of staff, meal times, meetings (relatives and visitors invited), menus, activities for the day, and other contacts the residents may wish to access, for example, Advocate, church services (all religions) and residents charter. Regular quality monitoring takes place through annual surveys and monthly visits to assess the service provided. Prospective service users are assessed prior to admission, to determine if the home can meet their needs. The home provides a homely, friendly and wellmaintained environment for the residents to live. A large lounge and dining area provides ample space for the residents. A ‘chill out’ room is available for residents to receive aromatherapy treatments, meet visitors and enjoy listening to music in peaceful surroundings. A bar area is also available for the residents and visitors to use. The home employs an ‘on site’ maintenance person who is available to repond quickly to repairs needed.
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 6 Internet access is available for the residents to maintain contact with family, friends or access information. Two activity organisers are employed who organise day trips on the homes transport bus to local shops and leisure facilities. An activity programme is in place and includes monthly ‘theme nights’ i.e. St Patrick’s night, quizzes, bingo and games. Residents and relatives interviewed commented, “I enjoy the trips out”, (Resident). “There is a lot going on here and it keeps them occupied”, (Relative). The recording systems are accurate, organised and up to date. Training provided is over and above the statutory training required to equip the staff with the skills to carry out their roles i.e. stress awareness, diabetes, and care practice. A full induction programme is in place and all staff are provided with a staff handbook. All senior carers have a NVQ Level 3 qualification and the manager and deputy manager have obtained NVQ Level 4. Staff interviewed said, “The training is excellent”. Over 50 of the care staff are qualified in Level 2 National Vocational Qualification (NVQ). The management and staff demonstrated an enthusiastic approach to their work and are motivated to meeting the needs of the residents and providing a pleasant home for them to live. Discussion with residents, relatives and staff confirmed this. What has improved since the last inspection?
No requirements were made at the last inspection. Of the recommendations made some have been addressed and a resident’s food and activity satisfaction survey has been completed, which has resulted in new menus and activities. There are now three choices available for all meals served and new menus are in place. Comments from the residents surveys viewed included, “On the whole the meals are very good”. Residents’ suggestions made for new meals are, “I would like to have some tripe”. “Ribs would be nice”. Suggestions for new activities include, “I would like to do some gardening”, “Go for walks”. The survey has resulted in the provision of more choice in what is available to the residents and their involvement in the day to day running of the home. Quality meetings also take place involving the residents to discuss new developments and services provided. The home has recently been re assessed for the Investors in People Award, which it achieved with no recommendations made.
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 7 The statement of purpose has been recently updated and contains information (As mentioned in the above section). Information on adult abuse has been distributed to all staff and contains a questionnaire to obtain their views and understanding of abuse. The protection of vulnerable adults policy is being updated to include the new procedures and leaflets on this are displayed in the home for the residents and visitors to access. The home’s ongoing training plan is continually reviewed to provide additional training specifically aimed at meeting the needs of the people they care for, i.e. stoma care, dementia and managing incontinence. The senior carers are in the process of an 8-week ‘team building’ training course. One senior care said, “It is going very well”. A new maintenance person has recently been appointed who is available daily to respond to any repairs needed. New TV’s have been purchased for the lounge. This will enable residents to view these from all areas of the large lounge. 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
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 8 contacting your local CSCI office. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 9 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 Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 10 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): 1,3,6. Pre admission assessments carried out by the manager are detailed and help ensure that the home can meet the needs of the residents. Detailed information is available to residents, prospective service users and visitors in the service user guide and statement of purpose. EVIDENCE: Detailed information is available in the statement of purpose and service user guide. This has recently been updated and includes - menus, a list of all staff, their qualifications, training programme, contracts and terms of residency, the most recent inspection report and letters of thanks from relatives and residents. A copy of this is in place in all rooms and at the reception area. The manager completes pre-admission assessments and those viewed provided detailed information on the residents needs. Two new residents and their relatives were spoken with to obtain their views on their admission process and the services provided. Comments include, “I have settled in very well. The staff are very good”, “I am very happy here and the staff are very
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 11 nice”. (Residents). The room is small but she has everything she needs. The staff are very helpful”. (Relatives). Standard 6, Specialist intermediate care is not provided. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 12 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 Residents health, personal and social cares needs are addressed in care plans, which are reviewed monthly to ensure care needs are met effectively. This ensures a good overall standard of care in the home. EVIDENCE: Care files viewed identify each resident’s individual needs and plan of care. This information is drawn up from the initial assessment completed prior to admission. The care files are very organised, easy to understand and outline the care needs, action required and outcome for each resident. Plans viewed identified likes, dislikes, social interests, choices, spiritual needs and personal profiles. Care documentation is subject to regular review to ensure the information is kept up to date. General risk assessments for health and safety issues are completed. Any manual handling requirements are assessed. Access is available to health care services and all visits are recorded.
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 13 Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 14 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): 14. Residents are able to exercise choice and control over their lives. EVIDENCE: Observation and discussion with residents, relatives, staff and viewing of records confirmed that the residents accommodated are encouraged to have choice and control over their lives and daily routines within the home. The statement of purpose, service user guide and residents rights charter (displayed in the entrance) outlines the services available and their right to have access to these services. Assessments and care plans viewed demonstrated that the care needs, likes and dislikes and social interests are recorded. Two activity organisers provide a wide range of activities and the home’s transport enables the residents to access services to the community facilities and trips out. Activities include – quiz nights organised with other homes, shopping, gentle exercise, bingo, games, skittles and theme nights. The home has arranged a St. Patrick’s evening for all the residents, staff and relatives. A visiting relative commented, “She enjoys the trips”. Errands are also run for residents wishing to purchase items of their choice. Transport is also provided for residents to attend religious services of their choice and information is displayed on all religious practice groups.
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 15 The activity programme is displayed for the residents to view and choose which they wish to attend. The notice board also provides information on local interests and forthcoming attractions in the Southport area. Residents spoken to said, they have the choice to remain in the privacy of their own room or use the lounge area to mix with others. One resident commented, “I like to stay in my own room for privacy and have all my meals here. The staff are all very good”. A recent food and activity satisfaction survey conducted resulted in changes in menus, more choice of food and activities made available. Comments from residents include – “I would like some tripe”. “I would like to do some gardening”. “I would like to get out in my wheelchair”. The residents charter outlines that residents have the right to ‘spend money as they wish’, ‘have a lie in’, go to bed when they wish’. Residents spoken with confirmed these choices are available to them. Regular residents meetings are held and recorded to discuss the day-to-day running of the home. Minutes of a recent ‘Quality assurance meeting’ held with residents’ representatives looked at new ideas and improvements. These include ‘an evening trip out to Wetherspoons’ and the request of one resident to have ‘bread and butter’ to be served with his lunch. These issues raised are then addressed by the home’s management and changes made. Regular satisfaction surveys are conducted and a suggestion box is available for residents, visitors and relatives to comment on the services provided. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 16 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): 18. Abuse policies, procedures are in place. Staff are trained to protect the residents from abuse. EVIDENCE: The training programme viewed showed that abuse training is provided to all staff to ensure they are aware and understand the adult protection procedures. Information on adult abuse has been distributed to all staff and contains a questionnaire to obtain their views and understanding of abuse. The protection of vulnerable adults policy is being updated to include the new procedures and leaflets on this are displayed in the home for the residents and visitors to access. Finance policies and procedures are in place for dealing with resident’s finances. Advocates are encouraged and are used by residents where required. All financial transactions are recorded, receipts and signatures obtained and balances are regular updated on the home’s computerised system. The administrator is responsible for keeping account of all residents’ monies, which is regularly monitored by one of the directors who is also audited by the company. All personal allowances are distributed monthly and signed on receipt by the resident. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 17 Records were viewed for one resident who is in the process of obtaining a bank account. The home, resident and advocate are working together to arrange this. Records viewed showed that this is being addressed. Residents’ contracts identify fees and charges and are signed on agreement by the resident/ family or representative. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 18 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. The home offers very comfortable ‘homely’ accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. EVIDENCE: A number of resident’s rooms were viewed and were found to be clean, comfortable and contained personal items of their choice. All areas are decorated to a very good standard and colours schemes are attractive and colourful. Residents spoken to said, “I am happy with my room and have a lovely view over the lake”, “My room is only small but I have everything I need”. The communal areas are comfortably furnished and provide sufficient space for the residents sit and chat, watch TV, take part in entertainment or meet their
Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 19 visitors. There is also a quiet area in the basement lounge were residents can listen to music, access the internet or use the ‘chill out’ room for relaxation. The home employs a full time maintenance person who is on site to attend to all repairs needed. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 20 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): 28. Staff are trained to ensure they are equipped with the skills to meet the needs of the residents. EVIDENCE: An excellent staff training programme is in place and staff receive over and above the statutory training required i.e. stress awareness, diabetes and care practice. The training programme includes eleven core areas of training, such as, manual handling, COSSH, first aid, fire safety, health and safety and food hygiene. Staff are also encouraged to take NVQ qualifications and over 50 are qualified in NVQ. All the senior carers have NVQ Level 3 and the manager and deputy manager have achieved NVQ Level 4. An induction programme is provided for all new staff. Staff interviewed said, “The training is excellent”. Certificates viewed confirmed the training received. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 21 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): 35. Policies and procedures are in place to safeguard residents’ finances. EVIDENCE: Policies and procedures are in place to safeguard residents’ finances. The residents’ charter outlines the rights of all residents to ‘spend their money as they wish’. Residents and/or families are encouraged to manage financial affairs. All financial transactions are computerised, recorded, receipts and signatures obtained. (These are outlined in Standard 18 Complaints and Protection). Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 22 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 4 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP19 OP31 Good Practice Recommendations The home should continue to look at the provision of a smoking area to provide a smoke free lounge. The issue of ownership is yet to be resolved. Promenade Rest Home DS0000005339.V281706.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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