CARE HOMES FOR OLDER PEOPLE
Promenade Rest Home 10/12 The Promenade Southport Merseyside PR8 1QY Lead Inspector
Elaine White Unannounced 5 October 2005
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. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Promenade Rest Home Address 10/12 The Promenade Southport Merseyside PR8 1QY 01704 538553 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) Midplant Limited T/A Care Link Mrs Susan Elizabeth Astley Care Home 49 Category(ies) of OP registration, with number of places Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 49 OP 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 30th November 2004 Brief Description of the Service: The Promenade Rest Home is a registered care home and provides care and support for up to 49 older people. The home provides personal care not nursing care, which 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 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 1 day, by 2 inspectors (Elaine White and Claire Lee), a total of 6 hours. 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 November 2004. 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, maintenance staff, administrator and 8 residents. Satisfaction cards were also left at the home for residents and relatives to complete at their leisure. What the service does well: Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 6 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. Residents are provided with a contract or statement of terms and conditions. Prospective service users are assessed prior to admission, to determine if the home can meet their needs. Trail visits are offered and unplanned admissions are avoided, except in emergency. Positive comments were received from residents spoken to, “The staff are excellent. It couldn’t be better”. “The staff cannot be faulted”. The home provides a homely, friendly and well-maintained environment for the residents to live. A ‘chill out’ room is available for residents to receive aromatherapy treatments, meet visitors and enjoy listening to music in peaceful surroundings. The home employs an ‘on site’ maitenance person who is available to repond quickly to repairs needed. Internet access is available for the residents. An activity organiser is employed. Day trips are provided in the homes transport bus to local shops and leisure facilities. An activity programme is in place and includes monthly ‘theme nights’ i.e. 6o’s evening. Residents interviewed commented, “We went out yesterday to the garden centre. It was a nice day”. “I enjoy the trips out but you can stay in if you wish”. The recording systems are 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 “we are given lots of training”. “We all work together”. What has improved since the last inspection?
The home has met all the requirements since the last inspection. The ongoing maintenance programme ensures that all rooms are re decorated when needed and repairs addressed in house. A computer and Internet access is now available to all residents.
Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 7 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. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 standard(s) 1,2,3,4,5. Pre admission assessments carried out by the manager are detailed and help ensure that the home can meet the needs of the residents. Information is available to residents, prospective service users and visitors on the services provided. Contracts of terms and conditions are in place for all residents. Visitors are welcomed to view the facilities provided. EVIDENCE: Detailed information is available in the statement of purpose and service user guide. A copy of this is in place in all rooms and at the reception area. Contracts viewed confirmed that each resident has a copy of their terms and conditions. The home welcomes visitors and prospective service users to view the facilities and services in place. Interviews with residents confirmed that they are satisfied with the care and support provided. “I like the home and feel settled here”. “The staff are very caring indeed”. “The staff are very obliging”. “All the staff are helpful”.
Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 standard(s) 7,8,9,10,11. Residents health, personal and social cares needs are addressed in care plans and care needs are met effectively. This ensures a good overall standard of care in the home. Medicines are administered according to the home’s policy and procedure. Staff were observed providing care and assistance to residents in a polite and sensitive manner. EVIDENCE: A number of care files viewed showed that each resident has a care file, which identifies their needs and plan of care. This information is drawn up from the initial assessment and from other health professional sources, for example social services. The care files are very organised, easy to read and staff interviewed had a good understanding and knowledge of residents’ needs. Plans viewed identified likes, dislikes, choices, spiritual needs, personal profiles and death wishes. Care documentation is subject to regular review to ensure the information was
Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 11 up to date. General risk assessments for health and safety issues are completed. GP visits are organised on behalf of the residents and these and other health professional appointments are recorded in the care files seen. One resident confirmed that the district nurse calls every week to dress her leg. Discussion with residents confirmed that staff offer a good standard of privacy and are respectful of their individual wishes especially around personal care. Comments include, “At bedtime the staff always help me”. “I need help the have a bath and they are very caring”. “Staff are polite, always”. The staff were observed to be polite, sensitive and caring with the residents. A number of medicine sheets were seen and these were completed to a satisfactory standard. A number of residents are self-medicating and undertake this practice following a risk assessment. Medication training has been provided to all staff who administer medication. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 standard(s) 12,13,15. There is a sociable atmosphere in the home and residents interviewed were happy with the daily routine. Social activities are well managed thus creating a positive atmosphere and visitors are made welcome. The home offers a choice of meals. EVIDENCE: Residents interviewed provided positive comments on the care and support provided. “All staff are helpful”. “Staff cannot be faulted”. The home employs an activity organiser who arranges the activity programme. This includes both ‘in house ‘ activities and external trips. Theme nights, quizzes and bingo are provided. The home has their own bus for transport, which is used for shopping trips and excursions for the residents. Residents spoken to said, “We play bingo and I like the trips to the garden centres. I’m going to Asda today in the mini bus”. “I love living here. There is a lot to do”. Residents also have the use of the ‘chill out’ room for aromatherapy sessions. Visitors are made welcome and were seen popping in at different times and meeting with residents in the lounge or in their bedroom. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 13 The home has a varied menu and alternatives are provided. Meals are served in a large, pleasant dining room. Residents are able to take their meals in their own rooms or in the lounge if preferred. Residents spoken to had different opinions on the menu and the food provided. Comments included, “The food is good”. “Food is excellent”. “The food is very poor. I don’t like the cooking”. These comments were discussed with the manager during the inspection who agreed to conduct a residents survey to obtain feedback on the meals provided. This is has been highlighted in the recommendations of this report. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 standard(s) 16 The home has a complaint procedure and residents were confident that their concerns would be listened to and acted upon. EVIDENCE: The complaint procedure for the home is contained in the statement of purpose. The home logs all complaints raised and action taken. Residents said that they are happy with existing arrangements in the home and that they could always speak to a member of staff if they had any worries. Resident said, “I am very happy with the home and have no complaints at all”. The last complaint recorded on 6th March 2005, was resolved. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 standard(s) 19,20,21,23,24,25,26 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: All areas are accessible by two passenger lifts, with the exception of 4 bedrooms. A number of resident’s rooms were viewed and were found to be clean, comfortable and contained personal items of their choice. A number of rooms are very small, however the residents interviewed confirmed that they are satisfied with their accommodation. “My room is small but ok and I have a washbasin and a toilet”. “My room is cleaned daily”. “ All areas are decorated to a very good standard and colours schemes are attractive and colourful, good quality bedding provides a nice touch to each bedroom.
Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 16 Residents interviewed were complimentary regarding the overall maintenance and the speed in which handy man jobs are undertaken. Emergency lighting is provided through out and subject to regular service checks. Laundry is washed and ironed each day and returned promptly to the residents. The communal areas provide sufficient space for the residents sit and chat, watch TV, take part in entertainment and meet their 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. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 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. Sufficient numbers of staff were on duty to care for the residents procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. Staff receive the necessary training to ensure competency in their role. EVIDENCE: Residents were pleased with staffing arrangements and felt there are enough staff about to help them. Residents interviewed were pleased with the staff and comments included, “staff are very caring indeed”, “always polite”, “staff cannot be faulted.” The home employs sufficient, which include care staff, admin staff, domestics, a handyman, laundry assistants, cook and kitchen assistants. 3 staff files of new staff recently appointed were viewed. These evidenced completed job application forms, health declarations; job description and contract of employment. References and the necessary police checks with regard to clearance from the Protection of Vulnerable Adults (POVA) register obtained. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 18 A 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 11 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. 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 “we get lots of training”, “I was given a full induction when I started”. “We have staff meetings and I wouldn’t hesitate to say what I think”. Certificates viewed confirmed the training received. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 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) 31,32,33,38. An experienced and qualified manager runs the home. Regular monitoring reports are undertaken to ensure that the home is run in the best interests of residents. General safety certificates for equipment and services to the home including the fire log book were in date. This promotes the health and safety of the residents. EVIDENCE: The manager is qualified in NVQ Level 4 and has many years experience in the care of older people. The staff and residents interviewed were very complimentary on the support, guidance and management. “We all work together”, “We all get on well”, “I would tell Sue, (manager) if I had any problems”. (Staff). “When I had a hospital appointment Sue came with me”, “If I had any worries I would tell Sue”.
Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 20 The responsible person conducts regular unannounced inspection visits. A report is completed on the findings and the report is then forwarded to the local Commission office. Last report seen 12/9/05 outlined the home is running effectively. The ownership of the home is yet to be determined, however this does not affect the running of the home. Regular questionnaires are conducted with residents. A number viewed provided the following comments, “There is no need for any improvements. “I am happy with the way the home is run”, “I am happy with everything. “The staff are lovely”. An up to date record was seen for the safety checks of the gas, electric, portable appliances testing, lift, manual handling equipment, fire prevention equipment and legionella compliance. The fire alarms are tested weekly. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x x x 3 Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 22 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 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. 3. Refer to Standard OP15 OP19 OP31 Good Practice Recommendations The registered manager should conduct a residents food satisfaction survey. The home should consider the provision of a smoking area to provide a smoke free lounge. The issue of ownership to be resolved. Promenade Rest Home 20051005 Promenade X10015 UN Stage 4 S5339 V226714 F53.doc Version 1.30 Page 23 Commission for Social Care Inspection Burlington House, South Wing 2nd Floor, Crosby Road North Waterloo Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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