CARE HOMES FOR OLDER PEOPLE
Ramsgate Care Centre 66-68 Boundary Road Ramsgate Kent CT11 7NP Lead Inspector
Brenda Pears Unannounced Inspection 19th January 2006 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 Ramsgate Care Centre DS0000023710.V273647.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. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ramsgate Care Centre Address 66-68 Boundary Road Ramsgate Kent CT11 7NP 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) 01843 585444 Choicecare 2000 Limited Julie Cuthbert Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. At any time, no more than four (4) Service Users under the age of 65 years but over the age of 55 years to be accommodated at the Home. 10th October 2005 Date of last inspection Brief Description of the Service: Ramsgate Care Centre is a detached property that is registered for 41 elderly service users. Accommodation is on two floors and all rooms are en suite. There is a shaft lift in use to access all floors. The Home is located in a residential area of the town with easy access to public transport, shops and amenities. A number of parking spaces are available on site and there is on street parking available close by. The Home is spacious and has wide corridors throughout the building, giving easy access for wheelchair users. There are a number of lounge areas sighted around the building. There is an open-air courtyard with seating for service users in the centre of the Home plus a large garden to the rear. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life of service users living in the home. The methods of inspecting the home included speaking to service users, visitors and management, sampling records and observations of the building. This report reflects the findings at this and at the previously announced inspection. What the service does well: What has improved since the last inspection?
Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 6 Staff have reviewed care plans and only relevant and working documents are incorporated in files, providing a much user friendly and organised care plan. Decoration continues around the home and the home has been brightened by the work to date. One service user with high needs has been supported by staff through a recent difficult period of change in behaviours. Health care professionals and additional support and advise has been obtained, resulting in more settled behaviours with appropriate seating to help this person settle during the day. There is now a full time maintenance person allocated to the home and all maintenance work is carried out as required. 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. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 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 Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 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): 1, 3 All new admissions are undertaken following a pre admission assessment. The Service User Guide and Statement of Purpose are currently being redeveloped to provide full information for all service users. EVIDENCE: Service user files have pre admission assessments in place. Full needs are assessed including personal and religious needs. Care Plans are developed by the home and with staff who observe and discuss needs with service users and/or family/advocates as necessary. The Service User Guide and Statement of Purpose have been completed to provide appropriate and current information for any person wishing to move into the home. However, there are a few more documents that are to be added before these are fully completed. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 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): 8, 10 Staff regularly review care plans and only relevant and working documents are incorporated in files, providing a much user friendly and organised care plan. Service users are treated with respect and the right to privacy is upheld. EVIDENCE: Personal and social care needs are set out in care plans and fully supported by the home, providing appropriate service user care and good practice. Choice and independence is encouraged and supported in the home. This was also evidenced when a tour of the building was undertaken and those wishing to remain in their rooms were treated and addressed appropriately. Visits by healthcare professionals are clearly recorded and specialist organisations are contacted to support service users. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 10 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 Choice and autonomy are supported and encouraged, with choices being undertaken with support if required, providing a good quality of life. EVIDENCE: Choice and autonomy is supported and encouraged through regular meetings with service users and also through informal discussions each day. Minutes of all formal meetings are recorded. Service users decide how each day will be spent and all individual choices are respected and encouraged by staff. Visitors in the home at the time of this inspection stated staff are caring and supportive. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 11 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 Service users and families know their complaints will be listened to and acted on. EVIDENCE: No complaints have been received and the home is constantly in touch with families to ensure full information is given at all times. The home continues to enjoy a good relationship with visitors and families, with regular meetings being undertaken in the home. Family members, friends and/or advocates attend service user meetings and this forum has ensured that any areas of concern are discussed and addressed quickly and appropriately. Visitors expressed their pleasure at visiting the home and were seen to be relaxed and comfortable during this inspection, particularly when speaking with the manager. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 12 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): 26 The home was clean and pleasant at the time of the inspection visit, providing a comfortable environment for those living in the home. EVIDENCE: The fabric of the building has been much improved with new carpeting, flooring and decoration in many areas. The continued upgrading of the home ensures service users are provided with the best possible environment in which to live. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 13 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 Staff are provided with appropriate skills to support service users and meet individual needs. EVIDENCE: There is a training matrix in place to ensure refresher and core training is up to date at all times. Staff are therefore provided with appropriate skills to support service users and meet individual needs. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 14 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, 37 The registered manager is a suitable person and service users benefit from a safe and well run home. The systems of consultation are good, with a clearly defined management structure that enables service users to feel supported at all times. There is a need for local procedures to be developed that would fully reflect routines currently undertaken in the home, to support staff and ensure the well being of service users at all times. EVIDENCE:
Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 15 Trips out are undertaken with appropriate staff support and these include visits to local pubs and shopping as chosen by service users. Families are included in any outings or celebrations being undertaken in the Home. As previously stated, one person had family and friends visiting to celebrate a special birthday. The specific wishes of the service user were respected regarding how the celebrations were undertaken, everyone was enjoying the occasion. There is a need for local procedures to be developed that would fully reflect routines currently undertaken in the Home. These would then support staff in all areas and fully inform new staff through the induction period. This is specifically required for use when dealing with any case of abuse. Clear and specific guidelines are required to ensure correct actions are taken by staff at all times. Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 16 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X 2 x Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 17 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. 1 Standard 1 Regulation 4, 5 Requirement That the Service User Guide and Statement of Purpose be fully developed in line with guidance under the National Minimum Standards. Local procedures are to be developed to support staff in their duties, to support the induction process and to protect/support service users. As required in the last inspection report. A plan of action to be sent to CSCI by the stated date. Timescale for action 02/02/06 2 18, 37 12, 17 02/02/06 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 Ramsgate Care Centre DS0000023710.V273647.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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