CARE HOMES FOR OLDER PEOPLE
Richard Peck House 1 St Thomas Road Lytham St Annes Lancashire FY8 1JL Lead Inspector
Denise Upton Unannounced Inspection 2nd November 2005 09:45 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 Richard Peck House DS0000033338.V259788.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. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Richard Peck House Address 1 St Thomas Road Lytham St Annes Lancashire FY8 1JL 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) 01253 721 821 020 89948504 The Royal Air Forces Association Mrs Annie Mulvey MBE Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (7), Physical disability (2) of places Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The registered person may accommodate up to a maximum of 9 older people when not utilising those places for younger adults with a physical disability. The registered person shall at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission 12th July 2005 Date of last inspection Brief Description of the Service: Richard Peck House is owned and managed by The Royal Air Force Association (RAFA) and joint funded by The Royal Air Force Benevolent Fund.The home provides short welfare breaks to service personnel and their relatives in a comfortable, hotel style environment. The accommodation registered with the Commission for Social Care Inspection, provides residential accommodation for up to nine service users who are assessed as requiring assistance with personal care tasks. In addition, further service users who are self-caring and do not require this level of support are also accommodated. The internal environment made available to service users and their relatives is welcoming, comfortable and maintained to a very high standard. All bedroom accommodation is provided with an en-suite facility and appropriate aids and adaptations are provided to promote independence including the provision of a passenger lift and ramped access to enable ease of access throughout the building.The home is conveniently located in a residential area of the town close to the main shopping area and community resources and facilities. A small library is provided; table games are available and `in-house` entertainment arranged. This is supplemented by very regular outings and trips in the home’s adapted minibus.The external environment provides a garden area with seating and a car park to the side of the building. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a three hour, midweek morning period. The inspector spoke with the home’s registered manager and two of the staff members that were on duty during the course of the visit. Informal discussion also took place with two groups of residents some of whom were assessed as requiring personal care and some who were self caring. In total seven residents were spoken with ‘in depth’ about their experience of taking a short term break at Richard Peck House. The majority of people spoken with had enjoyed previous visits to the home and all spoke very highly of the staff group and the support and care that is provided. The majority of the core standards regarding Care Homes for Older People had been assessed at the last inspection that took place in July 2005. The outstanding eight core standards were assessed at this inspection along with a reassessment of the single recommendation identified at the last inspection. What the service does well:
Richard Peck House has an enthusiastic group of well-qualified staff that work well together and who display a good understanding of the needs of residents and are keen to provide a high quality service to people who visit the home. The registered manager is very experienced in running a care home and guides staff to ensure a consistent service is provided that is tailored to meet individual needs, requirements and expectations. One resident spoken with commentated that the manager ‘is excellent and guides staff very well’. It is very clear that there is a good, friendly and supportive relationship between residents and staff that helps people staying at the home to feel comfortable, welcomed and valued. Residents spoken with were unanimous in their praise for the kindness and attitude of the staff group with one person saying that the ‘staff are not just carers but caring’. The standard of the environment at Richard Peck House is very high, providing service users with an attractive, comfortable and homely place to live during their ‘holiday’ at the home. The atmosphere in the home is very relaxed and visitors are made welcome at any time of the resident’s choice. A comprehensive social activities and entertainment programme is enjoyed by residents that includes very frequent visit out to places of interest in the home’s adapted mini bus. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 6 Service users at Richard Peck House are offered a varied, wholesome and nutritious diet with menus designed to incorporate the known likes and dislikes of service users accommodated. Specialist diets in respect of religious, cultural or medical need can be accommodated and as observed, hot and cold drinks and snacks are made available throughout the day. Service users spoken with were extremely positive in their comments regarding the quality and variety of the meals served. What has improved since the last inspection? 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. Richard Peck House DS0000033338.V259788.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 Richard Peck House DS0000033338.V259788.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): None of the six standards were assessed at this inspection. EVIDENCE: None of the six standards were assessed at this inspection. Richard Peck House DS0000033338.V259788.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): None of the five standards were assessed at this inspection. EVIDENCE: None of the five standards were assessed at this inspection. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 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): 12,13,14 & 15 A wide variety of social activities and outings are arranged to enable service users to enjoy social stimulation and interaction with fellow guests. Service users are encouraged and enabled to maintain contact with their family and friends to ensure these relationships are sustained. Dietary needs of service users are well catered for with a balanced and varied selection of meals available that meets service users expectations and requirements. EVIDENCE: Through direct observation and discussion with service users it was clearly evident that residents are able to choose and participate in activities as they so wish. During the pre admission assessment process, service users are asked to complete an ‘about me’ sheet that gives opportunity to detail their interests and hobbies. Wherever possible staff encourage service users to continue with these interests. A wide variety of social activities are arranged ‘in-house’ for the majority of evenings that include outside entertainers. To supplement in-house’ activities, outings in the home’s adapted mini bus to places of interest are arranged on a very regular basis and service users spoken with at the time of this inspection
Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 11 confirmed that this is usual practice and very much enjoyed by those who choose to participate. Routines are flexible to accommodate individual need and up to date information with regard to activities and outings is verbally imparted individually and also forms part of the introductory meeting that takes place each week to welcome new guests. A full calendar of entertainment has been arranged for the festive season and the registered manager is planning to introduce a further range of social activities for the daytime winter months when the weather is uncertain and residents may not wish to go out. A local college has been approached who it is hoped will be able to provide qualified instructors for interests such as social dancing, card making and flower arranging. The home is provided with a loop line system to enable service users with a hearing impairment to effectively enjoy the radio and television during their period of residence. Although guests at Richard Peck House are normally only ‘on holiday’ for a period of one or two weeks, a number of residents receive visitors during the course of their residency at the home. Information with regard to visitors is incorporated in the Statement of Purpose and Service Users Guide. All visitors are made welcome and service users are able to entertain their visitor in the privacy of individual bedroom accommodation or in any communal area of the service user’s choice. All service users at Richard Peck House are encouraged to remain financially independent while resident at the home. Occasionally a service user is admitted to the home that requires assistance with this task. An appropriate safe storage facility is provided for monies or valuables held in safekeeping with appropriate records kept. Service users spoken with were aware that documentation is required to be maintained in respect of themselves and of their right to access this information. Meals and mealtimes are given high priority at Richard Peck House. All meals are of a high quality and standard and presented and served in restaurant style environment. Service users spoken with were all extremely complementary with regard to the meals served in both quality and quantity and confirmed a wide choice of menu with an alternative of the service user’s choice is always made available if required. Prior to admission, prospective service users are asked to complete a dietary questionnaire to ensure the catering staff are prepared for any personal needs, preferences or wishes. Specialist diets in respect of religious, medical or cultural needs can be accommodated and the chef personally speaks with all service users on admission as part of the assessment process to clarify and confirm their dietary requirements. Richard Peck House DS0000033338.V259788.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 & 18 The home has a satisfactory complaints procedure that fulfils requirements with evidence that service users views are listened to and acted upon. Staff have a good knowledge and understanding of Adult Protection issues, which protects service users from abuse. EVIDENCE: Richard Peck House has a comprehensive complaint policy and procedure that is implemented if a complaint was raised. The procedures are compliant with all requirements and recommendations of the standard. Complaints are rare however the home does receive many cards and complements from people who have been resident at the home. A compliment, comment or complaint leaflet is readily available in all communal areas of the home and in individual bedroom accommodation and there is also a detailed service user survey covering a wide range of topics provide to each service user when they are going home. This enables all service users to freely express their views and opinions or raise any concerns. A suggestion box is also available for comments should a service user wish not approach a member of staff in person with their comment or concern. The relationship observed between staff and guests is extremely positive and residents spoken with all stated they would have no hesitation in raising any concern or complaint directly with the registered manager but that they ‘would find it difficult to find anything to complain about.’
Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 13 Richard Peck House has an appropriate policy and procedures for the Protection of Vulnerable Adults that incorporates the local protocol for reporting suspect abuse. The majority of care staff have already undertaken an adult abuse, Level 1 training course and have been registered to undertake a Level 2 adult abuse training course in January 2006. The remaining three members of staff are registered to undertake Level 1 of this training within the next two weeks. All staff are required to sign a document to confirm they have read and understood the home’s adult abuse policy that is tested out through supervision arrangements and line management discussion. Richard Peck House has also developed a variety of other policies and procedures for the protection of service users. The policy in respect of challenging behaviour, evidenced at the time of inspection, has recently been redeveloped to good effect. A policy in respect of service users monies and financial affairs was available along with a policy in respect of staff precluded from involvement in assisting in the making or benefiting from service users wills. This information is also incorporated in the Service Users Guide to advise service users of the home’s philosophy in respect of this matter. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 14 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 & 26 The internal and external environment at the home is maintained to a very high standard providing service users with an attractive, safe and comfortable place to visit. EVIDENCE: Service users at Richard Peck House are accommodated in a safe and extremely comfortable environment that is maintained to a very high standard. The home is domestic in character and is designed to meet the needs and requirements of service users accommodated. There is a programme of routine maintenance and renewal with records kept. Grounds are landscaped and well maintained with a car park facility to the side of the building. The premises comply with current requirements of the Environmental Health Department and Fire Service. CCTV cameras are installed as a protective measure but are restricted to entrance areas and the bar area of the home. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 15 Richard Peck House has developed and implemented policies and procedures for the control of infection and safe handling of clinical waste. All staff receive mandatory training in respect of infection control that is updated on an annual basis. Protective clothing is also provided. The home has recently introduced a system whereby fouled laundry is placed in a special bag that is sealed before being taken to the laundry and then washed in the bag to prevent staff having to handle fouled laundry. The home had a separate laundry area that does not intrude on service users and the washing machine has the specific programming ability to meet disinfection standards. Separate hand-washing facilities are also available in the laundry area and laundry floor and wall finishes are readily cleanable. It is understood that the home complies with the Water Supply (Water Fittings) Regulations 1999. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 16 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): 29 in part Since the last inspection the written vetting and recruitment procedure has been tightened to provide clear guidance on the procedures to be followed. EVIDENCE: At the last inspection, the only recommendation made was in respect of the wording in the staff recruitment procedures to clearly identify that a Criminal Records Bureau and POVA First clearance must be submitted and the POVA First obtained and deemed to be satisfactory, prior to newly appointed care staff actually taking up employment at the home. Although this process was actually evident in practice, the recruitment procedures were not clear in identifying this requirement. Observation at this inspection of the newly amended document, confirmed that the recruitment process in respect of CRB/POVA First requirements are now clearly identified. Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 17 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): None of the eight standards were assessed at this inspection. EVIDENCE: None of the eight standards were assessed at this inspection. Richard Peck House DS0000033338.V259788.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 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Richard Peck House DS0000033338.V259788.R01.S.doc Version 5.0 Page 19 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. 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. Refer to Standard Good Practice Recommendations Richard Peck House DS0000033338.V259788.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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