CARE HOMES FOR OLDER PEOPLE
Revelstoke 88 Promenade Bridlington East Yorkshire YO15 2QL Lead Inspector
Karen Ritson Unannounced 10 May 2005 09:30 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. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Revelstoke Address 88 Promenade Bridlington East Yorkshire YO15 2QL 01262 678253 01262 672362 N/A Pennine Care Services Limited 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) Mrs Julie Thompson Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Dementia - over 65 years of age (22) Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service Users admitted for respite care in the category (DE(E)), OP is limited to a maximum of four (4) service users at any one time. Date of last inspection 14/12/04 Brief Description of the Service: Revelstoke is registered for a maximum of 22 service users of either sex and provides care for people over the age of 65, some of whom may have dementia. The home is located in the centre of Bridlington, nearby local facilities such as the spa theatre, leisure world, restaurants, pubs and shops. Transport facilities in Bridlington include a train station and bus service. The home is laid out over three floors and has a lift to all areas, accessible to wheelchairs users. There is a patio to the front of the building, and no rear garden. Eighteen rooms are single and two rooms are double. Six are ensuite. The home has one communal assisted bath, and there are plans to consider a second bathroom on the first floor.Two toilets are situated on the ground floor near the communal areas. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 10th May 2005 and took eleven hours. This includes time for preparation and writing the report. Six service users and all staff on duty were spoken to during the inspection. The manager was available throughout the inspection and the proprietor visited for part of the day. There was a sociable and lively atmosphere throughout the day, with staff and service users chatting with one another. Particular comments from service users are detailed in the main report but all comments regarding the care offered since the new owners had taken over, were positive and complementary. What the service does well: What has improved since the last inspection?
The planned improvements to the home were discussed at the last inspection and many of these have now been carried out with more to come. The home is in the process of refurbishment and redecoration. The results so far make for a pleasant living environment, which service users said made them feel cared for and respected. The home is also beginning to bring in a new system of paperwork, which will help make sure that all service users needs are met. All staff having received training whether newly appointed or long standing, and all said they felt better prepared for their job following this. Staff roles have also been re graded which staff said has made them feel more valued and respected for what they do. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 6 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. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 standard(s) 1,2 and 3. Service users have the information they need to make an informed choice regarding admission and are assured that their care needs will be met. EVIDENCE: Standards one and two were looked at because of requirements from the previous inspection. The homes statement of purpose and the service user guide now contain all information required. Service users knew that they could refer to the statement of purpose but none could recall having done so before or after admission. The assessment documentation is being changed to cover all areas of care needs with risk assessments included. Pennine care services are to give training in implementing all new paperwork including assessments. Service users said they felt staff understood their needs very well and that they asked individuals about the way they preferred care to be given. Service users knew that the paperwork had changed and said that the staff knew what care was needed. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 standard(s) 7, 8 and 9 Service users health care needs are met. EVIDENCE: Care plans were detailed. Service users said that they were well cared for and felt staff were knowledgeable about care needs and that they were kind and patient. Service users were encouraged to be as independent as possible and those who were able to go out unaided did so. One service user was looking forward to going on holiday for a week abroad. Service users said that any problems with care were soon sorted out. A wheelchair was found to be faulty the day before and was attended to during the inspection day. All health care professional visits were recorded. All medication was suitably stored in a trolley away from the kitchen. All staff who administer medication have received suitable medication training. Some of the service users partially self medicate. Those who do so have signed to agree to responsibility for doing so and said they felt independent but also reassured that they could ask for medication to be administered for them if necessary. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 standard(s) 15 Service users receive a quality diet in pleasant surroundings. EVIDENCE: The dining room was attractively set out with flowers and fruit at each table. The proprietor has purchased new dining tables and chairs and the room has been recarpeted. The manager said that the suppliers of meat, vegetables and other foods had been changed since the new proprietors took over and she believed these to be of better quality than previously. The kitchen had been refurbished to allow meals to be prepared on the premises; as previously, meals had been sent over from the Revel stoke hotel. All service users said that the quality and variety of meals had improved over the past six months despite the meals having been good previously. Their views were sought in questionnaires and in meetings. Many suggestions had been acted upon. One service user said that the home catered well for her husband who was a diabetic. All service users receive a nutritional analysis on admission. The last environmental health reports requirements regarding the kitchen had been put into place immediately. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 standard(s) 16 and 18 Service users welfare is safeguarded and complaints are acted upon. EVIDENCE: All service users said they could talk to any member of staff at any time should they wish to complain or bring something to their attention. They said the manager and staff listened to what they had to say and did something about it. Several service users mentioned that the proprietor visited the home regularly; that he welcomed suggestions and that many suggestions had been put in place. The home has complaints and abuse policies with whistle blowing and a comments book. Staff said they had received training in abuse awareness during their induction. Service users said they felt safe in the home. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 standard(s) 19 and 26 Service users live in a safe, clean and well-maintained environment. EVIDENCE: The proprietors have begun a scheme of refurbishments to the building. The carpet and all furniture in communal areas on the ground floor have been replaced. All carpet on the stairs to the first floor and in hallways on the first floor has also been replaced. The lounges have been redecorated. Service user rooms have been redecorated when they have become vacant or when a service user has agreed to a temporary move to another room whilst work is being carried out. Service users said they were very pleased with the work, which had taken place to ‘cheer the place up’. One service user said ‘I can’t fault him (the proprietor). He’s done everything he said he would and more.’ One service users said she had complained of a draft from the main door to her room. The door was to be replaced on the day of inspection as the manager said it could not be repaired to alleviate the problem. Another service user had requested a rail upstairs to help with her balance and the proprietor
Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 13 had told her he would arrange for one to be fitted. There was some odour discernable which was restricted to two rooms only. The manager has arranged for one of the rooms to have new flooring fitted, which should alleviate the problem. The other room carpet is regularly cleaned but the carpet will soon require replacement. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 14 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 Service users needs are met by suitably recruited, well trained staff in adequate numbers. EVIDENCE: The home operated the same staffing rota as before. It was suggested that the rotas clearly show the role of the member of staff on duty. Two carers are on duty at all times with the manager or assistant on duty during the day and into the evening. Two waking night staff cover the nights. Service users said that staff had sufficient time to carry out their tasks without feeling rushed. Staff said they had time to chat to service users or to go out with them when asked. All staff are suitably recruited and service users reported that they liked every member of staff and felt they were all suited to the job. Staff receive thorough induction and foundation training. All said they felt better skilled, involved and confident in their role than before. Some expressed a desire to train in other specialist areas. There was a great sense of enthusiasm from all staff regarding the importance of training. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 15 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 and 38 Service users live in a well managed home where their health and safety are protected and promoted. EVIDENCE: The manager is now qualified to NVQ level 4 in management and is about to commence NVQ level 4 in care. The assistant manager has commenced NVQ level 4 in management. Both expressed enthusiasm regarding training. Health and safety documentation was examined; most was available. However, some records were missing and were forwarded to the CSCI after the inspection. All were in order. A fire risk assessment has been carried out and staff have received COSHH training. All health and safety staff training topics have been covered. The manager is due to begin environmental risk assessments and hopes to complete these in the next few weeks. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 2 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 3 2 x x x x x x 1 Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 17 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 38 Regulation 12 Timescale for action Environemental risk assessments 31/08/05 must be completed. Requirement 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 26 31 38 Good Practice Recommendations recommend that the condition of the carpet in the service user room where there is a continence problem be monitored. Manager is to be qualified to NVQ level 4 in care and management by 2005. All documentation should be available on site for examination. Revelstoke J53_JO4 S62592 Revelstoke V224066 100505 Stage 2.doc Version 1.30 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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