Inspection on 16/11/05 for The Links

This inspection was carried out on 16th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Links 03/11/06

The Links 11/07/05

The Links 01/09/04

The Links 10/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Links 7 Uphill Road North Weston Super Mare North Somerset BS23 4NE Lead Inspector Carolle Wise Scanlan Announced Inspection 16th November 2005 09:30 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 The Links DS0000008064.V254534.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. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Links Address 7 Uphill Road North Weston Super Mare North Somerset BS23 4NE 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) 01934 625869 01934 419244 general-manager@abbeycarehomes.org.uk WSM Free Church Housing Association Mrs Mair Wynne James Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 Brief Description of the Service: The Links is owned by Abbeycare, the Weston-super-Mare Free Church Housing Association and is situated on the seafront road. The home is in a converted older property and offers accommodation on two floors. A chair lift and staircase provides access to the upper floor although a few steps still need to be negotiated on the ground floor and first floor. The large lounge overlooks the well-maintained landscaped gardens and the dining room has a view of the local golf course. A well-stocked library is available in the reception area. Daily prayers and a church service every two weeks are held in the lounge. Although optional, the majority of residents choose to attend these services. The town centre with shops and recreational activities is close by and transport would be required to access this. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was announced inspection, which took place over seven hours. There were ten residents at The Links during the time of the inspection. The inspector met with six residents, one staff member, the manager and General Manager. The commission received positive views about the home in a feedback form from one of the General Practitioners who visit the home. Nine residents chose to comment and their views were also very positive with one comment stating ‘I am very happy and well looked after’. Four relatives took the time to complete the feedback to the commission and their comments could be summarised as being happy with the care provided for their loved ones. A ‘Case tracking’ methodology was used and the inspector reviewed a selection of records, which must be kept at the home. What the service does well: What has improved since the last inspection? Staff who have received medication training have their signatures listed and are evident within the homes medication records. The home has a signed record of medication returned to the pharmacy. Good practice was noted regarding the monitoring and record keeping with Warfarin medication. The homes décor has been improved for the benefit of the residents and includes further ensuite facilities. The copy of the duty rotas given to the commission demonstrated that two care staff are on duty at all times. The Links DS0000008064.V254534.R01.S.doc Version 5.0 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. The Links DS0000008064.V254534.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 The Links DS0000008064.V254534.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): 1, 2, 3 & 4 The residents receive sufficient information to enable them to make a choice about moving into The Links. No resident moves into the home without having their needs assessed. EVIDENCE: The homes Statement of Purpose is reviewed annually and an updated copy is forwarded to the commission and held on file. Robust procedures are in place to ensure that prospective residents receive sufficient information about the home prior to making a decision to live here. Residents are assessed prior to taking up accommodation at the home to ensure that their needs can be fully met. Residents recalled visiting the home prior to moving in and appreciated the months trail period offered to enable them to ‘test drive’ the service. One resident remarked that it was ‘remarkably easy to settle into your own routine here and that the staff and other residents were ‘extremely helpful and understanding’. The Links DS0000008064.V254534.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): 7, 8, 9, 10 Residents have general care plans and risk assessments in place, which would further safeguard the residents if they contained further detail. Residents are treated with respect with their privacy and dignity protected. Medication procedures and systems have been improved and some staff received medication training. Generally the systems were robust with the exception of one residents’ medication of which out of date stock needed to be returned to pharmacy. EVIDENCE: Each resident has a care plan that is reviewed on a monthly basis. A ‘getting to know you’ questionnaire is also completed which gives details of the resident’s day-to-day routines, likes, dislikes and preferences. The care plans contain general information about the care to be provided. On discussion with the residents it appeared that the care provided by the staff exceeded the written care plan. The care plans need to be more specific and detailed to ensure that all staff can rely upon this written information and to further safeguard resident’s wellbeing. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 10 Risk assessments are in place but they need to be further developed to incorporate specific care planning to mitigate the risks identified. An example of this was the absence of details such as observing for signs of bruising, bleeding or care of medication therapy in a resident at of the risk of falling on anticoagulation therapy. It was clear however, through discussion, that these observations were undertaken ‘on a regular basis’ just not written down. Since the last inspection medication training had been undertaken. Staff names are recorded on a signature list of those trained to undertake medication administration. A disposal book demonstrated that medicines no longer required by residents are returned to pharmacy. On the day of the inspection the manager was awaiting the pharmacy supply from Lloyds Pharmacy. These were in Nomad boxes, the supply is changing to blister packs in a few weeks time. Temazepam is stored in a separate locked metal cabinet with a record kept of each residents stock. The record stock books did not record the tablet dosage, this is needed. Some of the stock when checked was out of date. A record book of each residents stock of Temazepam can be kept as a page per person, noting the medication, dosage, residents’ name, total stock and signed by the staff member who administers the medication. Staff were observed with the residents. They had developed with the residents who they have come to know better, appropriate humour and banter. Residents without exception felt well cared for and respected they ‘could not fault the care or attention they received’. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 11 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 Residents social, religious and recreational needs and preferences are taken account of. The kitchen has been the subject of redecoration and refurbishment benefiting the residents and the staff. EVIDENCE: Residents felt ‘satisfied’ with the level of activities offered by the home, several felt less able to go out as much as they used to and enjoyed the arranged activities. Some residents choose not to partake in the activities, as they prefer to attend to their own entertainment, such as visiting friends, attending to correspondence and relaxing with music or television. The home arranges a variety of events and activities, which include hairdressing, communion services, coffee mornings and craft events such as creating greeting cards. The home enjoyed its 30th Anniversary Celebration and this year also had outings such as ‘horse world’ and chew Valley. A beautician visits monthly and the home arranges on a less regular basis visiting musician such as a pianist or more recently a harpist. The kitchen has been subject to a refurbishment with new kitchen furniture and design. It appeared light, airy and clean and the staff felt that the new The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 12 arrangement provided a more efficient working arrangement. Although not inspected during this visit the residents all remarked that they enjoyed the food, it was plentiful and generally suited their tastes. Where the menu was not to their taste an alternative was always offered. The staff were enjoying researching various new vegetarian menus for some residents. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 13 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 Residents have confidence in the homes robust complaints procedures and systems are in place to ensure that there are clear avenues in which complaints and compliments can be received. EVIDENCE: The complaints procedure is available in the service user guide and is posted in the reception hallway. Residents felt that they could approach any staff member should they need to complain and that it would be taken seriously and acted upon. All were at pains to add that they had no cause to complain during the inspection visit. The Links also have a ‘house visitor’ who visits the home on a weekly basis generally. The role of the ‘house visitor’ amongst others is that of ensuring the residents are satisfied with service they receive. The residents are able to discus any issues or concerns should they wish or need to do so with the ‘house visitor’ who can act as a liaison link between the resident and the home. The Links DS0000008064.V254534.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): 20, 21, 22, 23, 24, 25 & 26 Residents enjoy a pleasant and comfortable home to which improvements have been made to further meet their needs. EVIDENCE: The Links provides a well decorated comfortable home for its residents. There is pleasant relaxed ambience and the home was clean and well presented throughout as on each inspection visit. The accommodation is arranged over two floors with the communal areas on the ground floor. The lounge is to the front of the property overlooking the landscaped front garden. This large room is light and airy pleasantly arranged with various lounge chairs. The separate dining room leads off the inner hallway and overlooks the front and side of the property. This houses dining room tables and chairs and a ‘hostess trolley’. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 15 Access to the first floor is via a stair chair lift. There are several steps, which residents need to be able to manage at the bottom of the stairs and at the top, which the stair lift does not cover. Two upper floor bedrooms have been knocked into one and an ensuite double room created. Two ground floor rooms have been knocked into one and an ensuite added. Each of the resident’s rooms contained personal items of their choosing such as photographs or their own lounge chairs. There are eight single rooms ensuite and two double rooms ensuite. The home provides two bathrooms and three toilets. One bathroom has a walk in bath and another has a bath hoist. The bath hoist must be regularly maintained to ensure the safety of the residents. The radiators have low temperature covers and can be individually controlled. There are call bells available in each room. The staff have two ‘sleep in rooms’ one sited at the bottom of the stairs and the other at the rear of the property. The laundry room guidance regarding safe sluicing systems for soiled linen was updated during the inspection. The Links DS0000008064.V254534.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): 27 & 29 The home has robust recruitment and training for staff, safeguarding the interests of the residents. EVIDENCE: The staff training program is led by one of the deputy managers within the homes group. Staff over the last twelve months have completed their mandatory training as well as training in medication, dementia care, falls prevention and abuse awareness. Six of the current staff have completed their NVQ level two training and three staff are working towards it. There are two deputy managers who are both working towards their NVQ level 3. The majority of the staff at the home have undertaken first aid training. The staff rota comprises of two General Assistants, one senior staff member and a cook in the mornings. A General Assistant and senior staff member form the afternoon staff with two night staff who are sleeping staff. The rota demonstrated that the home has at least two care staff members available at all times. The registered manager ensures that rota is completed and the home staffed by carers who can meet the needs of the residents safely. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 17 The staff turnover generally is low, allowing staff to offer consistent care to the residents. New staff have orientation into the homes day to day routines and an induction program. Residents suggested that the home never really ‘reverberates with the sound of call bells ringing’ and that staff attend to their needs in a timely manner. Several remarked on how helpful staff were at ensuring that call bells were in reach. Staff recruitment and personnel files were well ordered and demonstrated good practice. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 18 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, 32, 33, 35, 38 The home is well organised and managed to meet the best interests of the residents. To improve on the general health and safety checks for the residents, water temperature checks if outside of the accepted range should be acted upon immediately. Regular maintenance of equipment, such as bath hoists need to be added to the homes servicing program. EVIDENCE: Mrs Mair James is the Registered Manager who holds the Registered Managers Award and has several years experience in the care sector. Her ‘open door’ approach enables staff and residents to discus any issues with her. She is well liked and respected by residents, staff and visitors. Residents meetings are held on a regular basis used as an open forum to gather opinions and views on the homes services and facilities. The minutes of The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 19 these meetings are available for all to see. Surveys of resident’s views in the form of a questionnaire were undertaken in July the outcome of which was of a ‘high satisfaction’ with the overall service. Regulation 26 visits are undertaken on a monthly basis and records of this audit are now forwarded to the commission. Following the refurbishments throughout the home the updated plans are to be forwarded to the fire officer once complete. The home has completed a fire risk assessment. Service records and dates of last servicing were forwarded within the pre inspection documentation and no issues arose in this regard other than that of the bath hoist as described earlier in the report. On checking the water temperature log it was evident that two rooms generally had higher temperature readings than 43oc. This was checked at source with the registered manager and maintenance was contacted immediately. It was thought to have been a problem since the boiler was serviced. Action taken was to decommission the use of the ensuites in these rooms until pre set valves with fail safe devices could be fitted and risk assessments put in place. One piece of equipment randomly selected had not been ‘PAT’ tested which is an electrical appliance check on ‘portable’ equipment. The manager said she would remove it to storage until it could be checked. Residents manage their own financial affairs with either their families or representatives. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 20 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 21 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. 1 2 Standard OP22 OP38 Regulation 13(4) 13(4) Requirement Timescale for action 16/12/05 3 OP38 13(4) 4 OP9 13(2) Bath hoist must be regularly maintained. Pre Set Valves with fail-safe 16/12/05 devises to be fitted as an immediate priority to those rooms in which water temperatures exceed 43oc .To fit these devises to all other rooms to provide water close to 43oc on a risk assessed basis. PAT testing must be completed 16/12/05 on the ‘fan’ seen during the inspection and on all portable electrical appliances, which have not already, had this undertaken this year. Medication to be administered 16/12/05 should be in date and if expired returned to pharmacy. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 22 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 OP7 OP38 Good Practice Recommendations Care plans to contain more detail and should link in any care planning needed to meet any identified risks from the risk assessments. Portable heaters provided for resident’s comfort in their rooms should have a completed risk assessment. The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 The Links DS0000008064.V254534.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!