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Inspection on 09/02/06 for The Sands Nursing & Retirement Home

Also see our care home review for The Sands Nursing & Retirement Home for more information

This inspection was carried out on 9th February 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff spoken to said that the residents are well cared for and that they within reason they can do what they want. All the residents the inspector spoke said that they were looked after well. One of them said " I am very happy here and everyone is so kind." The staff were observed to be courteous and sensitive when speaking or providing personal care to the residents. Many of the residents spend most of their time in their rooms. They said that they like the added privacy of their rooms and they can watch television or read in peace. They all said that they can do what they want but go along with the routines of the home such as mealtimes and cleaning etc. They added that they can get and go to bed when they want.

What has improved since the last inspection?

Two of the small kitchens on two floors have been refurbished. One of the four dining rooms has been redecorated. Some divan beds on the nursing floors have been replaced with nursing beds which would help with the nursing of residents. There has been an increase in staffing level to meet the increasing needs of the residents at the home.

What the care home could do better:

The percentage of care staff who have completed their NVQ level 2 and above is well over the 50% recommended, but the manager said that training is ongoing and her aim to ensure that all staff attain this qualification.

CARE HOMES FOR OLDER PEOPLE The Sands Nursing & Retirement Home 390 Marine Road East Morecambe Lancashire LA4 5AU Lead Inspector Mr Ajam Auckburally Unannounced Inspection 9th February 2006 10:30 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 Sands Nursing & Retirement Home DS0000006159.V278347.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. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Sands Nursing & Retirement Home Address 390 Marine Road East Morecambe Lancashire LA4 5AU 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) 01524 400300 01524 410284 Victoria & Thornton Court Limited Mr Robert Wilson, Ms Maureen Mackay Mrs Lisann Christine Smith Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80) of places The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home shall at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 7th July 2005 Date of last inspection Brief Description of the Service: The Sands is a purpose built care home which also provides nursing care and is known as a Care Home with Nursing. The home is situated on Marine Road in Morecambe and faces the sea front. The building has five floors and residents are accommodated on the ground, first, second and third floors. A passenger lift is available for access to all the floors. The central kitchen and the administrative section of the home are situated on the fourth floor. A total of 80 residents can be accommodated at any one time. The ground and first floors are for people who do not require nursing care and the second and third floors are for people requiring nursing care. Each floor has its own lounge, dining room and kitchenette. All the bedrooms are single rooms and all except four have an ensuite facility. The home is staffed around the clock to meet the needs of all the residents. Nursing staff are employed to meet the needs of residents who need nursing care. There were 75 residents staying at the home at the time of the inspection. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second of two statutory inspections to be carried out this year. The inspection was an unannounced one and took place on 9th February 2006 and lasted for 4 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a nice atmosphere and with the full cooperation of the manager, the staff and the residents. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. One resident said, “The staff are marvellous and they will do anything for you.” There were 75 residents in total living at the home at the time of the inspection and there were an adequate number of care staff on each floor to look after them. A qualified nurse was also on duty on each of the nursing floors. The registered manager was on duty and assisted in the inspection. The staff were observed to be polite and kind when talking to the residents. What the service does well: The staff spoken to said that the residents are well cared for and that they within reason they can do what they want. All the residents the inspector spoke said that they were looked after well. One of them said “ I am very happy here and everyone is so kind.” The staff were observed to be courteous and sensitive when speaking or providing personal care to the residents. Many of the residents spend most of their time in their rooms. They said that they like the added privacy of their rooms and they can watch television or The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 6 read in peace. They all said that they can do what they want but go along with the routines of the home such as mealtimes and cleaning etc. They added that they can get and go to bed when they want. 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. The Sands Nursing & Retirement Home DS0000006159.V278347.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 The Sands Nursing & Retirement Home DS0000006159.V278347.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): The home does not provide intermediate care. The other core standard was assessed during the previous inspection and was met. EVIDENCE: The Sands Nursing & Retirement Home DS0000006159.V278347.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): 9 & 10 The policies and procedures on medications are stringent. Practices to respect residents’ privacy are good. Residents’ privacy is respected and their medications are dispensed safely. EVIDENCE: The inspector observed the senior care staff dispensing medications to the residents. This was done according to procedures. The records of medications were examined and they were found to be correct. An audit trail of the medications of two residents was done and they were found to be accurate. The system employed to dispose of unused medications is robust. The manager and a senior staff are involved in this process. Appropriate records are kept. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 10 The recommendations made by the pharmacist inspector during his visit have been implemented. The manager was aware that following the death of a resident, medications should be kept for a week in the event that a post mortem is carried out. The residents said that the staff respect their privacy by ensuring that they are given time on their own. They said that when they are in their rooms, the staff always knock before entering. The staff were observed providing personal care like toileting behind closed doors. The staff spoken to said that they treat all the residents with respect and dignity. They were overheard speaking to the residents with kindness and patience. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 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): 14 & 15 There are good practices to encourage residents to remain active and afford them choices. Food preparing and serving systems are good. Residents are given choices in their daily activity and are given nutritious food. EVIDENCE: The residents said that they can have as much independence as they want and that the staff help them when they need assistance. The manager said that the policy of the home is to encourage residents to remain as independent as they want. Residents were observed doing their own things. Some were in the lounges and others were in their rooms. They said that they are able to remain as independent as they want or able to. They said that staff are helpful and will provide assistance when required. Several residents said that they like to stay in their rooms for most of the day. Some of them would join the others in the dining room at meal times, whilst some would eat in their rooms. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 12 An activity organiser is employed to do a variety of activities to suit the different needs of the residents. There were several residents on the nursing floors being cared for in bed. There were appropriate charts for staff to complete to ensure that all care provided is monitored. Several more nursing beds have been purchased which will help with the nursing of residents The staff spoken to said that although residents are encouraged to retain their independence, they are not forced to do anything. They can choose when to go to bed and when to get up. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 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): 18 Policies and procedures on abuse are comprehensive. Residents feel safe and protected. EVIDENCE: The owners have produced a detailed written policies and procedures on adult abuse. The staff and the management of the home have had training on adult abuse. The management team are fully aware of the steps to take in the event of an abuse taking place to a resident. The staff spoken to said that they would never abuse any resident in their care and that they would report if they saw any form of abuse. The residents said that they feel safe and secure living at the home and that everyone treats them well. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 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): 26 There are good practices to ensure the home is clean and hygienic. Residents live in a clean environment. EVIDENCE: A tour of the building was carried out and all the communal areas were found to be clean and tidy. With the permissions of the residents, several bedrooms were visited. They were found to be clean. The residents who were occupying some of these bedrooms said that the domestic staff come in everyday to tidy and clean their rooms. They said that they do not have to leave their rooms if they don’t want whilst cleaning is being done. The domestic staff spoken to said that they have had training on the use of cleaning materials and infection control. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 15 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 The recruitment policy and procedures are stringent. Staff training plays an important part in staff development. Residents are cared for by a team of well chosen and trained staff. EVIDENCE: The written recruitment policy gives detail of the way a member of staff is employed. When there is a vacancy for a job, it is advertised locally and interested parties are given application forms to complete. From information received, prospective staff are selected for interviews. Once a new staff has been selected, two written references are taken and POVA (Protection Of Vulnerable Adults) and CRB (Criminal Records Bureau) checks are done. No staff starts work until satisfactory checks have been done. Once a new member of staff starts work at the home, she undertakes an induction training programme involving orientation of the home, meeting residents and staff. Training also include, Fire Procedures, Moving and Handling and many other relevant courses. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 16 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): 38 Care practices promote residents’ best interest and their health and well-being. Residents live in a safe home and they are well cared for. EVIDENCE: The residents said that the manager and the staff are kind and helpful and that they are always available to see them. The residents said that they feel safe living at the home. They said that the staff are very caring. Staff training such as Moving and Handling, Fire Safety, First Aid, Food Hygiene and Infection Control are given to ensure the health and well being of the residents. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 17 The home benefits from having a room to provide training to the staff. Most of the training is done in house by management staff, by the use of audio visual aids and by bringing in experts such as incontinence adviser. The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 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 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 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 3 The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 19 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. 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 The Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 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 © 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 Sands Nursing & Retirement Home DS0000006159.V278347.R01.S.doc Version 5.1 Page 21 - 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!