CARE HOMES FOR OLDER PEOPLE
The Yachtsman Rest Home 41/42 Laidleys Walk Fleetwood Lancashire FY7 7JL Lead Inspector
Mr Wesley Cornwell Unannounced Inspection 23rd October 2007 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 Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 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 Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Yachtsman Rest Home Address 41/42 Laidleys Walk Fleetwood Lancashire FY7 7JL 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 873472 01253 873472 Graham Phillip Saunders Robert Mark Saunders ****Post Vacant**** Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. A suitably qualified and experienced manager must be employed Date of last inspection 16th August 2006 Brief Description of the Service: The Yachtsman is registered for 30 male and female residents over the age of 65 years. The home is located on the sea front at Fleetwood and has unrestricted views of Morecambe Bay. Accommodation comprises of two lounges, two dining rooms and a sun lounge. Resident accommodation is located on the ground and first floors and comprises of 28 single bedrooms and 1 double room. En suite facilities are available in 11rooms. A passenger lift is available to facilitate access between the ground and first floor. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £332.00 to £374.00 covering all aspects of care, food and accommodation. The manager provided this information on the 23rd October 2007. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 9.30am and took place over 5 hours. Prior to the site visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. A number of residents, their relatives and healthcare professionals were contacted prior to the site visit and their views about the home have been included in the report. In addition the Inspector spoke to three residents, three staff members, the manager and owners of the home. Staff, care, maintenance and financial records were examined during the site visit and a full tour of the premises was undertaken with the owners. What the service does well:
Residents spoken to said they enjoyed the quality and variety of food provided by the home. One resident said, “ I enjoy all my meals. The food is very good and we get plenty to eat ”. Staff at the home have been well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed residents are treated with respect and dignity. One resident said, “ I enjoy living here and I am very happy ”. A healthcare professional said, “ The care staff provide a homely and friendly environment, where residents are treated as individuals and always cared for in a dignified and respectful manner ”. The home has a structured activities programme to keep residents entertained. One resident said, “ I really enjoy the activities and never get bored. We get lots of trips out and there is always plenty going on in the home ”. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. The relative of one resident said, “ During our visits my wife and I are always treated in a courteous manner”. The relatives of residents were very positive in their comments about the home. One relative said, “ The owners and staff have created a homely atmosphere for residents. They provide good food and have a well trained staff The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 6 team. The home is clean and they provide plenty of activities for residents inside and outside the home. My relative is very happy ”. What has improved since the last inspection? What they could do better:
Staff files should be re-structured to ensure the information about people’s recruitment is clear confirming residents are being protected by the systems in place. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 8 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 Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The care plan records of two residents recently admitted to the home had full assessment information including the religious/cultural and relationship needs of residents. Staff members confirmed they had access to this information, found it easy to follow and could describe in detail the care needs of the residents. Staff responsible for the preparation of meals said they were informed about residents who had special dietary needs and these are always accommodated. This home does not provide intermediate care.
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously, resident’s welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out the action that is needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed at least once a month and updated to reflect any changing needs in the health and personal care of the resident and these were being actioned. The records of two residents were looked at and these described their healthcare needs. Discussion with staff members on duty confirmed they were fully aware of the healthcare needs of residents and these are monitored and
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 11 their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. The records of one resident confirmed a healthcare problem had been identified and appropriate action had been taken by the home to ensure the resident received the appropriate level of care. One resident recently discharged from hospital said they were happy to be home and was satisfied with the care he was receiving. One General Practitioner contacted prior to the site visit said the individual health care needs of residents were being met, residents privacy and dignity was respected and staff at the home had the right skills and experience to support the individual health and social care needs of residents. A healthcare worker who frequently visits the home said, “ The Care staff are always willing to assist the District Nursing staff if required and follow any advice given by us that will improve the care of patients ”. Discussion with staff confirmed they were aware of the needs of the residents and the level of care that needed to be provided. One resident said, “ I enjoy living at the home and I am very happy. I have always found the staff to be very kind and attentive to my needs ”. The relative of one resident said they were very satisfied with the care being provided by the home and found the staff to be very hard working, conscientious and respectful. Medication practices observed during this visit were safe and good records had been maintained. The staff members responsible for the administration of medicines had received accredited training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Residents spoken to said the staff team respected their privacy and they could spend time on their own if that was their wish. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Residents spoken to said routines within the home were flexible and they were able to make their own decisions about how to live their lives. One resident said, “ I have lived at the home for number of years and I am very satisfied with my care. I go out most days because I enjoy the exercise. I have complete freedom to come and go as I please ”. The relative of one resident said, “ My mother goes out for lunch with friends twice a week. I have always found the home is supportive of this arrangement ”. Residents spoken to said they were happy with arrangements in place for receiving their visitors. The relative of one resident said, “ My mother enjoys her accommodation. She feels safe and secure and likes the staff who in turn seem to like her. During our visits my wife and I have always been treated in a courteous manner ”.
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 13 Most residents handle their own financial affairs or these are handled by their relatives/representatives. Records being kept in respect of residents unable to manage their own finances were being well maintained. The home provides a varied and balanced diet for residents. The staff member responsible for the preparation of meals was able to confirm they had information about residents with special diets and personal preferences. Residents spoken to were happy with the choice and standard of meals available. One resident said, “ We are always provided with a choice of meal and we have three courses for lunch. I enjoy all my meals ”. The relative of one resident said, “ The food and catering is very good ”. Menu’s were on display informing residents about the choice of meals available for the day. Meal times were served in a relaxed and unhurried manner in pleasant surroundings. Staff members were observed being very attentive to residents needs. Residents spoken to were very happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on their admission and is also on display for the attention of all visitors. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. At the time of this site visit no complaints had been referred to the home or the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. Since the last inspection the manager and staff have received training in the protection of vulnerable adults and showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members spoken to said they wouldn’t hesitate to report any concerns they had about care practices to ensure residents are protected from potential harm or abuse. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensures residents live in a comfortable, homely, clean and safe environment. EVIDENCE: The home has been maintained and decorated for the comfort of residents. Since the last inspection a number of improvements have been made as part of the homes refurbishment programme. New furniture, carpets and light fittings have been purchased for communal areas. A number of resident bedrooms have been decorated and two rooms have had en-suite facilities added. The homeowners said the redecoration and refurbishment of the home
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 16 was ongoing and there were plans for further improvements. Residents spoken to were very pleased with the improvements being made A tour of the building confirmed resident bedrooms had been personalised with their own belongings. Residents spoken to said they were very happy with their room and could spend as much time there as they wanted without being disturbed by the staff. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic providing a pleasant environment in which to live. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment of a well-trained staff team throughout the day is sufficient to meet the needs of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive and were well treated by the staff. All residents seen during the visit said the staff were very quick to respond whenever called upon. One resident said, “ I am very satisfied with my care. The staff are very helpful and cannot do enough for you. I wouldn’t live anywhere else ”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Records show all staff members have access to a structured training and development programme ensuring the residents are being cared for by a well trained and competent staff team. In addition 70 of staff members have achieved National Vocational Qualifications (NVQ) ensuring the residents are in the safe hands of qualified and competent staff.
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 18 Examination of staff records showed good systems were in place for obtaining relevant documentation for staff members employed by the home ensuring the protection of residents. However, the files were disorganised and made it difficult to follow how staff members had been recruited. The homes recruitment procedures should be reviewed to ensure this information is clear. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The manager has been in post for three months and has recently completed a relevant care qualification. She has just enrolled to undertake a national management qualification and was in the process of applying to be registered with the Commission. She is well supported by the owners of the home who
The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 20 are based at the home on a daily basis. Records seen confirmed the manager has access to training to ensure her knowledge and skills are updated. The home has effective quality assurance systems in place to monitor the level of service being provided for its residents. An annual quality assessment of standards is undertaken by a professionally recognised organisation who complete an audit of the care being provided and seek the views of residents and their relatives. In addition the home has in place its own quality assurance systems in place to gather the views of residents and keep them informed about events being organised by the home. Since her appointment the manager has introduced a monthly newsletter for residents and their families to inform them about developments in the home and social events being organised. The manager has also introduced an employee of the month award who is chosen by residents and their relatives. The winner is announced in the newsletter. Residents spoken to said they looked forward to the newsletter as it was informative and fun to read. Inspection of records for residents finances were well maintained and up to date ensuring residents interests are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 21 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 22 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. 1 Refer to Standard OP27 Good Practice Recommendations The homes recruitment procedures should be reviewed to ensure the information about people’s recruitment is clear confirming residents are being protected by the systems in place. The Yachtsman Rest Home DS0000037739.V347833.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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