Inspection on 20/03/07 for Vitalise Sandpipers Centre

This inspection was carried out on 20th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Vitalise Sandpipers Centre 17/12/09

Vitalise Sandpipers Centre 09/03/06

Vitalise Sandpipers Centre 31/08/05

Vitalise Sandpipers Centre 16/02/05

Vitalise Sandpipers Centre 29/06/04

Vitalise Sandpipers Centre 11/01/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Sue Ryder Care Birchley Hall

Wyncourt

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

CARE HOME ADULTS 18-65 Vitalise Sandpipers Centre The Fairway Southport Merseyside PR9 0LA Lead Inspector Mrs Claire Lee and Mrs Margaret Van Shaick Key Unannounced Inspection 20 and 21st March 2007 11:00 th Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 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 Vitalise Sandpipers Centre DS0000017270.V326033.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 Adults 18-65. 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. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vitalise Sandpipers Centre Address The Fairway Southport Merseyside PR9 0LA 01704 538388 01704 549764 sandpipers@vitalise.org.uk www.vitalise.org.uk Vitalise 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) Mr Darren Andrew Holloran Care Home 36 Category(ies) of Dementia (36), Dementia - over 65 years of age registration, with number (36), Physical disability (36), Physical disability of places over 65 years of age (36) Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 36 PD and up to 36 PD(E) Maximum no. registered - 36, of which up to a maximum of 22 N (nursing) Service users to include up to 36 DE and up to 36 DE(E) Date of last inspection 9th March 2006 Brief Description of the Service: Sandpipers is a 36-bedded centre run by Vitalise. Vitalise is a national charity providing planned holiday breaks for guests (people who use the service) with physical disabilities and visually impaired people. It also offers planned breaks for carers (for the purpose of this report the term carer refers to a family member or friend who has accompanied a guest to the centre). Vitalise has five accessible centres in the United Kingdom. Sandpipers is located in Southport close to the town centre and with easy access to public transport and the beach. The centre also overlooks the marine lake. The centre is situated over the ground and first floor, the upper floor is accessible by stairs, covered walkway and spacious passenger lift. The centre has a balconied sun terrace, 2 lounges, dining room, bar and other recreational space with comfortable chairs on each floor. Sandpipers has 28 single rooms and 4 double rooms. Ensuite facilities are also available. The centre has an excellent standard of equipment and environmental adaptations suitable for guests with disabilities however staff do ensure maximum independence is promoted for the guests. The centre continues to meet specialised nursing needs and at the same time provides a relaxed holiday break with a full range of social activities and events within very pleasant, comfortable accommodation. The fee rate for accommodation at the centre ranges from £460.00 - £1050 a week. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days; two inspectors were present for the second day of the inspection. A partial tour of the centre was conducted and a number of guest care records and general management records of the centre were viewed. Discussion took place with the centre’s registered manager, the care manager, five staff members, ten guests and four volunteers. Vitalise relies on a volunteer force who assist with the social side of the guests’ stay. Experienced volunteers are trained to assist with low dependency personal care and the management team monitor this at all times. During the inspection four guests were case tracked (their care files were examined and their views of the centre were obtained). This process was not carried out to the detriment of other guests who also took part in the inspection process. All the key standards were inspected and also previous requirements from the last inspection in March 2006 reviewed. Satisfaction survey forms “Have Your Say About …” were distributed to the guests and carers/relatives/advocates during the inspection. The survey forms were not handed out in advance as the guest list changes each week at the centre. Comments included in this report were taken during the site visit and from the returned survey forms. What the service does well: Sandpipers is a well established service, which provides a good quality of care to the people who use the service. Vitalise gives “ Visually impaired and disabled people a real choice of holidays, provide vital breaks for carers and inspirational opportunities for volunteers”. Guests come to the centre unaccompanied or on occasions with their carer for one-two weeks at a time. Carers can be involved as much as they want with the care however they are also able to relax and enjoy the centre’s facilities. Guests interviewed were very complimentary regarding the overall service. Comments include: “Really good place” “Great staff” “Trips out are fun” “I like to stay at the centre and talk with the volunteers” “You can please yourself what you do” There continues to be a very good balance between meeting the care, health and support needs of the guests and providing a relaxed holiday/break Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 6 environment. Guests’ needs are identified prior to arriving at the centre and a further nursing assessment is completed by the nursing staff on arrival. This ensures the staff have the information, which they need in order to know the needs of the guest and determine whether or not the person’s needs can be met at the centre. As much information as possible is also obtained from other professional sources to ensure care needs are identified. The care files are organised and care plans are updated to reflect the care and treatment given during the guest’s stay. Care files viewed clearly identified potential risks, dependency levels and standard of disability equipment required. The guests have varying dependencies and the care files viewed reflected these diverse needs. A number of guests require a high level of nursing care and the centre is well equipped to deal with this; a clinical room is available. Many of the guests return two or three times a year and therefore the staff get to know them very well. A guest said, “It is like a family”. Staff who were interviewed understood the importance of promoting independence and delivering high quality outcomes for the guests. The guests have access to a GP and also an ‘out of hours’ service if required. Comments from the guests regarding care include: “The “The “The “The staff staff staff staff know what help I need” are on hand all day and night” acted professionally when I had a fall” are very busy but they give us good care and help” An important part of the centre is the social aspect and staff and volunteers go out of their way to ensure the guests have a good holiday. Sandpipers offers a variety of themed weeks for the guests and carers, for example, Queen Week, Youth Week, Irish Week, Alzheimer’s Week, Multiple Sclerosis Week, Holistic Week, Christmas Shopping Week and New Year Week. Many guests return each year for the same themed week as they enjoy meeting the same friends and the social activities arranged for that particular week. At the time of the site visit, volunteers and staff were accompanying guests to the Trafford Centre and the War Museum in Manchester. Several guests said that the trip to Birkenhead Market was popular. The centre has its own transport with designated drivers and where possible the centre aims to provide a volunteer on a 1 to 1 basis; a registered nurse accompanies guests with nursing needs. The lounge has a licensed bar, video, wide screen television (with cable channels) and karaoke nights are organised. Live music is arranged in the evenings. The centre has a swimming pool and the two computers with Internet access. Areas seen at the centre were well maintained and very clean. During the January each year the centre is closed for cleaning and general maintenance and refurbishment. The centre accommodates the guests’ wheelchairs, corridors are wide and handrails are placed throughout. All rooms have height adjustable beds, and a nurse call system is operational. The centre is fully accessible to people who are physically disabled and it is fitted with aids and adaptations. Overhead tracking is available for moving and handling purposes Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 7 in the bedrooms. The decoration and furnishings across the centre are of a very good standard. Guests have full use of all communal areas which includes two lounges, a large dinning area, bar and swimming pool. There is also a small fishpond and shop in the main hall. A door entry system is in place at the front entrance for security and guests, carers and visitors are asked to sign in and out. All staff and volunteers wear a badge for identification purposes. Guests interviewed were pleased with the accommodation and comments include: “Good equipment” “Nice outlook over the lake” “Good wide corridors” “Nice and clean” “Bedroom is ok” Good communication was evident between the staff, volunteers and guests. There was a lot of laughter and banter in the centre and guests appeared relaxed and at ease. The volunteers play a large part in ensuring the guests have a good social life and guests were complimentary regarding the attitude of the volunteers and their willingness to take part in all the trips. There was a good number of staff on duty during the site visit and it was evident that the care manager works closely with the care staff to ensure good standards of care are maintained. Staff receive training in safe working practices – first aid, infection control, moving and handling, food hygiene and fire prevention during January of each year as the centre is closed at this time. Over 90 of staff have also achieved an NVQ in care, which is commendable. The administrative and domestic staff also undertake NVQ courses in their line of work. The overall management of the service continues to be open and transparent. The views of the guests, carers and staff are obtained and quality monitoring systems, ensure the centre delivers an outcome based service. Sandpipers has a very good management structure and members of the management team were knowledgeable regarding their role and support required by the staff and guests. Guests and staff were pleased with the overall running of the centre and described the registered manager as “Helpful”, “Great at what he does”, “Can turn his hand to anything”, “Really good at what he does” and “Very organised”. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 8 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 summary of this inspection report can be made available in other formats on request. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments help ensure that the centre can meet the needs of the guests. EVIDENCE: Although Standard 1 was not assessed a copy of the Service User Guide was seen in a number of guest’s rooms and the centre had brochures on display regarding the service in public areas. Guests or their representatives are requested to complete a booking form/ initial assessment form in advance of their stay. This provides the centre with information they need to plan the care for the guest and also ensure the necessary equipment is in place. Guests are also required to provide a medical certificate from their G.P, which includes up to date information on their health and medication being taken. When a guest arrives at the centre on the Saturday a designated member of nursing staff carries out a further needs assessment. The centre does not provide a stay without having attained an appropriate amount of detail on the needs of the guest. Assessment documentation from other professional bodies is attained where possible to help with this process. Many of the guests return for several visits each year however the assessment is still carried out for each visit as the guest’s care needs may have changed. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 11 Vitalise are unfortunately “Unable to provide appropriate care for people who are bed-dependent, have uncontrolled epilepsy or have mental health difficulties”. The care manager stated that all staff are aware of this policy and would not accept guests to the centre with these conditions. They do however try and accommodate guests where possible following consultation with the relevant external professionals. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual plans of care are in place and guests are consulted and can choose to participate in all aspects of life at the centre. Staff support guests to maintain their normal lifestyle. EVIDENCE: As part of the case tracking process four guest care files were viewed. The files are organised and the information easy to read. Guests come to the centre for a week’s holiday and the information recorded ensures their health and personal care needs are understood and met by the staff. Guests have an individual plan of care and their consent and agreement is sought when the staff draw this up. Care plans seen identified information in key areas, for example, mobility, communication, personal hygiene, nutrition, pressure relief, skin care, sleep and social support. Clinical needs were also recorded with particular reference to each guest’s disability and range of equipment required Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 13 to maintain their normal lifestyle. Two care files evidenced details of wound care management and the guests when interviewed were very pleased with the clinical treatment and support given by staff in this area. The care manager stated that a care plan would be put in place for any medical condition or change in the guest’s general well being. This information would be passed on to the relevant person on the guest’s return home. One care file evidenced details of an invasive clinical procedure and an extended clinical risk assessment should be completed due to the nature of the procedure. Information from the district nurse service was evidenced as to why the procedure was needed. Care files viewed recorded risk assessments for moving and handling, pressure relief and any potential risks that may affect restriction to freedom and choice. Sandpipers is a holiday centre and the principles of the centre for delivering an excellent service are based on the belief that guests should be able to maintain their normal lifestyle, to relax, have fun and enjoy their stay at the centre. Through discussion with the staff and guests, reviewing care files and general observation it was evident that the centre remains committed to providing this environment and service. Staff are on hand though to give the support and care required for each guest. Comments from guests include: “Good care” “Fantastic place” “Such great fun” “Could not have better” “Companionship” “Really good holiday” “Staff give great care, could not have better anywhere” The centre’s GP holds a surgery each Monday and an ‘out of hours’ service is also available. A guest commented that it was reassuring to know a doctor was available. The guests are consulted on how the centre operates by completing satisfaction survey forms and also by general discussion with the staff during their stay. Guest meetings are not held as the guests are only at the centre for a short time and they wish to be out and about enjoying their stay. The centre is able to provide policies and procedures in a suitable format for individual needs. Guests can participate in the events and social arrangements organised by the centre or they may choose to arrange their own week. As previously stated risk management forms an important part of the care however this is well managed by staff to ensure the guests’ preferred activity or choice is not limited where possible. A guest reported, “The staff know what I can do and respect my decisions whilst I am here”. Activities are planned collectively and/or individually depending on the guests’ needs. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 14 A number of guests’ financial records were viewed, as the centre will hold monies on their behalf. Records seen were up to date and evidenced guests and staff signatures for transactions. Guests where possible manage their own personal finances. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The freedom of the centre enables guests to maintain their preferred lifestyle, to come and go as they wish and join in with the social events organised by the centre. Meal times are a social occasion and guests are offered an excellent choice of wellbalanced meals. EVIDENCE: Sandpipers offers a range of themed weeks for the guests. This includes, Queen Week, Youth Week, Garden Week, 30-45’s Week, Alzheimer’s Week, Multiple Sclerosis Week, Christmas Shopping Week and New Year Week. On this occasion the centre was holding a ‘normal’ week for the guests. Guests arrive with or without their carers therefore numbers present at the centre can fluctuate. There were two carers staying at the centre at this time, however, they were out on trips all day and therefore their views of the service could not be obtained. The centre does enable carers also to spend time on their own if they wish, as staff and volunteers accompany guests on the trips. On occasions Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 16 the centre has married couples or guests will visit their families if they live close by. Family members are welcome at the centre at any time. The centre has its own transport; one large coach and two smaller buses with designated drivers. The transport is suitably equipped to assist guests with limited mobility. Trips out are arranged most days and guests had gone to the Trafford Centre and the War Museum at Manchester at the time of the site visit. A number of guests were out with volunteers in Southport for shopping and some had chosen to stay at the centre. The entertainment board lists the entertainment for the week and this includes, bingo, quizzes, live music, a visit to Birkenhead market, trip to the War Museum and bowling. The parties advertised are held in the evenings. Staff and volunteers were observed spending time chatting with the guests in the lounge or in their own rooms. The lounge has a licensed bar, video, wide screen television (with cable channels) and karaoke. A shop is situated in the main reception hall and guests and their carers can use the swimming pool. A hoist is available poolside. Two computers on the first floor provide Internet access for the guests and the centre offers a full range of services including hairdresser and massage. Comments from guests regarding leisure time at the centre include: “Really good trips out” I like to stay and spend time in the lounge with my friends” “Staff and volunteers are great at taking us out, they never mind where I want to go” “The trips are well organised and great fun” “The volunteers make the stay” “Could do with a different trip” The centre actively encourages guests to be independent and staff interviewed stated that with the help from volunteers there is sufficient time to provide support with the social arrangements. Guests are able to lock their room if they wish and they are also provided with a lockable facility for money and valuables. A member of staff confirmed that guests do lock their rooms and staff would not enter without their permission. The centre has a terrace, which overlooks the marine lake and guests who smoke can use this area. All areas of the centre and the grounds are accessible for wheelchairs. A guest was enjoying a trip around the lake path at the time of the site visit. One guest stated, “The centre is large and easy to get round which is good”. The daily routines of the centre were observed to be flexible to the needs of the guests. Several guests confirmed that they like to get up at lunch time and that staff do not mind at all. A number of guests arrived late for lunch and staff provided their meals at this time. ‘Do not disturb’ signs are placed on doors by the guests and staff said they would not enter unless in an emergency. Guests Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 17 interviewed all stated that staff were polite and respected their privacy at all times. Guests interviewed were very complimentary regarding the standard, presentation and choice of meals available. The lounge has dining space and tables were laid for each meal. Laminated menus were evident on each table and these offered an excellent choice of varied foods. A choice of two meals with a vegetarian option is provided at dinner and guests and carers can enjoy wine with their meals. A lighter meal is cooked at lunchtime and a salad bar is available each day. A guest was observed to request something different for tea and the cook provided this straightaway. Guests can have a cooked breakfast if they wish and volunteers and staff have their meals with the guests when work permits. Although the majority of guests were out for the day, lunch was a sociable occasion and staff were observed to offer assistance to guests in a sensitive manner. A volunteer was observed to spend a great deal of time describing the food to a guest and ensuring that he was given choice as to what he wished to eat from the plate. Special occasions are celebrated and party nights catered for. The licensed bar is open at various times and staff receive bar training as part of their induction. Snacks and hot/cold drinks are available and there is drinks’ machine. For the trips out from the centre picnic lunches are provided. Guest made the following comments regarding the meals: “Far too much to eat” “Great food” “Can have anything I want” “The chefs will always do something different if I want” “The staff know how much I eat and give me time to eat it” “Really good food” “Tasty meals” “Dinner is fab.” The kitchen was observed to be clean and organised. There has been no recent environmental health inspection; records for Better Food, Safer Business were in place and environmental health records current. There was an excellent supply of foods in store. Dietary needs are recorded in the guest’s care plan and this information is also given to the chef. The chef has worked at the centre for many years and teaches food hygiene to the staff. Guests are given a food survey to complete and surveys seen evidenced satisfaction all round. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. General support, care and guidance are managed by staff to ensure the guests’ maximum independence and to maintain their privacy and dignity. Medicines are administered according to the centre’s policy and procedure and this includes self-medication. EVIDENCE: Discussion with guests confirmed that the staff provide a very good level of care and support, which is based on individual need. A guest reported that having suffered a fall the staff “Acted quickly and professionally” in assisting him. The guests have varying levels of dependency, some require minimal support and others full time care. This is regularly monitored and reviewed by the nursing staff. Care files seen evidenced this. Guests with communication difficulties have access to aids to assist with communication and a member of staff is able to perform sign language. The staff on duty were observed to interact well with the guests; a volunteer and guest were using pen and paper Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 19 to communicate and the volunteer was taking considerable time to understand the guest’s wishes. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 20 With regards to dependency levels and assessing any potential risk, information is collated when guests and/or carer complete the initial booking form and then a further assessment is undertaken when the guest arrives at the centre. Care files viewed evidenced this information. A guest who required a special bed said that this had been provided. The height of the bed was still a concern to the guest however the centre were observed to respond quickly to resolve this problem and were advising the guest of action that was being taken. The nursing staff perform clinical treatments and the guests come to the centre with their prescribed dressings and creams for wound care. Further supplied are obtained by the centre when needed. The centre has a wellequipped clinical room for undertaking clinical procedures. Staff have a guest dependency list and nursing list, which is updated with the care and support each guest requires. Verbal handovers are also given to staff at the beginning of each shift to inform them of the guest’s needs. The centre recently provided support for a guest with very complex needs and the use of specialised equipment; their carer gave the main care during the stay. This was arranged prior to arrival at the centre. The staff provided support to the guest and carer, however, training in this specialist area should be arranged to ensure the staffs’ knowledge. The centre provides a GP service once a week and this is conducted in the nurses’ surgery or in the privacy of a guest’s bedroom. Staff are also able to contact the out of hours GP service and A&E department of Southport Hospital. Any changes made to the plan of care are documented and GP’s and other health professionals are advised of these changes by letter when the guest returns home. Staff adhere to the centre’s medication policy and practice guidance. The medicine trolley was locked when not in use and kept in the clinical room. The centre has a policy document regarding administration of ‘home remedy’ tablets (medicines not prescribed, for example, paracetamol, strepsils) and this has been drawn up with input from the centre’s GP. Guests bring their own medicines to the centre. Medicines received are counted in, entered on individual medicine sheets and counted out when the guest returns home. Medicine charts had photographs for verification purposes and guests who wish to administer their own medications have a lockable facility in their rooms for safe storage of their medicines. Due to the high turn over of guests at the centre the nursing staff conduct a number of safety checks to ensure medicine administration is well managed. This demonstrates good clinical practice. A guest said, “The staff give me my tablets and I get them on time”. In house medicine training is given to the nursing staff and care staff who administer medicines on the trips also receive the appropriate training. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 21 A nurse interviewed was clear about his role when preparing medications for the guests for their trips out. A small portable lockable container is used for transporting the guests’ medicines when out on trips from the centre and these are recorded in a portable medicine file. Standard 21 was not inspected however discussion took place regarding an unexpected death of a guest that took place earlier this month. The registered manager worked closely with external professionals at this time and provided advice and support to the guest’s family and also the centre’s staff. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 22 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns by using an effective complaints procedure and are safeguarded from abuse by the home’s abuse policy. EVIDENCE: The centre has a complaints procedure. The registered manager or the care manager investigate any concern or complaint received and also liaise with senior management at Kendal with regard to their findings. The complaint log evidenced one complaint received since January 2007 and this has been resolved. An investigation undertaken into a complaint last year is still ongoing and in the hands of the legal department of the organisation. Guests interviewed did not have any concerns at this time and a guest said, “I would speak to Darren (registered manager) if I needed to, it would not be an issue”. The centre has an abuse policy however it is recommended that the centre obtain the latest edition of Sefton and Liverpool’s Protection of Vulnerable Adult Procedure. Details of the procedure should be made available for all staff. There are currently two adult protection cases being investigated by the adult protection team, which comprises of the Commission, police, and social services. The police are taking the lead for both alleged incidents. One adult protection case, which was referred to the adult protection team, is now being investigated internally at the centre on the advice of the police. The centre have acted appropriately in providing the necessary information and adhering to the adult protection procedure for all three alleged incidents. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 23 The centre has always provided adult protection training for staff but in light of the ongoing investigations more detailed training for staff and volunteers has reinforced what constitutes abuse and how to deal with an allegation. The volunteers’ handbook now contains more information and guidance on this subject. Staff files viewed showed staff are recruited through the correct recruitment and selection procedures. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 24 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 27, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Guests stay in a home, which is well presented, well maintained and provides safe comfortable accommodation. The centre is presented as clean and hygienic and the layout and location of Sandpipers is suitable for its stated purpose. EVIDENCE: Sandpipers is a purpose built centre situated near the sea front with easy access to the town centre. The centre is designed to provide maximum independence for the guests in a discrete non-clinical environment. The centre provides excellent accommodation and furnishings, fittings and equipment are suitably adapted for guests to maximise their independence and to maintain their normal lifestyle. At the time of the site visit a guest requested a hook on the bathroom door for hanging clothes. This was put in place immediately by the maintenance staff. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 25 The centre provides accommodation for to up to thirty six guests. Twenty eight of the rooms are for single occupancy and four are double rooms. Fourteen of the rooms have ensuite facilities. The centre are looking to make all the bedrooms ensuite and to increase the registration by two beds next year. The centre is situated over the ground and first floor; the upper floor is accessible by stairs, covered walkway and passenger lift. The lift is very spacious. The centre accommodates wheelchairs, corridors are wide and handrails are placed throughout. The second floor of the building provides accommodation for volunteers. All rooms have height adjustable beds, and guests have the use of a nurse call system. The centre is fully accessible to people who are physically disabled and is fitted with aids and adaptations and overhead tracking for moving and handling in the bedrooms bedrooms. The environment is appropriate to the diverse needs of the guests to ensure their preferred lifestyle is respected. Areas seen were very well presented, spotlessly clean and well maintained. The decoration and furnishings across the centre are of a very good standard. Guests have full use of all communal areas which includes two lounges, a large dinning area, bar and swimming pool. There is also a small fishpond and shop in the main hall. The terrace over looks the marine lake. A door entry system is in place at the front entrance for security and guests, carers and visitors are asked to sign in. The main hall has plenty of information regarding the centre and a receptionist is on duty during the day to assist with enquiries and general management of the centre. A number of guests stated that it is good to have someone at the front desk to greet them, “A friendly face is important when arriving at the centre”. Comments regarding the accommodation from the guests include: “Great place” “Bedroom is fine, would have liked ensuite but one was not available” “The centre is very clean” “The centre is easy to get around” “The lounge is great” “The views are great” “”Easy to get in to town” The laundry room was organised and clean. The centre has a housekeeper who also undertakes health and safety duties. There were sufficient domestic staff on duty at the time of the inspection and gloves and aprons were in use where needed. Policies, procedures and practices for infection control were in place and a staff member stated that the centre had the necessary infection control equipment to meet the guests’ needs. It was evident that the centre follows health and safety guidance. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 26 Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 27 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,34 35 and 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff recruitment practices are robust to protect the guests and appropriate numbers of well trained skilled staff provide the necessary care and support for the guests. EVIDENCE: A copy of the staffing rota for the month of February 2007 was provided as part of the pre inspection questionnaire and also the staffing rota for March 2007 was viewed at the time of the site visit. Rotas were in place for the duty manager/supervisor, care team, nursing staff, house keeping team/reception staff, catering team and maintenance/drivers. Staff names should be written in full for the purposes of monitoring staff in the building in the event of a fire. The number of staff on duty at the time of the inspection was sufficient for the thirty one guests accommodated at this time. The registered manager was on duty both days and the care manager for the first day of the site visit. The centre is well staffed and a new registered nurse is joining the team shortly. A number of staff have worked at the centre for many years and confirmed how much they enjoy the work. The centre generally has seven care staff on duty in the morning with two registered nurses (one may be the care manager). The centre is staffed as per the staffing notice agreed with the previous registration authority. Staffing levels are determined on a week-to-week basis Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 28 in line with the assessed needs of the guests. Guests made the following comments regarding the staff: “Very good team” “The staff provide good care” “The staff will do anything for you” “The staff get good training” “The staff are very busy but do a good job” Staff recruitment and selection practices were looked at through the examination of staff files for four new staff members and discussion with the registered manager. All relevant pre employment checks had been carried out prior to the member of staff starting work at the home. This includes two written references and Criminal Record Bureau (CRB) enhanced disclosure. A list was was available for all CRBs kept at the centre. The month, the date stated on the CRB should be entered on the list to ensure the record is up to date. This information is currently being provided to the Commission. Staff receive a full induction when they start and are given a staff contract. A staff member said the training provided was very good and the centre was happy place to work in. During the month of January the centre is closed for general maintenance and two weeks of staff training. Each member of staff has a training log for this purpose and the centre provides training in safe working - moving and handling, infection control, basic first aid, fire safety, abuse, food hygiene, oxygen training, medicine administration, wheelchair training and vehicle loading. Further training in moving and handling is being arranged as not all staff attended in January 2007 due to sickness. The nursing staff access courses in clinical care – diabetes, artificial feeding, multiple sclerosis and diabetes. A copy of the training plan was provided as part of the pre inspection questionnaire and also viewed at the time of the site visit. Four staff files seen evidenced the training dates for January 2007. Staff are encouraged and supported to take qualifications in NVQ (national vocational qualifications). Over 90 staff have an NVQ in care. NVQ courses are also accessed in Cleaning and Support Services and Customer Services/Administration. The duty manager and deputy manager have commenced NVQ Level 4 in Management. An up to date record for NVQ was seen. The centre holds regular staff meetings. Minutes were available for meetings held in March and February 2007. Staff files evidenced supervision sessions, which are given by the heads of the department. One staff member interviewed stated that she gives supervision to staff regularly, however, one staff member when interviewed stated that she had not received supervision for a year. The registered manager is planning a session as soon as possible as supervision should be given to staff to provide support and identify training needs. Registered nurses have a personal identification number as part of their registration; the registered manager should ensure that a list is kept of expiry Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 29 dates for these numbers PINS (professional identification numbers). This is to ensure nurses are fit to practice. A check is currently undertaken approximately every year. The centre has a large volunteer workforce, which is co-ordinated by another team within the Vitalise organisation and the deputy manager of the centre. Two written references and CRB disclosures are obtained for all volunteers at the centre. At the time of inspection there were twenty four volunteers and the centre aims to achieve a ratio of one volunteer to every guest. This means that the guests have a significant level of one to one support in pursuing activities. Volunteers do not provide personal care to any of the guests unless they have the appropriate training and experience to do this and have been passed as competent to carry out the tasks. A ‘blue badge’ is awarded for this purpose and the staff monitor the volunteers at all times. The volunteers receive an induction when they arrive at the home and an induction booklet evidenced the topics that are covered by the centre. The staff training plan for January 2007 evidenced a training sessions for the staff on the role of the volunteer. Guests were complimentary regarding the volunteers, comments include: “The volunteers are great” “They make the holiday” “”The social side of things is great due to the volunteers” Volunteer said the following regarding the centre: “The staff are really nice” “Always someone around to help” “The manager is alright and helpful” “The food is yummy, it is nice, two options at meals” “Have learnt a lot and able to understand patients in hospital better” (student nurse undertaking a volunteer placement) “Feels quite at home now” Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 30 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,38,39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well run, well managed and practices and quality assurance processes promote the health and safety of guests and staff. EVIDENCE: Sandpipers has a very good management structure and members of the management team were knowledgeable regarding their role and support required by the staff. Guests and staff were pleased with the overall running of the centre and described the registered manager as “Helpful”, “Great at what he does”, “Can turn his hand to anything”, “Really good at what he does” and “Very organised. The registered manager, Mr Darren Holloran has completed a Degree in Management. A staff member said, “Any concerns and Darren is Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 31 very receptive”. As the registered manager is not a registered nurse, the centre employs a care manager. Ms Viv Pilkington-Vella, care manager, holds a current nursing registration however a copy of her PIN should be placed on file. It would be beneficial for the care manager to undertake NVQ Level 4 in Management as part of the development of this role. Staff interviewed confirmed that the care manager assists staff with the nursing care of the guests and is keen to implement research-based practice. The centre also has a deputy manager and duty managers. Care staff are taking on the role as care team leader to provide support to junior care staff and take on extra responsibilities for the guests. Through discussion with guests and staff it was evident that the registered manager and care manager have a positive approach to ensuring the needs of the guests are met. They were seen to interact well with the guests and staff. A staff member said she enjoyed working at the centre as “The diversity of the centre is very good and the volunteers make it for the guests”. Guests and/or carer views are obtained of the service following each visit. The results of the guest quest questionnaire reports are collated by head office and the centre advised. A copy of this document was provided at the site visit. Comments from December 2006 include, “I am sure of excellent care”, “Volunteers are very good”, “More ensuites and the swimming pool to be in use always”, “Higher staff guest ratio”, A complete rest for carer, no washing, cooking or care” and “More places to visit”. Volunteers also receive a survey form and ones seen from February 2007 were satisfactory. The centre has a one year plan with objectives set; a copy of this was obtained at the site visit. The centre also has a strategic plan for 2004-2009 and a number of staff are undertaking an internal quality aware for small organisations as part of the development of the centre. As part of evaluating the service, Regulation 26 visits (in line with the care standards) are conducted by senior management who visit the centre each month. A detailed report was viewed for March 2007. The pre inspections questionnaire evidenced details of maintenance contracts for equipment and safe working practices. These were in date and a spot check was also undertaken of the gas, electric, fire prevention, and lift contracts. The fire log book evidenced that the fire alarms are tested weekly and a test of the emergency lighting was conducted at the time of the site visit. Staff receive fire prevention training and a fire risk assessment inventory, which includes the premises, was available. The accident book was viewed and two recent reports were written in sufficient detail regarding the incidents. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 32 Throughout the service there is an understanding by the staff of the diverse needs of the guests. Their individual needs are very different and through observation, discussion with guests and viewing documents it was evident that the staff take on board and understand the individual care and support the guests require. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 33 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 x 4 x 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 X 27 4 28 X 29 4 30 4 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 4 4 X X 4 X Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 34 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. 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. 2. 3. 4. Refer to Standard YA23 YA33 YA36 YA35 Good Practice Recommendations The latest edition of Sefton and Liverpool’s Protection of Vulnerable Adults Procedure should be obtained for staff referral. Staff names should be written in full for the purposes of monitoring staff in the building in the event of a fire. Staff should receive regular supervision to assist with them with the development of their role. A list is to be kept of the expiry dates for PINs for registered nurses as part of their fitness to practice. Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 35 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 © 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 Vitalise Sandpipers Centre DS0000017270.V326033.R01.S.doc Version 5.2 Page 36 - 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!