CARE HOME ADULTS 18-65
Vitalise Sandpipers Centre The Fairway Southport Merseyside PR9 0LA Lead Inspector
Debbie Corcoran Unannounced Inspection 9th March 2006 10:45 Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 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 Sandpipers DS0000017270.V280821.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 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. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 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) Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 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 31st August 2005 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 with physical disabilities and planned breaks for carers. 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. Sandpipers 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 chairs on each floor. Sandpipers has 28 single rooms and 4 double rooms. En-suite 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. 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. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over a period of 4.5 hours. This was the second unannounced inspection and carried out as part of the requirement for care homes to be inspected at least twice per year. For the purposes of the report the service users have been referred to as guests. Through the course of the visit the inspector spoke with 5 guests, 2 members of care staff, 2 volunteers, the chef, the care manager and the registered manager. A number of records were examined including the assessment of needs and care plans for a small number of guests. Other records checked included staff files, staff training records and health and safety records. A tour of the premises was carried out and a sample of guest rooms were viewed. What the service does well:
The findings of the inspection were very positive. Sandpipers is a well established service which provides a good quality of care to the people who use the service. Feedback from guests included comments such as the service is “excellent” and “the staff are lovely” and “I want to come back every year”. There is a good balance between meeting the care and health needs of the guests and providing a relaxed holiday / break environment. There is a constantly changing group of guests staying at the centre. Guests tend to stay for one or two weeks at a time. The home is well managed and well organised and staff have some very good ways for communicating between each other and this ensures that the guests needs are well met despite the constant change of guests. When a guest books a stay at the centre the staff ensure that they 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. Each of the guests has a care plan and these provide care staff with clear information on how to meet the needs of the person. Staff ensure the health care needs of the guests are met for the duration of their stay. Service users and staff were seen to interact in a warm and familiar manner. Staffing levels are good and can be increased as required in order to meet the needs of the service users. Staff have received training in many of the core skills relating to their work and in issues relating to the specific needs of the service users and the vast many of the of staff have either attained or are undertaking a National Vocational Qualification (N.V.Q) in care. The catering arrangements are well organised and guests were clearly more than satisfied with the quality of food and meals provided. The chef has
Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 6 information on the dietary needs of all of the guests and of their likes and dislikes of food. One of the guests said that “the food is gorgeous”. Sandpipers is located close to Southport town centre and beach and it overlooks a boating marina. The centre is well presented both inside and out and is comfortable, spacious and welcoming. The centre is purpose built and is fully accessible to people who use wheelchairs. Aids and adaptations are in place to promote the independence of residents and ensure staff carry out safe practices when assisting residents with moving and transferring. Guest bedrooms are well presented and all have appropriate aids, adaptations and a nurse call system. Health and safety practices are in place to ensure the well being of guests, staff and visitors. 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. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 7 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 Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Each of the guests has an assessment of needs carried out by a qualified member of staff at the home. Care management assessments are attained but not for all guests who are referred by Social Services. EVIDENCE: Guests or their representatives are requested to complete a booking form / initial assessment form in advance of their stay. Guests are also required to provide a medical certificate from their G.P which includes up to date information on their health and medications needs. When a guest arrives at the centre a designated member of nursing staff carries out a further assessment of needs with them. The centre does not provide a stay without having attained an appropriate amount of detail on the needs of the guest and it is clear that the person’s needs can be met at the centre. The care manager reported that the centre sometimes attains assessments from Social Services Departments particularly if the guest has difficulty in communicating their needs. These assessments (care management assessments) should be attained whenever possible. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Each of the guests has a care plan which clearly reflects their needs. EVIDENCE: Each of the guests has a care plan which provides clear and easy to follow information on how to meet the person’s needs. The care plans cover areas such as communication, social needs, nutrition, mobility, personal hygiene and diabetes care. Staff maintain a daily record as to how they have supported the guest as per their care plan. Some of the guests also have a care plan, for example from Social Services, which they bring in with them. These are kept securely in the guest’s bedroom for the duration of their stay. Care staff are encouraged to read the guests care plans and are provided with a brief outline of information on the guests care needs and nurses are provided with additional information on the person’s nursing needs. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 17 Guests are well supported to be involved in a good variety of both indoor and outdoor activities. Guests are provided with a choice of good quality food and the catering arrangements and kitchen are well organised. EVIDENCE: During discussions with a number of the guests they confirmed that the staff encourage them to make choices about what they would like to do for the duration of their stay and they said that they are offered a choice of activities. Information on the guest’s needs, preferences and choices of social activities and interests is also recorded in their care plan. Activities are clearly advertised on a large notice board in one of the reception areas. Guests can also choose to have a rest day and spend time relaxing at the centre. The activities arranged for this particular week included church, bowling, a visit to the Trafford centre, bingo, a trip to Chester, a trip to Liverpool and musical entertainment. The centre has coaches which are used for excursions. One of the guests said “we go out every day and I can swim everyday if I want to”.
Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 11 The centre holds themed weeks for example one of the guests was aware of the forthcoming “Irish week” and a member of staff explained that the centre has two weeks throughout the year which are for people who have Alzheimers and on these occasions the activities are arranged specifically in line with the needs of people living with Alzheimers. All of the guests spoken with were complimentary about the food and meals provided at the centre. One of the guests said that the food was “gorgeous” and that “you have a good choice” and another said that “the chef comes to you and asks you what you would like to eat”. Where a guest has special dietary needs this information is recorded in the persons care plan and is also provided to the chef. The chef has worked at the centre for many years and the kitchen is well run, well organised and was presented as very clean. Menus are displayed on each of the tables in the dinning room. These show that the guests have a choice of alternatives at mealtimes and there is always an additional vegetarian option. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Policies, procedures and practices are in place which aim to prevent an abusive, neglectful or issue self harm from occurring. Systems are in place for dealing with allegations of abuse and staff are trained in identifying signs of abuse. EVIDENCE: The home has an adult protection and prevention of abuse policy and procedure and a whistle blowing policy. Staff and volunteers are informed of procedures for the protection of vulnerable adults as part of their induction and care staff have been provided with some training on adult protection. The details of this training were not explored on this occasion. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, 29, 30 Guests stay in a home which is well presented, well maintained, safe and comfortable. The centre is presented as clean and hygienic and staff have been provided with training in health and safety. Health and safety precautions are taken and relevant safety checks are up to date. EVIDENCE: Sandpipers is a purpose built centre. It is located close to the sea front and town centre of Southport and it overlooks a boating marina. The centre provides accommodation for to up to 36 guests. 28 of the rooms are for single occupancy and 4 are double rooms and 14 of the rooms have en-suite facilities. All rooms have height adjustable beds, and have a nurse call system fitted. The centre is fully accessible to people who are physically disabled and is fitted with aids and adaptations. The environment is very well presented and maintained. The decoration and furnishings across the centre are of a very good standard. Guests have full use of all communal areas which includes 2 lounges, a large dinning area, bar and swimming pool. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 15 The centre was presented as clean and hygienic throughout. There were domestic staff on duty at the time of the inspection. Policies, procedures and practices for infection control are in place. During discussions with members of staff they confirmed that they have the necessary equipment to meet the guests needs and ensure they follow health and safety and maintain hygiene across the home. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Staff numbers are appropriate and guest’s needs are being met effectively and promptly. Guests are supported by staff who are qualified and provided with good training opportunities. EVIDENCE: The centre has a clear staffing structure. During the early part of the day there are 7 care staff and 2 qualified nurses on duty and at the time of inspection there was a full staff team on duty. Later in the day this level reduces to 4 care staff and 1 qualified nurse. The centre is staffed as per the staffing notice agreed with the previous registration authority The centre also has a large volunteer workforce which is co-ordinated by another team within the Vitalise organisation. At the time of inspection there were 23 volunteers working at the centre. The centre aims to achieve a ratio of 1 volunteer to every guest and 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. The care manager of the centre reported that staffing levels are determined on a week to week basis in line with the assessed needs of the guests. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 17 Guests spoke very highly of the staff and made the following comments when talking about the staff team - “the staff are lovely”, “the staff know me really well” and “nothing is too much trouble”. Guests are supported by the same staff for personal care for the duration of their stay whenever possible. This is to provide an opportunity for the guests and staff to become familiar and for consistency and privacy for the guests. During discussions with staff they said that they feel they have a good level of information on the needs of the guests and when asked they gave examples of how they support the guests so as to maintain their choice, routine and dignity. The centre is closed to bookings in January of every year. This allows for maintenance to be carried out and for staff training. The training is provided to all care staff and includes training on core health and safety skills for example moving and handling, fire safety and infection control and in issues relating to the care needs of the guests for example training in diabetes, guiding visually disabled people, communication, first aid and supporting people with Alzheimers, epilepsy and asthma. The centre employs 17 care staff and of these 6 have attained a National Vocational qualification (N.V.Q) in care and a further 5 were undertaking the award. The manager is working towards all care staff attaining an N.V.Q in care. Staff recruitment and selection practices were looked at through the examination of staff files for 3 of the newest members of staff and through discussions with the registered manager. There were good examples of recruitment practices were all relevant pre employment checks had been carried out prior to the member of staff starting work at the home. In one case there was only one reference for a member of staff but it is clearly common practice that two written references are usually attained. The requirements for attaining Criminal Records Bureau checks were also discussed with the manager. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The home is well run and well managed. Quality assurance processes are in place but these need to be developed further. Practices are in place which promote the health and safety of service users and staff. EVIDENCE: There is a good clear management structure and the registered manager ensures that the centre is run well. There are some very good systems in place which fit well with providing a service to a frequently changing group of service users / guests. The management support was described as “excellent” by one member of staff. The registered manager reported that the quality of the service is monitored through guest questionnaires, volunteer questionnaires, monthly visits by a representative from Vitalise and through measuring how the service is meeting the national minimum standards through the inspection process. The manager Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 19 reported that the organisation are looking to introduce a more formal system for quality assurance using a recognised system. Staff have been provided with core health and safety training for example in fire safety, infection control, food hygiene, moving and handling and first aid. Health and safety checks are regular and recorded. The manager provided an up to date gas safety certificate. The electrical safety certificate needs to be renewed. A comprehensive and up to date risk assessment has been carried out in relation to the home environment and safe working practices. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 20 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 x 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 x 27 x 28 3 29 4 30 4 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 x 16 x 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 4 x 2 x x 3 x Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 (1) (b) (i) Requirement Timescale for action 10/04/06 2. YA39 3. YA42 The registered person must ensure that two written references are attained for all staff prior to commencement of employment. 24 (1) The registered person must establish and maintain a system for reviewing the quality of care provided at the home at appropriate intervals. 13 (4) (c ) The registered person must ensure an up to date electrical safety certificate is attained and a copy forwarded to the Commission. 10/10/06 10/05/06 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 YA2 Good Practice Recommendations Community care assessments should be attained for service users referred through Care management. Sandpipers DS0000017270.V280821.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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