Care Home: Morecambe Re-enabling Unit

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What the care home does well The unit`s ethos is that clients are supported to re-learn their skills and confidence to enable them to return home. Professional assessments are made of prospective residents by healthcare and social work staff, to ensure the re-enabling unit will be of benefit to them. Usually the manager of the unit liaises within this multi-disciplinary team, and with the individual involved, to confirm the unit is the right place for them to be. In doing this, information about the unit can be given to the prospective resident prior to them being admitted, and more person centred information gathered by the manager, to make the care provided specific to the person. There are a range of professionals who work alongside staff at the home, including occupational therapists, physiotherapists, speech therapists, dieticians and G.P`s. One OT said, "The staff are very good and usually our guidance is followed well". Routines are flexible in the home. We spoke to residents who told us they did what they wanted in the home, "I like sitting in my room, it`s a bit more private. I can read my paper and do the crosswords. Then I might have to do some of my exercises. If a friend pays me visit I go and sit in the lounge with them where there`s more room. But they`re all nice girls, we have a good laugh", said one. All the residents said they usually liked the food, and got plenty. The environment presented as generally well maintained, warm, homely and welcoming. The appointment of a manager experienced in this work has stabilised the staff team, and provided more structure. Staff are monitored regularly, and receive appropriate training. What has improved since the last inspection? A number of requirements were made at the last visit, and these have been addressed. A manager has been appointed and has been registered with the Commission for Social Care Inspection. Staff follow the re-enabling programme, under the guidance of the multidisciplinary team, and record their actions to evidence this. Tasks carried out outside of the re-enablement are also recorded, such as personal care tasks. One to one supervision of staff is carried out, to ensure there are consistent care practices. The Lancashire Workforce Development Partnership, a training organisation, provides most staff training. This organisation also prompts when staff are due for updates and refresher training. Staffing levels are appropriate. A staff on waking watch overnight is available if needed by any resident. What the care home could do better: The manager needs to make sure the information held in any copies of the Statement of Purpose and Service User Guide available to residents is up to date and complete. All person centred information required as part of the home`s assessment of each resident should be fully completed, to ensure staff have full information and the care is focussed on the person`s individual needs. Daily entries made by staff in resident`s records should clearly record all events, and any actions prompted by those events. They should show the pattern of each person`s life in the home. Activities and stimulation for residents, outside of the re-enablement programme, could be further developed. The documents used and requested during the recruitment of staff could be more efficiently processed so it is clear when information is received with dates and signatures. Staff knowledge of the policy and procedures for handling resident`s finances needs refreshing. The Annual Quality Assurance Assessment should be completed more fully before being returned to us, so that we have a picture of how the home is running and how it plans to develop, linked to the National Minimum Standards for Care Homes for Older People. CARE HOMES FOR OLDER PEOPLE Morecambe Re-enabling Unit 29 Morecambe Road Morecambe Lancashire LA3 3AA Lead Inspector Ms Jenny Hughes Unannounced Inspection 27th November 2008 10:00 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 Morecambe Re-enabling Unit DS0000059653.V373559.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. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Morecambe Re-enabling Unit Address 29 Morecambe Road Morecambe Lancashire LA3 3AA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01524 420303 calderdeanltd@btinternet.com Calderdean Ltd Christine Mary Pullen Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 11 Date of last inspection 22nd November 2007 Brief Description of the Service: The purpose of Morecambe Re-Enabling Unit is to work with older people discharged from hospital and, with support, return to their own homes. A fulltime Manager and a team of staff manage the Unit. Ordinary living facilities are available within the Unit to enable residents to regain their daily living skills. To enable residents to develop the skills and confidence to return home, the staff at the unit work alongside a variety of professionals, including occupational therapists, physiotherapists, rehabilitation social workers and health visitors. The re-enabling programme normally lasts for a period of one to six weeks but this can be extended to meet the resident’s needs, if required. The Unit is situated in a residential area of Morecambe and is close to the shops and amenities in Torrisholme. It is situated on the main bus route into Morecambe town centre. Residents are encouraged to maintain their links in the community by attending Day Centres and Over 60’s Clubs and recommence their hobbies and interests. Opportunities are normally provided for them to engage in social activities both insides and outside the Unit. Visitors are made welcome at anytime. The service is fully funded by social services. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means that the people who use this service experience good quality outcomes. This was an unannounced site visit to the home, in that the owners were not aware that it was to take place. The site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The length of the visit was for 5 and a half hours. Every year the registered persons are asked to provide us (CSCI) with written information about the quality of the service they provide, and to make an assessment of the quality of their service. We use this information, in part, to focus our assessment activity. This document is called the Annual Quality Assurance Assessment (AQAA) Surveys were sent and received from residents, and staff from the home. During the site visit, staff records and residents care records were viewed, alongside the policies and procedures of the home. The manager of the home was not on duty when we visited, but the general manager of the company was present at the home. The general manager, residents and care staff were spoken to, along with Occupational Therapists who were working with residents, and any visitors who called during the day. Their responses are reflected in the body of this report. A tour of the home was made, viewing the lounge, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 6 The unit’s ethos is that clients are supported to re-learn their skills and confidence to enable them to return home. Professional assessments are made of prospective residents by healthcare and social work staff, to ensure the re-enabling unit will be of benefit to them. Usually the manager of the unit liaises within this multi-disciplinary team, and with the individual involved, to confirm the unit is the right place for them to be. In doing this, information about the unit can be given to the prospective resident prior to them being admitted, and more person centred information gathered by the manager, to make the care provided specific to the person. There are a range of professionals who work alongside staff at the home, including occupational therapists, physiotherapists, speech therapists, dieticians and G.Ps. One OT said, The staff are very good and usually our guidance is followed well. Routines are flexible in the home. We spoke to residents who told us they did what they wanted in the home, I like sitting in my room, its a bit more private. I can read my paper and do the crosswords. Then I might have to do some of my exercises. If a friend pays me visit I go and sit in the lounge with them where theres more room. But theyre all nice girls, we have a good laugh, said one. All the residents said they usually liked the food, and got plenty. The environment presented as generally well maintained, warm, homely and welcoming. The appointment of a manager experienced in this work has stabilised the staff team, and provided more structure. Staff are monitored regularly, and receive appropriate training. What has improved since the last inspection? A number of requirements were made at the last visit, and these have been addressed. A manager has been appointed and has been registered with the Commission for Social Care Inspection. Staff follow the re-enabling programme, under the guidance of the multidisciplinary team, and record their actions to evidence this. Tasks carried out outside of the re-enablement are also recorded, such as personal care tasks. One to one supervision of staff is carried out, to ensure there are consistent care practices. The Lancashire Workforce Development Partnership, a training Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 7 organisation, provides most staff training. This organisation also prompts when staff are due for updates and refresher training. Staffing levels are appropriate. A staff on waking watch overnight is available if needed by any resident. 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. Morecambe Re-enabling Unit DS0000059653.V373559.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 Morecambe Re-enabling Unit DS0000059653.V373559.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): Standards 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an assessment procedure, which is usually carried out for all residents. Healthcare professionals carry out full assessments on all residents. This means that the service provided is tailored to an individual’s needs and preferences. EVIDENCE: The rehabilitation unit is a dedicated unit, in a detached dwelling close to Morecambe. There is individual accommodation, with each person having their own personal room for the duration of their stay, and facilities and equipment are provided via the other professionals in the multi-disciplinary team. The general manager told us that usually the manager likes to see people who are referred to the unit before they arrive, in order to give them information about the service. This way people know where they are going to and who is going to be looking after them. The manager can then also make a preMorecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 10 admission assessment to ensure the home is the right place for the person to be, in that her staff have the abilities to provide the right care, and that the admission would cause no adverse impact on other people in the home. We found that on occasion people were admitted to the home following professional assessments by occupational therapists, physiotherapists and social workers, but with no involvement of the home manager. Social services staff confirmed that this may happen in an emergency situation, and they said they would ensure that the home were involved in other admissions. Staff we spoke to confirmed that good information is provided about the rehabilitation needs of the clients. I feel that all information we need is usually given in advance. A few matters have come to light that we werent advised of before admission. One example we found of this was the dietary needs of a resident, which were not passed onto the home on admission. We spoke to a resident who told us they were just brought here, but its nice, and a survey told us me and my family had the information about the home given us at the hospital. It was a pleasant surprise when I got there. Prospective residents are given a photograph brochure/service user guide so that they are able to see first hand what the unit is about, see photos of staff and the facilities and have any questions answered. Similar information is in the homes lounge, but this is incomplete and out of date. The management are aware of this and said they are due to address it. Each bedroom holds information about the service, and this also needs to be kept up to date. In each bedroom there is also a folder holding blank documents provided by the home so that the key member of staff (key worker) is able to talk to the resident, and ask them about their individual daily routines, activities, likes, dislikes, etc. so that the service can be better tailored to meet the individual needs of the client. These were not always fully completed. This information is an important addition to the professional assessments, as it makes the overall assessment of need of each person more person centred, so the management needs to ensure it is completed, making it relevant. We viewed two residents files. There was good information about their condition on the day of admission. Both had full professional assessments by healthcare staff, and clear contracts from the home, signed by the residents. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 11 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): Standards 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. Systems have been improved to provide enough information to enable staff to meet the health and personal care needs of each individual. EVIDENCE: A pharmacy inspector had made a thorough examination of the procedures used at this home earlier in the year and found improvements, stating Medicines are managed well so that the people who live at the service receive safe and effective treatment. The management confirmed that they are sustaining these procedures and standards. We saw a self-medication waiver form in place for a resident. The manager told us they like to make sure people are clear on taking their own medication before they return home. There is a standard format for the care plans covering areas that identify the needs of each individual, so staff know how best to look after people. These Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 12 are in the form of goals, where the goal to be achieved is identified, the action to be taken and how often, and when it has been achieved. We saw risk assessments on the selected resident files. These were signed by all the staff to show they understood what they should do. The physiotherapists and occupational therapists (OT) identify the exercises each person needs to do to improve their abilities, and we saw records to show they call at the home regularly to monitor their progress and guide the staff in the home. One OT at the home at this visit said I dont know of any problems at all. We (the OTs) carry on with home visits after people have left this care home to go to their own home, and they often tell us to send their love to staff at the home, which I think shows theyve enjoyed their stay. All the people I speak to who use the service are very happy. The staff are friendly which I think is important. Another OT said, The staff are very good and usually our guidance is followed well. Residents commented “They help us do our exercises each day, and “They are very caring, homely, helpful people with a lot of patience. Records are divided into sections covering different areas of care, such as mobility, health needs, and daily living skills. Staff need to ensure the entries in these records clearly address issues raised. For example the records for one resident stated that they were unwell one day, but subsequent records made did not mention any progress or action to deal with this. We spoke to staff who were able to tell us how they looked after this resident and what their problems were, showing that it was the records that were incomplete, not the staff knowledge. One incident had been recorded twice in different sections. Entries in the mobility section for one resident were not up to date, although we saw the staff working with the resident. There needs to be a system in place to ensure daily entries are made so there is a constant record. Weekly reviews of the support and progress of each resident take place with the health professionals and social work staff, who feedback to the manager any problems or changes to the care to be provided. Residents we spoke to were aware of why they were at the home, and discussed their plans to return home following their period of rehabilitation. On the day of this visit one resident had a trip to his own home with the OT, to assess whether any aids or adaptations would be required when he went home. We spoke to residents who told us they did what they wanted in the home. The general manager confirmed the flexible routines, People can stay in the lounge as long as they want. The OT suggests that people need a good nights sleep ready for the next day, with exercises and tasks to work at, but, for Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 13 example, all of the rooms have televisions, so they can watch it as long as they want to. No specific rehabilitation work is done overnight, although there is a staff member on duty who responds to any resident who needs them. We saw a letter from a relative, which commented on the improvement in confidence and appearance of their relative after their stay at the home, and also thanked the home for the support given to family. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 14 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): Standards 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. Meals are nutritious, and residents are encouraged to enjoy food and mealtimes. Some social activities are arranged to provide stimulation to residents in addition to re-enabling exercises. EVIDENCE: The professional assessments received by the home hold little information regarding social needs and any interests or activities people are involved in. The home, through its key-worker procedures, work with the resident and usually complete records regarding this information, to give a good picture of the person. We saw evidence of some activities available, with board games and crafts waiting to be used. A keyboard stood in a corner of the lounge. The general manager said that a lot of the activities were linked to exercises given by the physiotherapist, and we saw large balls and wooden blocks and shapes used in these. They also said that activities tended to be ad hoc rather than planned, Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 15 and there may be painting groups in an afternoon or evening, or an occasional quiz. They said that organised activities were difficult during the day, as they needed to be arranged around the visits from the OTs and physiotherapists, following which residents often wanted to rest after their exertions. A survey indicated this was an area the home could perhaps work on with More funded activities, more leisure activities. We spoke with some residents in the lounge. One was very pleased with her progress, saying, Ive just made my own cup of tea. Im really delighted, Ill be able to manage at home. One sat knitting, while another was chatting with a visitor. You can do what you want, said another, We had a quiz the other night. And theres always someone to talk to. We saw staff encouraging residents to walk around the home, and a couple helped wash and dry pots after lunch. Survey responses from residents said that they usually liked the food provided. We saw that there are two choices of main meal each day, and the management confirmed that there would always be something else offered if neither was liked. One survey commented that the home could improve the food with more fresh veg and meat. We saw fresh vegetables and fruit were available, and staff said that they also try to offer it in fresh fruit salads, or sweets such as bananas and custard. The food is beautiful. Ive got better since Ive been here said a resident. “I have no complaints about the food. I had a lovely buffet tea when it was my birthday – I think everyone enjoyed it”, said another. Refreshments were offered and served through the day. 50 of staff have received training in food hygiene. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The services complaints procedures works in that people know how to complain and that if they do it will be acted upon. This means that people live in a safe environment. EVIDENCE: Residents spoken with and those who returned survey forms all confirmed they know who to speak with if they are not happy and know how to make a complaint. Information (Statement of Purpose, facilities within the home, complaints procedure) is in each of the rooms for residents to read at their leisure and in private. Neither the commission nor the home has received any complaints, concerns or allegations regarding this service. Information from the home states that no safeguarding referrals or referrals to the “Protection of Vulnerable Adults” (POVA) register have been made. Staff spoken with confirmed that if a resident was not happy they would try to sort out the problem and, if needed, they would involve the manager of the service. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 17 Staff have previously confirmed that they have covered safeguarding adults within their NVQ training – staff spoken with were able to confirm appropriate action if any concerns regarding abuse were raised. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 18 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe, and homely place to live. EVIDENCE: Not all individual rooms were seen but a good selection were seen and were found to be clean and tidy and providing a homely environment for the clients to use. The communal areas, made up of a large lounge area and a dining room, are nicely decorated and also homely and welcoming. Some armchairs and beds have been renewed. The kitchen has been updated since our last visit, and is clean and bright, and easy for residents to use and help in, to aid their rehabilitation. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 19 I think Ive got a good room here. Its very comfortable and warm. They keep it clean, said a resident. The home has an alarm system in place for residents to use to inform staff if they have a problem. Each room is equipped with a remote alarm as the residents are mobile and they can carry it with them. Each bathroom and the lounges also have a remote alarm in them. Three control boxes around the home inform staff where the alarm has been activated. The home was fresh, clean and tidy and there is an ongoing redecoration programme in place. Staff complete a maintenance record if they note any minor jobs, for example broken drawers, or a bulb to replace, and a maintenance man completes the task. This is signed and dated to confirm it has been done, and when. 80 of staff have had infection control training and discussions with staff confirmed that there are a supply of plastic aprons and plastic gloves for use. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 20 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): Standards 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 home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are appointed. The residents are supported by trained staff, who are generally in sufficient numbers. EVIDENCE: We viewed the records of two staff. We saw that there is a standard recruitment procedure in place to make sure full checks are made prior to the person starting employment at the home. The dates of some references returned were not clear, and a verbal reference needed to be detailed and followed up with a written one. The manager needs to make sure the full process is always followed and records dated correctly No-one started work without at least a POVA check (Protection of Vulnerable Adults), which is then followed by a CRB disclosure (Criminal Records Bureau). We viewed the staff rota, which confirmed that there is usually three staff on duty, with a waking watch on overnight. Staff spoke confidently about their roles, and about the appointment of the new manager, who has been registered with the Commission for Social Care Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 21 Inspection. One said, We are a good settled team now. Communication is much improved, and we get involved in the decisions about the care we provide now. We can suggest ways of possibly doing things in a better way. Another commented, Things run very smoothly now as the present manager is always there to advise if there are any concerns. Previous management werent as forthcoming or helpful and Staff turnover has stabilised due to present manager. We saw that all staff have induction training on starting to work at the home, covering information about their role, and including health and safety, moving and handling, residents rights, and how to deal with complaints and accident reporting. The Lancashire Workforce Development Partnership provides ongoing training, and we viewed the online records for staff. This organisation also prompts the home when staff are due for updates and refresher training. Since our last visit, the management told us that team training has been provided in medication awareness, moving and handling, infection control and first aid. 60 of staff hold National Vocational Qualifications, with the remaining 40 working towards them. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 22 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): Standards 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 service protects the health, safety and welfare of the residents. EVIDENCE: There is a manager in place who is registered with the Commission for Social Care Inspection. Since her appointment this year, following about four years experience in the re-enabling service, comments from staff have indicated that the team have stabilised, and the procedures in the home have become more structured and transparent. The information we asked for from the home regarding how it was operating was sent back on time. This is in the form of the Annual Quality Assurance Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 23 Assessment (AQAA). However it only contained minimal information, and we discussed with the general manager the need to complete this with more specific detail linked to the National Minimum Standards for Care Homes for Older People, and Morecambe Re-enabling Unit. This should give us a complete picture on how the home is running, and any planned developments. Staff we spoke to said they felt supported in their work, and had regular one to one supervision sessions. We saw that all residents have weekly reviews of their progress with health professionals, who would feedback any problems to the manager and the keyworker, who also attend the meetings. On leaving the home, each resident is given a discharge pack, with a survey form to complete about how they found their stay. We saw positive results from these. In addition, another quality assurance procedure is a monthly visit made to the home by the general manager, who speaks directly to residents and staff, and monitors procedures in the home. The unit also holds the ISO 9001 Quality Assurance Award, and have recently had an inspection of their systems, which were passed. There is a procedure in place to deal with residents finances, which the general manager confirmed they do not usually get involved with, especially as people are only at the home for a short time. One resident was left pocket money by family, which we saw was all accounted for, but we noted it was being held and documented incorrectly by staff. The general manager instructed staff on the correct procedure, which was carried out straight away. We spoke to residents who said they had a lockable drawer in their room to keep personal things in. We saw that any accidents were recorded formally. Information supplied by the home confirms that all the required policies and procedures are in place and these have been reviewed recently. Staff spoken with also confirmed they have access to these, as needed. Information provided by the home confirms that all the required maintenance and servicing of equipment and facilities has taken place, there are written assessments for the control of substances hazardous to health (COSHH). Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 25 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. 2. 3. 4. 5. Refer to Standard OP1 OP3 OP7 OP12 OP29 Good Practice Recommendations All information available about the home in copies of the Statement of Purpose and Service User Guides should be up to date and complete. All assessment documentation should be completed efficiently to provide person centred information for staff to provide care that is focussed on the individual. Daily entries in individual records should reflect all events, any actions taken, and the pattern of each persons life in the home. The opportunities for stimulation through activities for residents should be further developed. The documentation used and requested during the recruitment procedure should be clear and dated to ensure, and give evidence that, the process is followed efficiently. The AQAA should be completed more fully, following CSCI DS0000059653.V373559.R01.S.doc Version 5.2 Page 26 6. OP33 Morecambe Re-enabling Unit 7. OP34 guidance, to give a picture on how the home is running. All staff should be made aware of the homes policy and procedures on handling residents finances. Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection NW Area Office Unit 1, 3rd Floor Tustin Court Port Way 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 © 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 Morecambe Re-enabling Unit DS0000059653.V373559.R01.S.doc Version 5.2 Page 28 - 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. 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