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Knowsley LINk

Enter & View Report

Whitestone Lodge

February 2011

Contents

1.About Knowsley LINk

2.Background to the report

3.Power to Enter and View

4.Knowsley LINk Enter and View Protocol

5.About the Visit

6.Arrival

7.Communal Areas

8.Tour of facility

9.Residents and Staff.

10.Activities.

11.Complaints

12.Conclusion.

13.Thanks

14.Contact Us

15.Appendix 1 – Audit Checklist

1.About Knowsley LINk

Local Involvement Networks (LINks) commenced from 1st April 2008, as laid down in Section 14 of the Local Government & Public Involvement in Health Act 2007. They build on the work of the Patient and Public Involvement Forums but aim to be more inclusive, and open to anyone to join. LINks cover all publicly funded health and social care services in an area, no matter who provides them. They make it easier for people who commission and manage health and care services to understand the views of the community. LINks are part of the local accountability and scrutiny arrangements and they have powers requiring health and social care managers to respond to them. LINks are also able to refer matters to Overview and Scrutiny Committees in councils that have social care responsibilities.

The money to fund LINks comes from the Department of Health (DoH) and is divided between every Local Authority in England that has responsibility for providing social services. Knowsley Council contracted a ‘Host’ organisation to help develop the LINk based in Knowsley. The reason for this is LINk is not directly managed by the Local Authorities, giving LINk the freedom to investigate service provision independently. Knowsley LINk is facilitated by the Knowsley LINk Support Team, managed by Sefton Council for Voluntary Services (CVS).

Knowsley LINk is an independent network of local people and groups that want to make healthcare and social care services better for their communities.

Knowsley LINk:

  • is helping to create a stronger local voice - finding out what people want, investigating issues and using its statutory powers to hold services to account. A key activity is working within the community engagement networks in Knowsley to understand the views of Knowsley people.
  • is a key part of enabling effective community engagement in health and social care decision making at a local strategic level.
  • has an elected Core Group which holds the remit for developing the activities on behalf of the Knowsley LINk membership.

2.Background to the report

A key element of the Knowsley LINk approach has been working in partnerships with other existing groups such as Knowsley Older People’s Voice, a forum designed to ensure that older people in the borough have their say in influencing services and policies.

Both Knowsley LINk and the Older People’s Voice identified Dignity in Care as one of their key priorities and were therefore delighted when they were invited by the Safeguarding Board to take part in the Dignity Audit which is part of the Borough’s Dignity Campaign. We believe that the collaboration of community members and statutory bodies can only lead to an improvement in services and increased dignity for all.

To carry out the Dignity Audit members exercised the LINks right to enter and view premises.

3.Power to Enter and View

LINks were established to:

  • give everyone an opportunity to say what they think about their localhealth and social care services – what is working well and what is notso good;
  • give people an opportunity to monitor and check how services areplanned and run; and
  • provide feedback on what people have said about services, so that
  • things can change for the better.

LINks use a range of methods to enable them to say how local servicescould improve, such as:

  • making reports and recommendations to commissioners and getting areply within a set period of time;
  • asking commissioners for information and getting a reply within a setperiod of time;
  • going into some types of health and social care premises to observethe nature and quality of services; and
  • referring issues to the local Overview and Scrutiny Committee andreceiving a response.

To enable LINks to gather the information they need about services, thereare times when it is appropriate for them to see and hear for themselveshow those services are provided. That is why the Government hasintroduced duties on certain providers of health andsocial care services (with some exceptions) to allow authorised LINkrepresentatives to enter premises that providers own or control to observethe nature and quality of services.

In the context of the duty to allow entry, the organisations or personsconcerned are:

  • NHS Trusts
  • NHS Foundation Trusts
  • Primary Care Trusts
  • Local Authorities
  • a person providing primary medical services (e.g. GPs)
  • a person providing primary dental services (i.e. dentists)
  • a person providing primary ophthalmic services (i.e. opticians)
  • a person providing pharmaceutical services (e.g. communitypharmacists)
  • a person who owns or controls premises where ophthalmic andpharmaceutical services are provided
  • Bodies or institutions which are contracted by Local Authorities or NHSTrusts, Primary Care Trusts or Strategic Health Authorities to providecare services.

4.Knowsley LINk Enter and View Protocol

  • All Visits undertaken on behalf of the Knowsley LINk must fully comply with the Local Involvement Networks Regulations 2008.
  • All Visits undertaken on behalf of Knowsley LINk must be agreed and authorised in advance by the Knowsley LINk Core Group. A Visit request must be made to the Core Group detailing the purpose of the Visit, normally at least 10 working days prior to the proposed visit.
  • A Visit Report must be produced within 10 working days of the Visit detailing any observations or recommendations made by the "authorised individuals". (Service providers must acknowledge and respond to any Visit Report within 20 working days of receipt)
  • The Knowsley LINk Core Group will nominate up to a maximum of 20 Knowsley LINk members to become "authorised individuals" to conduct any Visits on behalf of the LINk.
  • Authorised Representatives will agree to undertake training to help them carry out their Visit duties in an effective manner. Knowsley LINk Support will arrange relevant training and development opportunities.
  • Knowsley LINk Support will undertake "CRB" checks for all authorised individuals, at no cost to the individual.
  • Knowsley LINk Support will act as the "nominated person" on behalf of the LINk to satisfy themselves that the prospective representatives are "suitable for the purposes of entering and viewing, and observing the carrying-on of activities on, premises owned or controlled by a services-provider"
  • Knowsley LINk Support will maintain and update the Knowsley LINk Authorised Person Database and will issue all Authorised Persons with written evidence of that individual's authorisation.
  • For member safety and security any Visit must be made by at least 2 Authorised Individuals. It is recommended that the maximum number of Authorised Members on any one visit is 6.
  • If an authorised individual does not feel well on the day of the Visit, they should refrain from taking part and inform a member of Knowsley LINk Support as soon as possible.
  • At all times when conducting Visits Authorised Individuals must comply with the Knowsley LINk Code of Conduct and the Sefton CVS Equality and Diversity Policy.
  • At all times during Visits Authorised Individuals will respect the privacy and dignity of patients, residents, carers and staff.
  • Any contravention of this protocol will be dealt with under the Knowsley LINk Standards of Conduct.
  • Knowsley LINk Support will offer support and assistance in organising and conducting Visits and producing Visit reports.

5.About the Visit

The visit took place on 3rd February 2011 between 2:00pm and 3:30pm. Three members of the Knowsley LINk Enter and View Team took part accompanied by a member of the support team.

The people taking part in the visit were

  • Beryl Lyon – Knowsley LINk Enter and View Team
  • Geoff Lyon – Knowsley LINk Enter and View Team
  • Janet Tildsley – Knowsley LINk Enter and View Team
  • Jane Calveley – Knowsley LINk Support (Is a support capacity)

The Enter and View Team were given an opportunity to look around the communal area and talk to residents and staff. They were also invited by a resident to have a look round his bedroom and talk to him in there.

6.Arrival

On arrival we were shown into a lounge, in which there was one resident talking to a visitor. They were having what appeared to be a private conversation. The room alarm system seemed to be located in the hallway and this went off several times while we were in this room. This was quite loud and sometimes went on for a period of time. This was quite disturbing to people in that room.

The Duty Manager, Anne, came into this room to greet us and took us to a larger communal area with several residents in it.

7.Communal Areas

All the communal areas were clean and tidy with a pleasant smell. The rooms were decorated in a homely and comfortable manner, which gave a real feeling of it being people’s home

In the first room there was a television, but this was switched off as the people in the room were having a conversation. In the larger communal room there was a radio on which was tuned to Radio City, and we did find the music somewhat uncomfortable at times.

The premises have a large, pleasant garden to the rear, however residents informed us that they were only allowed to access it if they were accompanied by a member of staff.

8.Tour of facility

We were invited to visit a resident in his rooms. The room was clean and tidy with a reasonable standard of decor. The room afforded a good standard of privacy. There was a hand washbasin in the roomand residentsare able to wash, dress and receive personal care in private. The residents own pictures and personal possessions were displayed around the room. Residents can if they wish take their meals in their own room. At the time of our visit another resident was also in the room, as they have been friends for many years and enjoy sitting together in the afternoon to either watch television or just chat. The television also received Sky TV, for which residents pay extra.

The premises can also provide shared accommodation, should a resident wish, and have previously had a couple living there.

We were pleased to note in the communal area that there were posters giving details of various faith groups.

9.Residents and Staff.

We were given the opportunity to speak to several residents in the communal lounge. They all said that they were happy to live there, however some said they would like to go out more, for example one gentleman said he would appreciate being able to walk to the local shop for a newspaper. The staff interacted well with the residents and we were pleased to note during afternoon tea, that residents were given a choice of drink which was often served in a personal cup or mug and they were also offered a choice of biscuits.

Whilst we were there two residents were being visited by family members, who seemed to be very welcomed by the staff.

We were concerned to learn that there are no male staff at the premises, removing the option for male residents to have personal care delivered by someone of the same gender.

We were however pleased to learn that all staff had undergone safeguarding training.

10.Activities.

There are very few organised activities at Whitestone Lodge and we were informed that they do not go for day trips or excursions. There were some board games for residents, however having watched a member of staff attempt to play two games with residents we were concerned about their appropriateness.

However, a hairdresser does visit on a weekly basis, which is enjoyed by many of the residents, and there is the option to take part in faith activities, should the resident wish.

11.Complaints

On request we were shown both the Complaints Book and the “Residents’ Grumbles Book” . We were very concerned to note that the most recent entries in both books were from 2007, and given the relatively minor nature of these complaints it seemed unlikely that there had not been a similar concern since then.

We were assured that all residents and their families knew how to make a complaint, and we suggested that if it was not included in the welcome pack maybe it could be to ensure that the information was to hand.

12.Conclusion.

There did not appear to be any significantly negative comments with respect to dignity. Certainly the majority of residents with whom we spoke responded positively to all questions. We are certain that with the recruitment of some male staff and a more robust approach to ensuring residents and families are aware of the complaints and grumbles books that this residence would become even better.

13.Thanks

Our thanks go to the following people who took part in the preparation of this report

The Residents and Staff of Whitestone Lodge

Diana Ralph

Linda Crawley

Josie Melia

14.Contact Us

To comment on this report or to find out more information about the work of Knowsley LINk please contact:

Knowsley LINk

Freepost NWW8503A

Knowsley CVS

Nutgrove Villa

1 Griffiths Road

Huyton

L36 6NA

Tel: 0151 489 1222

Email:

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15.Appendix 1 – Audit Checklist

Care Home Audit

LINk/Older People’s Voice

Audit Checklist

Name
Care Home Visited
Date

GREEN - All aspects of the Dignity and Respect Standard are met.

AMBER - Some aspects of the Dignity & Respect Standard are met but there still needs to be further improvements.

RED - No aspects of the Dignity & respect Standard have been met and improvements need to be identified and met.

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
1. Treat each person as an individual with their own needs, wants, desires and expectations and provide a personalised service /
  • Do the residents feel valued as individuals?
  • Are care plans agreed in consultation with the resident?
  • Flexibility to meet individual needs
  • Is there a choice of daily activities?
  • Are residents able to attend activities or socialise outside the home?
  • Are the residents supported to maintain social relationships
  • Does the home respect the resident’s personal property?
  • Is respect given to religious beliefs?
  • Are residents consulted about the running of the home?
  • How does the home ensure that residents are wearing their own clothes.

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
2. Listen and support people to express their needs and wants /
  • Do staff have time to talk and listen to residents as well as deliver services?
  • How does the home ensure all staff know what people like to be called and what they like to eat?
  • Do residents know how to make a complaint and do they feel empowered to do so without fear of repercussions?

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
3. Have zero tolerance of all forms of abuse /
  • Have all staff had safeguarding training and understand their responsibilities?
  • Are residents supported throughout any Safeguarding Investigations?
  • If involved in a Safeguarding Investigations are residents asked about their experience of the process

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
4. Promote and encourage positive & respectful attitudes at all times /
  • Do all staff knock on resident’s bedroom doors before entering?
  • Is privacy observed at all times when residents are washing, dressing and using the toilet?
  • Is privacy observed when discussing any issues related to health or well-being?
  • Do staff respect the resident’s confidentiality?
  • Are there arrangements in place for privacy during treatment or examination by health professionals?

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
5. Respect people’s rights to have relationships /
  • Are resident given the choice and privacy to continue with their relationships?
  • Do staff understand that some residents may want to continue with existing relationships or make new friendships or relationships?

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
6. Provide all personal, medical & nursing care or advice in privacy at all times /
  • Are staff flexible and able to meet individual resident’s needs?
  • Is personal care assistance given that reflects individual’s wishes?
  • Is there consistency of carer?
  • Is the resident’s own room or treatment room always used for personal care and medical visits?

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green
7. Respect the resident’s right to privacy in their personal living space /
  • Do staff always knock on resident’s door before entering their room
  • Do the curtains & blinds close properly in the bedrooms?
  • Do residents have privacy when washing & dressing?
  • Is there privacy in relation to day-to-day living arrangements when desired?
  • Can meals be taken in own rooms if desired?

Dignity & respect means / Dignity & respect checklist / Evidence from own observation / Findings & comments from residents / Red / Amber / Green