HomeMy WebLinkAboutSignature 2018-06-30
Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange Facility Type:
Family Care Home Nursing Home X
Adult Care Home Combination Home
Facility Name/Address: Signature Healthcare of Chapel Hill
1602 E Franklin St, Chapel Hill, NC 27514
Visit Date: 06/30/2018 Time spent in facility: 1 hr 10 min Arrival time: 10:00 am
Name of person exit interview was held with: Carissa Campbell, Social Worker Interview was held: in Person X
SIC (Supervisor in Charge)
Committee Members Present: Stephanie Miller, Jacqulyn Podger, Molly Stein, Vibeke
Talley
Report Completed by: Vibeke Talley
Number of Residents who received personal visits from committee members: 10
Resident Rights Information is clearly visible: Yes X No Ombudsman Contact Info is correct and clearly posted: Yes X No
The most recent survey was readily accessible: Yes X No
(Required for Nursing Homes Only)
Staffing information clearly posted: Yes No X Staffing info posted was
from 6/28/18. No info posted from today.
Resident Profile Yes/No/NA Comments/Other Observations
1. Do the residents appear neat, clean and odor free? Yes
2. Did residents say they receive assistance with personal care
activities? Ex. brushing their teeth, combing their hair, inserting
dentures or cleaning their eyeglasses?
Yes
3. Did you see or hear residents being encouraged to participate in
their care by staff members? NA
4. Were residents interacting with staff, other residents & visitors? Yes
5. Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally? NA
6. Did you observe restraints in use? No
7. If so, did you ask staff about the facility’s restraint policies?
Resident Living Accommodations Yes/No/NA Comments/Other Observations
8. Did residents describe their living environment as homelike? Yes
9. Did you notice unpleasant odors in commonly used areas? No
10. Did you see items that could cause harm or be hazardous? Yes* 10: One door to a bio-hazard trash storage room
was left unlocked.
11. Did residents feel their living areas were too noisy? No
12. Does the facility accommodate smokers?
Where? Outside only Inside only Both Inside/Outside
Yes.
Outside
only
13. Were residents able to reach their call bells with ease? Yes
14. Did staff answer call bells in a timely & courteous manner?
If no, did you share this with the administrative staff?
Yes/no*
14: Most residents reported that call bells were
answered in a timely manner. Two of the
residents interviewed reported that the time it
takes to answer a call bell is too long.
Resident Services Yes/No/NA Comments/Other Observations
15. Were residents asked their preferences or opinions about the
activities planned for them at the facility?
Yes
16. Do residents have the opportunity to purchase personal items of
their choice using their monthly needs funds?
Can residents access their monthly needs funds at their
convenience?
NA
NA
17. Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
Yes*
Yes
17: A new feature is the display of several
options for alternate meals that the resident may
request.
18. Do residents have privacy in making and receiving phone calls? Yes
19. Is there evidence of community involvement from other civic,
volunteer or religious groups?
Yes
20. Does the facility have a Resident’s Council?
Family Council?
Yes
No
Areas of Concern Yes/No/NA Exit Summary
Are there resident issues or topics that need follow-up or review at a later
time or during the next visit?
- One resident felt that she has limited input about her care. She especially
feels that the physician decides her care without input from her.Even
though the resident participates in care conferences with facility staff, she
feels that the physician decides her care without input from her or the care
plan team.
- One resident stated that her wheelchair does not ride smoothly and she
feels unsafe in it. She would like a different wheelchair and asked us to
bring it up with management.
- Two residents stated it takes too long to answer call bells.
- Staffing list not updated.
- Door to bio-hazard closet not locked.
Discuss items from “Areas of Concern” Section
as well as any changes observed during the visit
- Discussed this with SW who stated that she'll
bring it up with the administrator.
- Discussed wheelchair concerns with SW who
stated that she would inform rehab to check out
the chair.
- SW was made aware of the two residents’
concern about the time it takes to answer call
bells.
- SW made aware of outdated staffing list.
- SW made aware of unlocked door to bio-hazard
closet.
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.
Top Copy is for the Regional Ombudsman’s Record. Bottom Copy is for the CAC’s Records.