HomeMy WebLinkAboutSignature 2019-08-28Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange Co Facility Type:
Family Care Home Nursing Home
Adult Care Home
Facility Name/Address: Signature Nursing Home
1602 E. Franklin St.
Chapel Hill, N 27514
Visit Date: 8/28/2019 Time spent in facility: 55 min Arrival time: 9 : 30 am pm
Name of person exit interview was held with: Carissa Campbell, MSW Interview was held: in Person Phone
Admin. SIC (Supervisor in Charge) Other Staff Rep. Director of Social Services
Committee Members Present: Bill Morgan, Jacqulyn Podger
Report Completed by: Bill Morgan
Number of Residents who received personal visits from committee members: 9
Resident Rights Information is clearly visable: Yes No Ombudsman Contact Info is correct and clearly posted:
Yes No
The most recent survey was readily accessible: Yes No
(Required for Nursing Homes Only)
Staffing information clearly posted: Yes No
Note: there was a report indicating number & type of staff as
well as census, but it was from the previous day (8/27/19),
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
2. Yes – residents we talked to
indicated they received the care
they needed.
3. Did you see or hear residents being encouraged to participate in
their care by staff members? n/a
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? N/A
6. Did you observe restraints in use? No
7. If so, did you ask staff about the facility’s restraint policies? N/A
Resident Living Accommodations Yes/No/NA Comments/Other
Observations
8. Did residents describe their living environment as homelike? n/a
9. Did you notice unpleasant odors in commonly used areas? No 9. Facility smelled neutral, staff
were actively cleaning when we
arrived
10. Did you see items that could cause harm or be hazardous? No 10. Med carts not in use were
locked, as well as storage closets
11. Did residents feel their living areas were too noisy? No 11. there was minimal noise during
our visit. No resident we visited
complained about noise
12. Does the facility accommodate smokers?
Where? Outside only Inside only Both Inside/Outside
Yes
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
14 residents we interviewed
indicated they could use the call
bells when they needed assistance
and felt the response times were
adequate. During the visit we
overheard 1 resident call for help
from another room
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 Residents indicated that there were
a variety of activities offered, and
were encouraged to participate
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?
Yes
yes
17. Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
Yes*
17* Residents reported being
content with the food.
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
Yes
we met with a resident who
indicated that they participated
regular in resident’s counsel. A
family member we talked to
indicated they had received info on
council
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?
N/a 1. one staff member was observed
talking on the phone via Bluetooth
headset (appeared to be work
related) while actively preparing
someone’s meds.
2. one resident yelling for support.
Staff rep indicated they encourage
participants to use the call buttons &
provide visual cues/reminders, but
sometimes residents will call out b/c
of preference/ cognition
3. One staff member was observed
referring to a resident by name,
when loudly asking if that resident
was “getting picked up” today.
*Note for the record, not a concern,
but we did discuss that residents
seemed overall content with the
quality of care they received. Staff
treated well.
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.