Inspection on 15/01/09 for Bishopsmead Lodge

This is the latest available inspection report for this service, carried out on 15th January 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bishopsmead Lodge 12/07/07

Bishopsmead Lodge 02/01/07

Bishopsmead Lodge 27/06/06

Bishopsmead Lodge 28/02/06

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bishopsmead Lodge Vicarage Road Bishopsworth Bristol BS13 8ES     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kath Houson     Date: 1 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Bishopsmead Lodge Vicarage Road Bishopsworth Bristol BS13 8ES 01179359414 01179359424 viviennec@mimosahealthcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mimosa Healthcare (No4) Limited care home 51 Number of places (if applicable): Under 65 Over 65 51 old age, not falling within any other category Additional conditions: 0 The maximum numbr of service users who can be accommodated is 51 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Bishopsmead Lodge Nursing home is a 51 bedded purpose built property, which is able to provide accommodation for the elderly residents. The property is a two-storey building with lift access to both floors. There are 43 bedrooms, which are for single occupancy; four double bedrooms are suitable for those who wish to share. All the rooms have ensuite toilet facilities. The aims and objectives of the home are to provide the highest standard of care to all our residents at Bishopmead Lodge, we are to provide a high standard of nursing and personal care in full compliance with the Care standards Act 2000 and to treat everybody concerned in a fair and considerable manner. The staff team consists of Care Homes for Older People Page 4 of 25 Brief description of the care home nursing, which is supported by care staff. Twenty-four hour care is provided on a daily basis. The property can be found in the residential area of Bishopsworth, which is located between Bedminster and Hartcliffe in the southern side of Bristol. The home is close to shops, local library, and the local church is part of the facilities the area has on offer. There are a number of green walkways close to the property. The home has a car park for several vehicles. There are local bus routes into Bristol, Hedley Park, Hartcliffe, Withywood and Whitchurch. The fees charged are based on individual assessment and were provided at the time of the inspection 15th & 16th January 2009; Social Services with a nursing element are £523.00, private nursing £640, residential £395, and private £400-500 all per week. Residents are able to keep all elements of their pension. Information obtained from the registered manager. Mimosa is the care provider for a cluster of services such as; Bishopsmead Lodge, Kingsmead Lodge, Honeymead Care Home, Sunnymead Manor and a care home in Shepton Mallet. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Visit: An unannounced visit was made on 15th and 16th January 2009 During the visit we: Talked with people who use the service, relatives, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records, such as their polices and procedures, staff rotas, the medication policy and the complaints book. Care Homes for Older People Page 6 of 25 Undertook a discussion to assess whether the staff had the knowledge, skills and training to meet the needs of the people who use the service. Looked around the building to make sure it was clean, safe and comfortable. Discussed, any improvements had been made since the last visit and if any requirements had been met. We provided feedback to the manager about the initial findings of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People whose needs can be met are admitted into the home; people benefit from sufficient information which help them to make an informed choice about their place of residence. Evidence: Prospective residents are given enough information prior to admission into the service. All potential residents are provided with a welcome pack. The homes Annual Quality Assurance Assessment states the welcome pack is provided on admission. This was confirmed during the inspection. A welcome pack was seen and contained several pages of information, such as the residents charter. This is document, which outlines the providers approach to residents care. The content includes for example, the provision of skilled, sensitive and sympathetic care to enable all residents to achieve the highest possible quality of care. Another Mimosa principle is the right of each resident to be consulted about daily living arrangements in the care home and to Care Homes for Older People Page 10 of 25 Evidence: participate in discussions about any proposed changes. The homes aims and objectives inform the potential resident the focus for their care. For instance, rights to choice, dignity and independence. Each potential resident are given a full assessment prior to admission. The care files looked showed assessments had taken place and the multi-disciplinary team have also been involved in the assessment of potential residents. Care plans are then devised using the Mimosa paperwork the sections are colour coded into a number of different sections. There is a relatives section for their comments to be included. The service takes a full personal history of the resident including their likes, dislikes and preferred name to be called. The homes admissions process is accurate, thorough and in compliance with their own admissions procedure, which is detailed. Residents are given a written contract, terms and conditions, which details the cost for their placement. Relatives spoken with said, They received enough information about the home which helped them make a decision. Another relative said, we are happy with the placement and we were shown around. The service also admits individuals for intermediate care. This consists of assessments being made with the aim to maximize their independence and return home. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from their needs being met in an individual and consistent manner, through good multidisciplinary working with health care professionals. Medication procedures maintain peoples safety including those who self medicate. Evidence: A selection of care plans was looked at to assess if residents health and personal care needs are being met. The care plans showed equity of care is being delivered. Each care plan was individual and planned according to their needs. For instance, those who need wound care have progress charts, which show improvements of their wounds. Assistance from the GPs and district nurses was recorded well and confirmed progress with peoples wounds. Care plans also show relatives input. For example relatives would provide more detail for the end of life care. The manager recognise this can be difficult for many relatives and the support from their next of kin or significant others ensure peoples wishes are handled sensitively. Care Homes for Older People Page 12 of 25 Evidence: The home has an effective medication procedure. A random medication count was conducted as part of the inspection and was found to be accurate no errors were detected. All medication is es administered by the qualified nursing staff. Those residents who are able to self medicate are enabled to do so with support. The nurses who monitor residents sugar levels support people who are able to self-administer their insulin injections. All medication records were looked at and no omissions were seen. The staff spoke to the residents respectfully, the relationships between staff and people living at the home were good, and personal support was provided in such a way as to promote and protect privacy and dignity. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are involved in meaningful activities, which are planned around their needs and preferences. Contact with family and friends are maintained. Residents enjoy a wide and varied menu, which is balanced and contains healthy options. Evidence: The home has an activities coordinator who spends time with the residents. This was evident in the residents activities file. A random look at the files confirms residents take part in meaningful activities. Such activities include, arts and crafts, massage and aromatherapy for those who choose to stay in their rooms, pottery, games such as bingo, cards, skittles, scrabble and some residents like 1:1 reading with the coordinator. If residents choose; the local vicar visits to perform a service this ensures residents spiritual needs are met. Residents are encouraged to maintain contact with their relatives and significant others. Many relatives were visiting on the day of the inspection and commented, their satisfaction with the care provided. The menus show a varied range of foodstuffs on offer. The service has a four weekly Care Homes for Older People Page 14 of 25 Evidence: menu. The food is cooked fresh on the premises and was being served during the inspection. The food was well presented offering choice to the residents, which catered to their preferred choice. Residents said,the food is lovely we get what we want here. Other residents said the food is good. One resident said the food is not always hot by the time it reaches me. This was discussed during the inspection when a resident said I like my food to be hotter. The manager was made aware of the comment made by the resident and said she would discuss this with the kitchen staff. It was also noticed during the inspection that there was a change to the menu and the residents had been informed but it was not written on the menu board. Any changes to the menu must be written on the residents menu board; this would ensure any changes are shared with the residents. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to the complaints procedure and are given support to voice their concerns. Residents living in the home are protected by the robust systems for dealing with complaints and safeguarding issues. Evidence: Residents are provided with a complaints procedure on admission into the home, which is part of the welcome pack. Residents are supplied with information about how to make a complaint. The staff team were aware of the complaints procedure and how to assist individuals who wished to make a complaint. Systems were in place for recording complaints. One complaint has been made since the last inspection and this matter was satisfactorily resolved. One relative said when asked has the service responded appropriately if you have raised concerns? The relative said always. The staff and management team understand when to apply safeguarding measures. For example, one member of staff said,I would refer any concerns to either the nurse or carer to deal with it. The staff team training for the Protection of Vulnerable Adults (POVA) were found to be up to date which keeps residents who use the service free from potential harm and abuse. The staff handbook also provides details for staff to report incidents in a confidential manner. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and a safe place for residents to live accommodating their needs. The atmosphere is pleasant and welcoming. Evidence: Bishopsmead Lodge is a purpose built two-storey property, which provides accommodation for people who need either personal or nursing care. The home provides a physical environment, which is appropriate to the specific needs of the residents who use the service. There is lift access to both floors. There are four double bedrooms, which is suitable for people who wish to share. There are forty-three bedrooms each suitable for single occupancy and have toilet en-suite facilities. Residents were complimentary about their place of residence and said its clean they are wonderful here. The property is located in the residential area of Bishopsworth, which is on the south side of Bristol. There is a car parking area at the front of the home. The rear of the home has garden. Views of the local bowling green can be seen from a number of bedrooms. The fixtures and fittings are suitable for residents needs and complement the decor of the home. The kitchen is managed and organised by the head chef. There are sufficient bathrooms and toilets to meet residents needs with a number of Care Homes for Older People Page 17 of 25 Evidence: hoists, stand aids and other specialist equipment assist with the task of personal care. There is evidence to show the equipment is regularly checked and serviced. The problem with the odour in one of the bathrooms has been addressed. Although no offensive smells were detected at the time of this inspection one GP said it is still a bit smelly. The manager must monitor this to ensure the home is pleasant for the residents at all times. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management has been working towards maintaining sufficient staffing levels to meet residents needs. Residents benefit from well trained staff who are able to meet their needs. The homes recruitment practices are robust and effective in protection residents from potential harm. Evidence: The service provides 24-hour care, which include of a team of staff during the day and night shifts. The staff team consists of qualified Registered General Nurses (RGNs), which is supported by a team of care workers. The RGNs are registered with the Nursing and Midwifery Council (NMC), which is a professional body responsible for ensuring the nurses maintain their professional qualifications and skill levels. The staff rotas show six RGNs per floor, which is supported by six care staff during the day. The shift at night consists of two RGNs and four care staff. There are concerns from the previous inspection 22nd & 23rd January 2008 the staffing levels could place residents at risk. The manager explained the staffing levels and is still working on obtaining the right number of staff especially for the weekends. The staff feedback surveys on this occasion made no comment to the staff shortages especially over the weekends. Care Homes for Older People Page 19 of 25 Evidence: Relatives and residents were both complimentary about the staff who provides the care at the home. Relatives said staff do everything possible to meet their needs, another said the staff do go that extra mile for the residents, residents said, the staff are pleasant, another said there is always a nurse on duty. The local GP expressed concerns and states things have now improved and goes onto say, I now usually see the same nurses on each of the floors which is great from a continuity of care point of view and generally they seem well informed. The GP goes onto say there are always staff around. The staff-training matrix shows a number of training, which has taken place. The nursing staff team take part in training to maintain their clinical practice. For example, diabetes care, syringe drivers, basic life support (BLS) would be for all staff; tissue viability, pressure area care, safe handling of medicines. A number of the staff team have the National Vocational Qualifications (NVQ) levels 1 and 2 some staff are working towards their NVQ L3. Mandatory training such as health and safety, moving and handling, first aid, fire awareness, food hygiene, POVA, infection control. This shows the staff team are participating in training, which is appropriate to their job. A selected number of staff files were looked at to assess the homes recruitment and selection practices. The files show the home has good recruitment procedures. The files contained; personal details, POVA notifications, enhanced Criminal records check (CRB). All CRBs were sign off during the inspection. The files contained job descriptions, two references, PIN confirmation from the NMC, terms and conditions and proof of identification such as passport and driving licence. Staff spoken with said, I enjoy working here, pleased with the progress of the home has made over the past 12 months. The staff team have regular supervision sessions and induction takes place with new employees. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has a clear understanding of the principles and focus of the service and people are confident their needs are being met. People are consulted and protected by good management systems and the service provided is consistent and flexible. Evidence: The manager had been register with the commission (CSCI) and has completed their level 4 registered managers award. The manager is a general nurse with Intensive Care (ITU) experience in the NHS. Staff spoken with said she is a very kind and supportive woman. During the inspection the manager assisted with the inspection and was able to produce documents. This showed transparency and the documents were available on request; such documents include; monthly audits for the use of bed rails, wound care, pressure sores and medication. The service has regular monthly visits, which is performed by the area manager. One resident said, She was being well looked after. The staff team were enthusiastic Care Homes for Older People Page 21 of 25 Evidence: about the home. The monthly visits also recommend areas for improvements within the service. This shows the home is being monitored within the organisation. Regular meetings take place between the Area Manager with the head of department. There are residents and staff meetings. The agenda includes, a number of concerns, which may affect the residents wellbeing, this shows good method of sharing information across the staff team. A random check of residents finance was examined during the inspection and found to be accurate. The homes system is appropriate for residents needs. The home is well maintained with a comprehensive range of policies and procedures. The home is secure with up to date health and safety tests maintained. This ensures residents live in a safe environment. The home is busy and relatives and residents were satisfied with their place of choice. No requirements were given on this occasion which, demonstrates that the service has improved since the previous inspection. The manager must ensure to maintain a good standard of care which people can benefit from and where the stakeholders can feel confident that the service provision continues to be consistent and flexible to meet peoples needs. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!