Inspection on 06/06/06 for Bakewell Cottage Nursing Home

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bakewell Cottage Nursing Home 04/07/07

Bakewell Cottage Nursing Home 20/05/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Bakewell Cottage Nursing Home Bakewell Cottage Nursing Home Butts Road Bakewell Derbyshire DE45 1EB Lead Inspector Angela Kennedy Unannounced Inspection 6th June 2006 10:30 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 Bakewell Cottage Nursing Home DS0000065048.V297576.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. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bakewell Cottage Nursing Home Address Bakewell Cottage Nursing Home Butts Road Bakewell Derbyshire DE45 1EB 01629 815220 01629 815330 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) Info@Westwickgroup.com The Westwick Group of Businesses Limited Sister Dorothy Black (acting manager) Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Bakewell Cottage is a sympathetically extended period home, which was previously a local community hospital. The home is located near to the centre of Bakewell where a variety of amenities are available. Accommodation is provided on three floors, which can be accessed at two levels. Two lifts provide access to all parts of the building and 36 service users can be accommodated in 32 single and 2 shared bedrooms. The care home provides personal care with nursing. Some bedrooms are equipped with en suite facilities. There is a range of lounges and dining areas. The home is well maintained both internally and externally. A large garden area with a patio is provided to the side of the building, which creates a pleasant sitting area for service users. Support services are provided locally with service users having a choice of GP and other support services accessed on request. At the time of inspection the current scale of charges at the home were; Private funded residents £485. Local authority funded residents between £374-£467 dependent on residents banding. Further information regarding the home and the current scale of charges can be obtained by contacting the home directly by telephone or via email. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced key inspection, which means the home was inspected against all the key national minimum standards, and took place over a 3 ½ hour period. During the inspection 3 residents were spoken with in detail as where 3 members of staff and one relative. Several of the homes records and documents were examined including 3 residents files, and 3 staff files. The medication practices of the home were inspected and other documentation relating to the health and safety practices and maintenance of the home were also examined. A tour of the home was undertaken and the acting manager was available throughout the inspection to provide the relevant documents and information as required. What the service does well: What has improved since the last inspection? The registered provider now undertakes written reports on the conduct of the home, in accordance with regulation 26 visits on a monthly basis, this demonstrates that the home monitors and evaluates the care provided on a regular basis. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 6 A valid electrical installation certificate is now in place and the temperature of the medication fridge is now recorded each day, this ensures residents health and safety is protected. 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. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 7 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 Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Resident’s needs are assessed prior to moving into the home to ensure their needs can be met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Three residents files were examined and all three residents had been assessed prior to admission. Where residents had been admitted with the involvement of social services the appropriate assessment documentation was on file. For residents admitted without the involvement of social services (privately funded residents) an assessment had been undertaken by the home prior to admission. The acting manager has now developed a new enquiry form that is used prior to assessment and evidence of completed enquiry forms were seen. This allows the acting manager to gather essential information in order to initially assess the suitability of the home for the resident. One of the residents who had recently moved into the home confirmed that he had received consultation regarding the admissions process prior to moving into the home. Bakewell Cottage does not provide intermediate care. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Resident’s health, personal and social care needs were set out in a plan of care and resident’s dignity was maintained when providing this care. The homes medication practices ensured that resident’s safety was maintained. Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: Of the three residents files seen all demonstrated that a comprehensive plan of care had been developed from the initial pre-admission needs assessment. The care plans seen were detailed and identified the needs of the resident and the action that needed to be taken to ensure their needs could be met. A range of risk assessments were in place and included; personal handling, skin integrity, pressure areas, nutrition, risk of falls and pain, and from these risk assessments care plans were developed as required. This demonstrates that the home actively seeks to meet the residents’ needs through a thorough assessment process. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 10 The majority of risk assessments and care plans in the files looked at, had been reviewed on a monthly basis with the exception of one that stated it was due for review in March 2006- however no evidence could be found to demonstrate that this had been done. The three residents spoken with were very complimentary regarding the standard of care provided, and stated that they couldn’t fault the care they received. One relative who was visiting on the day of inspection was also spoken with and was very positive about the standard of care her father received. This relative was a regular visitor to the home and said that she was always made welcome by the staff. This lady stated that she had no concerns about the home or the care that was provided. The medication practices of the home regarding the storage, handling, administration and disposal of medicines was looked at and found to be in general satisfactory. One minor error was noted where a resident’s medication had not been administered and staff had used the correct coding to demonstrate this, (this coding required a reason to be documented as to the non administration of medication) but staff had omitted to state why the medication had not been administered. This was brought to the attention of the acting manager who confirmed that she would discuss this with the nursing staff team to avoid any further errors. The temperature of the fridge used to store medication is now being recorded daily and the temperatures recorded where within the required temperature of between 2 and 8 degrees centigrade. This was a requirement from the last inspection, which has now been met. Evidence was in place within the care plans seen that residents privacy and dignity was respected when personal care was given and the residents preferred name was also recorded within their personal files. Residents spoken with felt that staff were very respectful when providing personal care. The majority of residents had private telephone lines within their rooms; a cordless telephone was also available for residents use if required. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The home meets the social, cultural and religious needs of residents and ensures that contact can be maintained with family, friends and local community activities if residents choose to do so. A varied and nutritious diet was provided to residents, which was positively accepted by residents. Quality in this outcome area is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: One of the staff team was allocated to the role of activities co-ordinator for 2 hours on 3 days a week and a programme was in place for activities, which included: • Melody, memory and movement. • Bingo • Trips out in Bakewell • Art and Design • Health and Beauty • Games • Sing-a-long • Music and Movement • Videos • Church Services at local church and in house Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 12 • • • • Visits from Minister twice a week. Library Seasonal Productions Visits from local hairdresser Residents spoken with were very happy with the activities that were provided at the home and some of the residents stated that they also went out on a regular basis with their families. Residents also confirmed that their were no restrictions on visiting and stated that their visitors were always made to feel welcome. Staff at the home openly encouraged visitors and their participation within the residents’ daily lives. One relative spoken with stated that she often visited at meal times, as she liked to support her father with his meals, this was positively encouraged and demonstrates an open and inclusive atmosphere at the home. Through observation it was noted that residents that were able, moved freely around the home, some residents were found to be undertaking activities of their choice within their rooms, whilst others could be found within the communal areas of the home. This demonstrates that residents are able to exercise as much control over their lives as possible. Residents can, if they are able handle their own financial affairs; although the home does have the facilities for the safe keeping of residents monies if required (assessed at standard 35). Meals at the home were served at the following times; • Breakfast 8am-10am • Lunch 12md-1pm • Evening Meal 4.45pm-5.30pm • Supper- as requested. The menus at the home, which ran over a 4-week period, were viewed and found to be varied and nutritional in content. Alternative choices from the dishes on the menu were available to residents who required them. The home was able to cater for any special dietary requirements and facilities were available for residents and their visitors to make drinks as required. The residents spoken with stated that the meals provided were of a high quality and cooked breakfasts were available if required, and confirmed that adequate portions were served and that alternative meals were available if requested. One resident spoken with stated that she had a big appetite and often requested additional portions of food which staff were happy to provide. This further demonstrates that the home strives to meet the individual requirements of each resident. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents were confident that any concerns they have would be taken seriously and acted upon. The homes practices regarding adult protection promote the safety of residents. Quality in this outcome area is good. This judgement has been made from available evidence, including a visit to the service. EVIDENCE: The complaints procedure was displayed within the entrance area of the home and within the written information about the home that is given to all residents. The home has received 2 complaints within the last twelve months both were responded to within the 28-day timescale and both were dealt with promptly and effectively. Residents spoken with stated that they were happy with the care provided and had no concerns, however they did confirm that if they had any concerns they would not hesitate in speaking to the acting manager. The home has an adult protection policy and access to Derbyshire local authority adult protection guidance. No adult protection referrals have been made by the home or in relation to any resident at the home within the last twelve months. Staff attended training Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 14 sessions on adult protection and the acting manager confirmed that this training would be updated on an annual basis for all staff. In the three staff files seen two members of staff had received adult protection training and the third member of staff who recently commenced in post had not yet undertaken this training. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Residents live in a clean and well-maintained environment. Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: The layout of the home is suitable for its stated purpose and all communal areas were accessible to the residents, including the grounds. Bakewell Cottage was once used as a cottage hospital and has been well maintained with many of its original features still in place. A homely and comfortable environment for the residents is maintained with views that overlook well-kept and attractive grounds. Two new bedrooms with en suite hand basins and toilets have been added to the home. These rooms are on the ground floor and have patio doors, which open onto an attractive patio and garden area. Next to these new bedrooms is a kitchen and sitting room area, which is at present undergoing decoration and Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 16 once completed residents, if desired will be able to receive visitors within this room and prepare beverages as required for themselves and their visitors. A programme of routine maintenance was in place and the homes handyman was responsible for ensuring maintenance work was completed. A tour of the building was undertaken and all areas seen were clean and free from offensive odours. Systems were in place to ensure that the spread of infection was controlled; this included the laundry area, which consisted of two rooms, one room being quite small next to a larger room where a washing machine with a sluicing facility was housed. The acting manager discussed plans that were at the development stage regarding the removal of the wall between the two rooms to provide one larger laundry area. Policies and procedures on the control of infection, including the safe handling and disposal of clinical waste were in place. Residents spoken with confirmed that the home was kept in clean condition. One relative spoken with stated that the home was well ventilated, whilst ensuring residents comfort was maintained, and gave an example of how a resident earlier that day said that she was in a draught from the window so the window had been closed promptly by staff. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The numbers and skill mix of the staff team needs can meet residents needs and resident’s protection is promoted by the homes recruitment practices. Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The staffing levels provided were appropriate to meet the assessed needs of the residents and staffing rotas were in place to demonstrate this. Residents and visitors spoken with considered the staff to be appropriate in numbers to manage their needs/the needs of their relatives and they felt that the staff worked hard to ensure a good standard of care was provided. The majority of care staff have undertaken or are in the process of completing a National Vocational Qualification in care at levels 2 and 3, this demonstrates that the care provided to residents is delivered by appropriately trained staff and indicates that the care delivery is safe. Three staff files were examined and demonstrated that a thorough recruitment practice was in place at the home, this included satisfactory criminal records bureau checks, 2 satisfactory references and the required identification documents. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 18 The homes induction package was seen and was in line with the recognised training standards required. One member of staff spoken with was recently recruited by the home and discussions took place regarding the recruitment process that she was presently undertaking, these were found to be satisfactory in ensuring that the relevant support and training was provided to ensure a safe working practice was maintained. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The management systems at the home were responsive to the needs of the residents and accessible to both residents and their relatives. The systems in place for seeking the views of the residents were in place but require further development to demonstrate that residents actively influence how their home is managed. Resident’s financial interests are safeguarded by the homes practices and when all radiators are covered this will further promote residents safety. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The acting manager had been in post at Bakewell Cottage for four weeks at the time of inspection. She is a Franciscan nun who has worked as a midwife in south Africa and has ten years experience in elderly care both in England and Scotland, her previous Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 20 post was as a deputy manager at another care home run by The Westwick Group of Businesses Limited. The acting manager has successfully gained a management certificate but has yet to apply for registration with the commission for social care inspection as the registered manager of Bakewell Cottage. Satisfaction questionnaires were developed for residents, relatives and visitors. However a method of publishing the results of these questionnaires had not been established. Discussions took place as to how this could be achieved, and one idea was to produce a new letter that could inform residents, relatives, prospective residents and any other interested parties of how the residents influence the way their home is managed. This will demonstrate that the home is run in the best interests of the residents. Most of the residents chose to keep their own monies and were able to do so. For residents who did not keep their own monies the home provided secure facilities and all financial transaction were recorded on individual financial transaction records with two signatures provided at each transaction. This demonstrates that the homes practice safeguards resident’s financial interests. A programme had commenced to fit radiator covers to protect residents from the risk of heat injury. The fitting of radiator covers was a previous requirement and the timescale for the completion of this work was extended. However this work has not as yet been completed, and therefore needs to be made a priority to ensure residents are safeguarded from the risk of heat injury. Some of the Safe Working Practices at the home were inspected, such as; • Fire Safety- the homes fire-fighting equipment was last checked in April 2006 and the Fire Officer lasted visited the home in May 2006 and fire alarms were checked on a weekly basis. Fire training was undertaken by some staff in May 2006 and was due for the remainder of staff in June 2006. • Electrical wiring certificate in place and in date- previous requirement, which has now been met. • Approved Gas Installation certificate in place and in date • Hoists Service in place and in date • Lift service certificate in date and in place Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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. 1. Standard OP38 Regulation 13 Requirement Temperatures of radiators must not exceed 43C (Previous timescale of 01/10/05 not met. Timescale extended since a programme of fitting of radiator covers is in progress (previous timescale 31/01/06) The acting manager must apply for Registration with Commission for Social Care Inspection. Timescale for action 31/07/06 2. *RQN CSA 11 (1) 01/08/06 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. Refer to Standard OP33 Good Practice Recommendations Feedback to residents/prospective residents on the summary results of satisfaction surveys should include published findings. Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 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 Bakewell Cottage Nursing Home DS0000065048.V297576.R01.S.doc Version 5.2 Page 24 - 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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