Inspection on 13/09/07 for Banbridge House

This inspection was carried out on 13th September 2007.

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 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

Banbridge House 30/07/08

Banbridge House 07/12/06

Banbridge House 22/02/06

Banbridge House 27/09/05

Banbridge House 18/11/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Banbridge House 3 The Esplanade Minehead Somerset TA24 5QS Lead Inspector Jane Poole Unannounced Inspection 13th September 2007 09:45 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 Banbridge House DS0000061623.V349011.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. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Banbridge House Address 3 The Esplanade Minehead Somerset TA24 5QS 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) 01643 702275 01643 708551 Miss Tina Boswell Miss Tina Boswell Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the maximum number of 19 beds registered, up to three services users in the category of DE(E) may be admitted Up to two service users between the ages of 60 - 64 years to reside on a respite care basis. 7th December 2006 Date of last inspection Brief Description of the Service: Banbridge House is large detached property situated on the seafront at Minehead. There are sea views from communal rooms and some service users bedrooms. All areas of the home have been well maintained and furnished to a high standard. The home is within easy reach of the town centre, where there are all local amenities. The home is also within minutes of the West Somerset Railway. Banbridge House is registered with the Commission for Social Care Inspection to provide accommodation for up to nineteen people over the age of 65 years, who require assistance with personal care. This includes three people who require care due to a dementia. The home is also able to provide respite care to up to 2 people who are 60 or over. The home is not registered to provide nursing care. The registered provider is Tina Boswell, who is also the registered manager. Fees at the home range from £351.00 to £450.00 per week. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The inspection was carried out over a 6 hour period. During this time the inspector was given unrestricted access to all areas of the home, was able to speak with staff and service users and observe care practices. The manager completed an Annual Quality Assurance Assessment (AQAA) before the inspection, which gave an overview of practices in the home since the last inspection and outlines plans for further improvement in the coming year. 8 members of staff and 2 relatives/carers completed questionnaires prior to the inspection and some of their comments have been included in this report. What the service does well: The home is ideally located to enable service users to easily access the town centre, sea front and other local amenities. All areas of the home are well maintained and there is a programme of ongoing redecoration and refurbishment. On the day of inspection the standard of cleanliness was excellent and service users stated that this was always the case. All prospective service users are fully assessed and have opportunities to visit the home to ensure that it meets their expectations. Service users were overwhelmingly complimentary about the staff working in the home. The inspector observed that people were assisted in an unhurried manner and staff spoke and acted in a way that respected peoples’ dignity. Visitors are always made welcome and are able to call at any time. Service users stated that they are able to see personal and professional visitors in private if they wished to. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Banbridge House DS0000061623.V349011.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 Banbridge House DS0000061623.V349011.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs assessed and are able to visit the home prior to making a decision to move in. Intermediate care is not provided. EVIDENCE: The home has a statement of purpose and service user guide which are available in the entrance hall. The inspector viewed the care plan for the most recently admitted service user. It contained a full assessment of need completed by professionals Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 9 outside the home and evidence that the manager had met with the service user prior to offering a place at Banbridge House. Many of the service users spoken to stated that they, or their representative, had been able to visit the home before deciding to move in on a permanent basis. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to healthcare professionals in line with their individual needs. Service users are treated with respect at all times. EVIDENCE: All service users are registered with GPs and other healthcare professionals according to their individual needs. Service users spoken to stated that the home assisted them to attend appointments outside the home or arranged for healthcare professionals to see them at the home. All stated that they were able to see personal and professional visitors in private. The inspector viewed the care plans of two people living at the home. Both were basic but personal to the individual. The care plans would benefit from Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 11 being expanded upon to ensure that they give clear guidelines to all staff. For example one care plan stated that the person had diet-controlled diabetes but there was no information as to how this was being managed by the service user or the home. Another person had bedrails on their bed but there was no rationale for this in the care plan. Staff write daily records in respect of all service users and those seen gave information about significant events and the activities of the service user. Throughout the inspection the inspector observed that the staff were friendly and polite to all service users and assisted people in a way that respected their dignity. Many of the service users commented on the politeness of the staff one person said they were “always obliging and pleasant.” The home uses the Boots Monitored Dosage System (MDS) for all medication, currently no one living at the home administers their own medication. There is appropriate storage for medication including things that require refrigeration. Medication is only administered by senior staff who have received training in this area. The inspector viewed the Medication Administration Records and found them to be correctly signed when received into the home and administered. Currently the staff do not sign to acknowledge when prescribed creams or lotions have been applied so there is no way to monitor their effectiveness. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assisted to access the local community. The quality of food in the home is good. EVIDENCE: Service users spoken to stated that there were no set times to get up or go to bed and that they were free to decide how to spend their day. There are some organised activities in the home and on the morning of the inspection there was a keep fit class in the lounge. The manager stated that in the summer months the staff concentrated on taking people out in the local area rather than on indoor activities. Service users spoken to stated that they enjoyed going shopping in the town or to the local park. One person said that staff assisted them to walk along the sea front on most days. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 13 There is a TV and video in the main lounge and the inspector noted that some people were enjoying watching a video in the afternoon. Service users are able to have visitors at any time and some people continue to go out with family and friends. One visitor was spoken with during the inspection, they stated that they were always made welcome in the home. The main meal of the day is at lunchtime and there is always a choice of meals. There is a pleasant dining room, with a sea view, that is large enough to seat all service users comfortably. The inspector observed lunch being served and the meal was well presented and appeared nutritious. The cook stated that they used fresh fruit and vegetables and was able to order good quality meats. The store cupboards were well stocked with good quality products. The majority of service users stated that the food was good and that there were always ample portions. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has taken reasonable steps to minimise the risk of abuse to service users. The management in the home is open and approachable meaning that service users are comfortable to share any worries or concerns. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Staff spoken to were aware of the whistle blowing policy and the ability to take serious concerns outside the home. No complaints have been received by the home or the CSCI since the last inspection. Both relatives/carers who completed questionnaires prior to the inspection stated that they knew how to make a compliant. All service users spoken to stated that they would be comfortable to approach the manager if they had any concerns or complaints about the home or their care. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 15 The inspector viewed the recruitment files of the most recently appointed staff which gave evidence of a robust recruitment procedure. All new staff had been checked against the Protection Of Vulnerable Adults (POVA) register before commencing work and had undergone an enhanced Criminal Records Bureau (CRB) check. All staff who completed comment cards stated that they had had a CRB check and that they were aware of the homes policies and procedures in respect of recognising and reporting abuse. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is ideally situated to enable service users to access the town centre, park and other amenities. The standard of cleanliness in the home is excellent. EVIDENCE: The home is located on the seafront of Minehead and many of the rooms have sea views. It is within walking distance of the town centre and other amenities. All areas of the home are fitted with a fire detection and call bell system. Service user accommodation is set over three floors and there is a passenger lift to all areas. Other aids and adaptations have been put in place to assist Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 17 service users to maintain their independence. These include assisted bathing and showering facilities, hand rails, raised toilets and ramps. All communal seating areas are on the ground floor and are accessible to people with all levels of mobility. There is a large lounge and dining room at the front of the house and a conservatory with access to the rear garden. The inspector viewed a sample of bedrooms and noted that service users are able to personalise their rooms to reflect their needs and tastes. Since the last inspection the home has refurbished the laundry and is now using the OTEX system. There are now two washing machines and one drier. Housekeeping staff spoken to stated that they received appropriate training, including infection control, and stated that they were supplied with adequate materials and equipment to carry out their roles. There is suitable hand washing facilities around the home. On the day of this inspection all areas were very clean and fresh. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the skills and experience to meet the needs of the service users. The robust recruitment procedure minimises the risks of abuse to service users. EVIDENCE: The home employs 16 care staff, 8 have a National Vocation Qualification (NVQ) in care at level 2 or above and a further 6 are working towards the award. The rotas seen by the inspector showed that there was a minimum of three care staff on duty during the day. The managers and all ancillary hours are in addition to this. Overnight there are two staff up to midnight and then one person awake and another sleeping in. Staff spoken to stated that they felt there were sufficient staff on duty at all times. The inspector observed that staff had time to spend with service users and assisted people in a way that was unhurried. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 19 Service users were overwhelmingly complimentary about the staff saying that they were always ‘happy to assist’ and that ‘ nothing was ever too much trouble.’ Staff were described as ‘kind’ ‘patient’ and ‘extremely nice and helpful.’ Staff stated that they had good opportunities to undertake training. Records are kept of all training undertaken by staff and many certificates are displayed in the entrance hall. All staff who completed comment cards prior to the inspection answered YES to the question ‘ Do you feel you received adequate induction and supervision when you began work?’ The inspector viewed the recruitment records of the three most recently appointed members of staff. These gave evidence of a thorough recruitment procedure including written references, Protection Of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed taking account of the views of service users and other interested parties. EVIDENCE: The registered manager/provider is Tina Boswell. She is a qualified nurse and has many years experience of working with older people. One relative/carer wrote on their questionnaire that the manager is very approachable and always happy to talk with relatives. Staff and service users spoken to during Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 21 the inspection stated that they were always comfortable to speak with the manager and felt involved in the day to day running of the home. The registered manager works alongside care staff to offer ongoing supervision and support. She gives clear leadership and direction to the home. There are regular staff and service user meetings which people said were an opportunity to share views and opinions not just information sharing. The manager stated that she is actively trying to encourage families to take a more active part in the home. In addition to meetings, the home has quality assurance systems that involve regular audits and seeking the views of service users and their representatives. The home does not act as a financial appointee or power of attorney for anyone living at the home. Small amounts of money are kept on behalf of service users and clear records are kept in respect of these. The inspector sampled some records and found that they correlated with monies held. Regular health and safety checks are carried out in the home. These include weekly checks of fire detection equipment and regular servicing of the system. All staff receive training in fire safety during their induction and up dates every six months. Two staff spoken to and one who completed a comment card stated that they had not received training in manual handling. All hoisting equipment in the home is serviced on a six monthly basis. Portable electrical appliances are tested annually. Since the last inspection the home have up graded the call bell system and implemented regular safety checks for any bedrails used in the home. Up to date certificates of registration and insurance are displayed in the entrance hall. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 22 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 3 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 4 3 X 3 X 3 X 4 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 3 3 X 3 X X 3 Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no 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. Standard Regulation Requirement Timescale for action 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 2 3 Refer to Standard OP7 OP9 OP38 Good Practice Recommendations The care plans should be further expanded to ensure that they give clear guidelines for staff and show rationale for practices in the home. There should be a recording system for the administration of prescribed creams and lotions to ensure that their effectiveness can be monitored. All staff should receive training in safe moving and handling practices and procedures. Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Banbridge House DS0000061623.V349011.R01.S.doc Version 5.2 Page 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. 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