Inspection on 30/07/08 for Banbridge House

This inspection was carried out on 30th July 2008.

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

Banbridge House 13/09/07

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Banbridge House 3 The Esplanade Minehead Somerset TA24 5QS Lead Inspector Jane Poole Unannounced Inspection 30th July 2008 10:15 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.V365131.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.V365131.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 Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (19) of places Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old Age, not falling with any other category (Code OP) - maximum of 19 places Dementia aged 65 years or over on admission (Code DE[E]) maximum of 5 places. The maximum number of service users that can be accommodated is 19. 13th September 2007 2. 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 up to five people who require care due to a dementia. 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 £368.00 to £450.00 per week. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. 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 The inspection was carried out over a one day period. During this time the inspector was able to talk with people living, working and visiting the home, observe care practices, tour the building and view records. The inspector was made welcome and given unrestricted access to all areas of the home. All records requested were made available. 3 relatives/carers, 4 health and social care professionals and 2 members of staff completed questionnaires, some of their comments have been incorporated into this report. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: Banbridge House is a well maintained and comfortable home. It is ideally located to enable people to access the seafront and other local amenities. Relatives/carers commented on the high standard of cleanliness within the home. On the day of the inspection all areas seen were clean and fresh. The home has a relaxed atmosphere with no strict routines. People are able to choose what time they get up, when they go to bed and how they spend their day. People are able to personalise their bedrooms with small items of their own furniture, pictures and ornaments. This gives bedrooms an individual homely feel. Everyone spoken to was complimentary about the staff. People said that they would be comfortable to approach the manager or a member of staff if they had any concerns. People said that the staff were kind and polite. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 6 People living at the home have access to healthcare professionals according to their individual needs. Staff assist people to attend appointments outside the home. There is a varied menu and a choice of food at every meal. People living at the home were happy with the quality of the food and the portion sizes. 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.V365131.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.V365131.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): 3&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Anyone wishing to move into Banbridge House has their needs assessed and has an opportunity to visit the home to ensure that it meets their needs and expectations. Intermediate care is not provided. EVIDENCE: The manager assesses all prospective residents to ensure that the home will be able to meet their needs. Copies of full assessments carried out by professionals outside the home are also obtained and these were seen in individual files. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 9 The terms and conditions of residence state that the first eight weeks of any stay is considered a trial period. This gives people an opportunity to get to know the home before taking up permanent residence. People spoken with on the day of the inspection said that they, or their representative, had been able to visit the home before deciding to move in. Banbridge House DS0000061623.V365131.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. People have access to healthcare services according to their individual needs. Care plans would benefit from more detail to ensure that people receive care in their preferred way. EVIDENCE: Everyone living at the home has a care plan and the inspector viewed three in detail. All contained information about peoples needs but gave limited information about likes, dislikes or preferences. The home cares for up to 5 people who require care due to a dementia and are not fully able to express their views, therefore it is important that their preferences are recorded. Two care plans stated that the person required ‘assistance’ with personal care but there were no details of the level of assistance required. Plans of care are Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 11 reviewed monthly but with limited information about the help being given to individuals it may be difficult to ascertain when needs and abilities change. Whilst it is acknowledged that this is a small home with a small staff team, more personal information should be recorded about lifestyle choices to ensure that people receive care in their preferred manner. Three people in the home have bedrails on their bed. There were no comprehensive assessments of need in respect of this and no personalised risk assessment in place, although agreements for their use had been signed. Everyone is registered with a GP and other healthcare professionals according to their individual needs. People spoken with stated that the staff assisted them to attend appointments outside the home. Details of appointments are recorded in daily records. People are weighed on a regular basis and records seen showed that weights were reasonably stable. The manager stated that they have good relationships with local healthcare professionals and carers said that visiting healthcare professionals were always happy to give advice and support. 4 health and social care professionals completed surveys before the inspection. All answered ALWAYS or USUALLY to the questions “Does the service seek advice and act upon it to improve individuals healthcare needs?” and “Are individual healthcare needs met by the service?” One relative commented that they had noticed improvements in their relatives’ health and well being since they moved into the home. 4 bedrooms have en suite facilities and all have wash-hand basins where people can be assisted with personal care. There is a level access shower and assisted bathroom for communal use. Everyone asked felt that their privacy was respected, although one healthcare professional commented that staff did not always knock on bedroom doors before entering. The inspector did not observe this during the day. People living at the home said that staff were always polite and called them by their preferred name. The home uses a Monitored Dosage System for medication. There is appropriate storage for medicines and staff who administer have received specific training in this area. The inspector viewed the Medication Administration Records (MARs) and found them to be correctly signed when received into the home and when administered. There were no clear guidelines for the use of ‘as required’ medication. It is important that staff are aware of how people who are unable to verbally Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 12 express themselves may communicate pain or discomfort and therefore receive appropriate medication. No one living at the home self-administers their medication. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 13 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. There are no strict routines and people are able to choose how they spend their time. Visitors are always made welcome. EVIDENCE: People living at the home said that there were no strict routines and that they were able to choose what time they got up, when they went to bed and how they spent their day. The inspector noted that people moved freely around the home. One person said that they preferred to spend time in their room and the staff respected this decision. There is a choice of communal areas, the main lounge has a TV and looks out across the sea and the conservatory opens on to a pleasant garden. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 14 There are some organised activities, such as quizzes and keep fit and some people said that they enjoyed going out along the seafront and to the local park. Staff stated that they try to take people out as often as possible and many people go out with relatives. One health and social care professional commented that they were impressed by the way in which the home had assisted someone to go out independently. One member of staff and one relative/carer who completed a questionnaire said that they felt people living in the home would benefit from more social stimulation. Visitors spoken with stated that they were able to visit at any time and always made welcome. One person said that they were often invited to stay for meals. The home has a pleasant dining room at the front of the house. People can eat in the dining room, in their personal rooms or in the conservatory. The main meal is served at mid-day and there is always a choice of food. The menu is displayed outside the dining room. The cook stated that the menu is drawn up in consultation with people who live at the home and known likes and dislikes are taken into consideration. Everyone spoken with stated that they were happy with the quality of the food and the portions. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 15 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. People living at the home and their relatives are comfortable to raise concerns and feel that any worries would be listened to. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Although no staff have received formal training in the protection of vulnerable adults, all spoken to were all very aware of what may constitute abuse and how to use the whistle blowing policy. Both members of staff who completed questionnaires answered YES to the question “Do you know what to do if a service user or advocate has concerns about the home?” People living at the home and their relatives stated that they were happy with the care that they received and would be comfortable to speak with the manager or a member of staff if they had any concerns. One person said “you can approach any of them if you are worried.” Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 16 No complaints have been received by the home or the Commission for Social Care Inspection since the last inspection. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 17 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. Banbridge House provides a comfortable environment for the people who live there. The standard of cleanliness is very good. EVIDENCE: Banbridge House is located on the sea front at Minehead within easy walking distance of the main shopping area. All areas of the home are fitted with a fire detection and emergency lighting system. Accommodation is set over three floors with a passenger lift between. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 18 Communal seating areas are on the ground floor and accessible to people with all levels of mobility. There is a lounge and dining room to the front of the house and a conservatory at the rear, opening onto a pleasant garden. Aids and adaptations have been put in place to meet the physical needs of the people who live at the home. There are assisted bathing facilities and a level access shower room. Handrails, ramps and raised toilets are in place to assist people to move around independently. Call bells are located throughout the home to enable people to summon assistance when required. The inspector viewed a sample of bedrooms and noted that people are able to bring personal possessions with them such as small items of furniture, pictures and ornaments. Relatives/advocates who completed questionnaires prior to the inspection stated that the home, including personal rooms, was always clean and tidy. One the day of this inspection all areas seen were extremely clean and fresh. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 19 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. There is a thorough recruitment procedure, which minimises the risks of abuse to the people who live at the home. Staff would benefit from training specific to the needs of the people who live at the home. EVIDENCE: The home employs 15 care staff, 9 (60 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. In addition to care staff the home employs 2 cooks and 2 housekeepers. Staff felt that the home was adequately staffed and rotas given to the inspector showed that there are a minimum of 4 care staff on duty each morning and 3 in the afternoon. At night there are 2 staff till midnight and then one waking member of staff and one person who sleeps in and is able to respond in an emergency. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 20 Staff spoken to stated that they had received training in statutory subjects such as fire safety and first aid. Manual handling training was taking place on the afternoon of the inspection. The home is registered to care for up to 5 people with a dementia. Only four members of staff, including the manager, have received training in caring for people who have a dementia. Some staff said that they thought this training would be very useful and one healthcare professional commented that, “staff are not always aware of the specialist needs of people with dementia.” There is an induction programme for staff, which has been personalized to the home but contains limited information about the care of people who have a dementia. The two members of staff who completed questionnaires before the inspection answered VERY WELL and MOSTLY to the question “Did the induction cover everything you needed to know?” The inspector viewed the recruitment file of the most recently appointed member of staff. Written references had been obtained and appropriate checks had been carried out before the person began work. People living at the home said that staff were kind and polite. One person said that “nothing is ever too much trouble and their manners are nice.” One relative/carer wrote “I feel there is nothing the staff would not do and it is always done with a smile.” Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has the appropriate skills and experience to manage the home. Appropriate checks are in place to maintain a safe environment. EVIDENCE: The registered manager/proprietor is Ms Tina Boswell. She is a qualified nurse and has many years experience of working with older people and of managing a care home. Tina is currently working towards the Registered Managers Award (NVQ level 4.) Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 22 The manager works alongside care staff to offer support and guidance. She demonstrates an excellent knowledge of the people who live and work at the home. One carer said that she was “an excellent boss” and a relative said that she was “marvellous” and “always happy to listen.” There are meetings for people who live and work at the home, to enable them to share their views and ideas. Periodically the home sends out questionnaires to gauge views on the running of the home. The manager is very visible in the home and meets with people on an almost daily basis. The manager does not act as a financial appointee or power of attorney for anyone living at the home. Small amounts of personal monies are looked after and records are kept of these. The inspector sampled some records and found that they correlated to amounts held. The deputy manager carries out regular health and safety audits. A fire risk assessment has been completed and alarms and emergency lighting is regularly tested and serviced. Records seen showed that all lifting equipment is regularly serviced by outside contractors. As previously stated comprehensive risk assessments for the use of bedrails have not been completed but the safety of the rails used is checked monthly. Certificates of registration and insurance are displayed. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 23 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 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 3 3 x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 2 Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP7 OP38 2 3 4 OP9 OP30 OP33 Good Practice Recommendations The care plans should be expanded to ensure that they give clear guidelines for staff and show rationale for practices in the home, such as the use of bedrails. Recommendation made at last inspection. There should be clear, individual, protocols in place for the use of ‘as required’ medication. The induction programme and ongoing training should include issues specific to the people who live at the home, such as dementia care. Quality assurance systems in place should seek the views of all interested parties. These views should be used to influence ongoing improvements in the home. Banbridge House DS0000061623.V365131.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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.V365131.R01.S.doc Version 5.2 Page 26 - 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!