CARE HOMES FOR OLDER PEOPLE
Bancroft Gardens Waterside Stratford On Avon Warwickshire CV37 6BA Lead Inspector
Jackie Howe Announced Inspection 18th January 2006 10:00 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 Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Bancroft Gardens Address Waterside Stratford On Avon Warwickshire CV37 6BA 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) 01789 269196 01789 263455 Mr D Barnfield Mrs Jeannette Sandra Barnfield Mrs Jeannette Sandra Barnfield Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: Bancroft Gardens is situated in the centre of Stratford-upon-Avon, opposite the Royal Shakespeare Theatre, gardens and the river. All the facilities of the town are easily accessible for residents, either on foot or with the use of a wheelchair. Car parking can be difficult, but there are large public car parks within reasonable walking distance. Access to the home is at street level where the front door leads into a small lounge with a picture window onto the road. Apart from this all the accommodation is on the two upper floors. There is a shaft lift serving all levels, but there are a number of small flights of steps here and there. The home has two lounges and a dining room, a kitchen, two bathrooms, one separate lavatory and a small laundry area. There are ten single and three double bedrooms, all of which have en-suite facilities. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over six hours and was announced. This was the second visit of the inspection year 2005/06. Staff cooperated fully with the inspection, and the registered manager was present throughout the day. The inspection process included discussions with the manager, examining records, reading care plans and observation of care practices. During the inspection seven residents, two relatives and seven staff were spoken with. The inspector joined residents for lunch. What the service does well:
Bancroft Gardens has a very homely feel about it. It is small and comfortable looking, with the kitchen situated in the heart of the home. Residents and visitors spoken with talked about the friendliness of the home and the staff, how happy they are to live there, and visitors said how welcome they are made. ‘I think Bancroft Gardens is a wonderful home and I am very pleased with my father’s care by all staff there’. The staff group is primarily well established with a core of senior staff who have been at the home for a considerable amount of time and are able to support new staff. Training and development is given a high priority within the home, with good opportunities for staff to attend a variety of courses. An independent trainer ensures all new staff undertake a thorough induction, which meets all the standards, and complete all mandatory courses within the time scales. Care planning processes and records were seen to be thorough covering personal needs of individuals, with robust assessments being made. Life histories have been completed on a number of residents with the assistance of family members, allowing staff a greater insight and promoting a personal approach to the needs of the residents in their care. Whilst the home does not have registration to provide dementia care, there is a commitment from the manager and the staff, to provide dementia care practices in their approach to individual care.
Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 6 Training in the most appropriate ways to care for people with dementia, has been given to staff, and this has resulted in the home having a very ‘person centred’ approach to all its residents and has improved care standards. 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. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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 Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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): 1, 3 The home’s Statement of Purpose and Service Users’ Guide are excellent providing residents and prospective residents with details of the services the home provides enabling an informed decision about admission to the home. All residents are assessed prior to moving into the home and given assurances that their needs can be met by the home and the services offered. EVIDENCE: The ‘Statement of Purpose’ and ‘Users Guide’ are available and accessible to residents and visitors. The information contained meets the standards, and provides potential residents with the detail required to make an informed choice of home. The language used is appropriate and written in plain English, and additional formats are available on request. Relatives spoken with said they had been able to visit the home prior to making a decision and had been made welcome to the home.
Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 9 A thorough assessment procedure is in place to ensure the home can meet the needs of potential residents and this information is transferred into the care plan. A very personal approach is taken in assessing each new resident and the manager gave evidence of how each individual’s personal circumstances are considered, involving families in the process. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 10 Staff ensure that the privacy and dignity of the residents is respected consequently the residents maintain individuality. There is a clear, consistent health assessment system in place, and the registered manager ensures that all residents have access to health care services to satisfactorily meet their needs. EVIDENCE: The care plan indicating health care needs is very detailed and includes risk assessments and review systems to ensure staff have the necessary information to meet needs. District nurses provide nursing care and the registered manager ensures that residents are able to access dental, optician, and chiropody services either at the home or by attending local clinics. Residents are able to keep their own dentist and optician if they choose to do so. Access to health care professionals in regard to psychological health is made via GP referral, and many residents are monitored by local support workers.
Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 11 Nutritional screening is undertaken, and in the care plans was good evidence of weight being monitored and actions taken to ensure good nutrition. There are no residents with pressure sores at present in the home, but good screening processes are in place and the home is very proactive in its approach providing specialist mattresses and cushions. Continence advice is available locally along with aids and other equipment. Care practices were observed during the day and residents were seen to be treated respectfully. The Service Users Guide informs residents how the home hopes to achieve the goals of treating people with respect. ‘A lovely homely atmosphere, small and personal, just right for me as I cannot see and I know where everything is that I need, so I do not have to advertise that I am blind to everyone’. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14 The residents’ lifestyle experience in the home matches their recreational, social, cultural and religious interests and needs. The home ensures that residents’ maintain contact with their family and friends and have choice and control over their life. Consequently they have a good quality of life. EVIDENCE: Relatives spoken with said they were free to visit the home at any time, and join their relatives for meals. They referred to the home as: ‘Home from home.’ ‘Part of an extended family’. ‘It is like visiting my mother in her own home, I feel just as comfortable’. Observations of care practices confirmed that residents are offered choice over how they spend their day, what time they get up in the morning, activities they attend and over their meals. One resident was offered a whole range of items for breakfast ranging from eggs to cereal before finally settling for toasted teacakes.
Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 13 The cook is very involved with the residents and makes every effort to offer as much choice as possible. Residents spoke highly about the quality of the food. ‘Food is lovely and always is’. Choice was observed to be given re drinks with meals, and portion sizes. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: Whilst these standards were not assessed at this inspection, training records indicated that staff are made aware of recognising signs of abuse, and the processes of reporting this. The commission has no concerns about the ability of staff to protect residents from abuse or to deal fairly with concerns raised. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Whilst these standards were not assessed at this inspection the home was seen to be comfortable, clean and appropriate to the needs of the resident group. Rooms are personal and well furnished. The home has specialist equipment to aid people with mobility and to prevent the development of pressure sores. The environment of the home is one of its strengths, being welcoming and friendly and its position in the heart of Stratford opposite the park and canal, was spoken of positively by residents.
Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 16 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 home provides sufficient numbers of staff with the skills mix necessary to meet the needs of service users. The procedures for the recruitment of care staff are robust, and appropriate pre employment checks are undertaken. These checks have not been undertaken on volunteers and such gaps in recruitment practice may lead to residents being exposed to people who are not suitable to work with vulnerable people. A commendable ongoing programme of training is provided to all staff to ensure residents’ needs are met safely. EVIDENCE: The home employs sufficient staff to meet the assessed needs of the residents. Whilst the home is not registered as a specialist facility to care for people with dementia, the manager identified a number of residents with memory loss and showing signs of a dementia, and has responded by providing training for staff and the use of life history within the care planning process. Staffing is flexible and the staffing rota shows that additional staff can be employed when the need arises, especially at night and in the evenings. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 17 The rota does not always record actual hours worked by staff especially on the morning shift, which does not allow a true picture of who is actually on duty to people visiting the home. Domestic staff are employed in sufficient numbers to support care staff and the home was noted to be clean and tidy with no unpleasant odours. Three staff files were accessed and recruitment practices were seen to be thorough. The hairdresser who works in the home has been known to the manager for a number of years, but has not yet had a police check. The manager is aware and is committed to undertaking this as soon as possible. The manager makes a big investment into training and developing her staff, employing an independent trainer to complete all induction and mandatory training, with a full selection of additional courses available to care for residents with special needs. Over 90 of staff have achieved their NVQ level II in care and some staff have achieved level III. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 18 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): 35 Systems for the management of residents’ finances ensure that their interests are safeguarded. EVIDENCE: The manager employs an accountant to manage the financial affairs of those residents who do not have family members to do so or lack the capacity to manage their own finances. Individual accounts are kept and monies are not pooled collectively. The money kept in the home could not be inspected as the key was with the accountant, but related paperwork and records were seen and appeared to be in order. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 19 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 20 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 Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 21 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 Refer to Standard OP27 OP29 Good Practice Recommendations Staff rotas should reflect the actual hours worked by staff for all shifts, so that a true picture of staff on duty can be Seen. CRB checks should be undertaken on all volunteers who are in regular contact with service users. Bancroft Gardens DS0000004204.V274588.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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