Inspection on 04/05/05 for Bank Close House

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bank Close House 29/04/08

Bank Close House 15/05/07

Bank Close House 13/11/06

Bank Close House 06/10/05

Bank Close House 02/12/04

Bank Close House 28/07/04

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 Bank Close House Hasland Road Hasland Chesterfield S41 0RZ Lead Inspector Eileen McHale Unannounced 4 May 2005 13:30 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 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. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bank Close House Address Hasland Road, Hasland, Chesterfield, Derbyshire,S41 0RZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01246 208833 John Patterson,Bank Close House Mrs Patricia Ann Milward Care Home providing personal care 27 Category(ies) of Old age ,not falling within any other category registration, with number of places Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/12/04 Brief Description of the Service: Bank Close House is a residential care home situated close to the centre of Chesterfield. The home is a listed building and has retained many of its original features. It is situated in extensive grounds, which offer a degree of privacy. The home accommodates 25 residents in the original part of the house and also in a wing extension. A range of communal spaces is provided which benefit from the creative use of the space available. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors. No visits had been undertaken since the last inspection and no complaints had been received about the home. A partial tour of the premises took place and care records and other records were inspected. On this occasion no staff records were inspected. Inspectors spoke to more than 10 residents and three of the 5 staff on duty. What the service does well: There is a strong commitment within the home to staff training and this is reflected within the competence of staff members and their polite, respectful and caring approach to residents. Good care staffing levels are maintained and as a result the home is able to provide a varied weekly programme of activities and planned monthly outings. Residents who spoke to the inspectors were very keen to tell them that they enjoyed living in the home. They spoke of the pleasures of sitting and talking to each other. When asked, residents confirmed that they could get up in a morning when they wanted to. Good records were kept of all contacts with health service staff and it was clear that where a resident had a problem, help was sought promptly. The home has a complaints procedure and takes complaints seriously. Matters were recorded and investigated. People, who made complaints of even a minor nature, were kept well informed. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 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. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 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 standard(s) 3 and 6 Full assessments of need were sought before admission, to ensure that the home could provide an appropriate service to new residents. EVIDENCE: The home does not provide intermediate care. The home had an extensive admission process and staff were able to locate pre-admission assessments and information. The assessment of needs put together by the home was based on the information available and was extensive. Staff on duty indicated that wherever possible the personal history of service users was recorded but acknowledged that the level of information provided by service users and their families varied. One file seen had no personal history apart from recording that the resident was married. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 The health, personal and social care needs of individuals were met to the satisfaction of residents although potential risks were identified with regard to medication and lack of privacy. EVIDENCE: The manager had purchased a care plan format in printed form. This had the advantage of giving a clear structure to aspects of health and personal care need. It had the disadvantage of limiting what could be written and it gave little space to social care needs. Although the care plans said little about social care needs, residents reported that those needs were identified and met. Care plans were evaluated monthly. Risk assessments were well recorded. Full records were kept of visits and treatment by GPs, District Nurses, opticians, dentists and chiropodists as well as any hospital treatments or tests. From these records the inspectors could see that any health needs identified were appropriately addressed. The residents spoken to confirmed that staff responded promptly to any illness and called for medical help. Medicines were found to be securely stored. A number of alterations had been handwritten onto the Medication Administration Record (MAR) charts by a Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 10 member of staff, with no signature or date. Neither had these been checked, signed and dated by a second member of staff. Several tablets were found in one resident’s monitored dosage medication pack although the relevant MAR chart indicated that these had been administered. The person-in-charge explained that a duplicate supply of boxed tablets had been used over several days. There was no record of this happening. At the time of this inspection one double bedroom was being used to check, file and record monitored dosage packs. The person-in-charge explained that this happens once a month. A visiting optician seeing referred residents was also using this room occasionally. The residents who spoke to the inspectors were keen to say that they were well treated by staff in the home. Staff members were seen to be polite, respectful and caring to residents. However the locks on bedroom doors, which had been fitted, were plastic break bolts rather than privacy locks. Residents were unable to lock their rooms from the outside if they left them. It was noted that for a few rooms there were twist locks set in the door, which in some instances could be locked and opened both from in and outside the room but in two instances could be locked from outside but not inside the room. These locks were not acceptable as they could be used as a restraint or locked inadvertently. Similarly there were interconnecting doors between some bedrooms and between a bedroom and bathroom. In one instance an external door was left open, as it was a fine day. This door was however to an en suite facility and lead directly into a bedroom. It was noted that a storage cupboard off the en suite was used by staff for equipment used in the home. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 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 standard(s) 12,13 The home succeeded in providing a quality of lifestyle, which was enjoyed and appreciated by residents. EVIDENCE: Residents who spoke to the inspectors were very keen to tell them that they enjoyed living in the home. They spoke of the pleasures of sitting and talking to each other. When asked, residents confirmed that they could get up in a morning when they wanted to. The home produced a weekly programme of activities, which included exercise, religious worship, entertainment, games and crafts. There was an annual plan of monthly outings. From discussion with residents it appeared that there was something for everyone and they were free to choose their own preferences. The display of notices about activities indicated that there were good links with the local community. Within care plans there were records of food preferences and special dietary needs. Residents confirmed that meals in the home were to a good standard and were enjoyable. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16 and 18 Complaints are dealt with formally and are acted upon. The home has taken steps to protect residents by providing policies, information and training. EVIDENCE: The home had a complaints policy. Full records were maintained of any complaints, which included details of the findings of the investigation and the action taken. It was noted that some matters such as missing clothing were addressed formerly as a complaint and records were made of when the clothing was found. The home had it’s own adult protection policy and staff had access to the Derbyshire Joint procedures. Staff had to sign to say they had read the policies and other procedures from the Department of Health. The home included adult projection within its induction training and the majority of staff had undertaken training provided by the Social Services Department. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 20,24,26 The home provided accommodation with character and interest for residents but was of an age and design, which provided ongoing maintenance problems and was difficult to change to meet the changing needs and expectations of residents. EVIDENCE: The home is a listed building set in extensive and well maintained grounds. The home is both comfortable and attractive. Services users accommodation has been extended by the conversion of outbuildings, which provides individual accommodation while retaining features of the original building. Although it was apparent to the inspectors that redecoration and refurbishment had taken place since the last inspection, there were still areas of the home, which required attention. There was some evidence of water damage. Although offering character, the home was clearly expensive and difficult to maintain. At the time of the last inspection a requirement had been made that the exterior of the building be painted. Although within the timescale given, arrangements had been made for the work to be completed. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 14 The home offered a range of communal areas both inside and out, with spacious lounges and dining rooms and courtyards with seating. A lawned area was used in the summer and was well equipped with garden furniture. Bedrooms were individual and the majority were personalised. Locks on doors were break bolts a matter addressed more fully in the section concerning privacy. Due to the age and design of the home some rooms were designated by the Fire Officer as fire escapes and interconnected with other bedrooms or bathrooms. These arrangements dated from the original registration of the home. At the time of the last inspection it was found that different areas of the home had different radiators. Some were low surface temperature radiators and others were not. The manager indicated that covers had been purchased for those radiators but had not been fitted. On the day of inspection someone visited the home to plan the fitting of those covers. On the day of inspection some 60-watt bulbs were found in bedrooms. Discussion took place with the person-in-charge on standard for lighting and the assessment of lighting levels as part of risk assessments on falls. The laundry is a small area not suited to the needs of the home. The proprietor had sought consent to extend this area but had been refused. As a result some clothes had to be hung in a corridor area when laundered. The home was maintained to a good standard of cleanliness. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The home provided good levels of care staffing and staff members were well trained. EVIDENCE: Overall, the home was providing adequate staffing levels and care staffing levels were high. There was evidence that additional staff were brought into the home where residents had hospital appointments. Dependence levels within the home varied, but were not high overall with appropriate staffing levels. The staff rota was untidy with items crossed out and frequent use of correcting fluid. One member of staff had previously worked in a range of settings and commented that the home provided more training than anywhere she had worked previously. She spoke very positively of working in the home. In the absence of the manager the inspectors had no access to staff files. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 There were systems in place for the seeking improvements in the quality of service provided in the home and the proper protection of residents’ monies. EVIDENCE: The home had policies and procedures in place for the monitoring of quality. Staff working in the home confirmed that monthly staff meetings and monthly residents’ meeting were held. They also indicated that they were aware that residents completed quality questionnaires. In the absence of the manager on the day of inspection the questionnaires and their analyses were not available. The home held money on behalf of residents although two residents chose to hold some cash themselves, leaving the remainder in the safe. Monies held for residents were held separately in named envelopes and stored in the safe. Full individual records were kept for each resident, which were initialled by two staff and held with any receipts of purchase. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 x COMPLAINTS AND PROTECTION 2 3 x x x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x x Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 18 yes Are there any outstanding requirements from the last inspection? 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 9 Regulation 13 Timescale for action Records of the administration of 30 June medication must be accurate and 2005 any change to the MAR sheets must be witnessed,signed and dated. Any lock on a bedroom door 30 June which might purposefully or 2005 unintentially be used to restrain the freedom of movement of a resident, must be removed. Specialist locks must be fitted on 30 bathroom and bedroom doors November which are also fire exits in 2005 accordance with the advice of the Fire Officer. The home must provide locks on 30 doors in accordance with the November advice of the Fire officer 2005 Requirement 2. 10 13 3. 10 12 4. 5. 10 12 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 7 Good Practice Recommendations Care plans should include specific plans to meet the social care needs of residents. C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 19 Bank Close House 2. 3. 4. 5. 6. 7. 10 10 10 19 25 26 The use of residents rooms for health care visits or the checking of medication should be reviewed. Protocols should be established on the use of any part of residents rooms which are used for general storage. Ensure that where exterior doors to private accommodation are opened ,attention is paid to security and the wishes of the service uses. Ensure that an on-going programme of repair is in place for the fabric of the building. The levels of lighting in areas used by residents should be reviewed. The proprietor should explore options to developm a laundry of adequate size to meet the requirements of residents. Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Bank Close House C52 C02 S19932 Bank Close House V226404 040505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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