Inspection on 06/10/05 for Bank Close House

This inspection was carried out on 6th October 2005.

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

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

Other inspections for this house

Bank Close House 29/04/08

Bank Close House 15/05/07

Bank Close House 13/11/06

Bank Close House 04/05/05

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 Derbyshire S41 ORZ Lead Inspector Andrew Bailey Unannounced Inspection 6th October 2005 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 Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bank Close House Address Hasland Road Hasland Chesterfield Derbyshire S41 ORZ (01246) 208833 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) pat@bankclosehouse.totalserve.co.uk Bank Close House Mrs Patricia Ann Millward Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Plus Three (3) Day Care Places Date of last inspection 4th May 2005 Brief Description of the Service: Bank Close House is a residential care home situated close to the centre of Chesterfield. The home is registered to provide personal care for up to 27 residents. The care home is a listed building and has retained many of its original features. Set within extensive grounds, the home offers a high degree of privacy. A range of communal spaces is provided, which benefit from the creative use of the space available. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration of the inspection was approximately four hours. A partial tour of the building took place. Discussions were held with five residents and with two visitors. A number of records were examined, including care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents). No visits had been undertaken since the last inspection and no complaints had been received about the home. What the service does well: What has improved since the last inspection? There has been on-going decoration of the home, internally and externally, and the hall and stairway has had new carpet fitted. All radiators now have covers fitted or are of a low surface temperature type, providing added safety for residents. There has been consultation with the Fire Officer with the purpose of finding a safe means of improving privacy for residents in their private accommodation and in the bathrooms. Although this remains to be addressed, there are now potential solutions in sight. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 6 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 DS0000019932.V255276.R01.S.doc Version 5.0 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 Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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): 2 & 3 (6 is not applicable to this home) Contracts/statements of terms and conditions had been provided at the point of moving into the home to ensure residents or representatives were clear about the admission arrangements. Full assessments of need had been undertaken before admission, to ensure that the home could provide an appropriate service to new residents. EVIDENCE: The home does not provide intermediate care. There was evidence within the care plan documentation examined as part of the case tracking process to confirm that written contractual arrangements were in place. There is a comprehensive admission process, with documentary evidence of this present within the care plan files of individual residents. Where residents had been admitted with Care Management (Social Services) involvement there was evidence that assessment documentation had been received. Staff from the home assess all residents prior to admission, even where Care Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 9 Management are involved. Some of the residents spoken with were able to confirm that they felt there had been full consultation with them about the admission process. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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): 7, 8, 9 & 10 Residents feel that the home meets their needs and there is comprehensive written care plan documentation to guide staff in meeting the needs of the residents. Residents state that their privacy is maintained, but there is some work outstanding relating to door locks to ensure that the privacy of residents is always safeguarded. EVIDENCE: There are detailed and comprehensive records of the identified needs of residents, with actions plans to address identified needs. An appropriate range of risk assessments is undertaken for each resident. As per the findings from the last inspection, the pre-printed documentation does not lend itself particularly well to the recording of social aspects of care, although there were suitable assessment records that captured social details within the residents’ past history sections. Notwithstanding this, the residents spoken with felt that the home satisfactorily met their social needs and it was evident that there is a varied programme organised to provide social and leisure opportunities for the residents. Staff are attempting to improve the recording of social aspects of care on an on-going basis. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 11 Risk of falls was covered in all of the care plans examined as part of the case tracking process, although use of a formal risk assessment document (along similar lines to the systems for assessing tissue viability and nutritional risk) would provide a more measured and consistent approach to assessment of this particular risk factor. A full audit of the medication systems was not undertaken, but it was established that a previous requirement with respect to recording on the Medication Administration Records (MAR) had been addressed. The only area identified from this inspection for the manager to attend to is to ensure that where a variable dose of a medication has been prescribed, the exact dose administered must be recorded. This is to ensure that there is a valid audit trail and also so that the therapeutic effect of medication can be reliably determined. There was documentary evidence to confirm that care staff had received medication training from a creditable source. The manager is currently discussing potential actions with the Fire Services with respect to certain privacy arrangements for residents, so as not to potentially jeopardise the safety of any resident in the event of fire. This relates to door locks and fire escape routes, where there also has to be specific consideration for individual resident privacy within their private accommodation and also in bathrooms, whilst also ensuring that there is never any obstruction present in the event of emergency evacuation. The privacy issue in the case of an escape route primarily concerns one bedroom in the home, and it is anticipated that a resolution can be found in the near future. Another instance where there is a potential privacy issue is not a fire escape route and in this case it is just a matter of finding a suitable privacy & security approach whereby two adjoining bedrooms have suitable arrangements provided. Discussion during the inspection may have identified a possible course of action to tackle this. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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): 12, 14 & 15 The home succeeds in meeting the expectations of the residents with regard to their daily life and social/recreational needs. There is an active programme of events and outings providing stimulating opportunities for the residents. Residents feel that the catering service provides a good standard of food, with choices available. EVIDENCE: The activities programme is well developed and received positive comment from the residents and visitors spoken with at this inspection. There are regular activities arranged within the home and frequent trips out are also organised. The daily programme includes exercise related activity. Participation in events reportedly differs from resident to resident, but the programme is sufficiently varied that it aims to provide opportunities to meet a range of needs. Meetings held with residents at six-weekly intervals provide a useful means of seeking feedback on the social programme and for introducing new ideas in line with the preferences of the residents. Residents confirmed that the standard of the food is very good, with individual likes and dislikes catered for. Again, feedback from the residents’ meetings is used to influence the menus. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There are suitable policies and procedures in place, and staff also undertake training to promote the protection of residents from abuse and neglect. EVIDENCE: The complaints system had been assessed as satisfactory at the last inspection and there had not been any complaints made in the intervening period. Residents and visitors spoken with felt able to raise any issues with staff. The home has an adult protection policy and there is access to the Derbyshire Adult Protection guidance. Staff attend the training sessions organised by the social services department and in-house training includes the use of a video presentation and questionnaires. The appropriateness of restraint as a last resort (as per Department of Health guidance) is covered within the training received by staff at the home. The arrangements in place promote the welfare and protection of the residents. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25 & 26 Environmentally, the residents were able to confirm that the home meets their needs and expectations. There are some maintenance challenges with a building of this age, with listed status, but the home has character and provides a safe and secure environment for the residents. EVIDENCE: There has been progress since the last inspection in painting the exterior aspects of the building and this has improved the visual appearance. Internally, there is an on-going programme of decoration and maintenance, with decoration and re-carpeting of the hall and stairway providing a recent example. A new Midi-Bath has been recently installed in one of the bathrooms to improve the hygiene facilities for the residents. There have been no recent inspections by the Fire Service and Environmental Health to report on. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 15 The house is set within extensive gardens and to the rear of the premises the residents have the benefit of a sensory garden. There are suitable access arrangements to the gardens and the perimeter walls help to provide a secluded and safe area for the residents. Residents report satisfaction with the standard of their private accommodation. However, whilst the bedroom doors have locks fitted, they are not of an approved type that complies with the relevant National Minimum Standard. The manager reported that many of the residents have no desire to have the use of a lock on their bedroom door, but there should be evidence of a proactive approach from management that verifies that all residents have the opportunity to have a suitable lock fitted to their bedroom door if they wish, for the purpose of personal privacy. Since the last inspection all radiators have guards fitted (or are of the Low Surface Temperature type) and this further assures the safety of the residents. There continues to be limited space in the laundry area, but management have limited options to relocate this facility, in part due to the listed status of the building. The home was clean and odour free at the time of inspection. The residents spoken with were satisfied with the laundry and domestic services, and the visitors spoken with commented that one of the things that attracted them to this home was the lack of odours. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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): 28 & 30 Staff receive a good standard of training to prepare them to meet the needs of the residents. EVIDENCE: The majority of the care staff have either undertaken National Vocational Qualification (NVQ) Level 2 (or 3) training or are currently undertaking this training. Therefore, residents are receiving care from staff that have undertaken recognised training and this can be taken as an indication that care is safe and based on sound principles. The induction programme for staff is based on recognised standards (Skills for Care, previously TOPSS). The personal file of a member of staff was examined at inspection and this provided confirmation that a robust induction had been undertaken. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38 There is effective management of this care home and management is accessible and responsive to residents. There are systems in place for seeking improvements in the service through consultation with residents. The safe working practices employed at this home promote the health and safety of the residents. EVIDENCE: Residents and visitors reported having confidence in the way that the home is managed. The residents feel that the manager is proficient at running the home and praised all of the staff for the care and service that they provide. The manager has not undertaken recognised training, but she is able to demonstrate that she manages the home effectively. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 18 The home is run in the best interests of the residents and evidence of this includes the way that consultation from residents’ meetings is acted upon. For example, the activities programme and the catering menus are driven by the feedback from residents. Yearly residents satisfaction surveys are conducted and there is summarised feedback published and made available to residents and other interested parties. Staff had received training in safe working practices such as moving & handling and fire safety. There was evidence that equipment and services had been regularly serviced/inspected (a sample of records was examined at this visit). The overall approach to safe working practices provides assurance that satisfactory efforts are being made to promote the health and safety of residents, staff and other persons visiting the premises. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X 2 3 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement Where a variable dose of a medication is prescribed the dose administered must be recorded. Specialist locks must be fitted on bathroom and bedroom doors, which are also fire exits in accordance with the advice of the Fire Officer. Following consultation with individual residents, approved safety locks must be fitted to bedroom doors (and keys provided), where this is the wish of the resident. Timescale for action 30/11/05 2 OP10 12 (4) (a) 31/12/05 3 OP24 12 (4) (a) 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations Care plans should include specific plans to meet the social care needs of residents. A formalised risk assessment scoring system should be DS0000019932.V255276.R01.S.doc Version 5.0 Page 21 Bank Close House 3 OP31 utilised to assess the risk of falls for all residents. The manager should undertake NVQ Level 4 (or equivalent) training in management & care. Bank Close House DS0000019932.V255276.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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