CARE HOMES FOR OLDER PEOPLE
Bank Hall Residential Home Colne Road Burnley Lancashire BB11 2AA Lead Inspector
Mr Jeff Pearson Unannounced Inspection 29th September 2005 09:30 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 Hall Residential Home DS0000009652.V252777.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 Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bank Hall Residential Home Address Colne Road Burnley Lancashire BB11 2AA 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) 01282 838909 01282 448855 bank-hall@tiscali.co.uk Rochecare Limited Mrs Karen Idle Care Home 36 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (34) of places Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home must, at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection When named service users no longer reside at the home, application must be made to vary the registration back to the original status of Old age, not falling within any other category (OP)36 8th March 2005 Date of last inspection Brief Description of the Service: Bank Hall a single story building is a former maternity hospital, which has a purpose built extension. Set in it’s own grounds, Bank Hall is close to a retail park and there are smaller shops quite close to the home. A driveway fronts the building with car parking spaces being available. Lawns and wooded areas surround the home. Garden furniture is provided to the front of the home and upon the rear decking area. Bank Hall is on a bus route with Burnley town centre being a fairly short distance away. There are 3 double bedrooms and 30 single bedrooms. All shared bedrooms and 8 of the single bedrooms have en suite toilets. There are three lounges and two dining rooms. Various aides and adaptations are provided to assist with mobility and independence. Staff are available, to provide assistance with personal care and support, in response to individual needs/wishes. In house recreational activities are provided and various outings are occasionally arranged. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took 8 hours and was carried over one day by one inspector. There were 32 residents accommodated. The files/records of 3 residents were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of residents. During the inspection, the residents, Manager, Registered Individual and staff were spoken with. A tour of the premises was carried out. Completed comment cards were received from 5 residents, and 5 relative/visitors. At the time of the inspection, work had commenced to extend the home to provide further accommodation. What the service does well:
Bank Hall had a welcoming, supportive and friendly atmosphere. The home was ‘homely’ and was pleasantly decorated; residents said they liked the accommodation provided, including their own rooms, shared rooms and the grounds, one resident said I don’t think you could find a better place” The home was clean and had no unpleasant odours. The home was being well run and there were plenty of staff. “I feel a lot more relaxed knowing that my dad is loved and cared for,” wrote one relative. Written information for residents about the home was good and there was a good method of finding out about peoples’ needs and wishes before they moved in. There were some good care practices in place; staff had an awareness of the residents needs, they treated the people living in Bank Hall with dignity and respect. People were getting support with medical and health cares, such as seeing the Doctor or attending hospital appointments. The residents were being given as much choice and control over their lives as possible one resident wrote, “I am generally happy here” Visiting arrangements were good; people were being helped to keep in touch with relatives and the community. Various outings and a short holiday had been arranged, One relative wrote “Bank Hall make every effort to communicate and make sure that our wishes and concerns (if any) are dealt with” another commented “I work away a lot, but the home keep in touch with me for anything to do with my father” Staff training and development was ongoing, the managers were supervising staff individually. The residents spoke positively about the staff describing them as “kind and helpful” Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 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 Hall Residential Home DS0000009652.V252777.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 Hall Residential Home DS0000009652.V252777.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): 1, 2, 3 The homes written material for potential and current residents was available in different formats and provided good information about the services available. Contracts/statements of terms and conditions, which provided safeguards on occupancy, had been agreed with the residents. The admission process ensured the residents’ were properly assessed, their needs and wishes known and planned for prior to moving into the home. EVIDENCE: The homes’ statement of purpose, service user guide and copies of previous inspection reports, were available in the homes entrance hallway. Residents spoken with said they had been provided with a copy of the guide. The homes guide had been produced in brail, on CD Rom and audiocassette. The guide had also been translated into Urdu. The copies of contracts of residence looked at as part of case tracking, included the good practice matters as in the specified in standard 2, they had been signed by the residents and manager.
Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 9 Case files included assessment information from Social Services as appropriate and pre admission assessments had been carried out by staff at the home. The assessment details included appropriate information. A copy letter was seen advising new residents the home was able to meet their needs. Bank Hall Residential Home DS0000009652.V252777.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, 8,10 Progress had been made in improving residents care plans, but not all needs/wishes had been noted, staff were not being fully instructed to respond to the residents’ individual needs and abilities. The health needs of the residents were being appropriately managed, with the involvement of health care professionals. Support with personal care was provided sensitively in a way which promoted the resident’s privacy and dignity. EVIDENCE: Some residents spoken with, had personal care/social needs which had not been recorded in their care plans. Risk assessments had been completed, the action to be taken in response to the assessment had not been included in the care plan. Reviews were being carried out monthly, not all residents had been fully involved with the reviews. Staff said they had been involved with the care planning process they expressed an awareness of individual residents needs and abilities. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 11 Records indicated residents were receiving attention from health care professionals and that general health was being monitored, this was confirmed in discussion with residents and staff. Health related policies were available. Residents said they were treated with dignity and respect, this approach and maintaining privacy, was observed within care practices, care plans and records. Screening was available for shared bedrooms. All comment cards received from residents indicated that their privacy was respected. Bank Hall Residential Home DS0000009652.V252777.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): 13, 14, Visiting times were flexible so residents could continue relationships with relatives and friends. Community contact was being maintained to enable the residents to retain links with others. Residents were being given the opportunity to make choices and decisions, to enable them to have as much control over their lives as possible. EVIDENCE: Some residents said that visiting times were flexible and explained that they often go out with families. The visiting arrangements were detailed in the homes guide. Relative/visitor comment cards received, indicated that staff welcome them into the home and that arrangements could be made for privacy. One resident had recently been assisted to contact a relative via email. The home had developed links with a nearby school, with pupils calling at Easter and Christmas. Two residents had been supported to take a short holiday abroad. Several residents commented they had enjoyed a recent trip to Blackpool. Others said they had been supported to visit shops and attend funerals. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 13 The residents had been encouraged to bring their own personal possessions and furniture with them, they were seen to be supported and enabled, to make their own choices and decisions. Financial arrangements were outlined in the homes guide. Residents spoken with felt they still had a degree of control over their lives. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 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): 18 Satisfactory arrangements were in place for protecting the residents from abuse, but one procedure needed amending to ensure a more appropriate response. EVIDENCE: The manager explained that dates for protection/abuse training for staff, was about to be arranged. Protection and abuse issues were include in the staff induction training programme. The homes’ policies and, which intended to ensure the residents’ were protected from abuse were available. Appropriate referral details had been included in the ‘whistle blowing’ policy but needed amending in the protection/abuse procedures. The document ‘No Secrets In Lancashire’ was readily available in the home. Guidance and procedures were available on dealing with aggressive behaviour and restraint issues. Staff had been given written instructions on their none involvement with residents wills and receiving gifts. All comment cards received from residents’ indicated that they felt safe in the home. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 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): 19, 21, 22, 26 The standard of the accommodation was good; providing the residents with an attractive and homely place to live, some matters needed attention to ensure the residents have safe surroundings and appropriate facilities. EVIDENCE: Records were seen of ongoing maintenance and proposed refurbishment. Most areas of the home seen were appropriately maintained and provided a comfortable environment for the residents. Some of the main corridors in the home had been scheduled for replacement. The lounges and dining room were appropriately furnished and provided pleasant living areas. The gardens were accessible to the residents, attractive and well kept. The residents spoken with said they were happy with the accommodation provided and expressed and appreciation of the homes grounds and wildlife. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 16 The shower room/toilet floor had hole in it, which was in need of attention, also a more appropriate shower seat was needed. The floor coverings in some other bathrooms and toilets, needed to be included in the longer-term refurbishment programme. An assessment of the home had been carried out an Occupational therapist, the report seen indicated Bank Hall has satisfactory equipment and facilities and systems in place to provide for individual, specific needs. The home was clean and free from unpleasant odours. The laundry was suitably located and included appropriate washing equipment and facilities. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 17 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 Staffing arrangements were sufficient in aiming to ensure the resident’s needs are effectively and safely met. Progress had been made in enabling staff to gain recognised qualifications to improve the quality of service for the residents. An improvement in staff recruitment practices, showed appropriate attention was being given to protecting the service users. Arrangements were in place to enable new employees to become familiar with role, duties and responsibilities. EVIDENCE: The required numbers of staff were on duty. Staff rotas and records of hours worked, indicated that appropriate staffing levels were being kept with extra staff also being on duty. Residents spoken with were complimentary about the staff team; all comment cards from residents indicated that staff treat them well. Most comment cards from relatives/visitors indicated they considered sufficient numbers of staff were on duty. There were a sufficient number catering and cleaning staff employed. An admin assistant had been recruited to assist with office duties. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 18 The records of the two most recently employed staff were examined and found to include satisfactory information. It was suggested the application form be updated to request a ‘full’ employment history. A TOPPS induction training programme was available, the manager explained staff were then being supported to commence NVQ level 2, Records were seen indicating new staff had completed the homes induction training. Ongoing training was confirmed with staff. A training matrix was seen showing courses attended and planned for. More than 50 of the care team had NVQ level 2 qualifications. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 19 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, 32, 33, 36 The manager of Bank Hall had the ability, experience and qualifications to effectively manage the service for the benefit of the residents. The management and leadership approach had helped create a supportive, positive environment for the residents and staff. Progress had been made in introducing quality systems to help ensure the home is run in the best interest of the residents. Staff were being supervised, to offer opportunity for individual development and to monitor progress. EVIDENCE: Karen Idle, Registered Manager had relevant experience and qualifications, including NVQ level 4 and The Registered Managers Award. She had completed additional training such as Basic Food Hygiene, a computer studies course and
Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 20 was to start an Advanced Management of Medication course and Dementia Care Training. Lines of accountability within the management structure were clear, good senior management support systems were in place. The atmosphere in Bank Hall was very relaxed and supportive, relationships between residents and staff were generally good, positive actions were observed to resolve ‘minor’ issues. Residents spoken with expressed an appreciation of the management team. Relative/visitor comment cards included positive statements about the running of the home. Staff spoken with said the managers were approachable and helpful. The home had recently been successfully reviewed for Investors In People accreditation. Systems were in place to review and update policies. A satisfaction survey had been carried out with the residents. Relatives and others such as GP’s and Social Workers had also been consulted. Summaries were seen of the findings, which were to be formulated into an action plan. A wall planner showed the arrangements made for individual staff supervision sessions and records of these were available. Staff confirmed they had time with a manager for one to one discussion. Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X 2 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X X Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 22 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. 1 Standard OP7 Regulation 15 Requirement Care plans must include all identified needs and be in sufficient detail to provide clear guidance to staff, of the actions to be taken, to meet the residents health and welfare needs. Instructions following specific assessments and risk assessments must be included in care plans. The procedure for dealing with suspicions, allegations and incidents of abuse must include appropriate referral details in line with ‘No Secrets’ guidelines. Action must be taken to replace the floor covering in the shower room. The shower must be fitted with an appropriate shower seat. Timescale for action 27/01/06 2 OP18 13 31/10/05 3 4 OP19 OP21 13 13 31/12/05 31/12/05 Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 23 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 Good Practice Recommendations The review of resident’s care plans should be carried out where possible, with their involvement. They should be enabled to sign in agreement with the review/changes to their care plan. This could be introduced as a one to one activity. The corridor carpets and some bathroom floor coverings should be replaced, the plans for this action being included in the homes refurbishment programme. 2 OP19 Bank Hall Residential Home DS0000009652.V252777.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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