CARE HOMES FOR OLDER PEOPLE
Bank House Bank House Chetwynd End Newport Shropshire TF10 7JE Lead Inspector
Janet Adams Unannounced Inspection 1st March 2006 1 pm 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 House DS0000020537.V266803.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. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Bank House Address Bank House Chetwynd End Newport Shropshire TF10 7JE 01952 814371 01952 814350 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) Mr. Colin James Richard Davies Mrs Sylvia Davies Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd August 2005 Brief Description of the Service: Bank House is registered with the Commission for Social Care Inspection to provide residential care for a maximum of twenty older people. The registered proprietor and manager of the home is Mr Colin Davies who is a qualified nurse. Bank House is a detached property situated in the heart of Newport close to all local amenities. The home has been undergoing extensive refurbishment since the present owner acquired the property in 1995. Ongoing improvements since the last inspection has resulted in improved bedroom accommodation and furnishings, only one bedroom (although in good condition,) remains to be completely refurbished. Bedrooms are located on both the ground and first floor, and are accessed by a passenger lift. For communal space, the home provides a large lounge, and separate dining room to the front of the building on the ground floor, and a conservatory that overlooks the private walled garden at the rear of the property. This has been specifically planned to be accessible for people of all abilities to enjoy. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and commenced at 1pm lasting four and a half hours. It included observing activity within the home, inspecting the premises, an ‘in depth look’ at records for residents and staff, observing, talking and listening to many of the 18 people living there, one relative and some of the staff on duty during the time of the inspection. No other visitors were met. Discussions with people were carried out in private on a one to one basis, or together in groups. Everyone was happy to share comments, which are explored and reflected in the main body of the report. Everyone including the residents was very welcoming. Colin Davies, the Registered Manager/ Proprietor was in charge at the time of the inspection and was most helpful and professional. The inspection also gave rise to the opportunity to meet the newly appointed Deputy Manager who has been appointed to assist Mr Davies in his role. The home has a history of meeting and exceeding national minimum standards and providing a good service for people, consequently, on this occasion only those certain ‘key’ standards have been inspected. A total of 28 out of a possible 38 National Minimum Standards for Older People were assessed. What the service does well:
Bank House provides a spotlessly clean, well furnished, decorated and homely place to live for the individuals who are currently supported and cared for there. It was impressive to see that the efforts of the home team have meant that Bank House had more than met 23 of the 28 National Minimum Standards for Older People looked at during the inspection. This shows that they excel in many aspects of providing a personal care service. Recordkeeping in particular, is exemplary. Unanimous comments received on the day of the inspection confirmed that home provides good quality care and support for the people living there in a desirable manner. Many people have lived at the home for many years. One resident stated that she felt: ‘Loved by and well cared for by everyone, the staff are lovely, the food is excellent and the place as always is spotlessly clean’. It is pleasing to meet many staff members on duty who have been present at earlier inspections during the past three years. People observed, spoken to and overheard carrying out their roles appeared to be enjoying their responsibilities and had a respectful rapport with the people living at the home. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 6 In order to make sure the team get the support to continually improve, the home employs a management consultant an afternoon a week to coach the team and assist them with their recordkeeping systems. It was seen that the home lives up to its motto: - What we do this week isn’t necessarily what we do next week’ in many ways. This reflects the team willingness to change to meet the needs of the people living there. For instance, the team are currently carrying out trials how to improve the laundry service, and are taking into account the comments, wishes and feelings of the residents for this matter. At the last inspection the home had just been notified it had achieved its Investors in People Award. When the report for this award was looked at, it was commendable that they had reported on very similar positive findings as CSCI. 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 House DS0000020537.V266803.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 Bank House DS0000020537.V266803.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): 3,4, & 5 Bank House has in depth pre- admission procedures, which assures people that the home will meet their needs by staff that individually and collectively have the skills and experience to deliver the care, which the home offers to provide. EVIDENCE: Inspection findings were of similar high standards when they were seen at the announced inspection in August 2005. When three residents records were looked at, including those for a resident on short term care, it was seen that the home has commendable systems to get as much information as they can about any person thinking about moving into the home. Bank house have specially designed assessment forms, which makes sure all necessary details are written down. All records seen had a wealth of written information which shows the person carrying out the assessments had the knowledge and skills necessary to make a professional decision whether the home could meet the individual needs of any one moving into Bank House. Furthermore, an ‘admission checklist’ form which details 11 different actions the staff have to sign for, makes sure anyone admitted gets the right information and support to settle in the home.
Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 9 The information, which is given to people thinking about moving into Bank House, clearly welcomes and encourages people to come to the home for ‘trial visits’ first. Although it was reported the home often gets requests to admit people they don’t know enough about, it is commendable the home does not go ahead with any admission until all people involved are happy the home can meet the potential resident’s individual needs. When life at Bank house this was discussed with one person, she commented: -‘I’m ever so particular – if it suits me it will suit a princess- everyone is so very kind.’ Another person commented, ‘I have lived here for 19 years and it just keeps getting better all the time.’ Bank House DS0000020537.V266803.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): 7,8,9,10 & 11 There is a good, consistent care planning management system in place, which confirms residents get the care they need and expect till the end of their life wherever possible, by staff that meets the individual needs of each resident in a professional and sensitive manner. EVIDENCE: The care plans of three of the 18 people living at Bank House were looked at in depth, including those of a person staying at the home for a short term, and those of two people whose name was seen in the accident book as a result of falls. It is obvious the home undertakes a lot of work and effort to keep these records up to date. It was commendable to see residents health, personal and social care needs set out in appropriate detail in their records to give a full picture of the way the person prefers them to be carried out. The records were maintained to a very professional standard and were full of information to make sure anyone reading it knew exactly how to safely care for that person. The variety of staff signatures seen in the care plans confirmed that the whole team is fully involved in delivering care according to the persons care plan. Some very easy to understand colour coded forms were seen to be in use.
Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 11 For example, a green coloured form clearly identifies a review of a person who has had falls with possible solutions to minimise it from happening again. It described the involvement of a physiotherapist for the provision of appropriate mobility equipment for that person, as well as a full review of the person’s medication. The explicit details recorded on all of the residents’ health and safety risk assessments showed that the home excelled in its recordkeeping to fully comply with all guidance and legislation for this matter. When the ‘end of life’ care for two residents met by a CSCI inspector on three earlier occasions was explored, it was seen that the home embraces this sensitive issue thoroughly. Although one of the residents had moved to another home for nursing care upon discharge from hospital, the home remained involved with that person until after he passed away, to ensure the humanitarian funeral planned met the person’s wishes. Review of medication management shows the home continues to improve this service. There is a new process in place to show how it monitors all the medicines it receives on the premises. Bank House DS0000020537.V266803.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): 12,13,14 &15 The home excels to ensure full involvement with individuals living at the home to promote choice and control over their lives wherever possible, including their day-to-day pastimes and opinions about the good homely type of meals provided. EVIDENCE: Unanimous comments from residents and staff confirm that the already good findings seen at the inspection in August 2005 for this part of the process have even further improved. This confirms the home continues to excel in providing a stimulating lifestyle to match the wishes, choice and feelings of the people living at Bank House. The Home works hard to involve residents in a range of leisure opportunities, consistent with each resident’s capabilities. The role of the activity organiser ensures there are a variety of things for residents to do as a group or own their own. It was seen that the people who currently live at the home enjoy the craft activities. Three of the residents all commented that there is now more entertainment and exercise activities as they had asked for. It was confirmed that the activity organiser arranges the residents meetings on a monthly basis to ensure the ‘Voices of Bank House’ are welcomed to ‘have their say’.
Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 13 The manager reported that the home was currently working towards the Telford and Wrekin Healthy Eating award for the very first time. The catering assistant seen asking residents their choices for the next day’s meals is currently undertaking her NVQ in catering, and the cook is also taking on extra training to be fully prepared for this. All residents spoken to commented that the food was excellent. The service and presentation of food prepared for afternoon tea reflected the good comments received. A homemade strawberry gateau was seen shared and enjoyed as part of birthday celebrations for one of the residents. One resident volunteered that the food was ‘out of this world’ – all of the other residents present when she said this nodded in agreement. Bank House DS0000020537.V266803.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): 16,17, & 18. The home has systems in place to make sure concerns and complaints are dealt with promptly and professionally and thus enhance the effective procedures and practices in place to protect individuals from abuse. EVIDENCE: It is commendable the home has not received any complaints since one received in November 2003.CSCI have not been made aware of any issues or concerns from other sources about this home. It was noteworthy to be informed that the residents know the activity organiser is more than happy to assist people to manage their own finances and do their ‘own banking’ and attend any other important personal professional appointments. The home has all necessary documentation in relation to the protection of vulnerable adults. The staff have regular training for this matter. The excellent record keeping the home has to look after the residents makes sure the home team are aware of any potential risks to resident well being. Bank House DS0000020537.V266803.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): 19,20,21,22 & 25 The standard of the environment within Bank House is continues to improve. Residents have a safe, well-furnished, homely, comfortable place to live. EVIDENCE: An ongoing refurbishment programme in the home has resulted in further improvements to the surroundings for the people living, visiting and working there. The home is maintained to a very high standard. The quality of the new bedroom furniture meets the approval of both residents and staff. New tiling to the en suites compliment the décor chosen. Only one bedroom was reported to be awaiting refurbishment. When this was looked at, although it was in very good order, the manager reported that plans to enlarge it and install en suite facilities were in hand. Extra side tables have been provided in the lounge area since the last inspection so that residents can have their personal belongings and drinks within easy reach. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 16 The home is to be commended for its cleanliness. All areas were seen to be spotlessly clean without unpleasant odour. Residents were happy to comment that the way the cleaning is now organised is much better. Improvements to the laundry service at the home are currently undergoing a trial. Residents all have their own individual supply of bed linen, which is washed separately for them. The actual laundry itself has also plans in place for a revamp to make more efficient use of its space. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 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 & 29 A well-trained and committed staff group meet the needs of each individual in a sensitive and professional manner at Bank House. EVIDENCE: The staff rotas for the period February 27th until March 26th 2006 looked at, alongside the staff seen on duty at the time of this inspection confirms that adequate numbers and skill mix of staff are on duty at all times. Many of the names of staff seen were recognised as those met by the inspector at earlier inspections. The manager confirmed that the staff team was settled, and there have only been two new starters since the last inspection. It is commendable the home has continued to maintain its well-organised systems and detailed records for staff. When the set of records for the latest recruit to the team were looked at in depth, they were seen to contain all the necessary information which demonstrates potential staff are well screened before they are deemed suitable to start work at the home. Bank House DS0000020537.V266803.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): 31,32,33, 35 & 38 The competent registered provider and manager at Bank House ensures the staff team have effective leadership. The health, safety and welfare for residents, staff and visitors continue to be maintained, improved and adjusted to make sure safe working systems already in place meet changing needs as they arise. EVIDENCE: The manner in which registered manager, and staff responded to this inspection indicated that a good management approach is in place and that staff are committed to ongoing improvements, achieving best practice and to developing equal opportunities. With the ongoing guidance and support of Colin Davies, the registered manager and his management team, the team spirit at the home goes from strength to strength. As recorded earlier, the recent appointment of a Deputy Manager is already being hailed as a successful move. Discussion with this
Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 19 person confirmed she was enjoying her new role. It was noteworthy to see times marked out on the team rota to show when the manager and deputy were having training sessions for this responsibility. A management consultant still attends the home one afternoon a week to offer advice and coaching to staff members in order to continue to raise the professional profile of the home, and keep up to date with any changes. This reflects the home motto ‘what we do this week isn’t necessarily what we do next week’, - staff are motivated to be flexible to peoples changing needs. At the last inspection the home had just received notification it had achieved its Investors in People Award. When the report for this award was looked at, it was commendable that they had reported on very similar positive findings as CSCI. Bank House continues to have a consistent and sensible approach to all health safety and well-being matters. Necessary six monthly service records for equipment and appliances seen confirm the home is being maintained as it should be in order to comply with all the legislation it needs to. Records looked at for three residents show the home has good systems in place to keep their monies safe on their behalf. It was commendable the home always ensured people were privately reminded of what monies they had left to make sure it was topped up for them by any family members as necessary. When the home held a clothing sale and fashion show lately, they were all reminded what they had to spend if they wished to do so. As with the other good record keeping systems already mentioned in this report, it is noteworthy to comment that the robust accident recording and audit system seen in August 2005 is continued to be maintained and up to date to a highly satisfactory standard. Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 4 18 4 4 4 4 4 X X 3 X STAFFING Standard No Score 27 4 28 X 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 X X 4 Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Not applicable STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bank House DS0000020537.V266803.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 House DS0000020537.V266803.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
